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: 01-01-23 and 03-31-23 Date of Report: 04-20-23 Page: 1
Child has a MEDICAID # Filter: Y
Eligibility Filter: Program Patients
With the filters selected there were 501 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 34 39 70.414285 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 34 39 70.414285 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
NUTR -97803 NUTRITIONAL EVAL, FOLLOW-UP 4 5 15.857142 $792.8600 $50.0000
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Subtotal (Total Children Is Unduplicated) 4 5 15.857142 $792.8600 $50.0000
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 57 91 133.277778 $6663.8900 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 12 15 11.255480 $281.3900 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 89 91 95.949880 $4797.5000 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 2 2 0.988889 $24.7200 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 57 58 65.046031 $3252.3000 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 1 1 1.000000 $25.0000 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 30 32 28.622103 $1431.1100 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 61 62 87.141271 $4357.0700 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 1 1 1.000000 $25.0000 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 44 50 377.857145 $18892.8500 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 14 20 95.785715 $6892.7200 $71.9600
PHY -97110 PT SESSION BY LICENSED PT 7 9 78.285713 $5633.4500 $71.9600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 21 25 207.464287 $14929.1200 $71.9600
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Subtotal (Total Children Is Unduplicated) 234 457 1183.674292 $67206.1100 $56.7800
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Total 501 1269.945719 $67998.9700 $53.5400
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Number of Children (Unduplicated) With at Least One Authorization 268