Therapeutic Services: Therapy/ Hippotherapy FAQ

What makes therapy at The Bridge Center unique?

• The Bridge Center offers a diverse range of treatment options to meet each client’s needs. In addition to conventional tools found in typical outpatient settings, Easterseals Massachusetts (ESMA) has the unique ability to incorporate equine movement/ Hippotherapy (HPOT) and use the natural environment to help clients reach their optimal level of functioning. Individualized treatment sessions are created and planned to ensure an enjoyable, meaningful, and memorable experience. Highly skilled ESMA therapists collaborate with clients and/ or caregivers to create and achieve meaningful therapeutic outcomes in an inclusive, natural, and fun environment.

What is Hippotherapy?

• Hippotherapy is a therapy tool used with other treatment tools to engage sensory, neuromotor, and cognitive systems to improve functional outcomes. An equine (horse) provides multidimensional movement that is variable, rhythmic, and repetitive, making it an excellent tool for increasing strength, endurance, motor planning, balance, and coordination. When sitting forward on the equine, a client experiences a walking pattern like a normal human’s gait. This similar gait pattern allows the therapist to purposefully use equine movement to reach desired effects. The effects of equine movement on postural control, sensory systems, and motor planning can be used to facilitate coordination and timing, grading of responses, respiratory control, sensory integration skills, and attentional skills.

What should a client expect during a therapy session?

• ESMA offers therapy services using a combination of therapy tools, including those that incorporate the use of Hippotherapy (when medically and clinically appropriate) and those that do not. The goal of Therapeutic Services at The Bridge Center is to ensure that all clients are provided with a personalized level of care to meet their functional goals, all while having fun and exploring the natural environment. An individualized plan of care will be established in collaboration with the client and/ or caregiver and will include both goals and expected outcomes. ESMA Therapeutic Services Registration Information Page 2 of 4 therapists regularly reassess goals and revise individual plans of care as clinically appropriate based on individual needs.
• When Hippotherapy is incorporated into a treatment session, this does not guarantee that the full duration of the session will be on the equine. The therapist will use their clinical discretion and judgement to determine the most optimal treatment tools to use during each session. It is considered best practice to incorporate equine-assisted movement with other treatment tools to achieve the most optimal functional outcomes. Therapy sessions range from 30 to 60 minutes.

What happens when all therapeutic goals are met?

• ESMA therapists regularly assess a client’s progress during each session. Once a client has met their goals for therapy services and the client, therapist, and/ or caregiver feel the client is ready to be discharged, the client may be referred to adaptive riding lessons, adaptive recreation, and/ or wellness programs. With this transition, participants continue to build on the skills developed and strengthened during therapy, while still participating in inclusive activities. Visit Horseback Riding & Horsemanship for information about adaptive riding lessons. Please note that other facilities may refer to adaptive riding as therapeutic riding.

What should I wear? Do I need a helmet?

• Closed-toe and closed-back shoes, helmets, and long pants are required to participate in equine-assisted activities. Clients must wear an ATSM/ SEI-approved riding helmet. It is highly recommended that clients acquire and bring their own helmets to ensure proper fit. If necessary, helmets are available for on-site use. Dress in comfortable clothing that is weather-appropriate, as therapy sessions will be held outdoors or in the riding arena, which is not heated.

Is an evaluation required? Is a doctor’s referral required?

• Yes, all clients must have an ESMA Physical Therapy, Occupational Therapy, or Speech and Language Pathology Evaluation to initiate Therapeutic Services at The Bridge Center. This allows the therapist, along with the client and/ or caregiver, to develop an appropriate plan of care and goals. An evaluation must be scheduled using the Registration process. Once an evaluation is completed, the therapist will provide the client and/ or caregiver with recommendations regarding therapy/ Hippotherapy.
• A healthcare provider’s clearance is required to participate in equine-assisted activities/ Hippotherapy. The Healthcare Provider Form is located on CampDoc after the client creates a profile and registers for the relevant term.

Do you accept insurance? What payment methods do you accept?

• Our team will work with the Massachusetts Department of Developmental Services for payments for Self-Directed Program participants.
• For all other clients, ESMA does not bill insurance companies directly. Clients are responsible for payment at the time of registration before beginning therapy services. All payments should be made through the online registration system CampDoc. After services are completed and upon request, ESMA can provide a client and/ or caregiver with an itemized receipt.
• Please submit all receipt requests to therapyservices@eastersealsma.org, and one will be provided within 7 business days of request. ESMA cannot guarantee reimbursement through insurance. It is advised that all clients reach out to their insurance company to confirm out-of-network coverage/ benefits if looking to receive reimbursement for Physical Therapy, Occupational Therapy, and Speech and Language Pathology services, as each insurance company handles cash-based practices differently. Suggested questions for a client’s insurance company when inquiring about reimbursement are included at the bottom of this page. 

Suggested Questions to Ask Your Insurance Company

ESMA cannot guarantee reimbursement, and payment is the sole responsibility of the client. ESMA advises all clients to reach out to their insurance company to confirm out-of-network coverage/ benefits if looking to receive reimbursement for physical therapy services, as each insurance company handles cash-based practices differently. 

During a therapy evaluation/ treatment session, all or some of the following CPT codes may be used. Therapists are not limited to the above codes when completing an evaluation or treatment session.

• PT: 97162, 97530, 97112, 97110, 97116, 97542, 97763, 97164, 97550, 97551
• OT:  97166, 97168, 97110, 97530, 97112, 97535, 97533, 97760, 97537, 97550, 97551
• SLP: 92507, 92526, 97130, 92606, 92609, 97550, 97551, 92521, 92522, 91523, 92514 

Here are some suggested questions to ask when inquiring about reimbursement from an insurance company:

• Do I have benefits that cover out-of-network or non-participating providers?
• Does coverage run on a calendar year or plan year? If it runs on plan year, when does it start and end?
• Is there a limit to the number of sessions per plan year and if so, does that include just PT or other therapies? How many sessions have I already used?
• If Autism diagnosis, is there an exception of maximum number of sessions, and do I have unlimited sessions?
• What is my deductible? After I meet my deductible, what is my co-pay or coinsurance?
• Do I need an MD referral or prior authorization?
• Are any specific services excluded?
• Are there any exclusions to my policy?

Please email therapyservices@eastersealsma.org with any additional questions or concerns.