Traumatic Brain Injury: Rehabilitation and Recovery

Sources

1. National Institute of Neurological Disorders and Stroke. Traumatic brain injury (TBI) (last reviewed March 13, 2026). Checked November 4, 2026.
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   “A traumatic brain injury (TBI) refers to a brain injury that is caused by an outside force. A forceful bump, blow, or jolt to the head or body can cause it, but not all blows or jolts to the head result in a TBI. An object entering the brain can also cause a TBI. TBIs are sometimes called brain injuries or even head injuries.” “Some types of TBI can cause temporary or short-term problems with brain function, including problems with how a person thinks, understands, moves, communicates, and acts. More serious TBIs can lead to severe and permanent disability—and even death.” “Headache, dizziness, confusion, and fatigue tend to start immediately after an injury but resolve over time. Emotional symptoms such as frustration and irritability tend to develop during recovery.” “Seek immediate medical attention if the person experiences any of the following symptoms, especially within the first 24 hours after an injury to the head”, including “Blurred or double vision” and “Clear fluids draining from the nose or ears”; perception symptoms include “Hearing problems, such as ringing in the ears”, “Unexplained bad taste in the mouth” and “Light-headedness, dizziness, vertigo, or loss of balance or coordination”. “A concussion is a type of mild TBI that may be considered a temporary injury to the brain but could take minutes to several months to heal.” “Post-concussion syndrome involves symptoms that last for weeks or longer.” Subdural hematomas, bleeding between the dura and the arachnoid mater: “They are very common in older adults after a fall.” “Adults 65 and older are at greatest risk for being hospitalized and dying from a TBI, most often from a fall.” “All TBIs should be evaluated immediately by a professional who has experience with these injuries. A neurological exam will judge motor and sensory skills and test hearing and speech, coordination and balance, mental status, and changes in mood or behavior, among other abilities.” “CT imaging can show a skull fracture and any brain bruising, bleeding, or swelling. MRI is more sensitive and can pick up more subtle brain changes that a CT scan may miss.” “currently available and clinically validated imaging technologies, blood tests, and other measures can’t always detect damage from mild, concussive injuries”; “Neuropsychological tests to gauge brain functioning are often used along with imaging in people who have suffered mild TBI. Such tests involve performing specific tasks that help assess memory, concentration, information processing, executive functioning, reaction time, and problem solving.” “people who receive immediate medical attention at a certified trauma center tend to have the best health outcomes”. “Compared with younger adults with the same TBI severity, older adults are more likely to have lasting symptoms. Older people often have other medical issues and may be taking multiple medications, which may complicate treatment.” “While most people recover fully from a first concussion within a few weeks, the rate of recovery from a second or third concussion is generally slower.” Medicines may include “Over-the-counter or prescribed pain medicines”, “Anticonvulsant drugs to treat seizures”, “Stimulants to increase alertness” and “Antidepressants and anti-anxiety medications to treat depression and feelings of fear and nervousness”. Immediate treatment of severe TBI focuses on “Preventing death”, “Stabilizing the person’s spinal cord, heart, lung, and other vital organ functions”, “Controlling blood pressure” and “Preventing further brain damage”; surgery may “Relieve pressure inside the skull” or “Remove debris, dead brain tissue, or hematomas”. “Once their injuries are treated and stabilized in the hospital, people with severe TBI are often transferred to a rehabilitation center where a multidisciplinary team of providers help with recovery.” “Therapy is aimed at improving the person’s ability to perform activities of daily living and to address cognitive, physical, occupational, and emotional difficulties. Treatment may be needed on a short- or long-term basis.” Research classification “would go beyond the currently used” mild, moderate and severe designations; “In January 2024, NINDS held the TBI Classification and Nomenclature Workshop to support these efforts.”
2. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Understanding TBI, part 2: brain injury impact on individuals’ functioning (2018). Checked November 4, 2026.
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   “It is impossible to tell early on which specific problems a person will have after a TBI.” “In most cases, the physical difficulties do not prevent a return to independent living, including work and driving.” “Individuals with a moderate-to-severe brain injury often have problems in basic cognitive (thinking) skills such as paying attention, concentrating, and remembering new information and events.” “They may think slowly, speak slowly and solve problems slowly.” “They may have speech and language problems, such as trouble finding the right word or understanding others.” “First, the changes can come directly from damage to brain tissue. This is especially true for injuries to the frontal lobe, which controls emotion and behavior.” “Second, cognitive problems may lead to emotional changes or make them worse.” “Third, it is understandable for people with TBI to have strong emotional reactions to the major life changes that are caused by the injury.” “Brain injury can bring on disturbing new behaviors or change a person’s personality. This is very distressing to both the person with the TBI and the family.” “Lack of self-awareness. Injured individuals may be unaware that they have changed or have problems. This can be due to the brain damage itself or to a denial of what’s really going on in order to avoid fully facing the seriousness of their condition.” “Fortunately, with rehabilitation training, therapy and other supports, the person can learn to manage these emotional and behavioral problems.”
3. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Cognitive problems after traumatic brain injury (2020). Checked November 4, 2026.
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   Abilities that can be affected: “Attention and concentration”, “Processing and understanding information”, “Memory”, “Planning, organizing, and assembling”, “Reasoning, problem-solving, decision-making, and judgment”. Cognitive communication: “Thinking difficulties can make it harder to express your thoughts and understand what others are trying to say.” “Difficulty thinking of the right word”; “Trouble starting or following conversations or understanding what others say”; “Rambling or getting off topic easily”; “Difficulty expressing thoughts in an organized manner”; “Having problems reading others’ nonverbal communication and social cues”; “Misunderstanding jokes or sarcasm”. “Aphasia is a disorder that can affect your speech or your ability to understand language properly. A speech therapist can test you for aphasia.” “If you are working with a speech therapist, it can be helpful to have a loved one join those sessions. Including family members in sessions can help you to carry over new skills to everyday life.” Memory aids: “memory notebooks to keep track of important information”; “calendar reminders on smartphones, tablets, and computers to remember appointments and scheduled activities”; “Structure your day with routine daily tasks and activities.” “Be organized: always put commonly used items back in the same place.” “Being unaware of cognitive problems, even if the problems are clear to others”. Family: “Offer to work with your loved one to problem-solve together, instead of solving problems for them.” “Give realistic, supportive feedback referring to a situation that happened and the unwanted consequence. Work together to come up with a different approach.” “A neuropsychologist usually evaluates changes in thinking abilities after TBI. The results of this testing can be used to design a treatment plan.” “In many cases, cognition can improve with cognitive rehabilitation.” “Some cognitive therapy approaches focus on improving skills that have been lost or impaired. Other approaches help the person to learn different ways to achieve a goal.” “Clinicians—such as occupational therapists, speech therapists, and neuropsychologists—often deliver cognitive therapy.” “Do not ignore new problems. Mention new problems as they develop to your health care team.”
4. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Fatigue and traumatic brain injury (2024). Checked November 4, 2026.
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   “After TBI, you may have more than one kind of fatigue”: physical, psychological and mental. “Fatigue can have a negative effect on your mood, physical functioning, attention, concentration, memory, and communication. It can interfere with your ability to work or enjoy leisure activities. It can make activities such as driving dangerous.” “Fatigue is one of the most common problems people have after a TBI. As many as 70% of survivors of TBI complain of mental fatigue.” “In people with TBI, fatigue often occurs more quickly and frequently than it does in the general population. The cause of fatigue after TBI is not clear, but it may be due to the extra effort and attention it takes to do even simple activities such as walking or talking clearly.” Conditions that cause or increase fatigue include “Depression”, “Sleep problems, such as sleep apnea”, “Hypothyroidism or other endocrine gland disorders” and “Low red blood cell counts (anemia)”. “Pay attention to what triggers your fatigue, and learn to identify the early signs of fatigue, such as becoming more irritable or distracted. Stop an activity before getting tired.” “Set a regular schedule of going to bed and getting up at the same time every day.” “Include some regular rest breaks or naps. Be careful to limit naps to 30 minutes and avoid evening naps.” “Resume activities gradually, over weeks or even months.” “Plan and follow a daily schedule.” “Do things that require the most physical or mental effort earlier in the day when you are fresher.” “Avoid over-scheduling.” “Exercise daily. Research has shown that people with TBI who exercise have better mental function and alertness. Over time, exercise and being more active helps lessen physical and mental fatigue and builds stamina.” “Have your doctor review all your current medications.”
5. Centers for Disease Control and Prevention. Facts about TBI (August 4, 2025). Checked November 4, 2026.
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   “People most commonly get TBIs from a fall, firearm-related injury, motor vehicle crash, or an assault.” “Falls lead to nearly half of the TBI-related hospitalizations.” Groups more likely to be affected include “Service members and veterans”. “Older adults are more likely to be hospitalized and die from a TBI compared to all other age groups.” TBIs “may be missed or misdiagnosed in older adults because symptoms of TBI overlap with other medical conditions that are more common among older adults, such as dementia”; providers should check for TBI if an older adult has “Fallen or has a fall-related injury, such as a hip fracture.” or “Been in a car crash.” Blood thinners: “Anticoagulants like warfarin (Coumadin), rivaroxaban (Xarelto), and apixaban (Eliquis).” “Antiplatelet medications like clopidogrel (Plavix), ticagrelor (Brilinta), and acetylsalicylic acid (Aspirin).” “These medicines may increase the risk for bleeding in the brain following a TBI.” “a person with a mild TBI or concussion may experience short-term symptoms and feel better within a couple of weeks or months. And a person with a moderate or severe TBI may have long-term or life-long effects from the injury.” “A person with a possible TBI should be seen by a healthcare provider.” “People with a moderate or severe TBI may need ongoing care, such as rehabilitation services, to help with their recovery.” “TBI affects children differently than adults.”
6. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Traumatic brain injury and acute inpatient rehabilitation (2021). Checked November 4, 2026.
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   “Acute inpatient rehabilitation (rehab) is an intensive form of medical rehabilitation in which patients receive three or more hours per day of core therapies (physical therapy, occupational therapy and speech therapy) overseen by a physician specialized in rehabilitation with around the clock nursing care.” “Research has shown that participating in inpatient rehabilitation after injury increases the likelihood of discharge to home and decreases risk of mortality among trauma patients, most of whom sustained TBI.” Choosing a facility: “Is this program covered by the patient’s insurance?” “What kind of experience does the staff have?” “What kind of accreditation does the facility have?” “Can the facility meet the patient’s medical needs?” Challenges addressed: “Thinking challenges. These include problems with memory, language, concentration, judgment, and problem-solving.” “Physical changes. These include loss of strength and problems with balance, coordination, movement, and swallowing.” “Sensory changes. These include changes in the patient’s sense of smell, sight, hearing, and touch.” “Emotional changes. These include changes in mood or feeling impulsive or irritable.” Eligibility: “The patient’s medical condition is stable enough to allow them to take part in therapy.” “The patient can make progress in therapy.” “The patient will have therapy 5–7 days a week.” “The patient will be under the care of a doctor who will see them at least three times a week.” “At least once a week, the team meets to talk about the patient’s progress and discharge plan.” The doctor: “This doctor is in charge of the patient’s overall treatment and directs the patient’s rehab program.” “Prescribe tailored physical, occupational, and speech therapy.” “Prescribe medicine to manage the patient’s mood, sleep, pain, and diet.” The nurse: “The rehabilitation nurse works very closely with the physician in managing medical problems and preventing complications.” “Educate the patient and their family about their TBI and any medicines they take”. Psychologists or neuropsychologists “will assess and treat any problems the patient has with thinking, memory, mood, and behavior”. PT: “The PT’s role is to teach the patient how to be as independent and safe as possible in their environment. The PT will give the patient exercises and re-train their muscles and nerves.” “The PT will also help the patient strengthen their muscles and improve endurance, walking, and balance.” OT: “These activities include eating, bathing, grooming, and dressing. They also include moving to and from your bed, wheelchair, toilet, tub, and shower.” Depending on the facility: “Assess the patient’s thinking skills.” “Assess the patient’s vision for any problems.” “Help the patient manage more complex tasks. These include meal prep and cooking, managing money, and getting involved in community activities.” “Recommend and order any equipment the patient may need before going home.” SLP: “The SLPs will treat problems with speech, swallowing, and communication.” “Help the patient understand what others say and speak clearly.” “This may include exercises to strengthen the muscles used in speech or swallowing.” “Assess the patient’s ability to swallow if they have problems swallowing (dysphagia).” “If needed, recommend foods and drinks that the patient can eat or drink safely.” Social workers: “Help figure out what benefits the patient is eligible for. This may include Medicaid or Social Security.” “The social workers will give the patient and their family information about community resources.” Family: “Ask about and talk about the discharge process early in a patient’s stay; the time in inpatient rehab can be short.” “Go to family training as the patient’s discharge gets closer.” “Recovery from a TBI may take months or even years. Most people will need ongoing therapy after they go home.” “Every discharge plan is different.” Discharge plans: “Discharge home with referral for home-based rehab services.” “Discharge home with referral for outpatient services.” “Discharge to a residential TBI rehab program.” “This plan is for people who are well enough to live in the community but need a supervised and structured environment.” “Discharge to a nursing facility.” “These wings are sometimes called subacute rehab or skilled nursing facilities, or SNFs.”
7. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Understanding TBI, part 3: the recovery process (2019). Checked November 4, 2026.
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   “A period of confusion and disorientation often follows a moderate-severe TBI. This may be referred to as post-traumatic amnesia; but a more correct name is confusional state.” “Often, the fastest improvement happens in the first six months after injury.” “As time goes by, the speed of improvement will slow down, but the person may continue to gain more function for years after the injury.” “Age and pre-injury health and abilities also affect how well a person will recover.” “We do know that the more severe the injury, the less likely the person will fully recover. How long a person remains unconscious and how long they remain in the confusional state after that may help to predict how well and how quickly a person will recover.” Two years after a moderate to severe TBI: “About 30% of people need some amount of assistance from another person.” “Over time, most people can move around again without help. They can also take care of themselves.” “Trouble with thinking is common. This includes how fast a person can think. It also includes forming new memories.” “About 25% of people have major depression.” “Just over 90% of people live in a private home.” “About 50% of people can drive again”; “About 30% of people have a job, but it may not be the same job they had before the injury.” “Keep in mind that these percentages apply across a large group of people recovering from moderate to severe TBI and refer to a time 2 years after injury.” “Also, recovery in these areas can still occur after 2 years.”
8. American Speech-Language-Hearing Association. Traumatic brain injury in adults (Practice Portal). Checked November 4, 2026.
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   “Severity of TBI is based on the extent and nature of the injury, duration of loss of consciousness, posttraumatic amnesia (PTA; loss of memory for events immediately following injury), and extent of confusion at initial assessment during the acute phase of the injury”. Department of Defense levels: concussion or mild TBI, “loss of consciousness for up to 30 minutes; or confused or disoriented state lasting less than 24 hours; or memory loss lasting less than 24 hours”; moderate, “loss of consciousness for more than 30 minutes, but less than 24 hours; or confused or disoriented state lasting more than 24 hours; or memory loss lasting more than 24 hours but less than 7 days; or meets criteria for concussion/mild TBI but with an abnormal CT”; severe, “loss of consciousness for more than 24 hours; or confused or disoriented state lasting more than 24 hours; or memory loss lasting more than 7 days”; penetrating TBI, “open head injury; scalp, skull, and dura mater (outer layer of meninges) are penetrated”. “The effects of TBI can be temporary or permanent, and no two individuals present with the same pattern.” “Cognitive-communication disorders can affect self-regulation, social interaction, activities of daily living, learning and academic performance, and vocational performance.” Speech: “Apraxia of speech (motor programming)”; “Dysarthria characterized by reduced respiratory support, articulatory imprecision, and/or vowel distortions”; “Anomia or word retrieval deficits”; voice: “Aphonia/dysphonia resulting from intubation, tracheostomy, or use of mechanical ventilator”. Dysphagia: “Swallowing problems secondary to oral and/or pharyngeal sensory disorders and/or motor deficits”; “Risk of aspiration while eating related to impact of cognitive impairment (e.g., poor memory, reduced insight, limited attention, impulsivity, and agitation”; factors include “duration of ventilation and endotracheal intubation and/or presence of a tracheostomy”. “Audiologists play a central role in the assessment, diagnosis, and rehabilitation of hearing and vestibular deficits in individuals with TBI.” “dysphagia management may include interdisciplinary teamwork between occupational therapists, dietitians, nursing staff, and the SLP”. “SLPs and audiologists do not diagnose TBI.” “The purpose of a comprehensive assessment for individuals with TBI is to determine speech, language, cognitive-communication, swallowing, and audiologic strengths and needs.” Assessment covers “Impact of current condition on the individual and their family/caregivers” and “Goals and priorities of the individual and their family/caregivers”. Treatment considers “personal and contextual factors, such as the individual’s age, education, premorbid status, social history, present social context, and vocational status (current or premorbid)”; “the impact of fatigue and limited physical endurance on participation in treatment”; and “the impact of poor insight and executive function deficits on the ability to (a) recognize breakdowns in function, (b) buy into the potential benefits of treatment, and (c) adhere to specific recommendations (e.g., swallow safety guidelines)”. “The goal of intervention in TBI is to achieve the highest level of independent function for participation in daily living.” “Treatment for TBI can be restorative and/or compensatory. These approaches are not mutually exclusive”; “Restorative approaches involve direct therapy aimed at improving or restoring impaired function(s) through retraining.” “Compensatory approaches focus on adapting to deficits by learning new or different ways of doing things to minimize difficulties”. “Family members and significant others play a critical role in supporting the individual with TBI and augmenting the treatment plan.” “Treatment typically begins with assessment in the acute or rehabilitation inpatient setting and may continue in post-acute care (e.g., post-acute rehabilitation).” “Time-limited residential programs and community-based programs are available in some areas to foster community integration and provide peer support.”
9. Centers for Disease Control and Prevention. About mild TBI and concussion (September 15, 2025). Checked November 4, 2026.
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   “Most TBIs that occur each year are mild TBIs or concussions.” Caused by “A bump, blow, or jolt to the head, or” “By a hit to the body that causes the head and brain to move quickly back and forth”. “Even if the injury doesn’t show up on these tests, you may still have a mild TBI or concussion.” “A scan of your brain (such as a CT scan) is not needed to spot a mild TBI or concussion, but may sometimes be used for patients at risk for bleeding on the brain after a head or brain injury.” “Healthcare providers may describe these injuries as mild because they are usually not life-threatening. Even so, the effects of a mild TBI or concussion can be serious.” “People with a mild TBI or concussion need to be seen by a healthcare provider.” “A person with a history of multiple or repeated mild TBIs or concussions may experience a longer recovery or more severe symptoms.”
10. Centers for Disease Control and Prevention. Symptoms of mild TBI and concussion (September 15, 2025). Checked November 4, 2026.
