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: 10-01-20 and 12-31-20 Date of Report: 01-23-21 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 5630 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 78 89 52.992066 $1960.7200 $37.0000
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Subtotal (Total Children Is Unduplicated) 78 89 52.992066 $1960.7200 $37.0000
Screening, Eval, and Assessment, Class # 02
OCTF -97168 OT RE-EVAL EST PLAN CARE 6 6 3.661111 $186.9000 $51.0500
OCTH -97167 OT EVAL HIGH COMPLEXITY 89 102 53.878567 $2750.4800 $51.0500
PSTF -97164 PT RE-EVAL EST PLAN CARE 4 4 1.644445 $83.9500 $51.0500
PSTH -97163 PT EVAL HIGH COMPLEXITY 39 47 25.772223 $1315.6800 $51.0500
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 104 124 71.446028 $3647.3000 $51.0500
SPCH -92610 EVAL OF ORAL,PHARYNGEAL SWALLOWING 8 8 2.927778 $130.4300 $44.5500
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Subtotal (Total Children Is Unduplicated) 167 291 159.330152 $8114.7500 $50.9300
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 5 12 1.705557 $85.2900 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 555 669 678.062676 $33902.9900 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 87 106 220.963492 $11048.1600 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 793 942 781.021376 $39050.7900 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 1 1 1.022222 $25.5600 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 103 108 1009.714279 $25242.9100 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 1229 1528 12388.963430 $619449.0400 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 1230 1543 12421.266607 $124212.8400 $10.0000
OCCT -97530 OT SESSION BY LICENSED OT 115 123 676.214308 $48308.6800 $71.4400
OCCT -97530HM OT SESSION BY OT ASST 6 8 68.857143 $3938.6400 $57.2000
OCCT -97530TL OT SESSION BY LICENSED OT 1 1 8.571429 $612.3400 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 45 49 332.785718 $23774.2200 $71.4400
PHY -97110HM PT SESSION BY PT ASST 3 4 25.096032 $1434.4900 $57.1600
PHY -97110TL PT SESSION BY LICENSED PT 1 1 8.714286 $622.5500 $71.4400
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 138 150 878.428591 $62754.9100 $71.4400
SPL -92508 GROUP SPL SESSION PER CHILD 5 5 41.285715 $573.0500 $13.8800
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Subtotal (Total Children Is Unduplicated) 1317 5250 29542.672861 $995036.4300 $33.6800
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Total 5630 29754.995079 $1005111.9000 $33.7800
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Number of Children (Unduplicated) With at Least One Authorization 1374