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 3801 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 108 110 73.596826 $2723.0900 $37.0000
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Subtotal (Total Children Is Unduplicated) 108 110 73.596826 $2723.0900 $37.0000
Screening, Eval, and Assessment, Class # 02
OCTF -97168 OT RE-EVAL EST PLAN CARE 1 2 0.505556 $25.8100 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 24 25 10.500001 $536.0300 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 1 2 0.505556 $25.8100 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 16 18 8.572225 $437.6300 $51.0500
SPCH -92522 EVAL OF SPCH SOUND PROD 1 1 1.000000 $51.0500 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 31 34 12.761114 $651.4700 $51.0500
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Subtotal (Total Children Is Unduplicated) 53 82 33.844452 $1727.8000 $51.0500
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 3 3 10.000000 $250.0000 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 132 156 1120.011107 $56000.5600 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1343 1733 12876.844414 $128768.4400 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 11 12 30.142856 $2153.4100 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 1 1 11.285714 $645.5400 $57.2000
PHY -97110 PT SESSION BY LICENSED PT 10 12 116.857142 $8348.2800 $71.4400
PHY -97110HM PT SESSION BY PT ASST 2 3 10.857143 $620.6000 $57.1600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 24 26 167.142854 $11940.7000 $71.4400
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Subtotal (Total Children Is Unduplicated) 1360 3609 15321.356319 $257638.3200 $16.8200
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Total 3801 15428.797597 $262089.2000 $16.9900
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Number of Children (Unduplicated) With at Least One Authorization 1385