Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Statewide
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: 07-01-19 and 06-30-20 Date of Report: 07-20-20 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 208575 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
CASE -CASE NON-TCM CASE MANAGEMENT 7 7 15.144445 $560.3500 $37.0000
SCONLY-SCONLY *SERVICE COORDINATION ONLY 1517 1880 5991.450856 $0.0000 $0.0000
SCTT -SCTT SERVICE COORDINATOR TRAVEL 10 11 92.717460 $0.0000 $0.0000
TCM -T1017TL TARGETED CASE MANAGEMENT 2722 3500 325629.625481 $12048296.3500 $37.0000
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Subtotal (Total Children Is Unduplicated) 4050 5398 331728.938242 $12048856.7000 $36.3200
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 572 937 933.350460 $45267.5300 $48.5000
AUD -92626 EVAL OF AUD REHAB STATUS 102 112 171.296455 $9676.5400 $56.4900
AUDE -92552 PURE TONE AUDIOMETRY -AIR ONLY 24 28 46.292576 $912.4300 $19.7100
AUDE -92553 PURE TONE AUDIOMETRY AIR & BONE 2086 2287 2631.464556 $61813.1000 $23.4900
AUDE -92555 SPEECH AUD THRESHOLD (DETECTION) 98 124 147.575878 $2046.8800 $13.8700
AUDE -92557 COMP AUDIO THRESHOLD EVAL/SPCH RECO 214 244 261.523014 $6198.0900 $23.7000
AUDE -92567 TYPMANOMETRY (IMPEDANCE TESTING) 100 138 172.258840 $1564.1100 $9.0800
AUDE -92568 ACOUSTIC REFLEX TESTING (MEMR) 3 3 2.977778 $29.6600 $9.9600
AUDE -92579 VISUAL REINFORCEMENT AUDIOMETRY 142 179 246.225279 $6852.4500 $27.8300
AUDE -92582 CONDITIONED PLAY AUDIOMETRY 15 22 25.294445 $973.0800 $38.4700
AUDE -92585 AUD EVOKED RESPONSE (COMP) 132 164 202.143761 $17149.8900 $84.8400
AUDE -92586 AUD EVOKED RESPONSE (LIMITED) 53 61 54.605251 $2788.6900 $51.0700
AUDE -92587 OTOACOUSTIC EMISSIONS (LIMITED) 143 168 163.579194 $2731.7700 $16.7000
AUDE -92588 OTOACOUSTIC EMISSIONS (COMP) 60 84 107.873289 $2416.3700 $22.4000
AUDE -V5010 ASSESSMENT FOR HEARING AID 103 139 193.721146 $8717.4600 $45.0000
AUDE -V5090 DISPENSING FEE PER HEARING AID 69 105 132.115175 $15193.2500 $115.0000
BEHV -H2012BA BEHAVIORAL ANALYSIS-PROF 1 1 11.285714 $687.9800 $60.9600
BEHV -H2014BA BEHAVIOR ANALYSIS-ASSOCIATE 2 2 27.000000 $1316.5200 $48.7600
EVAL -96111 DEVELOPMENTAL EVALUATION 133 164 145.707874 $7285.4100 $50.0000
EVAL -96111GT DEVELOPMENTAL EVALUATION 2 4 8.000000 $400.0000 $50.0000
EXIT -EXIT EXIT ASSESSMENT 2574 2679 4549.198726 $227459.9400 $50.0000
IPDEF -IPDEF FOLLOW-UP PSYCH AND DEV EVAL 37 39 46.012328 $3450.9200 $75.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 209 212 290.234250 $21767.5400 $75.0000
IPDEF -T1024GNTSGT F/U PHYC AND DEV EVAL BY SPAT 17 17 25.019407 $1876.4600 $75.0000
IPDEF -T1024GOTS F/U PSYCH AND DEV EVAL BY OT 64 65 88.499313 $6637.4500 $75.0000
IPDEF -T1024GOTSGT F/U PHYC AND DEV EVAL BY OT 2 2 2.005556 $150.4200 $75.0000
IPDEF -T1024GPTS F/U PSYCH AND DEV EVAL BY PT 50 50 59.625052 $4471.8600 $75.0000
IPDEF -T1024GPTSGT F/U PHYC AND DEV EVAL BY PT 14 14 19.024810 $1426.8600 $75.0000
IPDEF -T1024TLTS F/U PSYCH AND DEV EVAL BY EI PROF 180 244 317.590268 $23819.1900 $75.0000
IPDEF -T1024TLTSGT F/U PHYC AND DEV EVAL BY EI PROF 2 2 1.010959 $75.8300 $75.0000
