Although evidence based research supports the efficacy for the use of hippotherapy and equine assisted therapy as a therapeutic tool by occupational, physical and speech therapists, many reimbursement sources (insurance companies) will not cover these services because they are considered “experimental”. This prevents people from the ability to participate in a hippotherapy program if they are unable to pay for these services themselves.

Even when insurance reimburses for these services, the reimbursement rate is the same for hippotherapy as it is for traditional, clinic-based therapy however the cost to provide these services are vastly different. For every session of hippotherapy there must be an experienced horse handler to lead to horse, a sidewalker to ensure safety and the therapist. Additional expenses include but are not limited to hay, feed, medications (such as wormer), veterinary services, pasture land, a large, indoor, heated arena, horse care including labor to feed, exercise and clean them and hoof care.