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    “Some mild TBI and concussion symptoms may appear right away, while others may not appear for hours or days after the injury. Symptoms generally improve over time, and most people with a mild TBI or concussion feel better within a couple of weeks.” Physical: “Bothered by light or noise”, “Dizziness or balance problems”, “Feeling tired, no energy”, “Headaches”, “Nausea or vomiting (early on)”, “Vision problems”; thinking and remembering: “Attention or concentration problems”, “Feeling slowed down”, “Foggy or groggy”, “Problems with short- or long-term memory”, “Trouble thinking clearly”; social or emotional: “Anxiety or nervousness”, “Irritability or easily angered”, “Feeling more emotional”, “Sadness”; sleep: “Sleeping less than usual”, “Sleeping more than usual”, “Trouble falling asleep”. “A person may not recognize or admit that they are having problems”; “Problems may be overlooked by the person with a mild TBI or concussion, their family members, or their healthcare provider”. Danger signs in adults: “The people checking on you should call 9-1-1 or take you to an emergency department right away if you”: “Have a headache that gets worse and does not go away”; “Experience weakness, numbness, decreased coordination, convulsions, or seizures”; “Vomit repeatedly”; “Have slurred speech or unusual behavior”; “Have one pupil (the black part in the middle of the eye) larger than the other”; “Cannot recognize people or places, get confused, restless, or agitated”; “Lose consciousness, look very drowsy or cannot be woken up”.
11. Centers for Disease Control and Prevention. TBI data (April 27, 2026). Checked November 4, 2026.
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    “There were approximately 214,110 TBI-related hospitalizations in 2020” and “68,663 TBI-related deaths in 2023”; “This represents more than 586 TBI-related hospitalizations and 190 TBI-related deaths per day.” “These estimates do not include the many TBIs that are only treated in the emergency department, primary care, urgent care, or those that go untreated.” “People age 75 years and older had the highest numbers and rates of TBI-related hospitalizations” and deaths; “This age group accounts for about 32% of TBI-related hospitalizations and 28% of TBI-related deaths.” “Males were nearly two times more likely to be hospitalized” and “three times more likely to die” from a TBI than females.
12. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Sleep and traumatic brain injury. Checked November 4, 2026.
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    “A review of sleep disorder studies and surveys suggest that sleep disorders are three times more common in TBI patients than in the general population and that nearly 60% of people with TBI experience long-term difficulties with sleep”. “Sleep disturbances have been found in people with all severities of brain injuries”. “Insomnia is typically worse directly after injury and often improves as time passes.” “Changes in behavior and environment are the first line to treating sleep difficulties.” “Set an alarm to try to wake up at the same time every day.” “Exercise every day.” “Try to get outdoors for some sunlight during the daytime.” “Avoid caffeine, nicotine, alcohol and sugar for five hours before bedtime.” “Keep stress out of the bedroom.” “Most over-the-counter sleep aid medications contain an antihistamine (commonly diphenhydramine) and are not recommended for people with TBI because they may cause disturbances in memory and new learning.”
13. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Depression after traumatic brain injury (2025). Checked November 4, 2026.
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    “Rates of depression from different studies vary widely, but on average, about 27% of people with a TBI meet the criteria for a diagnosis of major depression or persistent mild depression (dysthymia). Also, 38% have symptoms of depression that are severe enough to interfere with daily life. The average rate of major depression among people with mild TBI or concussion is 16%; the rate among those with severe TBI is 30%.” “The good news is that depression is treatable.” “there is good evidence that antidepressants and counseling are effective treatments for depression. For people with major depression, research shows that using both counseling and medication together tends to work best.” “If you have thoughts of suicide, get help right away. If you plan to harm yourself or to die by suicide, call 988, which will connect you to a Suicide and Crisis Lifeline call center; call 911 for local emergency services; or go to an emergency room right away.”
14. Centers for Medicare & Medicaid Services. Inpatient rehabilitation care (Medicare.gov). Checked November 4, 2026.
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    “Medicare Part A (Hospital Insurance) covers medically necessary care you get in an inpatient rehabilitation facility or unit”; “Medicare Part B (Medical Insurance) covers doctors’ services you get while you’re in an inpatient rehabilitation facility.” Covered care includes “Rehabilitation services, including physical therapy, occupational therapy, and speech-language pathology”. “Your health care provider must certify that you have a medical condition requiring intensive rehabilitation, continued medical supervision, and coordinated care from your providers.” In 2026: “Days 1-60: After you pay the $1,736 deductible you pay $0 each day.” “Days 61-90: You pay $434 each day.” “Days 91-150: You pay $868 each day while using your 60 lifetime reserve days”. No deductible if “You’re transferred to an inpatient rehabilitation facility directly from an acute care hospital.”
15. Centers for Medicare & Medicaid Services. Physical therapy services (Medicare.gov). Checked November 4, 2026.
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    Part B helps pay for medically necessary outpatient physical therapy; “You can also get this therapy to help improve or maintain your current function, or slow your rate of decline”; your doctor or other health care provider “must certify that you need it”; “you pay 20% of the Medicare-approved amount”; “There’s no limit on how much Medicare pays for your medically necessary outpatient therapy services in one calendar year”.
16. Centers for Medicare & Medicaid Services. Jimmo settlement (CMS.gov). Checked November 4, 2026.
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    The settlement “clarified that the Medicare program covers skilled nursing care and skilled therapy services under Medicare’s skilled nursing facility, home health, and outpatient therapy benefits when a beneficiary needs skilled care in order to maintain function or to prevent or slow decline or deterioration”; coverage “does not turn on the presence or absence of a beneficiary’s potential for improvement, but rather on the beneficiary’s need for skilled care”.
17. Centers for Disease Control and Prevention. Facts about older adult falls (September 8, 2026). Checked November 4, 2026.
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    “Falls can cause head injuries. These can be very serious, especially if the person is taking certain medicines (like blood thinners). An older person who falls and hits their head should see their doctor right away to make sure they don’t have a brain injury.”
18. MedlinePlus Medical Encyclopedia, National Library of Medicine. Traumatic brain injury (reviewed October 14, 2025). “Head injuries that cause a TBI often occur with an injury to the neck and spine. Take special care when moving people who have had a head injury”. Checked November 4, 2026.
19. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Seizures after traumatic brain injury (2020). Checked November 4, 2026.
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    “Although most people with a TBI will never have a seizure, 1 out of 10 people who were hospitalized after a TBI will have seizures.” “Most seizures happen in the first few days or weeks after a TBI. But some may occur months or even years after the injury. About 70% to 80% of people who have had a TBI and who then have seizures are helped by medicine and can return to most activities.” “If the seizure doesn’t stop after 3 minutes, call 911.” “If the person doesn’t return to normal within 20 minutes after the seizure, call 911.”
20. Nelson LD, Temkin NR, Dikmen S, Barber J, Giacino JT, Yuh E, et al. Recovery after mild traumatic brain injury in patients presenting to US level I trauma centers: a Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study. JAMA Neurology. 2019;76(9):1049–1059. doi:10.1001/jamaneurol.2019.1313 (PMID 31157856). Cohort study.
