FAQ: Concussion Clinic Model

Athletic Trainers in a Physician Practice: Concussion Clinic Model


What role does an athletic trainer serve in a concussion clinic?  Athletic trainers (ATs) working in a physician practice setting have been seen as a valuable asset in both increasing revenue and patient satisfaction. Athletic trainers have a particularly unique role in a concussion clinic because of their educational background in prevention, recognition and treatment of concussions. This also includes an AT’s ability to administer and interpret a battery of cognitive testing used in concussion management.


What type of testing can an AT administer in a Concussion clinic? Testing provides insight on patients’ deficits and can help guide the plan of care to the areas where the patient is struggling the most. Testing can be used to measure progress and support shifts in treatment strategies.Three common test types administered (and corresponding E&M codes) include:

  • Neurocognitive Assessment Testing (96120, 0.51 RVUW) - Computerized neurocognitive assessments provide trained clinicians with objective data for return to learn and return to sport.
  • Balance Testing (92065, 0.37 RVUW) - Assessment of balance and body alignment in various stances and surfaces. Some applications will use motion sensors in an IOS device to quantify postural deviation.
  • Oculomotor Testing (92065, 0.37 RVUW) - Evaluation of saccades, rapid eye movement, between fixation points.


In what other ways can an athletic trainer function within a Concussion Clinic?

  • Obtain History of Present Illness (HPI). ACE - Acute concussion evaluation - This form includes HPI, symptom checklist, concussion history, and brief medical history.
  • Coordinate plan of care. Putting the plan of care into action is essential to the patient’s recovery. Most of these tasks take place after the office visit. Having an AT complete these tasks off-loads non-billable tasks the physician has to complete, allowing the physician to optimize the time they spend in a billable visit. Optimizing the physician’s time can directly impact the number of patients the physician is able to see.  
  • Find locations for physical therapy, occupational therapy, cognitive rehabilitation. Facilitating the patient’s aftercare is extremely important to recovery. Establishing relationships and creating a referral network allows the patient to receive the best care from trusted healthcare provider services such as physical and cognitive therapy.
  • Scheduling. The ability to line up the right patients with the right providers increases productivity and patient satisfaction. ATs utilize clinical background to develop, maintain, and navigate comprehensive triage algorithms to allow patients timely access to the appropriate provider. Additionally, ATs can coordinate care with typically “hard to reach” providers. For example, formal neuropsychology scheduling can take upwards of 3-9 months to secure appointments. ATs working in concussion clinics may have access to scheduling or have priority to schedule which can greatly reduce wait time.
  • Building community relationship. The ability to build relationships with community members external to the practice (schools, sports organizations, etc) expands the awareness of an AT’s involvement in concussion clinics to outside health care systems. There is also the potential to lead the formation of strategic partnerships in the community by educating clubs, school, groups, teams, etc with orthopedic/ concussion specific information. Additionally, ATs could organize and facilitate youth “baseline testing night,” increasing clinic exposure and downstream revenue.
  • Complete Administrative Duties
    • Document accommodations for work, school, daily activities
    • Phone calls - counseling patients and parents between visits
    • Emails - returning emails to other providers regarding care or changes in treatment strategies


How can an athletic trainer affect efficiency in a Concussion Clinic? Athletic trainers can affect efficiency in a concussion clinic by off-loading non billable tasks from the physician. The athletic trainer can administer cognitive testing and complete patient intake (HPI) allowing a physician to see another patient during that time. Total time administering cognitive testing and completing patient intake can be 50 –65 minutes that the physician can see additional patient(s).


How does increased throughput generate increased revenue for physicians? New concussion patients would have both an evaluation code and one or more cognitive testing codes associated with their visit. Due to the extensive amount of counseling for a new concussion, the visit is coded for a level 5 new patient (99205). The charts below compare the RVUW for a new concussion visit with a new orthopedic visit.  A new concussion visit is 3 more RVUW than a new orthopedic visit.


Visit Type & CPT


New concussion 99205 -


Impact – 96120


Sway Balance 92065


King Devick 92065





Visit Type and CPT


Ortho NP 99203





Visit Type and CPT

Medicare Rates for CPT

Ortho NP 99203


Concussion NP 99205



 Athletic trainers can perform a multitude of tasks in a concussion clinic that are vital to both clinic revenue and patient care. These tasks range from administering cognitive testing, to coordinating patient aftercare, to handling administrative tasks. While not all tasks ATs perform in a clinic are directly billable, tasks handled by ATs help free physician time to see additional patients, chart, dictate, bill, etc. These responsibilities affect clinic revenue in a downstream manner. All of these responsibilities are critical to running a successful, profitable concussion clinic.