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 367 398 466.071036 $25866.8000 $55.5000
IPDEF -T1024TSGT F/U PHYC AND DEV EVAL BY ITDS 39 40 38.638509 $2144.4200 $55.5000
IPDEI -IPDEI_NM INITIAL PSYCH & DEV EVAL BY NON-MED 1 1 1.500000 $83.2500 $55.5000
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 2086 2097 3325.476076 $249410.3600 $75.0000
IPDEI -T1024GNUKGT INITIAL PSYCH AND DEV EVAL BY SPAT 266 273 481.639724 $36122.9900 $75.0000
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 912 916 1646.830615 $123512.3400 $75.0000
IPDEI -T1024GOUKGT INITIAL PSYCH AND DEV EVAL BY OT 44 44 84.509589 $6338.2200 $75.0000
IPDEI -T1024GPUK INITIAL PSYCH AND DEV EVAL BY PT 576 579 529.252112 $39693.5900 $75.0000
IPDEI -T1024GPUKGT INITIAL PSYCH AND DEV EVAL BY PT 134 137 211.620552 $15871.5300 $75.0000
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 2878 2916 4423.542823 $245506.3600 $55.5000
IPDEI -T1024HNUKGT INITIAL PSYCH AND DEV EVAL BY ITDS 146 148 243.626025 $13521.2500 $55.5000
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 1841 2148 3521.219074 $264091.3400 $75.0000
IPDEI -T1024TLGT INITIAL PSYCH AND DEV EVAL BY EI PR 7 7 11.002740 $825.2000 $75.0000
NUTR -97802 NUTRITIONAL EVAL, INITIAL 14 17 145.723807 $7286.1800 $50.0000
NUTR -97803 NUTRITIONAL EVAL, FOLLOW-UP 24 43 261.403969 $13070.2000 $50.0000
OCTF -97168 OT RE-EVAL EST PLAN CARE 262 372 244.341567 $12473.7100 $51.0500
OCTF -97168GT OT RE-EVAL EST PLAN CARE 1 1 0.150685 $7.6900 $51.0500
OCTH -97165 OT EVAL LOW COMPLEXITY 44 48 57.666633 $2943.8800 $51.0500
OCTH -97165TLGT OT EVAL LOW COMPLEXITY 1 1 0.344444 $17.5800 $51.0400
OCTH -97166 OT EVAL MODERATE COMPLEXITY 307 353 332.660751 $16982.3800 $51.0500
OCTH -97166GT OT EVAL MODERATE COMPLEXITY 1 1 0.027778 $1.4200 $51.0900
OCTH -97167 OT EVAL HIGH COMPLEXITY 1879 2517 2173.675609 $110966.1400 $51.0500
OCTH -97167GT OT EVAL HIGH COMPLEXITY 4 4 0.706925 $36.0800 $51.0400
OCTH -97167TL OT EVAL HIGH COMPLEXITY 2 2 1.194444 $60.9700 $51.0500
OCTH -97167TLGT OT EVAL HIGH COMPLEXITY 3 3 1.655556 $84.5200 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 189 272 204.758234 $10452.9800 $51.0500
PSTF -97164TL PT RE-EVAL EST PLAN CARE 2 3 4.005556 $204.4900 $51.0500
PSTH -97161 PT EVAL LOW COMPLEXITY 23 28 26.038889 $1329.2900 $51.0500
PSTH -97162 PT EVAL MODERATE COMPLEXITY 152 176 205.801947 $10506.1900 $51.0500
PSTH -97162GT PT EVAL MODERATE COMPLEXITY 2 2 0.372222 $19.0000 $51.0500
PSTH -97162TL PT EVAL MODERATE COMPLEXITY 1 1 1.000000 $51.0500 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 1184 1831 1572.050284 $80253.2500 $51.0500
PSTH -97163GT PT EVAL HIGH COMPLEXITY 6 6 3.557154 $181.5900 $51.0500
PSTH -97163TLGT PT EVAL HIGH COMPLEXITY 2 3 0.475037 $24.2500 $51.0500
SCREEN-T1023 SCREENING 333 372 444.572218 $22228.5900 $50.0000
SENS -V5014TS HEARING AID REPAIR IN-OFFICE 8 17 71.026963 $1065.4000 $15.0000
SPCH -92521 EVAL OF SPEECH FLUENCY 71 77 112.235226 $5729.6200 $51.0500
SPCH -92521TLGT EVAL OF SPEECH FLUENCY 1 1 1.000000 $51.0500 $51.0500
SPCH -92522 EVAL OF SPCH SOUND PROD 98 105 112.978009 $5767.5300 $51.0500
SPCH -92522TLGT EVAL OF SPCH SOUND PROD 1 1 1.000000 $51.0500 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 2352 3096 2673.925788 $136504.0900 $51.0500
