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: 01-01-25 and 03-31-25 Date of Report: 04-06-25 Page: 1
Eligibility Filter: Program Patients
With the filters selected there were 1239 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 147 159 112.388888 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 147 159 112.388888 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 16 23 19.238888 $933.0800 $48.5000
AUDE -92579 VISUAL REINFORCEMENT AUDIOMETRY 2 2 0.493150 $15.6900 $31.8100
OCTH -97167 OT EVAL HIGH COMPLEXITY 18 23 14.055555 $816.7700 $58.1100
PSTH -97163 PT EVAL HIGH COMPLEXITY 20 25 15.322223 $890.3800 $58.1100
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 30 35 19.761108 $1148.3000 $58.1100
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Subtotal (Total Children Is Unduplicated) 71 108 68.870924 $3804.2100 $55.2400
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 9 11 11.000000 $55000.0000 $5000.0000
AUDE -V5160 DISPENSING FEE BINAURAL 1 1 0.189041 $43.7800 $231.5700
CONIF -CONIF CONSULT, ITDS FACE TO FACE 23 24 48.660319 $2433.0200 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 132 163 223.811117 $11190.5900 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 69 86 121.401589 $6070.0900 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 134 162 240.796825 $12039.8400 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 283 403 2193.504776 $118449.1900 $54.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 1 1 1.285714 $69.4300 $54.0000
OCCT -97530 OT SESSION BY LICENSED OT 27 33 208.614287 $16964.5100 $81.3200
PHY -97110 PT SESSION BY LICENSED PT 28 36 166.700001 $13556.0300 $81.3200
SENS -V5261 BEHIND EAR DIGITAL BINAURAL HEARING 1 1 0.189041 $185.3600 $980.5300
SENS -V5264 EARMOLD 1 1 0.567123 $10.2800 $18.1300
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 38 50 234.280954 $19051.7000 $81.3200
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Subtotal (Total Children Is Unduplicated) 534 972 3451.000787 $255063.8100 $73.9100
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Total 1239 3632.260599 $258868.0200 $71.2700
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Number of Children (Unduplicated) With at Least One Authorization 667