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: 07-01-24 and 09-30-24 Date of Report: 04-06-25 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 1345 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 163 181 126.417445 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 163 181 126.417445 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 21 25 22.622222 $1097.1800 $48.5000
OCTH -97165 OT EVAL LOW COMPLEXITY 3 5 3.511111 $204.0300 $58.1100
OCTH -97167 OT EVAL HIGH COMPLEXITY 19 25 14.177778 $823.8700 $58.1100
PSTH -97163 PT EVAL HIGH COMPLEXITY 19 23 17.933333 $1042.1000 $58.1100
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 28 31 32.531746 $1890.4200 $58.1100
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Subtotal (Total Children Is Unduplicated) 74 109 90.776190 $5057.6100 $55.7200
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 9 9 8.533333 $42666.5000 $4999.9800
CONIF -CONIF CONSULT, ITDS FACE TO FACE 24 28 37.633335 $1881.6800 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 109 136 206.258734 $10312.9700 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 92 121 147.938887 $7396.9400 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 162 207 272.983344 $13649.2200 $50.0000
EIIF -EIIF_NM EI INDIVIDUAL SESSION BY NONMED PRO 1 1 3.266667 $163.3400 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 279 409 2158.709514 $116570.4000 $54.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 1 1 13.142857 $709.7200 $54.0000
OCCT -97530 OT SESSION BY LICENSED OT 31 42 186.709523 $15183.2300 $81.3200
PHY -97110 PT SESSION BY LICENSED PT 36 43 176.819046 $14378.9200 $81.3200
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 52 58 238.180950 $19368.8900 $81.3200
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Subtotal (Total Children Is Unduplicated) 557 1055 3450.176190 $242281.7900 $70.2200
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Total 1345 3667.369825 $247339.3900 $67.4400
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Number of Children (Unduplicated) With at Least One Authorization 711