Use case · Neurology and sports medicine

mTBI: recovery you can measure without a sensor

Most of neurology has no wearable. There is no cuff for a concussion. What exists is a camera, a screen, and a set of validated tasks — oculomotor function, photophobia thresholds, reaction time — that a patient can perform at home and a platform can turn into a recovery trajectory. This is the program Bluetooth-only platforms cannot run at all.

The problem

Concussion recovery is multi-system, and office visits sample it weekly

Oculomotor function, light sensitivity, symptom burden, sleep, and exertional tolerance recover on independent clocks. A weekly visit samples that trajectory a handful of times, under clinic lighting, with an athlete or a student who has every incentive to underreport. Cleared too early risks reinjury; held too long costs a season, a semester, or a job. Both errors come from deciding on too few data points.

Oculomotor tasks, at home
Camera-derived · daily
Smooth pursuit, saccades, convergence — scored from smartphone camera tasks the patient runs in under four minutes. The trajectory, not any single score, is the clinical object.
Photophobia threshold
Luminance staircase · daily
A screen-based staircase finds the brightness the patient tolerates. It is the stream that most often diverges from what the patient says at the visit.
Symptom burden and exertion
PRO + staged protocol
Standardized symptom inventory paired with a staged exertional protocol. Each stage advance is a threshold decision with a named owner, not a sideline judgment call.

The billing reality, stated before you build on it

This program runs as RTM under the cognitive behavioral therapy device-supply category (98975 · 98978 · 98986 with the management codes), and that category fit is imperfect. Document the therapeutic monitoring rationale explicitly and get a coverage read from your MAC before you build volume assumptions on it. The 2026 short-duration codes matter here: a two-week return-to-play protocol is now a billable program, not a courtesy. Full code logic on the post-concussion program page.

What to measure

The numbers this program should be judged on

Median days to symptom-free at full exertion. Percentage of return-to-learn decisions made without relapse. And the clinically interesting one: how often the oculomotor curve and the symptom report disagree — because that divergence, in either direction, is where a camera earns its place in a clinic that used to decide by asking.