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: 10-01-24 and 12-31-24 Date of Report: 03-31-25 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 1320 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 163 174 125.374594 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 163 174 125.374594 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 21 26 25.022222 $1213.5800 $48.5000
AUDE -92579 VISUAL REINFORCEMENT AUDIOMETRY 2 2 0.246575 $7.8400 $31.8100
OCTH -97165 OT EVAL LOW COMPLEXITY 2 3 1.400000 $81.3500 $58.1100
OCTH -97167 OT EVAL HIGH COMPLEXITY 18 23 13.400001 $778.6800 $58.1100
PSTH -97163 PT EVAL HIGH COMPLEXITY 20 23 16.283332 $946.2200 $58.1100
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 34 41 35.259523 $2048.9300 $58.1100
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Subtotal (Total Children Is Unduplicated) 79 118 91.611653 $5076.6000 $55.4100
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 10 12 10.194445 $50972.5000 $5000.0300
CONIF -CONIF CONSULT, ITDS FACE TO FACE 24 25 36.755557 $1837.7900 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 119 145 224.079373 $11204.0100 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 84 96 160.877779 $8043.9000 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 154 186 299.111112 $14955.5600 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 291 427 2325.319021 $125567.3100 $54.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 1 2 13.142857 $709.7200 $54.0000
OCCT -97530 OT SESSION BY LICENSED OT 26 35 227.842854 $18528.2100 $81.3200
PHY -97110 PT SESSION BY LICENSED PT 34 38 174.723809 $14208.5600 $81.3200
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 49 62 291.561901 $23709.8100 $81.3200
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Subtotal (Total Children Is Unduplicated) 559 1028 3763.608708 $269737.3600 $71.6700
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Total 1320 3980.594955 $274813.9600 $69.0400
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Number of Children (Unduplicated) With at Least One Authorization 713