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DESCRIPTIONHippotherapy, also referred to as equine movement therapy, describes physical therapy using a horse. Hippotherapy has been proposed as a type of physical therapy for patients with impaired walking related to spastic cerebral palsy. Horseback riding is also being investigated as a social therapy for children with autism.
Patients with spastic cerebral palsy frequently have impaired walking ability due to hyperactive tendon reflexes, muscle hypertonias, and increased resistance to increasing velocity of muscle stretch. These abnormalities result in a lack of selective muscle control and poor equilibrium responses. Hippotherapy has been proposed as a technique to decrease the energy requirements and improve walking in patients with cerebral palsy. It is thought that the natural swaying motion of the horse induces a pelvic movement in the rider that simulates human ambulation. In addition, variations in the horse’s movements can also prompt natural equilibrium movements in the rider. It is hoped that the multi-sensory environment may also be beneficial to children with profound social and communication deficits, such as autism spectrum disorder.
POLICYHippotherapy is considered investigational.
POLICY GUIDELINESInvestigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary.
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.
POLICY HISTORY7/21/2005: Approved by Medical Policy Advisory Committee (MPAC)
1/30/2008: Policy reviewed, no changes
04/27/2010: Policy description expanded regarding spastic cerebral palsy and autism. Policy statement unchanged.
04/20/2011: Policy reviewed; no changes.
12/13/2011: Policy reviewed; no changes.
02/20/2013: Policy reviewed; no changes.
SOURCE(S)Blue Cross Blue Shield Association policy # 8.03.12
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.