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 6242 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 80 105 80.022148 $3881.0700 $48.5000
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 1 1 0.005479 $0.4100 $75.2900
IPDEF -T1024GOTS F/U PSYCH AND DEV EVAL BY OT 1 1 0.005479 $0.4100 $75.2900
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 2 2 0.010958 $0.6100 $55.7000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 13 13 22.010958 $1650.8300 $75.0000
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 6 6 9.002740 $675.2000 $75.0000
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 34 34 56.524656 $3137.1200 $55.5000
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 12 12 24.000000 $1800.0000 $75.0000
OCTF -97168 OT RE-EVAL EST PLAN CARE 3 3 7.961112 $406.4200 $51.0500
OCTH -97165 OT EVAL LOW COMPLEXITY 2 2 1.505556 $76.8600 $51.0500
OCTH -97166 OT EVAL MODERATE COMPLEXITY 6 7 1.342465 $68.5300 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 4 4 2.287671 $116.7800 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 11 12 8.022223 $409.5400 $51.0500
PSTH -97161 PT EVAL LOW COMPLEXITY 1 1 1.011111 $51.6200 $51.0500
PSTH -97162 PT EVAL MODERATE COMPLEXITY 6 6 3.747945 $191.3300 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 6 6 3.859818 $197.0500 $51.0500
SPCH -92521 EVAL OF SPEECH FLUENCY 2 2 0.694597 $35.4600 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 15 18 8.371308 $427.3500 $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) 262 365 366.746910 $19865.9900 $54.1700
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 24 34 23.002741 $115013.5000 $4999.9900
AUD -92592TS AUDIOLOGY SERVICES (Monaural) 2 2 0.227397 $11.3700 $49.9800
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 590 774 1813.134354 $90656.4500 $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 159 200 1524.290481 $76214.4900 $50.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 1 1 0.266667 $13.3400 $50.0100
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 25 30 230.354761 $16456.5400 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 22 25 217.586903 $15544.4000 $71.4400
PHY -97110HM PT SESSION BY PT ASST 2 2 26.000000 $1486.1600 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 23 27 215.461905 $15392.6100 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 1 1 13.000000 $180.4400 $13.8800
TRAV -TRAVS Travel by mile 735 2016 506635.107197 $225452.6300 $0.4500
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Subtotal (Total Children Is Unduplicated) 789 5872 521113.947188 $771447.3300 $1.4800
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Total 6242 521483.237324 $791313.3200 $1.5200
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Number of Children (Unduplicated) With at Least One Authorization 799