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
Eligibility Filter: Program Patients
With the filters selected there were 1519 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 19 20 13.700000 $0.0000 $0.0000
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 19 20 13.700000 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
OCTH -97166 OT EVAL MODERATE COMPLEXITY 1 1 1.000000 $58.1100 $58.1100
PSTH -97161 PT EVAL LOW COMPLEXITY 1 1 1.000000 $58.1100 $58.1100
SCREEN-T1023 SCREENING 3 3 3.000000 $161.9400 $53.9800
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 1 1 1.000000 $58.1100 $58.1100
SPL -92526 TREATMENT OF SWALLOWING DYSFUNCTION 1 1 3.133333 $182.0800 $58.1100
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 7 7 9.133333 $518.3500 $56.7500
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 3 3 7.166666 $358.3300 $50.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 418 593 1759.716650 $87985.7500 $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 244 305 1074.299991 $53714.9600 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 1 2 3.033333 $75.8300 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 142 194 768.533323 $38426.6200 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 234 292 867.599992 $43379.9600 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 16 18 64.533332 $1613.3300 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 46 57 284.319046 $15353.2400 $54.0000
INTR -T1013 INTERPRETER 4 4 45.066667 $2253.3400 $50.0000
OCCT -97530 OT SESSION BY LICENSED OT 5 5 17.571429 $1428.9100 $81.3200
OCCT -97530HM OT SESSION BY OT ASST 2 2 7.209524 $469.4900 $65.1200
PHY -97110 PT SESSION BY LICENSED PT 5 5 27.850000 $2264.7600 $81.3200
PHY -97110GT PT SESSION BY LICENSED PT 2 2 9.100000 $740.0100 $81.3200
PHY -97110HM PT SESSION BY PT ASST 2 2 12.133334 $790.1300 $65.1200
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 5 5 27.533334 $2239.0200 $81.3200
SPL -92507GT SPL THERAPY SESSION BY LICENSED SLP 1 1 0.933333 $75.9000 $81.3200
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 499 1492 4978.999954 $251254.5500 $50.4600
-------------------------------------------------------------------------------------------------------------------------------------
Total 1519 5001.833287 $251772.9000 $50.3400
-------------------------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Authorization 518