Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 57
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 6584 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
TCM -T1017TL TARGETED CASE MANAGEMENT 293 301 205.069840 $7587.5800 $37.0000
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Subtotal (Total Children Is Unduplicated) 293 301 205.069840 $7587.5800 $37.0000
Screening, Eval, and Assessment, Class # 02
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 1 1 0.428571 $32.1500 $75.0100
OCTF -97168 OT RE-EVAL EST PLAN CARE 10 12 11.380160 $580.9600 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 120 144 95.526997 $4876.7200 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 6 7 1.772223 $90.4800 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 67 79 36.033341 $1839.5400 $51.0500
SPCH -92522 EVAL OF SPCH SOUND PROD 3 3 1.477778 $75.4400 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 118 140 67.088906 $3424.9800 $51.0500
SPCH -92610 EVAL OF ORAL,PHARYNGEAL SWALLOWING 16 20 9.905557 $441.3000 $44.5500
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Subtotal (Total Children Is Unduplicated) 220 406 223.613533 $11361.5600 $50.8100
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 6 14 6.066672 $303.3600 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 471 585 336.443655 $16822.2000 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 65 87 68.473016 $3423.6500 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 788 977 567.231746 $28361.5900 $50.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 106 179 987.571421 $24689.3000 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 1325 1710 12758.088861 $637904.4400 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1343 1733 12876.844414 $128768.4400 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 133 208 744.500002 $53187.1200 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 5 5 23.928571 $1368.7100 $57.2000
OCCT -97530TL OT SESSION BY LICENSED OT 1 1 4.714286 $336.7900 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 81 110 505.785717 $36133.3500 $71.4400
PHY -97110HM PT SESSION BY PT ASST 6 8 29.785714 $1702.5600 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 161 253 1076.142860 $76879.6800 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 7 7 14.428571 $200.2700 $13.8800
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Subtotal (Total Children Is Unduplicated) 1463 5877 30000.005506 $1010081.4400 $33.6700
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Total 6584 30428.688879 $1029030.5800 $33.8200
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Number of Children (Unduplicated) With at Least One Authorization 1500