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: 04-01-20 and 06-30-20 Date of Report: 07-20-20 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 5180 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 86 97 63.155553 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 86 97 63.155553 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 13 16 5.644448 $273.7700 $48.5000
AUD -92626 EVAL OF AUD REHAB STATUS 1 1 1.000000 $56.4900 $56.4900
AUDE -V5010 ASSESSMENT FOR HEARING AID 2 2 0.811112 $36.5000 $45.0000
OCTF -97168 OT RE-EVAL EST PLAN CARE 1 1 0.283333 $14.4600 $51.0400
OCTH -97166 OT EVAL MODERATE COMPLEXITY 2 2 0.955556 $48.7800 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 212 275 107.544478 $5490.3200 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 1 1 0.311111 $15.8800 $51.0500
PSTH -97161 PT EVAL LOW COMPLEXITY 1 1 0.061111 $3.1200 $51.0400
PSTH -97162 PT EVAL MODERATE COMPLEXITY 3 3 1.272223 $64.9500 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 155 199 76.077803 $3883.9000 $51.0500
SPCH -92521 EVAL OF SPEECH FLUENCY 4 4 1.866668 $95.3000 $51.0500
SPCH -92522 EVAL OF SPCH SOUND PROD 2 4 0.677778 $34.6000 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 103 146 42.442076 $2166.7300 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF VOICE AND 1 1 0.255556 $13.0500 $51.0600
SPCH -92610 EVAL OF ORAL,PHARYNGEAL SWALLOWING 11 12 3.705557 $165.0900 $44.5500
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Subtotal (Total Children Is Unduplicated) 384 668 242.908810 $12362.9500 $50.9000
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 31 93 26.486114 $1324.3200 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 5 8 4.333334 $216.6700 $50.0000
CONIF -CONIFGT CONSULT,ITDS,FACE TO FACE 1 1 1.011111 $50.5600 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 1 1 1.011111 $25.2800 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 5 9 6.355556 $317.7800 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 2 2 1.111111 $27.7800 $25.0000
CONPF -CONPFGT CONSULT,PT,FACE TO FACE 1 1 1.011111 $50.5600 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 2 2 1.944444 $97.2200 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 3 3 1.200000 $30.0000 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 128 239 1400.714287 $35017.8400 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 1156 1513 12843.509528 $642175.4800 $50.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 30 30 393.714285 $19685.7200 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1192 1580 13383.603183 $133836.0500 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 176 229 1666.641273 $119064.8500 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 94 148 838.499998 $47962.2200 $57.2000
OCCT -97530HMGT OT SESSION BY OT ASST 1 1 13.000000 $743.6000 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 137 186 1366.642854 $97632.9700 $71.4400
PHY -97110GT PT SESSION BY LICENSED PT 1 1 13.000000 $928.7200 $71.4400
PHY -97110HM PT SESSION BY PT ASST 67 100 603.678572 $34506.2700 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 66 92 641.642858 $45838.9600 $71.4400
SPL -92507GT SPL THERAPY SESSION BY LICENSED SLP 1 1 1.714286 $122.4700 $71.4400
SPL -92507HM SPL THERAPY SESSION BY SLP ASST 34 52 284.500003 $16273.3900 $57.2000
SPL -92507TL SPL THERAPY SESSION BY LICENSED SLP 1 1 13.000000 $928.7200 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 62 108 493.928568 $6855.7400 $13.8800
TELEC -TELEC TELECONFERENCE,PROVIDER TO FAMILY,P 10 14 50.178571 $1856.6200 $37.0000
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Subtotal (Total Children Is Unduplicated) 1466 4415 34052.432158 $1205569.7500 $35.4000
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Total 5180 34358.496521 $1217932.7000 $35.4500
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Number of Children (Unduplicated) With at Least One Authorization 1522