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: 10-01-19 and 12-31-19 Date of Report: 02-01-20 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 2654 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 67 78 51.977775 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 67 78 51.977775 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 8 12 3.949999 $191.5700 $48.5000
OCTH -97167 OT EVAL HIGH COMPLEXITY 11 14 3.533335 $180.3900 $51.0500
PSTH -97162 PT EVAL MODERATE COMPLEXITY 1 2 0.511111 $26.0900 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 13 16 5.311110 $271.1300 $51.0500
SPCH -92522 EVAL OF SPCH SOUND PROD 1 1 0.361111 $18.4300 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 18 21 4.594445 $234.5500 $51.0500
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Subtotal (Total Children Is Unduplicated) 40 66 18.261111 $922.1600 $50.5000
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 1 1 1.000000 $5000.0000 $5000.0000
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 1 1 1.000000 $50.0000 $50.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 58 186 82.476190 $4123.8200 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 6 7 4.577778 $228.8900 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 5 5 4.100000 $205.0000 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 5 5 15.720634 $786.0300 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 3 4 2.288889 $114.4500 $50.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 9 9 93.142856 $2328.5800 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 233 302 2603.571405 $130178.7100 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1429 1940 16993.173681 $169931.9600 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 7 9 64.428571 $4602.7800 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 5 6 23.714285 $1356.4600 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 5 7 46.857142 $3347.4900 $71.4400
PHY -97110HM PT SESSION BY PT ASST 8 10 80.857142 $4621.8000 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 5 7 44.571427 $3184.2000 $71.4400
SPL -92507HM SPL THERAPY SESSION BY SLP ASST 5 5 31.285714 $1789.5400 $57.2000
SPL -92508 GROUP SPL SESSION PER CHILD 4 5 39.857144 $553.2200 $13.8800
TRAV -TRAVS Travel by mile 1 1 2.142857 $0.9500 $0.4500
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Subtotal (Total Children Is Unduplicated) 1501 2510 20134.765715 $332403.8500 $16.5100
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Total 2654 20205.004601 $333326.0100 $16.5000
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Number of Children (Unduplicated) With at Least One Authorization 1561