Launching a neurological rehab program can transform both your clinic and your community. You’ll not only improve patient lives but also open new doors for growth and long-term success. In this guide, you’ll find practical insights, lessons learned, and real-world steps to help you confidently add neuro rehab to your outpatient practice.
Launching a neurological rehabilitation program can be one of the most rewarding and strategically powerful decisions your clinic ever makes. I know because I’ve been there myself. As a clinic owner and physical therapist who managed an outpatient orthopedics/sports medicine clinic, I saw firsthand how opening to neurological rehabilitation not only filled a major community need but also brought new life and purpose into our clinic’s mission.
If you’re considering expanding your services, this guide offers real-world insight and practical steps you can take to build a thriving outpatient neurological rehab program.
Understanding Neurological Rehab
To think of the human body in silos of ortho, neuro, cardio, etc is helpful at times but I believe it oversimplifies the complexity of the human body and takes away from how amazing we truly are as humans. Although this article talks about neurological rehab, we all understand the overlap and interplay of all the bodies systems. For the purposes of this article, neurological rehabilitation will be defined as the treatment and support of individuals with conditions affecting the central and peripheral nervous systems such as:
- Stroke
- Parkinson’s disease and other centrally mediated movement disorders
- Traumatic brain injury (TBI)
- Concussion
- Spinal cord injury
- Vestibular disorders
When working with patients with neurological conditions, it’s important to understand that prior level of function is unrealistic in many cases. Full recovery is not always the goal; it’s also about adapting to permanent or progressive impairments with the best possible function and independence.
Deciding When to Make the Jump
If neurological rehabilitation is of interest to you, it is important to get into it for the right reasons. In my case, my primary interests were sports medicine and orthopedics. However, we kept hearing a local demand for neuro rehab services – requests that we couldn’t fulfill. Instead, we had to refer those patients elsewhere, which never sat well with me. I wanted to be able to help the people who came to us. Over time, I discovered a passion for treating vestibular conditions (I stand by the fact that the Epley maneuver is the greatest manual therapy technique ever!).
The final push came when a therapist on my team expressed interest in working with patients with Parkinsons Disease. With a clear community need, my newfound interest in vestibular rehab, and a motivated team member, I decided to make the jump and expand our services.
My clinic developed a new program to treat patients with neurological conditions, where we hadn’t been able to do so before. This didn’t happen overnight, and we navigated many trials and triumphs alone the way. From each challenge came a lesson, so here are 12 insights to guide any clinic through the process of adding a new service.
1. Assessing Local Demand
To determine what the local demand is for an outpatient neurological rehabilitation program, start by asking some of the below questions:
- Demographic data: Are you near a retirement community or large hospital system? Are there any other outpatient neurology groups close by?
- Referral volume: Are local physicians referring patients out of town for neurological care?
- Support groups: Are there groups for individuals post stroke, SCI or post diagnosis of Parkinson’s disease meeting nearby? Reach out to these groups and ask what services they are missing—they’ll be eager to tell you.
2. Funding a New Neuro Rehab Program
Getting started does not have to be excessively costly, but it can require up-front investment. Be prepared for costs in:
- Equipment
- Specialty certifications
- Staff training
- Marketing
For small practices: Start with versatile tools and a few trained clinicians. Even having one clinician who specializes in one specific diagnosis can be a great, low-cost start. There is also the potential for local grants or business development funds.
For larger organizations: Consider a phased launch or pilot program to get an understanding of how to best implement this company wide if that is a goal. You may only want to have one location that is the specific outpatient neuro clinic.
In my clinic, we started slow and tried to minimize expense. First, we paid for our therapist to get LSVT certified. We bought new equipment, and in some cases, we got creative and made tools with items we already had on hand. The combination of investing in new equipment and using our creativity helped us start on the right foot.
3. Making Your Facility Accessible
Your space should support patients with diverse impairments both physically and cognitively. Use ADA facility guidelines to ensure your facility is compliant. These guidelines will also give you ideas on how to make your facility most accessible.
- Flooring: Non-slip, firm surfaces. Rugs, transition strips, raised surfaces, slopes, etc can create obstacles for accessibility.
- Layout: Wide hallways, minimal clutter, clear signage
- Parking: Ensure you have enough handicapped spaces and they are ADA compliant.