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    “Most traumatic brain injuries (TBIs) are classified as mild (mTBI) based on admission Glasgow Coma Scale (GCS) scores of 13 to 15.” “mTBI [n = 1154]” patients “presenting to US level I trauma centers” with “clinical head CT scans”; “Patients with peripheral orthopedic trauma injury served as the control (OTC) group.” “At 12 months, the percentage of mTBI participants reporting functional limitations was 53% (95% CI, 49%-56%) vs 38% (95% CI, 30%-45%) for OTCs.” “A higher percentage of CT+ patients reported impairment (61%) compared with the mTBI CT- group (49%; relative risk [RR], 1.24; 95% CI, 1.08-1.43)”
21. Centers for Disease Control and Prevention. What to do after a mild TBI or concussion (September 15, 2025). Checked November 4, 2026.
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    “With proper care, most people can return to work, school, and many other activities within a few days or weeks after a mild TBI or concussion.” Talk with your healthcare provider if symptoms “Do not go away within 2 to 3 weeks, or” “Get worse after you return to your regular activities”. “Resting is good the first few days after a mild TBI or concussion as this is when symptoms are more severe.” “After one or two days of rest, it’s important to ease back into your regular activities even if you still have some mild symptoms. If your symptoms get worse, you should cut back on that activity.” “Recovery may be slower among: older adults, young children, and people who have had a concussion or other TBI in the past.”
22. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Concussion recovery. “Most people with a concussion who have symptoms recover in hours or a week to a few months. If you are older than 40, it may take a bit longer to get back to normal.” Checked November 4, 2026.
23. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Vision problems and traumatic brain injury (2014). Checked November 4, 2026.
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    “Therapists or other rehabilitation clinicians may be the first to notice a problem. They can make a referral to an eye doctor who can examine you and offer advice for treatment.” “Neuro-optometrists and neuro-ophthalmologists are specialists with additional training in working with people with brain-related vision problems.” Most common: “Blurred vision, especially with seeing up close”, “Double vision”, “Decreased peripheral vision”. “It may be difficult to read a computer screen.” “Irritable in places with a lot of patterns or motion (visual overload).” “Bothered by light or glare.” “Other visual problems can affect posture, balance, or moving through space.” “Professionals who provide vision treatment include eye doctors who specialize in brain-injury-related visual problems, low vision specialists, and occupational therapists.” Treatment “may involve surgery and/or vision rehabilitation therapy including therapeutic eye exercises”; “Specialized glasses such as prism glasses”; “Patching should be done under the supervision of a trained professional”.
24. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Employment after TBI (2025). Checked November 4, 2026.
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    “Vocational rehabilitation (VR) programs help you get the services you need to go back to work and to find and keep a job. VR counselors help with job seeking skills and job placement. VR counselors also help you learn and perform activities needed for your job (job coaching).” “They may have recommendations, such as working part-time at first and slowly returning to full-time or taking longer rest breaks.” “Volunteer to help you return to the community and to work. For example, volunteering can help improve communication skills, teamwork, and cognitive and physical endurance.” “When you are in rehabilitation, you can ask your doctor, rehabilitation therapist, or social worker to refer you to a VR program.” “VR counselors are available through state vocational rehabilitation agencies.” “You will work with your VR counselor to make a written plan with specific steps to reach your short- and long-term goals.” “Setting goals is important but keep in mind that you may need to adjust your goals as you work through this process.”
25. Turner-Stokes L, Pick A, Nair A, Disler PB, Wade DT. Multi-disciplinary rehabilitation for acquired brain injury in adults of working age. Cochrane Database of Systematic Reviews. 2015;(12):CD004170. doi:10.1002/14651858.CD004170.pub3 (PMID 26694853).
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    “To assess the effects of multi-disciplinary rehabilitation following ABI in adults 16 to 65 years of age.” “We identified a total of 19 studies involving 3480 people.” “Within the subgroup of predominantly mild brain injury, ‘strong evidence’ suggested that most individuals made a good recovery when appropriate information was provided, without the need for additional specific interventions. For moderate to severe injury, ‘strong evidence’ showed benefit from formal intervention, and ‘limited evidence’ indicated that commencing rehabilitation early after injury results in better outcomes. For participants with moderate to severe ABI already in rehabilitation, ‘strong evidence’ revealed that more intensive programmes are associated with earlier functional gains, and ‘moderate evidence’ suggested that continued outpatient therapy could help to sustain gains made in early post-acute rehabilitation.” “Those with moderate to severe brain injury benefit from routine follow-up so their needs for rehabilitation can be assessed.”
26. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Balance problems after traumatic brain injury (2021). Checked November 4, 2026.
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    “About half of people with TBI have dizziness and loss of balance at some point in their recovery.” “If you have other injuries along with your TBI. For example, in a car crash, you could have a TBI, neck injury, and broken ribs and legs. All of these injuries will affect your ability to keep your balance.” “If you have poor balance after a TBI, you have a high risk of falling. Falls can cause another TBI or a broken bone.” “PTs and occupational therapists (OTs) use balance tests to identify specific problems and assess your risk for a fall. These tests also measure and track your progress with balance.” Causes: “Medications.” “Postural hypotension.” “Vision problems.” “Inner ear problems.” “Problems with your ability to feel things.” “Brain stem injury.” “Mental health issues.” “Balance problems have many different causes. Each cause requires a different treatment.” “Your doctor, PT and OT, and other health care providers will work with you to find out and treat the different causes.” “A PT or OT can help design a program that is safe for you to practice at home.” “Most people with a TBI can walk on their own within 3 months of their injury. While most people walk again, many have problems moving quickly. They do not have the balance they need to return to activities such as running or sports.” “With hard work, people with TBI can continue to improve their balance for many years after injury.”
27. Kleffelgaard I, Soberg HL, Tamber AL, Bruusgaard KA, Pripp AH, Sandhaug M, Langhammer B. The effects of vestibular rehabilitation on dizziness and balance problems in patients after traumatic brain injury: a randomized controlled trial. Clinical Rehabilitation. 2019;33(1):74–84. doi:10.1177/0269215518791274 (PMID 30056743).