SPCH -92523GT EVAL OF SPCH SOUND PROD; EVAL LANG 21 21 15.628159 $797.8200 $51.0500
SPCH -92523TL EVAL OF SPCH SOUND PROD; EVAL LANG 2 2 1.972222 $100.6800 $51.0500
SPCH -92523TLGT EVAL OF SPCH SOUND PROD; EVAL LANG 10 10 5.261111 $268.5800 $51.0500
SPCH -92524 BEHAV & QUAL ANALYSIS OF VOICE AND 67 74 71.242238 $3636.9200 $51.0500
SPCH -92524GT BEHAV & QUAL ANALYSIS OF VOICE AND 1 2 0.533334 $27.2300 $51.0600
SPCH -92524TLGT BEHAV & QUAL ANALYSIS OF VOICE AND 1 1 0.188889 $9.6400 $51.0500
SPCH -92610 EVAL OF ORAL,PHARYNGEAL SWALLOWING 410 459 612.032816 $27266.0600 $44.5500
SPCH -92610TLGT EVAL OF ORAL,PHARYNGEAL SWALLOWING 2 2 2.000000 $89.1000 $44.5500
VISD -99202 VISION EVAL DIAG (SIMPLE) 1 1 0.955556 $34.3800 $35.9800
VISD -99204 VISION EVAL DIAG (MOD COMPLEXITY) 2 2 1.866667 $141.3500 $75.7200
VISF -92499 VISION EVALUATION FUNCTIONAL 2 2 1.816666 $90.8300 $50.0000
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Subtotal (Total Children Is Unduplicated) 14249 27923 35435.287582 $1978958.0900 $55.8500
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 635 990 1084.954006 $5424774.0000 $5000.0000
AUD -92592TS AUDIOLOGY SERVICES (Monaural) 42 66 138.278695 $6913.9500 $50.0000
AUD -92593TS AUDIOLOGY SERVICES (Biaural) 144 222 489.426165 $24471.3400 $50.0000
AUD -92630 AUD REHAB PRELING HEARING LOSS 4 4 18.167460 $1300.9700 $71.6100
AUD -92633 AUD REHAB POSTLING HEARING LOSS 38 46 149.805077 $10727.5400 $71.6100
AUDE -V5160 DISPENSING FEE BINAURAL 228 264 389.207350 $89517.7300 $230.0000
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 3937 5588 6799.232862 $339962.5400 $50.0000
COIFF -COIFFGT IFSP CONSULT,PROF,FACE TO FACE 58 65 57.788847 $2889.4500 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 1105 1355 1193.341570 $29833.6400 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 7141 11852 39761.842272 $1988091.7400 $50.0000
CONIF -CONIFGT CONSULT,ITDS,FACE TO FACE 73 87 131.492063 $6574.6000 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 864 1373 3557.411306 $88935.2700 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 4449 7589 20645.102108 $1032255.0300 $50.0000
CONOF -CONOFGT CONSULT,OT,FACE TO FACE 62 67 77.352375 $3867.5900 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 362 832 2123.980945 $53099.5100 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 2648 4379 13002.754093 $650137.6900 $50.0000
CONPF -CONPFGT CONSULT,PT,FACE TO FACE 47 51 61.399998 $3069.9900 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 127 299 855.008737 $21375.2400 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 7665 12059 30274.996948 $1513749.2800 $50.0000
CONSF -CONSFGT CONSULT,SLP,FACE TO FACE 92 99 113.158726 $5657.9200 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 861 1286 3154.170626 $78854.2500 $25.0000
COUN -H2019HR INDIVIDUAL/FAMILY THERAPY 19 19 104.546030 $7665.3100 $73.3200
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 865 1890 40476.696021 $1011917.3600 $25.0000
EIIF -96154 HEALTH AND BEHAVIOR INTERVENTION 10 10 94.693651 $4734.6900 $50.0000
