Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period Statewide
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 72644 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 897 1001 5255.376965 $0.0000 $0.0000
SCTT -SCTT SERVICE COORDINATOR TRAVEL 2 2 10.355555 $0.0000 $0.0000
TCM -T1017TL TARGETED CASE MANAGEMENT 190 206 46381.423012 $2118703.3900 $45.6800
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Subtotal (Total Children Is Unduplicated) 1088 1209 51647.155532 $2118703.3900 $41.0200
Screening, Eval, and Assessment, Class # 02
AACIS -92597 AAC INTIAL EVAL BY LICENSED SLP 11 12 11.544444 $1348.7300 $116.8300
AACIS -92597TL AAC INTIAL EVAL BY LICENSED SLP 2 2 2.000000 $233.6600 $116.8300
ASTE -ASTE ASSISTIVE TECHNOLOGY EVAL 281 336 276.509298 $13410.7200 $48.5000
AUD -92626 EVAL OF AUD REHAB STATUS 169 186 281.055662 $17343.9300 $61.7100
AUDE -92550 TYMPANOMETRY & REFLEX THRESH 156 164 240.061903 $3646.5400 $15.1900
AUDE -92552 PURE TONE AUDIOMETRY -AIR ONLY 1193 1253 1233.714543 $26475.5000 $21.4600
AUDE -92553 PURE TONE AUDIOMETRY AIR & BONE 7 9 7.266667 $189.2200 $26.0400
AUDE -92555 SPEECH AUD THRESHOLD (DETECTION) 1145 1196 1199.718810 $19375.4600 $16.1500
AUDE -92557 COMP AUDIO THRESHOLD EVAL/SPCH RECO 192 203 178.926651 $4344.3200 $24.2800
AUDE -92558 OTOACOUSTIC EMISSIONS (SCREENING) 33 33 33.000000 $226.7100 $6.8700
AUDE -92567 TYPMANOMETRY (IMPEDANCE TESTING) 1110 1157 1161.181214 $9196.5600 $7.9200
AUDE -92568 ACOUSTIC REFLEX TESTING (MEMR) 37 37 36.094444 $392.7100 $10.8800
AUDE -92579 VISUAL REINFORCEMENT AUDIOMETRY 1119 1167 1190.948184 $37884.0600 $31.8100
AUDE -92582 CONDITIONED PLAY AUDIOMETRY 4 6 3.300000 $163.6500 $49.5900
AUDE -92587 OTOACOUSTIC EMISSIONS (LIMITED) 127 136 98.511107 $1496.3800 $15.1900
AUDE -92588 OTOACOUSTIC EMISSIONS (COMP) 1203 1257 1252.147879 $28974.6900 $23.1400
AUDE -92650 AEP SCR AUDITORY POTENTIAL 2 2 -0.844444 $-46.3600 $54.9000
AUDE -92651 AEP HEARING STATUS DETER I&R 3 3 9.203175 $720.1500 $78.2500
AUDE -92652 AEP THRSHLD EST MLT FREQ I&R 3 4 3.155555 $256.3500 $81.2400
AUDE -V5010 ASSESSMENT FOR HEARING AID 78 87 78.872384 $3574.5000 $45.3200
AUDE -V5090 DISPENSING FEE PER HEARING AID 45 51 50.736074 $5875.7500 $115.8100
EXIT -EXIT COS Exit 406 417 386.916221 $19345.8100 $50.0000
IPDEF -IPDEF FOLLOW-UP PSYCH AND DEV EVAL 30 38 63.603273 $4770.2500 $75.0000
IPDEF -T1024GNTS F/U PSYCH AND DEV EVAL BY SPAT 69 71 112.750761 $9130.5400 $80.9800
IPDEF -T1024GNTSGT F/U PHYC AND DEV EVAL BY SPAT 27 27 41.668341 $3374.3200 $80.9800
IPDEF -T1024GOTS F/U PSYCH AND DEV EVAL BY OT 13 13 23.011111 $1863.4400 $80.9800
IPDEF -T1024GOTSGT F/U PHYC AND DEV EVAL BY OT 4 4 8.000000 $647.8400 $80.9800
