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: 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 3249 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 37 40 62.117462 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 37 40 62.117462 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
EXIT -EXIT EXIT ASSESSMENT 63 87 116.361058 $5818.0600 $50.0000
IPDEF -IPDEF FOLLOW-UP PSYCH AND DEV EVAL 9 9 4.849314 $363.7100 $75.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 17 17 12.108296 $908.1300 $75.0000
IPDEF -T1024GOTS F/U PSYCH AND DEV EVAL BY OT 5 5 6.004110 $450.3100 $75.0000
IPDEF -T1024GPTS F/U PSYCH AND DEV EVAL BY PT 4 4 2.106850 $158.0100 $75.0000
IPDEF -T1024TLTS F/U PSYCH AND DEV EVAL BY EI PROF 4 4 0.090412 $6.7700 $74.9100
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 43 44 42.274566 $2346.2100 $55.5000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 54 54 0.724668 $54.3200 $74.9500
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 4 4 0.015069 $1.1300 $74.6600
IPDEI -T1024GPUK INITIAL PSYCH AND DEV EVAL BY PT 49 49 0.200012 $14.9600 $74.8100
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 60 60 1.315276 $72.9700 $55.4800
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 25 25 0.080828 $6.0100 $74.3200
OCTH -97166 OT EVAL MODERATE COMPLEXITY 1 1 0.122222 $6.2400 $51.0400
OCTH -97167 OT EVAL HIGH COMPLEXITY 6 6 3.204871 $163.6200 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 5 5 3.421918 $174.6900 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 17 17 7.694521 $392.8100 $51.0500
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Subtotal (Total Children Is Unduplicated) 241 391 200.573991 $10937.9200 $54.5300
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 14 14 12.446576 $62233.0000 $5000.0100
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 44 48 90.825868 $4541.3000 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 690 862 1227.719037 $61386.0100 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 9 9 18.492858 $462.3300 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 273 330 552.721895 $27636.0900 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 3 3 6.400000 $160.0000 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 286 357 533.317309 $26665.8900 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 3 3 4.400000 $110.0000 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 570 734 983.877738 $49193.9400 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 14 14 26.866668 $671.6700 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 21 31 178.866663 $4471.6800 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 248 306 2421.538084 $121077.0700 $50.0000
INTR -T1013 INTERPRETER 18 22 201.333332 $10066.6700 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 13 14 94.857143 $6776.6000 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 2 2 31.857143 $1822.2300 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 15 17 124.214286 $8873.8700 $71.4400
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 40 49 392.357142 $28030.0100 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 3 3 32.571429 $452.0900 $13.8800
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Subtotal (Total Children Is Unduplicated) 842 2818 6934.663171 $414630.4300 $59.7900
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Total 3249 7197.354624 $425568.3500 $59.1300
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Number of Children (Unduplicated) With at Least One Authorization 926