Building a Concussion Program

Syllabus

1. Lesson 1: The Concussion Opportunity: Clinical & Business Case (20–25 min)

   • Articulate the epidemiological and clinical gap that concussion programs address
   • Build the revenue case for a structured concussion program within a neurosurgery practice
   • Identify your target patient population and referral sources

   Takeaway: A structured concussion program is both a clinical obligation and a highly efficient revenue diversification strategy for neurosurgeons.

2. Lesson 2: Your Clinical Care Pathway: From First Visit to Recovery (~25 min)

   • Walk the end-to-end pathway — initial visit, targeted testing, feedback visit, and the re-evaluation cycle.
   • Know what actually happens at each visit, and what your staff can run versus what needs you.
   • Know which ancillary tests to order, and WHEN — by indication, not reflexively.

   Takeaway: Here's the whole pathway in one breath. The initial visit characterizes the problem and triages who needs what. Targeted testing fires by indication — neurocognitive, vestibular, vision, sleep, EEG — never as a reflex panel. The feedback visit turns those results into a written rehabilitation plan the family can follow. And the twelve-week re-evaluation cycle repeats the measures and ends at a clear decision: recovered and discharged with precautions, or escalate and re-loop. Build that loop, give it an off-ramp, and you don't just see concussions — you run a concussion program. Adapt it to your own setting; this is the template I use.

3. Lesson 3: Baseline Assessment Protocols (25–30 min)

   • Select and implement appropriate neurocognitive baseline testing tools
   • Build a standardized intake workflow for concussion patients
   • Train non-physician staff to administer baseline assessments

   Takeaway: Baseline testing is your clinical infrastructure. Without it, post-injury assessment is guesswork.

4. Lesson 4: Acute Concussion Management (25–30 min)

   • Apply current evidence-based guidelines for acute concussion management
   • Implement return-to-learn and return-to-play protocols in your practice
   • Identify red flags requiring escalation to imaging or neurosurgical intervention

   Takeaway: Most concussions resolve with early active recovery. Your job is identifying the ones that won't, and managing them differently.

5. Lesson 5: Post-Concussion Syndrome: Recognition & Approach (25–30 min)

   • Identify PCS symptom clusters and their clinical implications
   • Differentiate PCS from comorbid psychiatric and vestibular conditions
   • Build a multidisciplinary treatment pathway for PCS patients

   Takeaway: PCS is not one condition. Treating the dominant symptom cluster rather than the syndrome label gets better outcomes.

6. Lesson 6: AI-Powered Assessment Tools in Concussion Care (20–25 min)

   • Evaluate digital concussion assessment tools against clinical workflow needs
   • Integrate a remote symptom tracking platform into your concussion program
   • Use AI risk stratification to prioritize follow-up and intervention

   Takeaway: Digital tools don't replace clinical judgment — they give you data between visits so your clinical judgment is better informed.

7. Lesson 7: Building the Multidisciplinary Team (20–25 min)

   • Identify the core and extended team members for a comprehensive concussion program
   • Structure referral relationships that support bi-directional patient flow
   • Choose between co-located and virtual team models based on practice size

   Takeaway: Your program is only as good as your team. The neuropsychologist and vestibular PT are not referral options — they are program requirements.

8. Lesson 8: TMS and Emerging Treatments for PCS (25–30 min)

   • Understand the evidence base for rTMS in post-concussion depression and cognitive symptoms
   • Navigate CPT coding and payer coverage for TMS services
   • Integrate NeuroStar or comparable TMS systems into a concussion program

   Takeaway: TMS is underutilized in PCS. The evidence is building, the coding exists, and the patients who need it are already in your practice.

9. Lesson 9: Coding, Billing & Documentation for Concussion Care (25–30 min)

   • Select and document the correct CPT codes for concussion-related services
   • Avoid common documentation errors that lead to denials and audits
   • Build a billing workflow that captures all revenue generated by your concussion program

   Takeaway: Concussion care is a high-value service that is chronically underbilled. The codes exist — you just need the documentation to support them.

10. Lesson 10: Sports Partnerships & School Programs (20–25 min)

    • Develop partnerships with athletic departments, leagues, and schools
    • Design a sideline protocol that generates referrals and builds program visibility
    • Create a concussion education program that drives long-term community relationships

    Takeaway: Athletic trainers are the gatekeepers to the sports concussion population. Build that relationship first and everything else follows.

11. Lesson 11: Building a Research-Integrated Concussion Program (25–30 min)

    • Understand the basics of IRB oversight and clinical research in a private practice setting
    • Design a data collection infrastructure that supports future publications
    • Use published outcomes to strengthen payer relationships and referral credibility

    Takeaway: A research-integrated program is not academic indulgence — it is the highest-leverage marketing strategy available to a clinician.

Related guides

• How to Build a Revenue Generating Concussion Program
• Billing Codes and Reimbursement for a Concussion Program