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: 10-01-23 and 12-31-23 Date of Report: 01-14-24 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 974 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 69 76 180.938101 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 69 76 180.938101 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
NUTR -97802 NUTRITIONAL EVAL, INITIAL 1 1 13.142857 $657.1500 $50.0000
NUTR -97803 NUTRITIONAL EVAL, FOLLOW-UP 13 16 74.390477 $3719.5400 $50.0000
SPL -92526 TREATMENT OF SWALLOWING DYSFUNCTION 6 6 58.714286 $3018.5100 $51.4100
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Subtotal (Total Children Is Unduplicated) 20 23 146.247620 $7395.1900 $50.5700
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 96 146 223.121201 $11156.0600 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 14 16 15.000000 $375.0000 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 166 176 182.681747 $9134.0900 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 91 93 107.881747 $5394.0900 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 49 50 59.688095 $2984.4000 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 109 113 118.499205 $5924.9500 $50.0000
EIIF -96154 HEALTH AND BEHAVIOR INTERVENTION 1 1 13.142857 $657.1500 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 158 198 1475.619054 $73780.9800 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 21 26 202.857144 $14597.6200 $71.9600
PHY -97110 PT SESSION BY LICENSED PT 18 21 187.649208 $13503.2400 $71.9600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 32 35 304.678573 $21924.6900 $71.9600
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Subtotal (Total Children Is Unduplicated) 404 875 2890.818831 $159432.2500 $55.1500
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Total 974 3218.004552 $166827.4400 $51.8400
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Number of Children (Unduplicated) With at Least One Authorization 482