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    Single-blind randomized controlled trial: “A total of 65 patients (45 women) with mild-to-moderate traumatic brain injury”; “Group-based vestibular rehabilitation for eight weeks.” “At the first follow-up, statistically significant mean differences in favor of the intervention were found in the primary” outcome (Dizziness Handicap Inventory) and secondary outcome (High-Level Mobility Assessment Tool); “At the second follow-up, no significant between-group differences were found.” “No significant between-group differences in the other outcomes were found at the two follow-ups.” Other outcomes: “Vertigo Symptom Scale; Rivermead Post-concussion Symptoms Questionnaire; Hospital Anxiety and Depression Scale; and Balance Error Scoring System”. “The intervention appeared to speed up recovery for patients with dizziness and balance problems after traumatic brain injury. However, the benefits had dissipated two months after the end of the intervention.”
28. Hassett L, Moseley AM, Harmer AR. Fitness training for cardiorespiratory conditioning after traumatic brain injury. Cochrane Database of Systematic Reviews. 2017;(12):CD006123. doi:10.1002/14651858.CD006123.pub3 (PMID 29286534).
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    “Reduced cardiorespiratory fitness (cardiorespiratory deconditioning) is a common consequence of traumatic brain injury (TBI).” “A total of eight studies incorporating 399 participants are included in the updated review. The participants were primarily men aged in their mid-thirties who had sustained a severe TBI.” “no adverse events were reported in any study”. “There is low-quality evidence that fitness training is effective at improving cardiorespiratory deconditioning after TBI; there is insufficient evidence to draw any definitive conclusions about the other outcomes.” “there is no evidence of harm”
29. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Spasticity and traumatic brain injury (2024). Checked November 4, 2026.
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    “Spasticity is the uncontrolled overactivity of muscles caused by disrupted signals from the brain. It is common in persons with more severe traumatic brain injuries (TBIs).” “Regular stretching (range-of-motion) exercises will help maintain flexibility and temporarily reduce muscle tightness in mild to moderate spasticity.” “Splints, braces, or temporary casts that are adjusted as range of motion improves provide continuous muscle stretching that helps to maintain flexibility.” Medicines and injections such as botulinum toxin are other treatments; “You should discuss the benefits and side effects of these medications with a physician.”
30. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Driving after traumatic brain injury (2024). Checked November 4, 2026.
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    “Research suggests that between 60% and 70% of people return to driving after a TBI.” Changes include “Drive less than before their TBI.” “Drive only at certain times (such as during daylight).” “Drive only on familiar roads.” Abilities a TBI can affect: “Vision.” “Reaction time.” “Ability to do multiple tasks at one time.” “Ability to focus.” “Memory.” “Safety awareness and judgment.” “Many people with TBI may not be able to recognize their impaired driving skills. This makes it important to include family, friends, and health care providers in the choice to return to driving.” “Preliminary evaluation. This is a review of physical and cognitive abilities.” “This part may involve a doctor familiar with the person, a neuropsychologist, or an occupational therapist.” “Road test. This is a driving test.” “A certified driver rehabilitation specialist (CDRS) is a trained expert who helps drivers with unique needs.” “People who want to return to driving need to check the laws in their state. Laws are different for each state.” “Many states restrict driving within 6 months of a significant neurological event, such as a TBI.” “Many states require that people who had a seizure after TBI are seizure-free for some time (usually 6 months) before they return to driving.”
31. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Understanding TBI, part 4: the impact of a recent TBI on family members (2018). Checked November 4, 2026.
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    “For most family members, life is not the same after TBI.” Common problems include “less time for yourself, financial difficulties, role changes of family members, problems with communication, and lack of support from other family members and friends”. “Family members have commonly reported feeling sad, anxious, angry, guilty, and frustrated.” “If you are under constant stress, you are not going to be as helpful to your injured family member or anyone else.” Coping strategies others have found helpful: “Taking time for yourself”, “Getting regular exercise such as taking a 20-30 minute walk each day”, “Participating in support groups”, “Being more assertive about getting the support you need”. “Attending therapy when possible and working with the therapists and nurses are the best ways to learn to help the person before discharge from the hospital.” “Establish and maintain a daily routine - this helps the person feel more secure in their environment.” “Keep a calendar of activities visible on the wall.” “Maintain a photo album with labeled pictures”. Avoiding over-stimulation: “Agitation can be heightened by too much activity and stimulation.” “Restrict the number of visitors (1 or 2 at a time).” “Not more than one person should speak at a time.” “Use short sentences and simple words.” “Treat the person as an adult by not talking down to them.” “The person who has confusion or impaired judgment may be unable to remember where dangers lie or to judge what is dangerous”; “Keep clutter out of the hallway and off stairs or anywhere the person is likely to walk. Remove small rugs that could cause tripping or falls.” “Keep medications in a locked cabinet or drawer.” “Make sure rooms are well lit, especially in the evening. Night-lights can help prevent falls.” To be resumed only after consulting a health care professional: “contact sports, horseback riding, swimming, hunting or access to firearms, power tools or sharp objects, riding recreational vehicles, and cooking without supervision”. “Also, NO DRIVING until approved by your doctor.”
32. Togher L, Douglas J, Turkstra LS, Welch-West P, Janzen S, Harnett A, et al. INCOG 2.0 guidelines for cognitive rehabilitation following traumatic brain injury, part IV: cognitive-communication and social cognition disorders. Journal of Head Trauma Rehabilitation. 2023;38(1):65–82. doi:10.1097/HTR.0000000000000835 (PMID 36594860).
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    “Cognitive-communication disorders can significantly limit a person’s ability to socialize, work, and study”; “Cognitive-communication disorders should be individualized, goal- and outcome-oriented, and appropriate to the context in which the person lives and incorporate social communication and communication partner training. Group therapy and telerehabilitation are recommended to improve social communication. Augmentative and alternative communication (AAC) should be offered to the person with severe communication disability and their communication partners should also be trained to interact using AAC.”
33. Cicerone KD, Goldin Y, Ganci K, Rosenbaum A, Wethe JV, Langenbahn DM, et al. Evidence-based cognitive rehabilitation: systematic review of the literature from 2009 through 2014. Archives of Physical Medicine and Rehabilitation. 2019;100(8):1515–1533. doi:10.1016/j.apmr.2019.02.011 (PMID 30926291).
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    Systematic review for “cognitive rehabilitation of people with traumatic brain injury (TBI) or stroke”; “121 studies were fully reviewed”. “Evidence supports Practice Standards for (1) attention deficits after TBI or stroke; (2) visual scanning for neglect after right-hemisphere stroke; (3) compensatory strategies for mild memory deficits; (4) language deficits after left-hemisphere stroke; (5) social-communication deficits after TBI; (6) metacognitive strategy training for deficits in executive functioning; and (7) comprehensive-holistic neuropsychological rehabilitation to reduce cognitive and functional disability after TBI or stroke.”
