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
Eligibility Filter: Program Patients
With the filters selected there were 5303 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 52 57 113.707939 $0.0000 $0.0000
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 52 57 113.707939 $0.0000 $0.0000
Screening, Eval, and Assessment, Class # 02
AUD -92626 EVAL OF AUD REHAB STATUS 1 1 1.000000 $61.7100 $61.7100
NUTR -97802 NUTRITIONAL EVAL, INITIAL 41 51 285.431202 $14271.5600 $50.0000
NUTR -97803 NUTRITIONAL EVAL, FOLLOW-UP 16 20 135.933331 $6796.6800 $50.0000
OCTF -97168 OT RE-EVAL EST PLAN CARE 4 5 17.142857 $996.1700 $58.1100
OCTH -97165 OT EVAL LOW COMPLEXITY 14 16 76.571428 $4449.5700 $58.1100
OCTH -97166 OT EVAL MODERATE COMPLEXITY 1 1 10.428571 $606.0100 $58.1100
PSTF -97164 PT RE-EVAL EST PLAN CARE 3 3 24.571428 $1427.8500 $58.1100
PSTH -97161 PT EVAL LOW COMPLEXITY 4 4 3.142857 $182.6300 $58.1100
SPCH -92521 EVAL OF SPEECH FLUENCY 16 22 90.285713 $5246.5100 $58.1100
SPCH -92610 EVAL OF ORAL,PHARYNGEAL SWALLOWING 1 1 18.285714 $1062.5800 $58.1100
SPL -92526 TREATMENT OF SWALLOWING DYSFUNCTION 41 52 678.780949 $39443.9500 $58.1100
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 124 176 1341.574050 $74545.2200 $55.5700
EI Services, Class # 03
ASST -ASST ASSISTIVE TECHNOLOGY 2 2 2.022222 $10111.0000 $4999.9500
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 264 421 600.572448 $30028.6200 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 131 153 173.487725 $4337.1900 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 381 431 475.033472 $23751.6800 $50.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 177 197 232.359521 $11617.9700 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 2 2 1.444444 $36.1100 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 152 174 184.455839 $9222.8000 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 2 2 2.000000 $50.0000 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 225 245 241.452617 $12072.6200 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 3 4 4.011111 $100.2800 $25.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 1787 2314 18638.842899 $1006498.9600 $54.0000
OCCT -97530 OT SESSION BY LICENSED OT 236 300 2473.604157 $201153.7000 $81.3200
OCCT -97530GO OT SESSION BY LICENSED OT 1 1 6.428571 $522.7700 $81.3200
OCCT -97530HM OT SESSION BY OT ASST 23 26 253.285711 $16493.9800 $65.1200
OCCT -97530HMGT OT SESSION BY OT ASST 1 1 13.142857 $855.8700 $65.1200
PHY -97110 PT SESSION BY LICENSED PT 249 330 2994.696158 $243528.9000 $81.3200
PHY -97110HM PT SESSION BY PT ASST 11 14 108.142856 $7042.2700 $65.1200
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 358 450 3860.734171 $313955.2300 $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
SPL -92507TL SPL THERAPY SESSION BY LICENSED SLP 1 1 13.142857 $1068.7800 $81.3200
----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated) 2088 5070 30293.431064 $1893397.6000 $62.5000
-------------------------------------------------------------------------------------------------------------------------------------
Total 5303 31748.713053 $1967942.8100 $61.9800
-------------------------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Authorization 2133