Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 52
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
Child has a MEDICAID # Filter: Y
Eligibility Filter: Program Patients
With the filters selected there were 926 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 8 8 7.088888 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 8 8 7.088888 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
PSTH -97162 PT EVAL MODERATE COMPLEXITY 1 1 1.000000 $58.1100 $58.1100
SCREEN-T1023 SCREENING 3 3 3.000000 $161.9400 $53.9800
SPCH -92521 EVAL OF SPEECH FLUENCY 1 1 1.000000 $58.1100 $58.1100
SPL -92526 TREATMENT OF SWALLOWING DYSFUNCTION 1 1 9.857143 $572.8000 $58.1100
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Subtotal (Total Children Is Unduplicated) 6 6 14.857143 $850.9600 $57.2800
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 2 2 8.133333 $406.6700 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 267 389 1264.516676 $63225.8800 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 173 208 760.600002 $38030.0100 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 82 123 509.733340 $25486.7000 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 128 154 504.533338 $25226.6900 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 3 4 4.500001 $112.5000 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 15 22 96.285715 $5199.4400 $54.0000
OCCT -97530 OT SESSION BY LICENSED OT 4 5 30.180953 $2454.3100 $81.3200
PHY -97110 PT SESSION BY LICENSED PT 1 1 0.066667 $5.4200 $81.3600
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 1 2 6.133334 $498.7700 $81.3200
SPL -92507GT SPL THERAPY SESSION BY LICENSED SLP 1 2 12.542857 $1019.9900 $81.3200
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Subtotal (Total Children Is Unduplicated) 310 912 3197.226216 $161666.3800 $50.5600
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Total 926 3219.172247 $162517.3300 $50.4800
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Number of Children (Unduplicated) With at Least One Authorization 318