CurrentOptum Health Behavioral Solutions of California (OHBS-CA)Policy BH727BCPCAMPT072026

Complementary and Alternative Psychotherapeutic Modalities for the Treatment of Behavioral and Substance Use Disorders

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This policy governs coverage determinations for complementary and alternative psychotherapeutic modalities used to treat behavioral health and substance use disorders for Optum Health Behavioral Solutions of California members and providers, subject to the member-specific benefit plan and applicable law.

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CurrentOptum Health Behavioral Solutions of California (OHBS-CA)Policy BH727BCPCAMPT072026

Complementary and Alternative Psychotherapeutic Modalities for the Treatment of Behavioral and Substance Use Disorders

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Policy Summary

PayerOptum Health Behavioral Solutions of California (OHBS-CA)

PolicyComplementary and Alternative Psychotherapeutic Modalities for the Treatment of Behavioral and Substance Use Disorders

Policy CodePolicy BH727BCPCAMPT072026

Change TypePolicy restructuringno material clinical, coverage, or coding change

Effective DateN/A

Last ReviewJul 21, 2026

Next Review DateJul 21, 2026

Key ActionConfirm member eligibility and identify the member-specific benefit plan document and applicable federal or state laws before applying this policy.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

5Modalities addressed

InvestigationalCoverage status

13 pagesDocument length

7 RCTsAnimal-assisted therapy studies

4Reference procedure codes

Investigational Coverage Determination

Investigational Complementary and Alternative Modalities

The listed complementary and alternative psychotherapeutic modalities are investigational for treating behavioral and substance use disorders.

Investigational modalities

Animal-assisted therapy is investigational.
Art therapy is investigational.
Dance/movement therapy is investigational.
Equine therapy is investigational.
Music therapy is investigational.

Procedure Codes

CPT Codesmixed

90899	Unlisted psychiatric service or procedure
G0176	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)
H2032	Activity therapy, per 15 minutes
S8940	Equestrian/hippotherapy, per session

Application and Billing Guidance

Documentation Required

Confirm eligibility and governing benefit terms

Before applying this Policy, confirm member eligibility and identify the member-specific benefit plan document and any applicable federal or state laws governing benefit coverage. If the Policy conflicts with the member-specific benefit plan document, the plan document governs; if the plan document conflicts with applicable law, applicable law governs.

Denial Risk

Investigational modalities may be denied

Claims for the listed complementary and alternative psychotherapeutic modalities may be denied because they are classified as investigational for treating behavioral and substance use disorders.

Animal-assisted therapy
Art therapy
Dance/movement therapy
Equine therapy

Policy Background

This policy addresses nonmainstream psychotherapeutic approaches used together with, or in place of, conventional medicine for behavioral health and substance use disorders. The modalities discussed are animal-assisted therapy, art therapy, dance/movement therapy, equine therapy, and music therapy. Although the evidence includes some potentially beneficial findings, it is generally preliminary or heterogeneous, with limitations such as small samples, variable intervention protocols, limited follow-up, and insufficient evidence to establish clinical utility or optimal treatment parameters. The policy identifies each listed modality as investigational for treating behavioral and substance use disorders.

Terminology

Complementary

DefinitionA nonmainstream practice developed outside conventional medicine.

UseUsed together with conventional medicine.

TermA nonmainstream practice used alongside conventional medicine is considered complementary.

Alternative

DefinitionA nonmainstream practice developed outside conventional medicine.

UseUsed in place of conventional medicine.

TermA nonmainstream practice used instead of conventional medicine is considered alternative.

Modality-Specific Criteria and Evidence

Animal-Assisted Therapy

Animal-assisted therapy is investigational for treating behavioral and substance use disorders.

Investigational status: Animal-assisted therapy is investigational for treating behavioral and substance use disorders.

Art Therapy

Art therapy is investigational for treating behavioral and substance use disorders.

Investigational status: Art therapy is investigational for treating behavioral and substance use disorders.

Dance/Movement Therapy

Dance/movement therapy is investigational for treating behavioral and substance use disorders.

Policy Summary

PayerOptum Health Behavioral Solutions of California (OHBS-CA)

PolicyComplementary and Alternative Psychotherapeutic Modalities for the Treatment of Behavioral and Substance Use Disorders

Policy CodePolicy BH727BCPCAMPT072026

Change TypePolicy restructuringno material clinical, coverage, or coding change

Effective DateN/A

Last ReviewJul 21, 2026

Next Review DateJul 21, 2026

Key ActionConfirm member eligibility and identify the member-specific benefit plan document and applicable federal or state laws before applying this policy.

SourceLink

On This Page

Billing Rule

Code listing does not guarantee coverage

Do not assume that reporting a listed procedure code establishes coverage or payment. Coverage and claim payment depend on the member-specific benefit plan document, applicable law, and any other applicable clinical criteria; inclusion of a code does not guarantee reimbursement.

90899 — Unlisted psychiatric service or procedure
G0176 — Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)
H2032 — Activity therapy, per 15 minutes
S8940 — Equestrian/hippotherapy, per session

Animal-assisted intervention

DefinitionAn intervention with objective goals and structured activities that integrates animals into health, education, or human services.

Therapeutic roleUses animals for a therapeutic role in improving health and wellness.

AnimalsDogs are the most common animals used, although a variety of animals and species may provide these interventions.

