To all credentialed therapists and professional members of AHA, Inc.,
Over the past 18 months and intensely over the last four weeks, we have been dealing with the impact of TRICARE/ECHO reimbursement policy for hippotherapy (hpot) as a treatment strategy in a physical therapy plan of care. For those of you who are not informed of the issues, the most prominent ones are: the term Hippotherapy has been equated with Therapeutic Riding and they require the S code (equestrian therapy) for billing. In our dealings with insurance carriers, specifically TRICARE, there appears to be a continued misrepresentation of the terms therapeutic/adaptive riding and hippotherapy. These terms are not equivalent.
As your representative to Congressional members, insurance carriers and clients, I feel it is imperative to take a united stand against the use of the S code for billing. The S code makes hippotherapy the service ....period. Hippotherapy is not a service, or even a billable code since we do not bill for treatment strategies; we bill for procedures (defined by CPT codes) in our service (physical therapy, occupational therapy or speech therapy). While the current situation is frustrating to all, if we relinquish control of our services at this point, we will not be able to gain it back. Education is the key. Once TRICARE and other third party payors understand the implication of their terms, they will gladly use appropriate terminology.
We have numerous individuals working to contact the appropriate government entity to change to wording of the TRICARE/ECHO policy. Several clients are independently working their way through the system as well. Squeaky wheels do get greased; and when squeaky wheels stop turning, the engineers finally have to pay attention to the problem.
Please help us to collectively become the squeaky wheel. Let us all stand united for a more immediate and appropriate response from the government offices involved. Once we are able to get TRICARE to listen, all others will follow in step.
WE HAVE ONLY ONE CHANCE TO GET THIS RIGHT. TOGETHER WE ALL MOVE FORWARD.
PLEASE DO NOT USE THE S CODE FOR BILLING.
Our office and insurance task force are working together to track information, if you have a contact and/or are in the process of your own educational plight please email us directly, email AHA, Inc.
I look forward to your positive responses and support.
Jane Burrows, DPT, HPCS
American Hippotherapy Association, Inc.