IPDEF -T1024GPTS F/U PSYCH AND DEV EVAL BY PT 11 11 17.022222 $1378.4600 $80.9800
IPDEF -T1024GPTSGT F/U PHYC AND DEV EVAL BY PT 2 2 1.504110 $121.8000 $80.9800
IPDEF -T1024TS F/U PSYCH AND DEV EVAL BY ITDS 62 63 112.249913 $6726.0100 $59.9200
IPDEF -T1024TSGT F/U PHYC AND DEV EVAL BY ITDS 33 33 45.822527 $2745.6800 $59.9200
IPDEF -T1024TSTL F/U PSYCH AND DEV EVAL BY EI PROF 31 43 78.021916 $6318.2200 $80.9800
IPDEF -T1024TSTLGT F/U PHYC AND DEV EVAL BY EI PROF 2 3 6.000000 $485.8800 $80.9800
IPDEI -T1024GNUK INITIAL PSYCH AND DEV EVAL BY SPAT 596 618 1192.109580 $96537.0700 $80.9800
IPDEI -T1024GNUKGT INITIAL PSYCH AND DEV EVAL BY SPAT 119 124 267.785714 $21685.2900 $80.9800
IPDEI -T1024GOUK INITIAL PSYCH AND DEV EVAL BY OT 216 218 434.000000 $35145.3200 $80.9800
IPDEI -T1024GOUKGT INITIAL PSYCH AND DEV EVAL BY OT 73 73 145.000000 $11742.1000 $80.9800
IPDEI -T1024GPUK INITIAL PSYCH AND DEV EVAL BY PT 207 208 411.566667 $33328.6700 $80.9800
IPDEI -T1024GPUKGT INITIAL PSYCH AND DEV EVAL BY PT 32 33 63.500000 $5142.2300 $80.9800
IPDEI -T1024HNUK INITIAL PSYCH AND DEV EVAL BY ITDS 628 668 1330.044347 $79696.2900 $59.9200
IPDEI -T1024HNUKGT INITIAL PSYCH AND DEV EVAL BY ITDS 342 368 723.005479 $43322.4900 $59.9200
IPDEI -T1024TL INITIAL PSYCH AND DEV EVAL BY EI PR 394 471 936.510958 $75838.6600 $80.9800
IPDEI -T1024TLGT INITIAL PSYCH AND DEV EVAL BY EI PR 150 202 421.005479 $34093.0300 $80.9800
NUTR -97802 NUTRITIONAL EVAL, INITIAL 64 81 340.566124 $17028.3100 $50.0000
NUTR -97803 NUTRITIONAL EVAL, FOLLOW-UP 16 20 135.933331 $6796.6800 $50.0000
OCTF -97168 OT RE-EVAL EST PLAN CARE 162 201 116.660660 $6779.1200 $58.1100
OCTF -97168GT OT RE-EVAL EST PLAN CARE 4 5 10.984127 $638.2900 $58.1100
OCTH -97165 OT EVAL LOW COMPLEXITY 317 357 356.575480 $20720.5800 $58.1100
OCTH -97165GT OT EVAL LOW COMPLEXITY 13 13 9.161112 $532.3600 $58.1100
OCTH -97165TL OT EVAL LOW COMPLEXITY 1 1 0.266667 $15.5000 $58.1200
OCTH -97165TLGT OT EVAL LOW COMPLEXITY 1 1 1.000000 $58.1100 $58.1100
OCTH -97166 OT EVAL MODERATE COMPLEXITY 111 120 110.753633 $6435.9200 $58.1100
OCTH -97166GT OT EVAL MODERATE COMPLEXITY 11 13 8.607610 $500.1900 $58.1100
OCTH -97166TL OT EVAL MODERATE COMPLEXITY 4 4 1.313167 $76.3200 $58.1200
OCTH -97166TLGT OT EVAL MODERATE COMPLEXITY 1 1 0.461111 $26.7900 $58.1100
OCTH -97167 OT EVAL HIGH COMPLEXITY 219 271 181.029597 $10519.5900 $58.1100
OCTH -97167GT OT EVAL HIGH COMPLEXITY 9 10 6.894444 $400.6300 $58.1100
OCTH -97167TL OT EVAL HIGH COMPLEXITY 89 100 37.466659 $2177.1400 $58.1100
OCTH -97167TLGT OT EVAL HIGH COMPLEXITY 4 4 2.838889 $164.9700 $58.1100
PSTF -97164 PT RE-EVAL EST PLAN CARE 96 110 78.342049 $4552.4500 $58.1100
