Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Center: 09
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: 10-01-25 and 12-31-25 Date of Report: 01-07-26 Page: 1
Child has a MEDICAID # Filter: Y
Eligibility Filter: Program Patients
With the filters selected there were 2983 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 35 40 78.158732 $0.0000 $0.0000
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Subtotal (Total Children Is Unduplicated) 35 40 78.158732 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
NUTR -97802 NUTRITIONAL EVAL, INITIAL 23 28 154.117460 $7705.8700 $50.0000
NUTR -97803 NUTRITIONAL EVAL, FOLLOW-UP 8 11 82.571427 $4128.5800 $50.0000
OCTF -97168 OT RE-EVAL EST PLAN CARE 3 4 16.142857 $938.0600 $58.1100
OCTH -97165 OT EVAL LOW COMPLEXITY 2 2 7.142857 $415.0700 $58.1100
PSTF -97164 PT RE-EVAL EST PLAN CARE 2 2 14.142857 $821.8400 $58.1100
PSTH -97161 PT EVAL LOW COMPLEXITY 1 1 1.000000 $58.1100 $58.1100
SPCH -92521 EVAL OF SPEECH FLUENCY 4 5 5.000000 $290.5500 $58.1100
SPCH -92610 EVAL OF ORAL,PHARYNGEAL SWALLOWING 1 1 18.285714 $1062.5800 $58.1100
SPL -92526 TREATMENT OF SWALLOWING DYSFUNCTION 12 14 171.142855 $9945.1200 $58.1100
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Subtotal (Total Children Is Unduplicated) 51 68 469.546027 $25365.7900 $54.0200
EI Services, Class # 03
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 156 244 328.947509 $16447.3700 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 80 91 98.663557 $2466.5900 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 220 252 262.637092 $13131.8400 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 98 110 117.771427 $5888.5600 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 2 2 1.444444 $36.1100 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 95 111 124.324418 $6216.2200 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 2 2 2.000000 $50.0000 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 125 137 137.093213 $6854.6500 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 2 2 2.000000 $50.0000 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 1186 1537 12341.799853 $666458.1800 $54.0000
OCCT -97530 OT SESSION BY LICENSED OT 97 122 900.496016 $73228.4700 $81.3200
OCCT -97530HM OT SESSION BY OT ASST 10 12 98.142856 $6391.0800 $65.1200
PHY -97110 PT SESSION BY LICENSED PT 82 103 858.884916 $69844.5800 $81.3200
PHY -97110HM PT SESSION BY PT ASST 6 7 58.571428 $3814.1800 $65.1200
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 113 141 1109.360391 $90213.2900 $81.3200
SPL -92507HM SPL THERAPY SESSION BY SLP ASST 1 1 7.285714 $474.4400 $65.1200
SPL -92507HMGT SPL THERAPY SESSION BY SLP ASST 1 1 7.285714 $474.4400 $65.1200
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Subtotal (Total Children Is Unduplicated) 1269 2875 16456.708548 $962040.0000 $58.4600
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Total 2983 17004.413307 $987405.7900 $58.0700
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Number of Children (Unduplicated) With at Least One Authorization 1299