34. Bayley MT, Janzen S, Harnett A, Teasell R, Patsakos E, Marshall S, et al. INCOG 2.0 guidelines for cognitive rehabilitation following traumatic brain injury: methods, overview, and principles. Journal of Head Trauma Rehabilitation. 2023;38(1):7–23. doi:10.1097/HTR.0000000000000838 (PMID 36594856).
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    “Moderate to severe traumatic brain injury (TBI) results in complex cognitive sequelae.” “reconvene the international group of cognitive researchers and clinicians (known as INCOG)”; “In total, the INCOG update contains 80 recommendations (25 level A, 15 level B, and 40 level C) of which 27 are new.” “Evidence-based cognitive rehabilitation guided by these recommendations should be offered to individuals with TBI.”
35. Ponsford J, Velikonja D, Janzen S, Harnett A, McIntyre A, Wiseman-Hakes C, et al. INCOG 2.0 guidelines for cognitive rehabilitation following traumatic brain injury, part II: attention and information processing speed. Journal of Head Trauma Rehabilitation. 2023;38(1):38–51. doi:10.1097/HTR.0000000000000839 (PMID 36594858).
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    “The team recommends screening for and addressing factors contributing to attentional problems, including hearing, vision, fatigue, sleep-wake disturbance, anxiety, depression, pain, substance use, and medication.” “Metacognitive strategy training focused on everyday activities is recommended for individuals with mild-moderate attentional impairments. Practice on de-contextualized computer-based attentional tasks is not recommended because of lack of evidence of generalization, but direct training on everyday tasks, including dual tasks or dealing with background noise, may lead to gains for performance of those tasks.” “methylphenidate is recommended to improve information processing speed”
36. Velikonja D, Ponsford J, Janzen S, Harnett A, Patsakos E, Kennedy M, et al. INCOG 2.0 guidelines for cognitive rehabilitation following traumatic brain injury, part V: memory. Journal of Head Trauma Rehabilitation. 2023;38(1):83–102. doi:10.1097/HTR.0000000000000837 (PMID 36594861).
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    “Of the external compensatory strategies, which should be the primary strategy for severe memory impairment, electronic reminder systems such as smartphone technology are preferred”; “Memory strategies should be taught using instruction that considers the individual’s functional and contextual needs while constraining errors.” “Computer cognitive training should be conducted with therapist guidance.”
37. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Understanding problem behavior changes after moderate to severe TBI (2021). Checked November 4, 2026.
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    “Behavior changes (also called personality changes) are common for people with a moderate or severe TBI. These changes often occur soon after the TBI and may change across time.” “People with a severe TBI are more likely to have behavior changes that last for a while. The good news is that behavior changes can get better as time passes.”
38. Model Systems Knowledge Translation Center (MSKTC), Traumatic Brain Injury Model Systems. Headaches after traumatic brain injury (2021). Checked November 4, 2026.
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    “Headache is one of the most common symptoms after traumatic brain injury”. “Over 30% of people with moderate to severe TBI report having headaches which continue long after injury. An even larger percentage people with mild TBI complain of headache.” “Most headaches are not dangerous. In the first few days after a concussion or head injury, a person should see a health care professional experienced in treating persons with brain injuries IF the following occurs”: “Headaches get worse.” “There is nausea and/or vomiting with a headache.” “Arm or leg weakness or problems speaking develop along with a headache.” “Increasing sleepiness occurs with headache.” “If some over the counter pain medications for headaches or certain prescribed medications are taken every day, they can actually lead to worsening headaches overall.” “Get daily exercise.” “Avoid taking pain medicines on a daily basis unless your health care provider prescribes it.” “Aerobic exercise such as walking and good stretching often help to prevent headaches by improving sleep and decreasing triggers.” “It’s important to discuss your headaches with your doctor and to keep track of headaches and your response to treatment. Many people use a headache diary to help them do this.”
39. Centers for Disease Control and Prevention. Moderate and severe TBI (May 16, 2024). Checked November 4, 2026.
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    “For those who survive, a moderate or severe TBI may lead to long-term or life-long health problems that may affect all aspects of a person’s life. These health problems have been described as being similar to the effects of a chronic disease.” Five-year outcomes: “22% died, 30% became worse, 22% stayed the same, and 26% improved.” “Data are US population estimates based on the TBI Model Systems National Database. Data refer to people 16 years of age and older who received inpatient rehabilitation services for a primary diagnosis of TBI.”
40. Moore JL, Potter K, Blankshain K, Kaplan SL, O’Dwyer LC, Sullivan JE. A core set of outcome measures for adults with neurologic conditions undergoing rehabilitation: a clinical practice guideline. Journal of Neurologic Physical Therapy. 2018;42(3):174–220. doi:10.1097/NPT.0000000000000229 (PMID 29901487).
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    “Strong, level I evidence supports the use of the Berg Balance Scale” and “the Activities-specific Balance Confidence Scale”; “Strong to moderate evidence supports the use of the Functional Gait Assessment”, “the 10 meter Walk Test to assess changes in gait speed, and the 6-Minute Walk Test to assess changes in walking distance”; “Best practice evidence supports the use of the 5 Times Sit-to-Stand”; “Evidence was insufficient to support use of a specific OM to assess patient-stated goals across adult neurologic conditions. Physical therapists should discuss the OM results with patients and collaboratively decide how the results should inform the plan of care.”
41. Centers for Medicare & Medicaid Services. Medicare Benefit Policy Manual, Chapter 15 (Rev. 13889, issued July 30, 2026), sections 220.1.2, 220.2 and 220.3. Checked November 4, 2026.
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    “The plan of care shall contain, at minimum, the following information”: diagnoses, “Long term treatment goals” and “Type, amount, duration and frequency of therapy services”. “Improvement is evidenced by successive objective measurements whenever possible”. “The minimum progress report period shall be at least once every 10 treatment days.”
42. Levack WM, Weatherall M, Hay-Smith EJC, Dean SG, McPherson K, Siegert RJ. Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation. Cochrane Database of Systematic Reviews. 2015;(7):CD009727. doi:10.1002/14651858.CD009727.pub2 (PMID 26189709).
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    “We included 39 studies (27 RCTs, 6 cluster-RCTs, and 6 quasi-RCTs) involving 2846 participants in total.” “The most common health conditions included musculoskeletal disorders, brain injury, chronic pain, mental health conditions, and cardiovascular disease.” “There is some very low quality evidence that goal setting may improve some outcomes for adults receiving rehabilitation for acquired disability. The best of this evidence appears to favour positive effects for psychosocial outcomes (i.e. health-related quality of life, emotional status, and self-efficacy) rather than physical ones.”
