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: 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 3339 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 31 34 56.517455 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 31 34 56.517455 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
EXIT -EXIT EXIT ASSESSMENT 36 46 71.527397 $3576.3600 $50.0000
IPDEF -IPDEF FOLLOW-UP PSYCH AND DEV EVAL 6 6 6.931507 $519.8600 $75.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 18 19 18.039725 $1352.9800 $75.0000
IPDEF -T1024GOTS F/U PSYCH AND DEV EVAL BY OT 2 2 4.000000 $300.0000 $75.0000
IPDEF -T1024GPTS F/U PSYCH AND DEV EVAL BY PT 5 5 6.179452 $463.4600 $75.0000
IPDEF -T1024TLTS F/U PSYCH AND DEV EVAL BY EI PROF 7 9 2.526029 $189.4400 $74.9900
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 56 57 39.673976 $2201.8800 $55.5000
IPDEF -T1024TSGT F/U PHYC AND DEV EVAL BY ITDS 2 2 2.002740 $111.1500 $55.5000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 54 57 0.743839 $55.7700 $74.9800
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 3 3 0.013699 $1.0300 $75.0100
IPDEI -T1024GPUK INITIAL PSYCH AND DEV EVAL BY PT 26 26 0.109593 $8.2100 $74.8700
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 61 61 2.269861 $125.9700 $55.5000
IPDEI -T1024HNUKGT INITIAL PSYCH AND DEV EVAL BY ITDS 1 1 0.005479 $0.3100 $55.7000
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 10 10 0.032879 $2.4500 $74.3600
IPDEI -T1024TLGT INITIAL PSYCH AND DEV EVAL BY EI PR 1 1 0.002740 $0.2000 $73.9100
OCTH -97166 OT EVAL MODERATE COMPLEXITY 2 2 1.505556 $76.8600 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 8 8 3.556317 $181.5500 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 2 2 1.210959 $61.8200 $51.0500
SPCH -92521 EVAL OF SPEECH FLUENCY 1 1 1.000000 $51.0500 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 12 13 5.660274 $288.9500 $51.0500
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Subtotal (Total Children Is Unduplicated) 220 331 166.992022 $9569.2900 $57.3000
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 16 17 14.004186 $70021.0000 $5000.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 52 53 159.085629 $7954.2800 $50.0000
COIFF -COIFFGT IFSP CONSULT,PROF,FACE TO FACE 2 2 0.900000 $45.0000 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 701 893 1239.925515 $61996.1800 $50.0000
CONIF -CONIFGT CONSULT,ITDS,FACE TO FACE 17 17 7.512698 $375.6300 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 3 4 5.866667 $146.6700 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 266 331 419.732473 $20986.5400 $50.0000
CONOF -CONOFGT CONSULT,OT,FACE TO FACE 2 2 0.919047 $45.9500 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 4 4 10.300000 $257.5000 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 292 366 690.447496 $34522.3100 $50.0000
CONPF -CONPFGT CONSULT,PT,FACE TO FACE 6 6 2.055556 $102.7800 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 583 745 987.849235 $49392.3200 $50.0000
CONSF -CONSFGT CONSULT,SLP,FACE TO FACE 11 11 2.361111 $118.0600 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 7 7 8.872221 $221.8000 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 11 12 111.142858 $2778.5700 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 239 297 2198.203168 $109910.1300 $50.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 55 55 106.988891 $5349.4500 $50.0000
INTR -T1013 INTERPRETER 13 14 134.328572 $6716.4300 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1 1 3.033333 $30.3300 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 14 17 99.500000 $7108.2700 $71.4400
OCCT -97530GT OT SESSION BY LICENSED OT 1 1 2.285714 $163.2900 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 12 13 87.104761 $6222.7600 $71.4400
PHY -97110TLGT PT SESSION BY LICENSED PT 2 2 5.428571 $387.8200 $71.4400
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 35 40 287.428572 $20533.8900 $71.4400
SPL -92507GT SPL THERAPY SESSION BY LICENSED SLP 6 6 10.214285 $729.7100 $71.4400
SPL -92507TLGT SPL THERAPY SESSION BY LICENSED SLP 1 1 1.142857 $81.6500 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 2 2 15.428572 $214.1500 $13.8800
TELEC -TELEC TELECONFERENCE,PROVIDER TO FAMILY,P 47 55 46.890479 $1734.9500 $37.0000
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Subtotal (Total Children Is Unduplicated) 836 2974 6658.952467 $408147.4000 $61.2900
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Total 3339 6882.461944 $417716.7000 $60.6900
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Number of Children (Unduplicated) With at Least One Authorization 888