PSTF -97164GT PT RE-EVAL EST PLAN CARE 6 7 3.838889 $223.0800 $58.1100
PSTH -97161 PT EVAL LOW COMPLEXITY 205 232 203.844158 $11845.3700 $58.1100
PSTH -97161GT PT EVAL LOW COMPLEXITY 3 3 3.000000 $174.3300 $58.1100
PSTH -97161TL PT EVAL LOW COMPLEXITY 3 3 2.100000 $122.0300 $58.1100
PSTH -97162 PT EVAL MODERATE COMPLEXITY 50 55 40.728181 $2366.7300 $58.1100
PSTH -97162GT PT EVAL MODERATE COMPLEXITY 7 9 4.977777 $289.2500 $58.1100
PSTH -97162TL PT EVAL MODERATE COMPLEXITY 3 4 1.650000 $95.8800 $58.1100
PSTH -97163 PT EVAL HIGH COMPLEXITY 150 178 105.172218 $6111.5300 $58.1100
PSTH -97163GT PT EVAL HIGH COMPLEXITY 9 10 7.288888 $423.5500 $58.1100
PSTH -97163TL PT EVAL HIGH COMPLEXITY 100 109 42.199996 $2452.2200 $58.1100
SCREEN-T1023 SCREENING 43 45 50.593651 $2731.0400 $53.9800
SENS -V5014TS HEARING AID REPAIR IN-OFFICE 5 6 3.655555 $55.2300 $15.1100
SPCH -92521 EVAL OF SPEECH FLUENCY 442 489 525.169432 $30517.5800 $58.1100
SPCH -92521GT EVAL OF SPEECH FLUENCY 23 26 13.127778 $762.8600 $58.1100
SPCH -92521TL EVAL OF SPEECH FLUENCY 110 126 64.720635 $3760.9200 $58.1100
SPCH -92521TLGT EVAL OF SPEECH FLUENCY 2 2 12.205556 $709.2700 $58.1100
SPCH -92522 EVAL OF SPCH SOUND PROD 24 27 21.014916 $1221.1800 $58.1100
SPCH -92522GT EVAL OF SPCH SOUND PROD 5 6 3.863166 $224.4900 $58.1100
SPCH -92522TL EVAL OF SPCH SOUND PROD 5 5 2.031887 $118.0700 $58.1100
SPCH -92522TLGT EVAL OF SPCH SOUND PROD 1 1 0.511111 $29.7000 $58.1100
SPCH -92523 EVAL OF SPCH SOUND PROD; EVAL LANG 536 612 437.303715 $25411.6600 $58.1100
SPCH -92523GT EVAL OF SPCH SOUND PROD; EVAL LANG 9 10 6.194444 $359.9600 $58.1100
SPCH -92523TL EVAL OF SPCH SOUND PROD; EVAL LANG 9 9 7.877777 $457.7700 $58.1100
SPCH -92523TLGT EVAL OF SPCH SOUND PROD; EVAL LANG 1 1 0.483333 $28.0800 $58.1100
SPCH -92610 EVAL OF ORAL,PHARYNGEAL SWALLOWING 59 65 65.173688 $3787.2300 $58.1100
SPCH -92610GT EVAL OF ORAL,PHARYNGEAL SWALLOWING 1 1 0.427778 $24.8600 $58.1100
SPCH -92610TL EVAL OF ORAL,PHARYNGEAL SWALLOWING 17 19 11.005555 $639.5300 $58.1100
SPCH -92610TLGT EVAL OF ORAL,PHARYNGEAL SWALLOWING 2 2 2.000000 $116.2200 $58.1100
SPL -92526 TREATMENT OF SWALLOWING DYSFUNCTION 215 254 2492.250774 $144824.7600 $58.1100
SPL -92526TL TREATMENT OF SWALLOWING DYSFUNCTION 29 33 281.931746 $16383.0500 $58.1100
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Subtotal (Total Children Is Unduplicated) 6321 14670 19983.399433 $1002212.9700 $50.1500
EI Services, Class # 03
AACFIT-92609 AAC FITTING, ADJUST, TRAINING VISIT 15 16 17.266666 $827.7600 $47.9400
AACFIT-92609TL AAC FITTING, ADJUST, TRAINING VISIT 1 1 0.333333 $15.9800 $47.9400
ASST -ASST ASSISTIVE TECHNOLOGY 306 372 512.192997 $2560969.5000 $5000.0100
