CommercialCoverageMedium impact
Hippotherapy (CPB 0151, reviewed 2026-03-20)
Aetna·Physical Therapy, Occupational Therapy, Pediatrics +4 more·Medical Policy
Effective date
Mar 20, 2026
We identified it
Aug 17, 2026
Summary
Aetna's Clinical Policy Bulletin 0151 (effective 2026-03-20) designates hippotherapy (equine/therapeutic horseback riding) as experimental, investigational, or unproven for all indications including cerebral palsy, autism, ADHD, chronic pain, and 15+ other conditions. HCPCS code S8940 and associated ICD-10 codes are now non-covered for these indications, requiring billing teams to deny or redirect claims.
Action Required
By March 20, 2026: Billing team must update claim processing system to flag and deny all claims for HCPCS code S8940 (Equestrian/hippotherapy, per session) when linked to the listed ICD-10 diagnoses. Update billing software with automated denial rules referencing CPB 0151. Communicate policy change to providers, front desk staff, and prior authorization team. Flag existing standing orders or pre-authorizations for hippotherapy to prevent inappropriate claims. Add to claim scrubbing logic: reject S8940 claims paired with diagnosis codes G80.0-G80.9 (cerebral palsy), F01.50-F99 (mental/behavioral), G30.0-G30.9 (Alzheimer's), G35.A-G35.D (multiple sclerosis), G40.001-G40.C19 (epilepsy), E66.811-E66.9 (obesity), T74.21XA-T76.22XS (abuse/trauma), and all other listed codes. Failure to implement will result in claim denials on appeal and potential compliance issues with Aetna.