Could indie ATPs be the answer?

BELLE VERNON, Pa. - Beginning April 1, 2008, the rehab industry's going to need a lot more Chris Chovans. That's when CMS will require that an ATP evaluate beneficiaries for certain power mobility devices. It's not quite that clear-cut, though: The ATP can't work for manufacturers or providers, and he must specialize in wheelchair evaluations. Chovan works for himself--he owns Rehab Mobility Specialists in Belle Vernon, Pa.--and he's an OT/ATP whose bread and butter is evaluating patients for wheelchairs. But right now, therapists like Chovan are an anomaly. "When you're doing a wheelchair evaluation, it's very time consuming and labor intensive for what you get reimbursed," he said. "Most therapists treat multiple patients at a time, and the facilities they work for get reimbursed for their time many times over." Medicare reimburses anywhere from $70 to $80 for a standard wheelchair evaluation that takes a couple of hours, Chovan said. In more complicated cases--for a patient that requires a wheelchair with specialty controls, for example--the agency reimburses more. The rate varies from state to state, but in Pennsylvania, Medicare reimburses $27 per 15-minute increment, meaning it would reimburse $648 for a six-hour evaluation. Unlike therapists working for hospitals and clinics, the reimbursement works for Chovan because he has little overhead. He conducts in-home evaluations and uses special software to streamline billing. "For some of the larger organizations, they're choosing not to do wheelchair evaluations, because, for the time it requires and the rate you get reimbursed, it's not worth it," he said. Still, Chovan may not be an anomaly for long. He receives several calls a week from therapists across the country who have left organizations because they're interested in doing what he's doing. "There is a way to get adequately reimbursed for this," Chovan said. "It just comes down to a business decision."