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: 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 6020 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 72 96 51.344443 $0.0000 $0.0000
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 72 96 51.344443 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 11 14 5.972224 $289.6600 $48.5000
AUDE -V5010 ASSESSMENT FOR HEARING AID 2 2 1.011112 $45.5000 $45.0000
OCTF -97168 OT RE-EVAL EST PLAN CARE 6 6 2.061111 $105.2200 $51.0500
OCTH -97166 OT EVAL MODERATE COMPLEXITY 2 3 0.516666 $26.3700 $51.0400
OCTH -97167 OT EVAL HIGH COMPLEXITY 266 347 138.860349 $7088.9900 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 5 5 1.972223 $100.6900 $51.0500
PSTH -97161 PT EVAL LOW COMPLEXITY 1 1 0.505556 $25.8100 $51.0500
PSTH -97162 PT EVAL MODERATE COMPLEXITY 2 3 1.011111 $51.6200 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 192 262 101.834947 $5198.8200 $51.0500
SPCH -92521 EVAL OF SPEECH FLUENCY 4 5 1.844443 $94.1500 $51.0500
SPCH -92522 EVAL OF SPCH SOUND PROD 2 2 1.011112 $51.6200 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 140 179 96.630969 $4933.1000 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF VOICE AND 2 2 0.738889 $37.7200 $51.0500
SPCH -92610 EVAL OF ORAL,PHARYNGEAL SWALLOWING 11 17 3.744446 $166.8200 $44.5500
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 475 848 357.715158 $18216.0900 $50.9200
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 1 2 2.000000 $10000.0000 $5000.0000
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 1 1 1.000000 $50.0000 $50.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 55 188 62.760725 $3138.0900 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 7 7 5.211111 $260.5600 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 1 1 0.544444 $13.6100 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 6 6 6.533333 $326.6700 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 1 1 0.544444 $13.6100 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 3 3 10.841270 $542.0700 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 4 5 4.305555 $215.2800 $50.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 171 257 1875.571424 $46889.2800 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 1281 1704 15171.619829 $758581.0300 $50.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 32 32 113.285716 $5664.2800 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1332 1831 15524.023006 $155240.2500 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 194 238 2009.062697 $143527.4400 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 144 193 1226.245243 $70141.2300 $57.2000
OCCT -97530HMGT OT SESSION BY OT ASST 1 1 2.285714 $130.7400 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 136 182 1357.037297 $96946.7800 $71.4400
PHY -97110GT PT SESSION BY LICENSED PT 1 1 4.714286 $336.7900 $71.4400
PHY -97110HM PT SESSION BY PT ASST 107 147 1069.150396 $61112.6500 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 71 82 698.214285 $49880.4200 $71.4400
SPL -92507HM SPL THERAPY SESSION BY SLP ASST 52 59 379.000001 $21678.8000 $57.2000
SPL -92507TL SPL THERAPY SESSION BY LICENSED SLP 1 1 3.000000 $214.3200 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 111 133 770.214288 $10690.5700 $13.8800
TRAV -TRAVS Travel by mile 1 1 4.142857 $1.8400 $0.4500
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 1641 5076 40301.307921 $1435596.2800 $35.6200
-------------------------------------------------------------------------------------------------------------------------------------
Total 6020 40710.367522 $1453812.3700 $35.7100
-------------------------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Authorization 1694