AUD -92630 AUD REHAB PRELING HEARING LOSS 68 95 168.899678 $11713.2300 $69.3500
AUD -92633 AUD REHAB POSTLING HEARING LOSS 6 7 3.216666 $223.0700 $69.3500
AUDE -V5160 DISPENSING FEE BINAURAL 60 68 75.133941 $17402.4900 $231.6200
COIFF -COIFF IFSP CONSULT, PROF, FACE TO FACE 1424 1854 2006.455817 $100322.8200 $50.0000
COIFF -COIFFGT IFSP CONSULT, PROF, TELEMEDICINE 281 319 300.433476 $15021.6300 $50.0000
COIFP -COIFP IFSP CONSULT, PROF, BY PHONE 221 248 274.169397 $6854.2400 $25.0000
CONIF -CONIF CONSULT, ITDS FACE TO FACE 3541 4564 9388.726451 $469436.9400 $50.0000
CONIF -CONIFGT CONSULT, ITDS, TELEMEDICINE 267 333 677.066683 $33853.3800 $50.0000
CONIP -CONIP CONSULT, ITDS PHONE 281 329 437.002373 $10925.0400 $25.0000
CONOF -CONOF CONSULT, OT, FACE TO FACE 1816 2349 4693.806450 $234690.5600 $50.0000
CONOF -CONOFGT CONSULT, OT, TELEMEDICINE 177 205 345.300802 $17265.0900 $50.0000
CONOP -CONOP CONSULT, OT, PHONE 101 188 276.925395 $6923.1300 $25.0000
CONPF -CONPF CONSULT, PT, FACE TO FACE 1049 1386 2802.914079 $140145.8500 $50.0000
CONPF -CONPFGT CONSULT, PT, TELEMEDICINE 154 195 345.528215 $17276.4500 $50.0000
CONPP -CONPP CONSULT, PT, PHONE 48 84 102.395242 $2559.8900 $25.0000
CONSF -CONSF CONSULT, SLP, FACE TO FACE 2580 3050 5326.158235 $266308.1700 $50.0000
CONSF -CONSFGT CONSULT, SLP, TELEMEDICINE 234 273 452.545674 $22627.3300 $50.0000
CONSP -CONSP CONSULT, SLP, PHONE 300 351 543.481802 $13587.0500 $25.0000
EIGF -EIGF_NM EI GROUP SESSION BY NONMED PROF 5 6 161.714286 $4042.8600 $25.0000
EIGF -T1027TTSC EI GROUP SESSION BY EI PROF 340 409 3383.357112 $91350.8300 $27.0000
EIIF -EIIF_NM EI INDIVIDUAL SESSION BY NONMED PRO 10 15 70.423809 $3521.2000 $50.0000
EIIF -T1027SC EI INDIVIDUAL SESSION BY EI PROF 14868 18709 152467.641408 $8233262.4000 $54.0000
EIIF -T1027SCGT EI INDIVIDUAL SESSION BY EI PROF 761 925 6865.176925 $370720.0500 $54.0000
INTR -T1013 INTERPRETER 374 539 1867.366658 $93368.3700 $50.0000
NESF -99600 NATURAL ENVIRONMENT SUPPORT FEE 4413 6251 49132.258557 $589587.8200 $12.0000
OCCT -97530 OT SESSION BY LICENSED OT 1771 2209 15372.956505 $1250129.8800 $81.3200
OCCT -97530GO OT SESSION BY LICENSED OT 56 62 282.653966 $22985.4300 $81.3200
OCCT -97530GOGT OT SESSION BY LICENSED OT 20 21 78.825399 $6410.0800 $81.3200
OCCT -97530GT OT SESSION BY LICENSED OT 10 11 79.142857 $6435.9000 $81.3200
OCCT -97530HM OT SESSION BY OT ASST 250 312 2638.607129 $171826.2400 $65.1200
OCCT -97530HMGT OT SESSION BY OT ASST 9 13 92.676189 $6035.0800 $65.1200
OCCT -97530TL OT SESSION BY LICENSED OT 259 309 1860.403955 $151288.2500 $81.3200
OCCT -97530TLGO OT SESSION BY LICENSED OT 88 101 439.447617 $35735.8900 $81.3200
