Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 06
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 3815 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 98 107 145.630951 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 98 107 145.630951 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
EXIT -EXIT EXIT ASSESSMENT 108 110 220.000000 $11000.0000 $50.0000
SENS -V5014TS HEARING AID REPAIR IN-OFFICE 1 1 0.232877 $3.4900 $15.0000
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Subtotal (Total Children Is Unduplicated) 109 111 220.232877 $11003.4900 $49.9600
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 2 2 2.000000 $10000.0000 $5000.0000
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 3 3 2.366667 $118.3400 $50.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 176 181 49.857973 $2493.1100 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 16 16 6.544448 $163.6200 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 26 33 44.092857 $2204.6500 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 21 27 38.092065 $952.3100 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 16 20 27.576190 $1378.8100 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 9 14 21.849999 $546.2500 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 7 8 13.776191 $688.8200 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 2 2 0.600000 $15.0000 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 17 20 31.876190 $1593.8100 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 12 13 11.544445 $288.6100 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 1 1 8.857143 $221.4300 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 461 609 4554.523806 $227726.2300 $50.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 1 1 6.285714 $314.2900 $50.0000
INTR -T1013 INTERPRETER 43 48 278.457143 $13922.8500 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1625 2438 18267.843635 $182678.4500 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 19 28 125.857143 $8991.2400 $71.4400
OCCT -97530GT OT SESSION BY LICENSED OT 1 1 2.142857 $153.0900 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 5 7 35.333333 $2021.0600 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 26 36 173.926192 $12425.2900 $71.4400
PHY -97110HM PT SESSION BY PT ASST 5 6 36.321429 $2076.1300 $57.1600
SENS -HA_INS SENSORY AID INSURANCE PER EAR 2 2 1.232877 $80.1400 $65.0000
SENS -V5014 *HEARING AID REPAIR BY MANUFACTURER 1 1 0.232877 $26.5500 $114.0100
SENS -V5140 BEHIND EAR BINAURAL HEARING AID 1 1 0.677778 $309.0800 $456.0100
SENS -V5264 EARMOLD 1 1 0.677778 $12.2000 $18.0000
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 54 69 340.178570 $24302.3500 $71.4400
SPL -92507GT SPL THERAPY SESSION BY LICENSED SLP 1 1 4.285714 $306.1700 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 7 8 84.857144 $1177.8200 $13.8800
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Subtotal (Total Children Is Unduplicated) 1657 3597 24171.868158 $497187.6500 $20.5700
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Total 3815 24537.731986 $508191.1500 $20.7100
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Number of Children (Unduplicated) With at Least One Authorization 1734