Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 57
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 4790 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
TCM -T1017TL TARGETED CASE MANAGEMENT 58 59 39.330952 $1463.1100 $37.2000
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Subtotal (Total Children Is Unduplicated) 58 59 39.330952 $1463.1100 $37.2000
Screening, Eval, and Assessment, Class # 02
AUDE -V5010 ASSESSMENT FOR HEARING AID 22 23 23.000000 $1042.3600 $45.3200
OCTF -97168 OT RE-EVAL EST PLAN CARE 40 48 17.983340 $1045.0500 $58.1100
OCTH -97167 OT EVAL HIGH COMPLEXITY 32 32 20.494448 $1190.9500 $58.1100
OCTH -97167GT OT EVAL HIGH COMPLEXITY 1 1 1.000000 $58.1100 $58.1100
PSTF -97164 PT RE-EVAL EST PLAN CARE 24 30 11.694448 $679.5800 $58.1100
PSTH -97163 PT EVAL HIGH COMPLEXITY 15 15 15.883335 $922.9900 $58.1100
PSTH -97163GT PT EVAL HIGH COMPLEXITY 2 2 2.000000 $116.2200 $58.1100
SPCH -92521 EVAL OF SPEECH FLUENCY 43 53 25.505563 $1482.1700 $58.1100
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 1 1 0.116667 $6.7800 $58.1300
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Subtotal (Total Children Is Unduplicated) 116 205 117.677801 $6544.2200 $55.6100
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 1 1 0.155556 $7.7800 $50.0100
CONOF -CONOF CONSULT, OT, FACE TO FACE 544 620 712.878537 $35643.7500 $50.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 49 57 111.176193 $5558.8100 $50.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 879 1005 843.280104 $42163.7500 $50.0000
CONSF -CONSFGT CONSULT, SLP, TELEMEDICINE 1 1 0.422222 $21.1100 $50.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 112 235 1157.071431 $31240.9200 $27.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 1553 1935 18535.684919 $1000927.0100 $54.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 1 1 9.142857 $493.7200 $54.0000
OCCT -97530 OT SESSION BY LICENSED OT 124 245 778.928568 $63342.4700 $81.3200
OCCT -97530HM OT SESSION BY OT ASST 2 2 17.285714 $1125.6400 $65.1200
OCCT -97530HMGT OT SESSION BY OT ASST 1 1 3.071429 $200.0100 $65.1200
PHY -97110 PT SESSION BY LICENSED PT 78 150 457.857140 $37232.9500 $81.3200
PHY -97110HM PT SESSION BY PT ASST 1 2 26.000000 $1693.1200 $65.1200
SENS -V5264 EARMOLD 1 1 1.000000 $18.1300 $18.1300
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 114 229 603.923807 $49111.0700 $81.3200
TRAV -TRAVS Travel by mile 33 41 323.598412 $144.0000 $0.4400
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Subtotal (Total Children Is Unduplicated) 1664 4526 23581.476889 $1268924.2500 $53.8100
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Total 4790 23738.485642 $1276931.5800 $53.7900
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Number of Children (Unduplicated) With at Least One Authorization 1700