Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 03
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: 10-01-22 and 12-31-22 Date of Report: 01-23-23 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 1213 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 135 145 102.672209 $0.0000 $0.0000
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 135 145 102.672209 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 31 35 26.444443 $1282.5500 $48.5000
OCTH -97165 OT EVAL LOW COMPLEXITY 8 11 4.038889 $207.6400 $51.4100
OCTH -97167 OT EVAL HIGH COMPLEXITY 1 1 0.169863 $8.7300 $51.4200
PSTH -97161 PT EVAL LOW COMPLEXITY 4 5 2.366666 $121.6700 $51.4100
PSTH -97163 PT EVAL HIGH COMPLEXITY 5 7 5.683333 $292.1800 $51.4100
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 21 24 15.166667 $779.7200 $51.4100
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 56 83 53.869861 $2692.4900 $49.9800
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 8 8 7.022222 $35111.0000 $4999.9800
CONIF -CONIF CONSULT, ITDS FACE TO FACE 32 38 43.733334 $2186.6700 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 143 168 244.444436 $12222.1800 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 91 111 138.577773 $6928.8700 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 200 251 361.494446 $18074.7400 $50.0000
EIIF -96154 HEALTH AND BEHAVIOR INTERVENTION 1 1 10.714286 $535.7200 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 244 356 1957.030151 $97851.5500 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 9 12 87.752382 $6314.6800 $71.9600
PHY -97110 PT SESSION BY LICENSED PT 9 12 89.342857 $6429.1200 $71.9600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 23 28 133.711112 $9621.8500 $71.9600
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 540 985 3073.822999 $195276.3600 $63.5300
-------------------------------------------------------------------------------------------------------------------------------------
Total 1213 3230.365069 $197968.8500 $61.2800
-------------------------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Authorization 669