Hippotherapy

Description:

HIPPOTHERAPY (HPOT): The term hippotherapy refers to how occupational therapy, physical therapy and speech-language pathology professionals use evidence-based practice and clinical reasoning in the purposeful manipulation of equine movement as a therapy tool to engage sensory, neuromotor and cognitive systems to promote functional outcomes.

Best practice dictates that occupational therapy, physical therapy and speech-language pathology professionals integrate hippotherapy into the patient’s plan of care, along with other therapy tools and/or       
strategies.

Hippotherapy exists within a medical model of treatment, in which the equine movement is a treatment tool/strategy applied by the therapist.

IDENTIFICATION OF HIPPOTHERAPY IN REIMBURSEMENT:
The American Medical Association CPT Coding Manual (Current Procedural Terminology, 2018) guides the medical billing process. All tools/strategies, such as Hippotherapy, that are used by therapists are part of their clinical protocols and fall under the designation of Therapeutic Procedures within the HCPCS Level I CPT coding system. Elements of equine interaction, equine movement, or the equine environment can be considered treatment tools and/or treatment strategies and may be utilized within an overall treatment plan. Tools/strategies do not have their own CPT billing codes.

TREATMENT TOOL – An object or element that can be manipulated to achieve specific goals.

TREATMENT STRATEGY – A plan of action or technique, selected by a therapist based on specific principles. Strategies and/or treatment techniques may be learned in professional education programs or may be sought out by the healthcare professional as continuing education or by mentorship as advanced practice.

THERAPEUTIC PROCEDURE – A manner of effecting change through the
application of clinical skills and/or services by a physician or other
qualified healthcare professional (i.e. licensed therapist).11 Therapeutic
procedures are used to diagnose, treat, or restore function and include
physical rehabilitation procedures. Such procedures are billed for using
existing Current Procedural Terminology (CPT) codes such as Therapeutic
Exercise (97110), Therapeutic Activities (97530), or Treatment of speech,
language, voice, communication and/or auditory processing disorder
(92507). The Therapeutic Procedure a therapist provides typically
consists of the application of many possible techniques, approaches, tools
or strategies. Hippotherapy is not a therapeutic procedure.

MODALITY – Any physical agent applied to produce therapeutic changes to biologic tissue: includes but not limited to thermal, acoustic, light, mechanical or electric energy. Hippotherapy does NOT meet the definition of a modality and should not
be referred to as such.

Age Restrictions:

Patients must be at least two (2) years of age.

Fees:

The costs are typically covered under insurance following medical referral by a licensed physician under prescription. Prescriptions must indicate referral for oupatient physical, occupational, or speech therapy, NOT hippotherapy!

The use of the horse’s movement is an intervention tool only.

The prescription should say OUTPATIENT (PHYSICAL, OCCUPATIONAL OR SPEECH-LANGUAGE PATHOLOGY SERVICES) and have a diagnosis, with a frequency and duration.

Company information: We are listed under our corporation name for insurances

Brandywine Valley Consultants, Inc. d.b.a. Making Strides

NPI: 1013141134

Tax ID: 20-0957111

Scheduling and Payments:

  • To enroll, all riders must have current paperwork on file dated within 1 year
  • A valid email is required for communication
  • A prescription is required from your MD, DO or DMD indicating a diagnosis, frequency and duration for Outpatient Physical Therapy, Occupational Therapy or Speech-Language Pathologist services. Prescriptions written for Hippotherapy or Horse will not be accepted.
  • Co-payments can be made online through PayPal, Square or by check or cash.
  • Riders may be denied a riding time if they have an outstanding balance from prior sessions.

Insurances accepted:

  • United Healthcare (UHC)
  • Anthem & Anthem CovaCare
  • Cigna
  • VA Community Care
    • Patient Centered Community Care (PCCC)
    • Veterans Choice Program (VCP)
  • CCC Plus Managed Care Program
    • Basic Concept of  CCC Plus is managed care, which means that instead of medical and other service providers contracting with Medicaid directly and billing Medicaid directly, each provider will have to go through one of six managed care organizations (MCOs) to enroll, get service authorization, and bill. These MCOs are usually for-profit insurance companies. The move toward managed care is part of a large and growing national trend to contain costs for Medicaid.
        • The 6 MCO’s administering the CCC Plus Waiver are:
          • United Healthcare  
          • Anthem Health Keepers Plus
          • Optima Health  
          • Magellan Complete Care of VA  
          • AETNA Better Health of VA  
          • Virginia Premier (OUT OF NETWORK)

      Detailed information about the program can be found at: https://thearcofnova.org/content/uploads/sites/6/2018/08/Commonwealth-Coordinated-Care-Handout-8.7.18.pdf

Missed Lessons:

Cancellations really hurt!  Making Strides of Virginia has staff, volunteers and horses ready for a session and no one to participate. Please help us respect the time of our volunteers and staff.  We do understand that unexpected medical conditions can affect our riders and, if that is the case, we will discuss tuition adjustments on an individual bass.  If Making Strides of Virginia cancels an appointment, we will notify you by phone as soon as we can and credit your account.  If you do not show up for a lesson and you do not call, you will be charged for the appointment.