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: 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 3247 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 35 38 63.360320 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 35 38 63.360320 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 1 2 2.000000 $97.0000 $48.5000
EXIT -EXIT EXIT ASSESSMENT 18 21 34.200000 $1710.0000 $50.0000
IPDEF -IPDEF FOLLOW-UP PSYCH AND DEV EVAL 10 10 16.123288 $1209.2400 $75.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 8 8 15.538812 $1165.4100 $75.0000
IPDEF -T1024GNTSGT F/U PHYC AND DEV EVAL BY SPAT 3 3 1.008296 $75.6200 $75.0000
IPDEF -T1024GOTSGT F/U PHYC AND DEV EVAL BY OT 1 1 0.005556 $0.4200 $75.5900
IPDEF -T1024GPTS F/U PSYCH AND DEV EVAL BY PT 9 9 13.837378 $1037.8100 $75.0000
IPDEF -T1024GPTSGT F/U PHYC AND DEV EVAL BY PT 2 2 0.009589 $0.7200 $75.0900
IPDEF -T1024TLTS F/U PSYCH AND DEV EVAL BY EI PROF 6 6 2.542466 $190.6800 $75.0000
IPDEF -T1024TLTSGT F/U PHYC AND DEV EVAL BY EI PROF 1 1 0.010959 $0.8300 $75.2800
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 40 40 64.513700 $3580.5000 $55.5000
IPDEF -T1024TSGT F/U PHYC AND DEV EVAL BY ITDS 22 22 14.613698 $811.0500 $55.5000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 3 3 3.998630 $299.9000 $75.0000
IPDEI -T1024GNUKGT INITIAL PSYCH AND DEV EVAL BY SPAT 25 28 18.586301 $1393.9800 $75.0000
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 1 1 2.000000 $150.0000 $75.0000
IPDEI -T1024GPUK INITIAL PSYCH AND DEV EVAL BY PT 2 2 3.000000 $225.0000 $75.0000
IPDEI -T1024GPUKGT INITIAL PSYCH AND DEV EVAL BY PT 14 14 7.542466 $565.6900 $75.0000
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 13 13 9.531507 $529.0000 $55.5000
IPDEI -T1024HNUKGT INITIAL PSYCH AND DEV EVAL BY ITDS 20 22 5.093149 $282.6800 $55.5000
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 1 1 0.087671 $6.5800 $75.0200
IPDEI -T1024TLGT INITIAL PSYCH AND DEV EVAL BY EI PR 2 2 3.000000 $225.0000 $75.0000
OCTH -97166 OT EVAL MODERATE COMPLEXITY 2 2 1.388889 $70.9000 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 7 8 1.652969 $84.3900 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 2 2 1.472222 $75.1600 $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 7 7 0.808220 $41.2500 $51.0400
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Subtotal (Total Children Is Unduplicated) 161 231 223.565766 $13879.8500 $62.0800
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 10 10 8.666895 $43334.0000 $4999.9500
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 34 35 106.938594 $5346.9200 $50.0000
COIFF -COIFFGT IFSP CONSULT,PROF,FACE TO FACE 26 29 25.509915 $1275.5000 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 643 807 1271.628952 $63581.3700 $50.0000
CONIF -CONIFGT CONSULT,ITDS,FACE TO FACE 60 73 91.323810 $4566.1900 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 1 1 1.466667 $36.6700 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 235 288 362.415471 $18120.7600 $50.0000
CONOF -CONOFGT CONSULT,OT,FACE TO FACE 27 29 29.216665 $1460.8300 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 5 5 19.880952 $497.0200 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 285 345 549.929348 $27496.3700 $50.0000
CONPF -CONPFGT CONSULT,PT,FACE TO FACE 28 31 41.383331 $2069.1600 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 2 2 2.350000 $58.7500 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 541 660 843.319440 $42165.9500 $50.0000
CONSF -CONSFGT CONSULT,SLP,FACE TO FACE 45 47 66.508728 $3325.4300 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 5 5 10.138888 $253.4700 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 5 6 25.857143 $646.4300 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 213 277 1816.673014 $90833.6300 $50.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 128 153 1208.534916 $60426.7800 $50.0000
INTR -T1013 INTERPRETER 5 7 42.285714 $2114.2900 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1 1 1.466667 $14.6700 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 13 20 101.142858 $7225.6300 $71.4400
OCCT -97530GT OT SESSION BY LICENSED OT 3 5 15.142859 $1081.7900 $71.4400
OCCT -97530TLGT OT SESSION BY LICENSED OT 1 1 10.142857 $724.6100 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 7 8 50.790476 $3628.4700 $71.4400
PHY -97110TLGT PT SESSION BY LICENSED PT 1 1 9.714286 $693.9900 $71.4400
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 19 23 154.142858 $11011.9500 $71.4400
SPL -92507GT SPL THERAPY SESSION BY LICENSED SLP 8 10 81.857143 $5847.8700 $71.4400
SPL -92507TLGT SPL THERAPY SESSION BY LICENSED SLP 3 3 20.428572 $1459.4100 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 1 1 2.285714 $31.7300 $13.8800
TELEC -TELEC TELECONFERENCE,PROVIDER TO FAMILY,P 79 95 464.215474 $17175.9800 $37.0000
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Subtotal (Total Children Is Unduplicated) 790 2978 7435.358207 $416505.5700 $56.0200
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Total 3247 7722.284293 $430385.4100 $55.7300
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Number of Children (Unduplicated) With at Least One Authorization 836