- Restrooms: ADA compliant
4. Getting the Right Equipment
When choosing equipment, look for:
- Multi-functionality
- Objective data tracking
- Evidence-based support
Start with the essentials. Check out our Guide to Neuro and Hand Therapy Tools for tips on evaluating treatment tools. It is important for patients and caregivers to receive reliable and valid assessments and treatments. Measurable progress should be provided via the equipment you are using to assess and treat with. This facilitates buy-in from patients and caregivers and it also allows the clinicians to monitor progression/regression.
In my clinic, we had multiple patients that were emotionally distressed by their diagnosis and were not motivated to participate in PT. However, we were able to turn that around when caregivers attended the sessions. We provided them with results of baseline testing and educated them on what that data means and how we were going to work on it together. With this explanation, caregivers were encouraged and highly motivated to ensure compliance.
When we reassessed after treatment, both the patients and caregivers saw significant improvement. The caregivers would be ecstatic to witness the patient’s excitement and renewed engagement in therapy. Sometimes, a small dose of hope (grounded in good objective data) can mean the world to patients and caregivers.
Neuro Rehab Treatment Tools
There are a lot of treatment tools out there, some simple and some complex and technology based. It was always exciting for me to see patient reactions when they were able to use a rehab tool that simulated functional tasks that they could no longer do because of their condition. Below is a list of some of the key tools that are helpful for treatment of neurological conditions:
- Hi-low tables
- Low mat tables
- Parallel bars and training stairs
- Standing frames
- Gait and motion analysis technology
- Body weight support and unweighting systems
- Functional Electrical Stimulation
- Slide boards
- Pulley systems
- Straps for positioning and isolating
Essential BTE products for neurological rehab:
- Capri – Upper extremity therapeutic gaming device for motor control and coordination
- Alfa – Ideal for balance, proprioception, and functional mobility
- PrimusRS – High-performance rehab system for quantifiable, functional movement training for both upper and lower extremities
- Simulator II – Great for upper body task-specific training and ADL simulation
Also see: Occupational therapy equipment for stroke rehab
5. Neuro Rehab Outcome Tracking Tools
Tracking outcomes both objectively and subjectively is of utmost importance in all populations. Ensuring your outcome tracking tools stays up to date will be massively helpful for patient success. Here are a few tracking tools that are common in neuro rehab:
- Subjective
- Dizziness Handicap Inventory
- ABC scale
- Stroke Impact Scale
- NeuroQOL
- Objective
- Timed Up and Go (TUG) and its many variations
- Berg Balance Scale
- Unterberger Test (or Fakuda Step Test)
- Romberg Test
- MiniBEST test
- Functional Gait Assessment
- Dynamic Gait Assessment
- Modified Ashworth Scale
- HINTS Exam
- BTE’s built-in data tracking for patient progress
Read more on Five Essential Balance Assessments for Stroke Rehab and Standardized Stroke Assessments.
6. Hiring and Training for a New Neuro Rehab Program
Staffing is key. Sound clinical reasoning skills and creativity are necessary to be successful in neuro rehab. Compassionate therapists who desire to serve others and can handle complex cases physically, socially, and emotionally are imperative for well-delivered care.
Consider:
- Interview questions to ask new clinical candidates
- Neuro-specific certifications like NCS, Lee Silverman Voice Technique (LSVT)
Management also needs to be aware of how demanding neuro rehab can be on therapists. Support your team well, because neuro rehab can be taxing emotionally and socially. Check in often and make sure your therapists are getting the support they need. Healthy staff equals healthy patients.
I would find ways to get therapists extra PTO when I sensed their workload was high in terms of volume and/or complexity. This was always appreciated, even more than financial compensation, when I asked staff for feedback on our operations and care delivery.
7. Interprofessional Communication in Neuro Rehab
Rehab is usually only one aspect of a patient case. Care for individuals with neurological impairments typically involves multiple disciplines. Unfortunately, communication between these disciplines is often lacking and practitioners operate in silos verses as an interprofessional team.
A successful neuro rehab program will be intentional about establishing relationships with other disciplines involved in the care of their patients. This type of communication allows for relationships to be established which will help grow your practice. Also, understand your role in patient care, you are not going to be the best fit for every individual and you must understand when to refer out to someone who can better serve the patient
At my clinic, we had a standard procedure of calling the referring physician after we evaluated their patient to give them a brief synopsis of our assessment. This organically led to good relationship building and efficient communication. If you are an outpatient clinic with no affiliations, it may sound “old fashioned” but, communicating via phone call is the move.
