Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 02
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: 01-01-20 and 03-31-20 Date of Report: 05-15-20 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 7977 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 5 5 2.543226 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 5 5 2.543226 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 101 133 98.866897 $4795.0400 $48.5000
AUD -92626 EVAL OF AUD REHAB STATUS 2 2 1.054795 $59.5900 $56.4900
AUDE -92557 COMP AUDIO THRESHOLD EVAL/SPCH RECO 2 3 3.000000 $71.1000 $23.7000
EXIT -EXIT EXIT ASSESSMENT 126 126 133.111371 $6655.5700 $50.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 4 4 4.010958 $300.8300 $75.0000
IPDEF -T1024GOTS F/U PSYCH AND DEV EVAL BY OT 1 1 0.005479 $0.4100 $75.2900
IPDEF -T1024TLTS F/U PSYCH AND DEV EVAL BY EI PROF 1 1 2.000000 $150.0000 $75.0000
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 6 6 6.016437 $333.9200 $55.5000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 98 98 163.084925 $12231.3900 $75.0000
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 35 35 47.402736 $3555.2200 $75.0000
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 127 129 215.636977 $11967.8700 $55.5000
IPDEI -T1024HNUKGT INITIAL PSYCH AND DEV EVAL BY ITDS 2 2 4.000000 $222.0000 $55.5000
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 50 50 95.504110 $7162.8100 $75.0000
IPDEI -T1024TLGT INITIAL PSYCH AND DEV EVAL BY EI PR 2 2 4.000000 $300.0000 $75.0000
OCTF -97168 OT RE-EVAL EST PLAN CARE 17 17 14.205666 $725.2100 $51.0500
OCTH -97165 OT EVAL LOW COMPLEXITY 6 6 3.533334 $180.3800 $51.0500
OCTH -97166 OT EVAL MODERATE COMPLEXITY 25 28 11.074200 $565.3300 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 48 56 34.030041 $1737.2300 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 26 29 14.171541 $723.4800 $51.0500
PSTH -97161 PT EVAL LOW COMPLEXITY 4 4 2.494444 $127.3400 $51.0500
PSTH -97162 PT EVAL MODERATE COMPLEXITY 23 23 12.339879 $629.9500 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 55 61 39.329205 $2007.7700 $51.0500
SPCH -92521 EVAL OF SPEECH FLUENCY 4 4 2.200153 $112.3200 $51.0500
SPCH -92522 EVAL OF SPCH SOUND PROD 3 3 0.632876 $32.3000 $51.0400
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 82 93 75.352284 $3846.7400 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF VOICE AND 1 1 0.249315 $12.7300 $51.0500
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Subtotal (Total Children Is Unduplicated) 465 917 987.307623 $58506.5300 $59.2600
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 124 161 135.040716 $675202.5000 $4999.9900
AUD -92592TS AUDIOLOGY SERVICES (Monaural) 3 3 0.649619 $32.4800 $49.9900
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 102 119 181.921919 $9096.0700 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 5 7 4.066665 $101.6600 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 591 776 1816.167687 $90808.1200 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 2 2 1.166667 $29.1700 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 315 398 888.457111 $44422.7000 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 2 3 6.066667 $151.6700 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 57 76 158.452377 $7922.6000 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 1 1 1.666667 $41.6700 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 548 677 1387.799933 $69389.6700 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 8 10 13.233334 $330.8400 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 632 805 6449.152370 $322457.6200 $50.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 8 8 9.695238 $484.7700 $50.0000
INTR -T1013 INTERPRETER 26 38 145.315132 $7265.7700 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 683 1429 7627.368310 $76273.6300 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 144 176 1473.754073 $105284.9900 $71.4400
OCCT -97530GT OT SESSION BY LICENSED OT 1 1 2.285714 $163.2900 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 3 4 36.142857 $2067.3700 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 135 167 1558.533328 $111341.5800 $71.4400
PHY -97110GT PT SESSION BY LICENSED PT 2 2 2.714285 $193.9100 $71.4400
PHY -97110HM PT SESSION BY PT ASST 7 8 50.463601 $2884.4900 $57.1600
SENS -V5050 IN EAR MONAURAL HEARING AID 1 1 0.208219 $47.4700 $227.9800
SENS -V5264 EARMOLD 1 1 0.624658 $11.2400 $18.0000
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 134 156 1428.282649 $102036.5200 $71.4400
SPL -92507GT SPL THERAPY SESSION BY LICENSED SLP 1 1 1.142857 $81.6500 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 7 7 56.428571 $783.2300 $13.8800
TRAV -TRAVS Travel by mile 735 2018 507415.107197 $225799.7300 $0.4500
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Subtotal (Total Children Is Unduplicated) 817 7055 530851.908421 $1854706.3600 $3.4900
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Total 7977 531841.759270 $1913212.8900 $3.6000
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Number of Children (Unduplicated) With at Least One Authorization 820