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: 01-01-25 and 03-31-25 Date of Report: 04-06-25 Page: 1
Child has a MEDICAID # Filter: Y
Eligibility Filter: Program Patients
With the filters selected there were 841 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 5.877778 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 8 8 5.877778 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
OCTH -97165 OT EVAL LOW COMPLEXITY 1 1 1.000000 $58.1100 $58.1100
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Subtotal (Total Children Is Unduplicated) 1 1 1.000000 $58.1100 $58.1100
EI Services, Class # 03
CONIF -CONIF CONSULT, ITDS FACE TO FACE 256 360 1053.233334 $52661.6700 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 1 1 6.000000 $150.0000 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 135 181 592.766668 $29638.3400 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 1 1 3.000000 $75.0000 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 75 116 411.733332 $20586.6600 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 119 142 468.666666 $23433.3300 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 11 12 41.800001 $1045.0000 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 12 15 71.104762 $3839.6600 $54.0000
INTR -T1013 INTERPRETER 2 2 10.809524 $540.4800 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 1 1 3.000000 $243.9600 $81.3200
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 1 1 3.533333 $287.3300 $81.3200
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Subtotal (Total Children Is Unduplicated) 282 832 2665.647620 $132501.4400 $49.7100
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Total 841 2672.525398 $132559.5500 $49.6000
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Number of Children (Unduplicated) With at Least One Authorization 287