It takes some leg work to establish your own list of providers you trust in different disciplines. But once you do, picking up the phone and calling them to talk shop or refer a patient to them is very helpful not only for you, but also the patient.
8. Designing The Patient Experience
Great outcomes start with great receptionists and thorough evaluations. Having a friendly and capable front office staff makes a huge difference in the entire patient experience. They are the first line of interaction with patients and set the tone for what type of experience they will have. Qualities to look for in your front office staff include compassion, patient, outgoing, good at multitasking, working independently, and problem-solving skills.
Once the intake is complete, a thorough evaluation is of utmost importance. According to a 2022 study, patients want answers to these four questions right away:
- What is going on with me? (diagnosis)
- How long will it take to see improvement? (prognosis)
- What can I do about it? (treatment plan)
- What can you, the therapist, do about it? (treatment plan)
Read more about The 4 Things Patients Expect from You.
If a patient and/or caregiver leaves your clinic with clear answers to those questions, they will be set up for success because they know what’s going on and have a plan in place.
In neuro rehab, caregivers often have a very active role. At times, they need to be taught how to administer interventions if appropriate. When talking to caregivers or patients, it is important to be “realistically optimistic” about outcomes.
9. Documentation and Billing in Neuro Rehab
Billing in neuro rehab will typically involve CPT 97530 (therapeutic activity) and 97112 (neuromuscular re-reduction). These codes typically reimburse at higher rates than other rehab CPT codes. Avoid pitfalls with proper documentation by checking out this guide to physical therapy CPT codes.
10. Marketing New Neuro Rehab Services
When you start a neurological rehab program, you will need to get the word out to potential patients and referrers. Some ways to build awareness are:
- Contact local physicians and senior centers
- Email your current contacts
- Update your website with search engine optimization strategies
- Finding local advertising and engagement opportunities, such as races, community fundraisers, street festivals, etc
Your new rehab program set you apart from other PT clinics around you. Getting the word out will be helpful to those who need it and also improve your clinics revenue. We had other PT clinics referring patients to us because they did not have the skillset needed for specific patients. Our schedules got busy after our program gained traction, we were billing CPT 97530 more often which reimburses about $5-8 more per unit, and our cancellation rate improved. All these factors and more had a positive financial impact on our bottom line.
Need help? Here’s how to build a clinic marketing strategy.
11. Growing Referrals in Neuro Rehab
To build a good referral base, establishing good relationships is key. Investing in relationships with local neurologists through lunches or talking through patient cases will be pivotal in gaining referrals. However, word of mouth and establishing yourself in the community is a great way to grow referrals as well.
In the early days, we found a local support group for individuals with PD and provided free education about PD treatment strategies. This brought around five new patients over the next two weeks, and it’s been a consistent referral source ever since. We continue to do a free educational session once or twice a year to keep that relationship going. In addition, I set up lunch and learn sessions at local physicians’ practices to educate them on our services and how we can benefit their patients.
We also established a great connection with a non-profit whose mission it was to help individuals get back to exercising after neurological injuries. They had relationships with adaptive equipment manufactures, neurology groups, OT’s and strength and condition professionals that worked with people who had neurological impairments. We did this by supporting them at the events they held and even participating in their annual triathlon with adaptive athletes.
12. Tracking Program Success
Once you establish your neurological rehab program, you need to monitor it to see if it is successful. A successful program is one that delivers high quality of care, positively impacts the lives of your patients and improves your PT practice culturally and financially. To ensure this is happening, monitor the following details:
- Patient outcomes
- New patient volume
- Referrals
- Revenue growth
Use both clinical data and business KPIs to track progress.
Adding New Services to your Clinic
In conclusion, starting a neuro rehab program takes vision, planning, and persistence, but it’s more than worth it. You’ll make a massive impact, not only in your community, but also in your clinic’s long-term success.
Explore BTE’s neuro rehab equipment:
Capri Upper Extremity Neuro Rehab System
Dan Squire, PT, DPT earned his degree from Campbell University. Before joining BTE as a Clinical Specialist, he managed an outpatient physical therapy clinic where he specialized in orthopedic and sports medicine as well as vestibular therapy. With BTE, he performs installations and provides training on advanced rehabilitation equipment for clinicians around the world.
