Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 09
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: 01-01-22 and 03-31-22 Date of Report: 04-16-22 Page: 1
Child has a MEDICAID # Filter: Y
Eligibility Filter: Program Patients
With the filters selected there were 513 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 45 49 121.071428 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 45 49 121.071428 $0.0000 $0.0000
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 63 98 144.000000 $7200.0000 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 21 26 26.288889 $657.2200 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 93 99 126.505555 $6325.2700 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 75 79 74.177777 $3708.8900 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 2 2 2.000000 $50.0000 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 33 37 36.188889 $1809.4500 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 1 1 1.000000 $25.0000 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 81 86 99.546032 $4977.3000 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 1 1 1.000000 $25.0000 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 11 11 91.142858 $4557.1300 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 7 8 43.000001 $3071.9100 $71.4400
PHY -97110 PT SESSION BY LICENSED PT 6 8 69.285715 $4949.7700 $71.4400
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 6 8 51.285714 $3663.8500 $71.4400
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Subtotal (Total Children Is Unduplicated) 217 464 765.421430 $41020.7900 $53.5900
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Total 513 886.492858 $41020.7900 $46.2700
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Number of Children (Unduplicated) With at Least One Authorization 255