Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 07
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
Child has a MEDICAID # Filter: Y
Eligibility Filter: Program Patients
With the filters selected there were 1112 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 39 41 76.856347 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 39 41 76.856347 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
EXIT -EXIT EXIT ASSESSMENT 93 94 100.140182 $5007.0200 $50.0000
PSTH -97162 PT EVAL MODERATE COMPLEXITY 1 1 2.000000 $102.1000 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 3 3 2.250000 $114.8600 $51.0500
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Subtotal (Total Children Is Unduplicated) 97 98 104.390182 $5223.9800 $50.0400
EI Services, Class # 03
AUD -92592TS AUDIOLOGY SERVICES (Monaural) 1 1 1.011111 $50.5600 $50.0000
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 1 1 0.246575 $12.3300 $50.0100
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 130 157 155.044849 $7752.2900 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 17 19 16.005556 $400.1400 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 312 435 1209.611883 $60480.5000 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 4 4 6.890476 $172.2600 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 103 131 368.016661 $18400.8100 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 2 2 5.200000 $130.0000 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 45 61 158.452376 $7922.6000 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 1 1 1.000000 $25.0000 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 112 138 260.852376 $13042.6000 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 4 4 8.899999 $222.5000 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 9 12 121.071429 $6053.5700 $50.0000
INTR -T1013 INTERPRETER 3 4 12.652381 $632.6200 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 1 1 13.000000 $928.7200 $71.4400
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 2 2 32.428571 $2316.7000 $71.4400
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Subtotal (Total Children Is Unduplicated) 394 973 2370.384243 $118543.1700 $50.0100
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Total 1112 2551.630772 $123767.1500 $48.5100
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Number of Children (Unduplicated) With at Least One Authorization 481