EIIF -EIIF_NM EI INDIVIDUAL SESSION BY NONMED PRO 1 1 12.000000 $600.0000 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 24393 42953 625950.361020 $31297520.8100 $50.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 790 871 7677.474588 $383873.7600 $50.0000
INTR -T1013 INTERPRETER 733 1081 7654.865215 $382743.2700 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 14549 33998 392838.035707 $3928380.6100 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 3814 6435 78282.396719 $5592495.1700 $71.4400
OCCT -97530GT OT SESSION BY LICENSED OT 131 150 1201.403167 $85828.2300 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 1422 2386 28651.774576 $1638881.5700 $57.2000
OCCT -97530HMGT OT SESSION BY OT ASST 33 33 358.464285 $20504.1400 $57.2000
OCCT -97530TL OT SESSION BY LICENSED OT 14 15 132.623812 $9474.6400 $71.4400
OCCT -97530TLGT OT SESSION BY LICENSED OT 36 37 227.885712 $16280.1500 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 3970 7094 87114.316491 $6223447.6300 $71.4400
PHY -97110GT PT SESSION BY LICENSED PT 117 127 1042.855553 $74501.6300 $71.4400
PHY -97110HM PT SESSION BY PT ASST 467 793 9623.047054 $550053.3500 $57.1600
PHY -97110HMGT PT SESSION BY LICENSED PT ASST 11 11 88.695238 $5069.8200 $57.1600
PHY -97110TL PT SESSION BY LICENSED PT 11 12 56.195236 $4014.5900 $71.4400
PHY -97110TLGT PT SESSION BY LICENSED PT 35 40 208.473808 $14893.3800 $71.4400
PHY -97110TLHM PT SESSION BY PT ASST 1 1 14.714286 $841.0700 $57.1600
RSPT -RSPT RESPITE 1 1 1.000000 $0.0000 $0.0000
SENS -HA_INS SENSORY AID INSURANCE PER EAR 10 17 15.494674 $1007.1600 $65.0000
SENS -V5014 *HEARING AID REPAIR BY MANUFACTURER 5 10 6.340639 $722.8400 $114.0000
SENS -V5050 IN EAR MONAURAL HEARING AID 36 56 45.143833 $10292.7600 $228.0000
SENS -V5060 BEHIND EAR HEARING AID 12 14 21.866667 $4985.6100 $228.0000
SENS -V5140 BEHIND EAR BINAURAL HEARING AID 50 69 130.555175 $59533.1700 $456.0000
SENS -V5264 EARMOLD 195 298 610.859660 $10995.4800 $18.0000
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 7427 12233 157334.568431 $11239982.4500 $71.4400
SPL -92507GT SPL THERAPY SESSION BY LICENSED SLP 290 327 2573.798403 $183872.1700 $71.4400
SPL -92507HM SPL THERAPY SESSION BY SLP ASST 65 94 1008.586509 $57691.1500 $57.2000
SPL -92507HMGT SPL THERAPY SESSION BY SLP ASST 1 1 6.285714 $359.5400 $57.2000
SPL -92507TL SPL THERAPY SESSION BY LICENSED SLP 20 21 219.428572 $15675.9800 $71.4400
SPL -92507TLGT SPL THERAPY SESSION BY LICENSED SLP 74 78 482.038889 $34436.8500 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 554 837 9304.962429 $129152.8700 $13.8800
SPL -92508TLGT SPL THERAPY SESSION BY LICENSED SLP 2 2 4.142857 $57.5000 $13.8800
TELEC -TELEC TELECONFERENCE,PROVIDER TO FAMILY,P 159 194 1322.556741 $48934.6300 $37.0000
TRAV -TRAVS Travel by mile 4629 14472 2187982.111413 $973652.0500 $0.4500
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Subtotal (Total Children Is Unduplicated) 32457 175254 3766960.131004 $75401132.6200 $20.0200
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Total 208575 4134124.356828 $89428947.4100 $21.6300
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Number of Children (Unduplicated) With at Least One Authorization 34321