Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 05
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 3123 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 29 29 42.582540 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 29 29 42.582540 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
EXIT -EXIT EXIT ASSESSMENT 103 139 178.350295 $8917.5200 $50.0000
IPDEF -IPDEF FOLLOW-UP PSYCH AND DEV EVAL 3 3 0.315069 $23.6300 $75.0100
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 5 5 1.279453 $95.9600 $75.0000
IPDEF -T1024GOTS F/U PSYCH AND DEV EVAL BY OT 2 2 0.002740 $0.2100 $76.6400
IPDEF -T1024GPTS F/U PSYCH AND DEV EVAL BY PT 4 4 0.473973 $35.5500 $75.0000
IPDEF -T1024TLTS F/U PSYCH AND DEV EVAL BY EI PROF 1 1 1.000000 $75.0000 $75.0000
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 21 22 10.061648 $558.4000 $55.5000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 51 51 0.208228 $15.5800 $74.8100
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 5 5 0.023287 $1.7500 $75.0400
IPDEI -T1024GPUK INITIAL PSYCH AND DEV EVAL BY PT 54 54 0.264398 $19.7600 $74.7500
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 69 69 0.345221 $19.0800 $55.2700
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 21 21 0.075350 $5.6200 $74.5500
OCTH -97167 OT EVAL HIGH COMPLEXITY 8 8 5.145509 $262.6800 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 5 5 3.290411 $167.9800 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 19 19 10.779604 $550.3000 $51.0500
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Subtotal (Total Children Is Unduplicated) 271 408 211.615186 $10749.0200 $50.8000
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 16 17 15.643988 $78220.0000 $5000.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 34 36 27.858744 $1392.9200 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 2 2 1.234703 $30.8700 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 643 835 1211.424205 $60571.3500 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 10 10 30.636510 $765.9200 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 263 323 527.518185 $26375.9200 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 2 2 3.533334 $88.3400 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 272 337 452.586042 $22629.3300 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 3 4 7.933333 $198.3300 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 522 679 911.842463 $45592.1900 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 18 19 37.265081 $931.6300 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 25 34 271.228568 $6780.7300 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 233 295 2262.160313 $113108.2000 $50.0000
INTR -T1013 INTERPRETER 13 15 192.652380 $9632.6300 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 10 13 92.571428 $6613.3100 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 4 4 50.142857 $2868.1700 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 14 17 108.880954 $7778.4600 $71.4400
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 33 41 466.928571 $33357.3900 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 3 3 14.000001 $194.3200 $13.8800
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Subtotal (Total Children Is Unduplicated) 761 2686 6686.041660 $417130.0000 $62.3900
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Total 3123 6940.239386 $427879.0200 $61.6500
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Number of Children (Unduplicated) With at Least One Authorization 856