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: 04-01-25 and 06-30-25 Date of Report: 07-19-25 Page: 1
Child has a MEDICAID # Filter: Y
Eligibility Filter: Program Patients
With the filters selected there were 892 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 15 15 10.833333 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 15 15 10.833333 $0.0000 $0.0000
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 2 2 4.133333 $206.6700 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 265 373 1136.549992 $56827.4600 $50.0000
CONIF -CONIFGT CONSULT, ITDS, TELEMEDICINE 1 1 1.000000 $50.0000 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 1 1 1.400000 $35.0000 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 149 187 671.033329 $33551.6500 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 1 2 3.033333 $75.8300 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 81 112 452.999992 $22649.9600 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 126 160 493.299996 $24664.9800 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 10 11 41.266666 $1031.6700 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 15 21 95.404761 $5151.8600 $54.0000
INTR -T1013 INTERPRETER 4 4 45.066667 $2253.3400 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 2 2 2.557143 $207.9400 $81.3200
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 1 1 13.000000 $1057.1600 $81.3200
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Subtotal (Total Children Is Unduplicated) 291 877 2960.745212 $147763.5100 $49.9100
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Total 892 2971.578545 $147763.5100 $49.7300
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Number of Children (Unduplicated) With at Least One Authorization 304