Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 02
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: 01-01-24 and 03-31-24 Date of Report: 04-04-25 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 3444 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 3 3 1.555556 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 3 3 1.555556 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 52 61 53.230934 $2581.7100 $48.5000
AUD -92626 EVAL OF AUD REHAB STATUS 1 1 0.238356 $14.7100 $61.7200
AUDE -92555 SPEECH AUD THRESHOLD (DETECTION) 2 2 0.743912 $12.0200 $16.1500
EXIT -EXIT COS Exit 4 4 3.066667 $153.3400 $50.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 1 1 2.000000 $161.9600 $80.9800
IPDEF -T1024GOTS F/U PSYCH AND DEV EVAL BY OT 1 1 2.000000 $161.9600 $80.9800
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 9 10 16.010958 $1296.5700 $80.9800
IPDEI -T1024GNUKGT INITIAL PSYCH AND DEV EVAL BY SPAT 2 2 4.000000 $323.9200 $80.9800
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 6 6 12.000000 $971.7600 $80.9800
IPDEI -T1024GOUKGT INITIAL PSYCH AND DEV EVAL BY OT 2 2 4.000000 $323.9200 $80.9800
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 17 17 30.010958 $1798.2600 $59.9200
IPDEI -T1024HNUKGT INITIAL PSYCH AND DEV EVAL BY ITDS 4 5 10.000000 $599.2000 $59.9200
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 19 25 48.000000 $3887.0400 $80.9800
IPDEI -T1024TLGT INITIAL PSYCH AND DEV EVAL BY EI PR 1 1 2.000000 $161.9600 $80.9800
OCTF -97168 OT RE-EVAL EST PLAN CARE 3 3 0.910426 $52.9000 $58.1100
OCTH -97165 OT EVAL LOW COMPLEXITY 10 10 9.419656 $547.3800 $58.1100
OCTH -97166 OT EVAL MODERATE COMPLEXITY 4 5 4.883333 $283.7700 $58.1100
OCTH -97167 OT EVAL HIGH COMPLEXITY 2 2 1.505556 $87.4900 $58.1100
PSTH -97161 PT EVAL LOW COMPLEXITY 7 8 4.934367 $286.7400 $58.1100
SPCH -92521 EVAL OF SPEECH FLUENCY 10 10 5.029605 $292.2800 $58.1100
SPCH -92522 EVAL OF SPCH SOUND PROD 1 1 11.857143 $689.0200 $58.1100
SPCH -92522TL EVAL OF SPCH SOUND PROD 1 1 0.104110 $6.0500 $58.1000
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 4 5 2.850000 $165.6100 $58.1100
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Subtotal (Total Children Is Unduplicated) 111 183 228.795981 $14859.5600 $64.9500
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 13 15 52.196032 $260981.0000 $5000.0200
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 78 80 103.310293 $5165.4700 $50.0000
COIFF -COIFFGT IFSP CONSULT, PROF, TELEMEDICINE 9 10 9.604166 $480.2100 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 2 2 4.266666 $106.6700 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 424 594 1179.966627 $58998.1400 $50.0000
CONIF -CONIFGT CONSULT, ITDS, TELEMEDICINE 4 5 6.966667 $348.3400 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 2 2 2.000000 $50.0000 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 256 315 602.930500 $30146.3900 $50.0000
CONOF -CONOFGT CONSULT, OT, TELEMEDICINE 2 2 6.066666 $303.3300 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 4 5 10.033332 $250.8300 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 15 17 38.882647 $1944.1300 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 3 4 8.166666 $204.1700 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 401 505 1054.177737 $52708.6800 $50.0000
CONSF -CONSFGT CONSULT, SLP, TELEMEDICINE 1 1 1.566667 $78.3400 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 7 9 17.033333 $425.8300 $25.0000
EIIF -96154 HEALTH AND BEHAVIOR INTERVENTION 3 4 32.571428 $1628.5700 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 113 142 1080.269845 $58334.5400 $54.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 10 13 103.009524 $5562.5200 $54.0000
INTR -T1013 INTERPRETER 18 27 111.579648 $5578.9800 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 322 710 3402.990455 $40835.8600 $12.0000
OCCT -97530 OT SESSION BY LICENSED OT 22 25 216.136506 $17576.2200 $81.3200
PHY -97110 PT SESSION BY LICENSED PT 10 11 90.857142 $7388.5100 $81.3200
PHY -97110HM PT SESSION BY PT ASST 1 1 3.285714 $213.9600 $65.1200
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 19 20 151.345650 $12307.4200 $81.3200
TRAV -TRAVS Travel by mile 314 739 178846.638085 $79586.7500 $0.4500
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Subtotal (Total Children Is Unduplicated) 519 3258 187135.851996 $641204.8300 $3.4300
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Total 3444 187366.203533 $656064.3900 $3.5000
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Number of Children (Unduplicated) With at Least One Authorization 543