Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 04
This report estimates subtotals of units and fees for the number of days of overlap between each included
FSPSA record and the user-selected report period. For example, if the FSPSA record authorizes services from
01/01/01 to 08/01/01, and the Report Period is selected as 01/01/01 to 03/01/01, this summary calculates
authorized units/fees for the 28 days of overlap (02/01/01 to 03/01/01). Note that service authorization periods
may range from 1 to 12 months and may vary in intensity from child to child.
FSPSAs overlapping: 07-01-19 and 09-30-19 Date of Report: 11-04-19 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 2671 FSPSA's found
Services Cpt Code Number of Number of Total Units Total Fees Avg Fee
Children Records Overlapping Overlapping Per Unit Auth
Report Period Report Period
Service Coordination, Class # 01
SCONLY-SCONLY *SERVICE COORDINATION ONLY 69 84 51.114282 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 69 84 51.114282 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 10 12 4.127778 $200.2000 $48.5000
OCTH -97167 OT EVAL HIGH COMPLEXITY 13 17 7.433332 $379.4700 $51.0500
PSTH -97162 PT EVAL MODERATE COMPLEXITY 1 1 0.511111 $26.0900 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 14 19 5.277778 $269.4300 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 15 15 5.955555 $304.0300 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF VOICE AND 1 1 0.016667 $0.8500 $51.1500
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Subtotal (Total Children Is Unduplicated) 44 65 23.322221 $1180.0700 $50.6000
EI Services, Class # 03
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 1 2 2.000000 $100.0000 $50.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 47 124 48.495236 $2424.7500 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 6 6 13.530158 $676.5100 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 2 3 1.244444 $62.2200 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 6 7 6.392063 $319.6000 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 1 1 1.022222 $51.1100 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 1 2 2.433334 $60.8400 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 11 13 92.142857 $2303.5800 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 241 299 2620.142844 $131007.3300 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1409 2011 17780.196000 $177802.1200 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 6 6 38.571428 $2755.5400 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 9 11 54.714286 $3129.6500 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 7 8 55.142856 $3939.4100 $71.4400
PHY -97110HM PT SESSION BY PT ASST 9 13 89.714286 $5128.0800 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 8 8 79.285714 $5664.1800 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 8 8 75.000000 $1041.0000 $13.8800
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Subtotal (Total Children Is Unduplicated) 1474 2522 20960.027728 $336465.9100 $16.0500
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Total 2671 21034.464231 $337645.9700 $16.0500
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Number of Children (Unduplicated) With at Least One Authorization 1533