Mystery theater: Why is wheelchair utilization down?

Provider Rick Perrotta says his wheelchair business is down about 30% for the first four months of this year compared to last year, but he's not sure why.

"The way our  business is set up, our monthly revenues are very stable," said Perrotta, president of Network Medical Supply in Charlotte, N.C., which specializes in standard power wheelchairs and repairs. "They're going to vary, maybe, 15% above average on a good month and 10% below average on a bad month. But 30%—never."

Perrotta says he hasn't lost any referral sources or patients. And for the past year,  Medicare reimbursement and documetnation requirements have remained relatively constant. Maybe it was the colder-than-usual winter?

"When it's cold, people aren't thinking about wheelchairs," Perrotta said. "But by April, we should have been gangbusters and we weren't."

A look at the  utilization data that HME News obtains each month from CMS through the Freedom of Information Act (FOIA) shows Perrotta may not be alone. Here's a comparison of the number of allowed beneficiaries for standard power wheelchairs (K0823) in January 2009 vs. January 2010 for the four jurisdictions:

Jurisdiction A: 1292 to 1327, up 2.7%

Jurisdiction B: 1818 to 1848, up 1.6%

Jurisdiction C: 5533 to 4730, down 15%

Jurisdiction D: 3234 to 2453, down 24%.

Perrotta's in Jurisdiction C, which means he's not alone but he's probably suffering more than most.

Provider Tim Pederson says "I do sense some softening on the consumer power side."

"I think it has to do with increased scrutiny," said Pederson, CEO of WestMed Rehab in Rapid City, S.D., which provides both standard and complex wheelchairs. "Physicians are being more wary about what they're prescribing. There's some hesitation on their part."

Perrotta says his revenues are up for May and June. They're down about 15% instead of 30%.

"We're still not where we should be," he said. "I'm scratching my head."

Liz Beaulieu