Art therapy

DefinitionA therapy combining knowledge of human development and psychological theories or techniques with visual arts and the creative process.

Creative componentsUses art media and the creative process as part of therapy.

ProcessingIncludes verbal processing of produced imagery to help clients communicate beyond verbal expression.

Dance/movement therapy

DefinitionThe psychotherapeutic use of movement to further emotional, cognitive, physical, and social integration.

StrategiesInterventions apply affective, behavioral, motoric, cognitive, and systemic strategies.

Practice termsMay also be described as dance movement psychotherapy, dance therapy, body psychotherapy, or therapeutic movement.

Equine therapy

DefinitionUses purposeful manipulation of equine movement to engage sensory, neuromotor, and cognitive systems.

PurposeAims to achieve functional outcomes.

Related termsMay be identified as hippotherapy, therapeutic horseback riding, horse therapy, therapeutic horsemanship, or equine-assisted therapy.

Music therapy

DefinitionThe clinical use of music interventions to accomplish individualized goals within a therapeutic relationship.

DeliveryTypically conducted by an individual who has completed an approved music therapy program.

Clinical focusTherapists may assess emotional well-being and social functioning through musical responses and develop sessions based on specific client needs.

Animal-assisted therapy (AAT)

DefinitionTherapy involving assistance from an animal as part of the intervention.

Reviewed animalsThe reviewed studies primarily involved dogs, horses, dolphins, or other animal-assisted activities.

Evidence contextReviewed outcomes included mental health, social functioning, and overall quality of life.

Equine-assisted activities and therapies (EAAT)

DefinitionEquine-assisted activities and therapies that incorporate preparation or warm-up, ground-based activities, mounted therapeutic riding or riding instruction, and closure activities.

Ground-based activitiesMay include grooming, feeding, leading horses, and horsemanship skills.

Closure activitiesMay include thanking the horses and staff, drawing or reflection activities, and parent or caregiver debriefing.

Equine-assisted services (EAS)

DefinitionA group of equine intervention types.

Included servicesIncludes equine-assisted therapy, equine-assisted services, equine-assisted activities and therapies, and equine-assisted psychotherapy.

Clinical scopeThe reviewed equine interventions were used with populations including individuals with autism spectrum disorder, veterans with post-traumatic stress disorder, people with substance use disorders, and children or youth with attention deficit hyperactivity disorder.

Dance/movement therapy

Intervention formsUses improvisation, shared rhythm, and structured movement.

Clinical purposeAddresses clinical outcomes such as stress and depression.

Delivery variationReviewed interventions varied in session frequency, duration, and movement approach.

Investigational status: Dance/movement therapy is investigational for treating behavioral and substance use disorders.

Equine Therapy

Equine therapy is investigational for treating behavioral and substance use disorders.

Investigational status: Equine therapy is investigational for treating behavioral and substance use disorders.

Music Therapy

Music therapy is investigational for treating behavioral and substance use disorders.

Investigational status: Music therapy is investigational for treating behavioral and substance use disorders.

Animal-Assisted Therapy: Evidence and Modality Criteria

The reviewed evidence is preliminary and does not establish clinical utility or standardized efficacy for animal-assisted therapy.

Evidence summary: Preliminary evidence suggests possible benefits across psychiatric and neurological conditions, ASD, dementia, and PTSD, but findings are inconsistent and limited by small samples, short interventions, weak study designs, inadequate outcome measures, and limited durability data.

Further rigorous research is needed to establish efficacy and clinical utility.

Art Therapy: Evidence and Modality Criteria

The reviewed evidence suggests potential benefits, but does not establish standardized protocols or long-term clinical utility for art therapy.

Evidence summary: Art therapy may improve PTSD symptoms and selected emotional, behavioral, social, and motor outcomes, but evidence is heterogeneous and does not establish standardized protocols or long-term clinical utility.

Interventions were delivered by trained art therapists in individual or group formats in the reviewed studies.

Dance/Movement Therapy: Evidence and Modality Criteria

Evidence for dance/movement therapy is limited and of low certainty.

Evidence summary: Dance interventions may reduce depression, anxiety, and stress in some adult populations, but evidence for dementia-related neuropsychiatric and cognitive outcomes is minimal to absent and overall certainty is low.

One meta-analysis reported statistical benefits, but no included trials were considered high quality.

Equine Therapy: Evidence and Modality Criteria

Available evidence is insufficient to establish standardized efficacy or formal endorsement of equine therapy for ASD or other conditions.

Evidence summary: Equine-assisted interventions may improve selected social, behavioral, language, motor, sensory, PTSD, treatment-retention, and physiological outcomes, but available evidence is insufficient to establish standardized efficacy or formal endorsement for ASD or other conditions.

Further empirical investigation and larger, rigorously designed randomized controlled trials are needed.

Music Therapy: Evidence and Modality Criteria

Music-based interventions show possible short-term benefits, but evidence quality and treatment parameters remain uncertain.

Evidence summary: Music-based interventions may reduce anxiety, depressive symptoms, selected behavioral symptoms, PTSD symptoms, and substance craving or improve motivation for treatment, but substantial heterogeneity and low or uncertain evidence quality limit conclusions regarding optimal treatment parameters and durability.

Reviewed approaches included active, receptive, combined, therapist-led, self-directed, individual, group, and passive listening interventions.