43. Centers for Disease Control and Prevention. TBI in the workplace (August 5, 2025). Checked November 4, 2026.
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    “Returning to work after a TBI is different for each person”, depending on “Severity of the injury and symptoms” and “Tasks employees are required to perform as part of their job”. “Some people with a TBI can return to work within a couple of days of their injury and may only need short-term support or accommodations during their recovery, like rest breaks during the day or earplugs to limit sensitivity to noise. Others may need weeks, months, or longer before returning to work. Some people may not be able to return to work (or the same type of employment) due to long-term disability or persistent symptoms.” Workers may need more time off if a job requires “Working from heights, including climbing a roof or ladder, or the risk of falling”, “Intense physical activity, such as running and heavy lifting”, “Attention or concentration”, “Driving”, “Operating machinery or heavy equipment” or “High-stress or safety risks, such as work with hazardous materials”. Providers “can also provide instructions on when a worker can safely return to work and list any needed supports or accommodations”.
44. U.S. Equal Employment Opportunity Commission. Facts about the Americans with Disabilities Act. Checked November 4, 2026.
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    “The ADA covers employers with 15 or more employees, including state and local governments.” “An employer is required to make a reasonable accommodation to the known disability of a qualified applicant or employee” unless it would impose an undue hardship; “An employer generally does not have to provide a reasonable accommodation unless an individual with a disability has asked for one.”
45. U.S. Department of Labor, Wage and Hour Division. Family and Medical Leave Act. Checked November 4, 2026.
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    “The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for qualifying family and medical reasons”; “up to 12 workweeks of leave in a 12-month period”; “Eligible employees may use FMLA leave intermittently or on a reduced schedule when medically necessary”.
46. Centers for Medicare & Medicaid Services. Skilled nursing facility care (Medicare.gov). Checked November 4, 2026.
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    Medicare covers SNF care after a “qualifying inpatient hospital stay”, “inpatient hospital stay of at least 3 days in a row (starting the day you were admitted as an inpatient, but not including the day you leave the hospital)”; “Time you spend at the hospital under observation or in the emergency room before you’re admitted doesn’t count toward the 3-day qualifying inpatient hospital stay”. In 2026: “Days 1–20: You pay $0 each day after you pay the $1,736 deductible”; “You don’t have to pay the Part A deductible for skilled nursing facility care if you already paid it for care you got in a hospital during the same benefit period.” “Days 21–100: You pay $217 each day.”
47. Centers for Medicare & Medicaid Services. Costs (Medicare.gov), “What you pay in 2026”. Checked November 4, 2026.
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    Part B deductible: “$283 before Original Medicare starts to pay”; coinsurance: “Usually 20% of the cost for each Medicare-covered service or item after you’ve paid your deductible”. Skilled nursing facility stay: “Days 1-20: $0 each day after you pay the Part A deductible.” “Days 21-100: $217 each day.”
48. Centers for Medicare & Medicaid Services. Occupational therapy services (Medicare.gov). “Therapy to help you perform activities of daily living (like dressing or bathing). You can get this therapy to help improve or maintain your current capabilities, or slow your rate of decline”; a doctor or other health care provider “must certify you need this care”. Checked November 4, 2026.
49. Centers for Medicare & Medicaid Services. Speech-language pathology services (Medicare.gov). Evaluation and treatment “to regain and strengthen speech and language skills. This includes cognitive and swallowing skills, or therapy to improve or maintain current function or slow decline”. Checked November 4, 2026.
50. Centers for Medicare & Medicaid Services. Therapy services (CMS.gov, page last modified March 10, 2026). Checked November 4, 2026.
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    The law “preserves the former therapy cap amounts as thresholds above which claims must include the KX modifier as a confirmation that services are medically necessary as justified by appropriate documentation in the medical record”; “Claims for services over the KX modifier threshold amounts without the KX modifier are denied. For CY 2026 this KX modifier threshold amount is: $2,480 for PT and SLP services combined, and $2,480 for OT services”; “the MR threshold is $3,000 for PT and SLP services and $3,000 for OT services”; “not all claims exceeding the MR threshold amount are subject to review”; section 6209 of the Consolidated Appropriations Act, 2026 “extended the ability of PTs, OTs, and SLPs to furnish Telehealth Services” “through December 31, 2027”.
51. Centers for Medicare & Medicaid Services. Compare Original Medicare & Medicare Advantage (Medicare.gov). Checked November 4, 2026.
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    Medicare Advantage: “You may need to use doctors and other providers who are in the plan’s network”; “You may need to get a referral to see a specialist”; “You may need to get approval (prior authorization) from your plan before it covers certain services or supplies”; “Plans may have different out-of-pocket costs for certain services”; “Plans have a yearly limit on what you pay for covered Medicare services”.
52. Centers for Medicare & Medicaid Services. Home health services (Medicare.gov). Checked November 4, 2026.
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    Covered services include “Physical therapy, occupational therapy, and speech-language pathology services”; “You must need part-time or intermittent skilled services and you’re” homebound; home health can help you “maintain your current condition or level of function, or slow your rate of decline”; “You pay nothing for covered home health services.”
53. Centers for Medicare & Medicaid Services. Telehealth (Medicare.gov). “Through December 31, 2027, Medicare covers telehealth services that you can get from anywhere in the U.S., including your home.” The examples listed include “Speech therapy” and “Cognitive assessments”. Checked November 4, 2026.
54. HealthCare.gov. What Marketplace health insurance plans cover. Checked November 4, 2026.
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    “All plans offered in the Marketplace cover these 10 essential health benefits”, including “Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)”; “Specific services covered in each broad benefit category can vary based on your state’s requirements”.
55. Brain Injury Association of America. Guiding principles when selecting a brain injury rehabilitation program. Checked November 4, 2026.
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    “Learn as much as you can about any program that might be appropriate for your loved one by asking questions about its staff, service philosophy, history, and method of collecting outcome data.” “try to talk with individuals who have participated in each one. Support groups are often a good way to find people who have had experience with a program you are considering.” “Ask prospective facilities how to obtain outcome data and quality information about their program.” “The closest program or the one that offers the most services may not necessarily be the best for your loved one’s individual needs.” “Get any commitments in writing of the types, quantities, and costs of services to be provided before you finalize your decision.” “talk with your insurance carrier, managed care organization, or other health care payer to find out how much it will pay, for what services, for how long, and under what conditions”.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your individual situation. If you are worried about immediate safety, call or text 988 (US). Never start, stop, or change a dose without medical guidance. Seek emergency assessment for any head injury with the symptoms listed above.