OCCT -97530TLGOGT OT SESSION BY LICENSED OT 1 1 0.388889 $31.6300 $81.3200
OCCT -97530TLGT OT SESSION BY LICENSED OT 2 2 0.165873 $13.4800 $81.2800
OCCT -97530TLGTHM OT SESSION BY OT ASST 4 4 36.428571 $2372.2400 $65.1200
OCCT -97530TLHM OT SESSION BY OT ASST 18 27 67.781745 $4413.9600 $65.1200
PHY -97110 PT SESSION BY LICENSED PT 1776 2247 15650.950148 $1272736.2600 $81.3200
PHY -97110GP PT SESSION BY LICENSED PT 38 46 287.257143 $23359.7900 $81.3200
PHY -97110GPGT PT SESSION BY LICENSED PT 19 24 190.114286 $15460.1100 $81.3200
PHY -97110GT PT SESSION BY LICENSED PT 26 29 162.839681 $13242.1400 $81.3200
PHY -97110HM PT SESSION BY PT ASST 124 155 1289.759516 $83989.1600 $65.1200
PHY -97110HMGT PT SESSION BY PT ASST 5 8 56.000000 $3646.7100 $65.1200
PHY -97110TL PT SESSION BY LICENSED PT 258 303 1850.203172 $150458.6400 $81.3200
PHY -97110TLGP PT SESSION BY LICENSED PT 4 5 34.142858 $2776.4900 $81.3200
PHY -97110TLGT PT SESSION BY LICENSED PT 4 5 29.969841 $2437.1500 $81.3200
RSPT -RSPT RESPITE 1 1 13.142857 $0.0000 $0.0000
SENS -V5014 *HEARING AID REPAIR BY MANUFACTURER 2 2 3.000000 $344.4300 $114.8100
SENS -V5050 IN EAR MONAURAL HEARING AID 8 9 11.133333 $2556.3200 $229.6100
SENS -V5060 BEHIND EAR HEARING AID 34 42 48.711416 $11184.6200 $229.6100
SENS -V5140 BEHIND EAR BINAURAL HEARING AID 9 11 12.266667 $5633.1100 $459.2200
SENS -V5261 BEHIND EAR DIGITAL BINAURAL HEARING 8 9 14.252055 $13977.6000 $980.7400
SENS -V5264 EARMOLD 98 129 275.774494 $4999.7900 $18.1300
SPL -92507 SPL THERAPY SESSION BY LICENSED SLP 2721 3374 23394.341245 $1902429.3300 $81.3200
SPL -92507GT SPL THERAPY SESSION BY LICENSED SLP 98 112 831.111106 $67586.0400 $81.3200
SPL -92507HM SPL THERAPY SESSION BY SLP ASST 37 42 338.285716 $22029.1600 $65.1200
SPL -92507HMGT SPL THERAPY SESSION BY SLP ASST 6 6 56.071429 $3651.3700 $65.1200
SPL -92507TL SPL THERAPY SESSION BY LICENSED SLP 378 443 2231.276975 $181447.5600 $81.3200
SPL -92507TLGT SPL THERAPY SESSION BY LICENSED SLP 16 20 52.460318 $4266.0800 $81.3200
SPL -92507TLGTHM SPL THERAPY SESSION BY SLP ASST 1 1 3.285714 $213.9600 $65.1200
SPL -92508HA GROUP SPL SESSION PER CHILD 4 4 25.285713 $398.5000 $15.7600
TRAN -TRAN *FAMILY TRANSPORTATION 2 2 16.209524 $1620.9600 $100.0000
TRAV -TRAVS Travel by mile 2236 3523 26649.873865 $11859.2000 $0.4500
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Subtotal (Total Children Is Unduplicated) 19360 56765 337175.089894 $18794785.6700 $55.7400
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Total 72644 408805.644859 $21915702.0300 $53.6100
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Number of Children (Unduplicated) With at Least One Authorization 20862