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TBI Resources for Medical Providers

TBICoE develops practical, easy-to-use clinical recommendations and tools to support military and civilian health care providers in assessing and treating service members and veterans who have sustained a TBI. Providers can access clinically relevant information and resources that address common symptoms associated with mild TBI, such as headache, sleep disturbances, and vision problems. Most clinical recommendations have related patient resources to help educate patients through recovery. Check out the Patient and Family Resources section to locate fact sheets, patient resources, and family and caregiver support tools.

Interested in learning more about the potential effects of low-level blast exposure? Discover which occupations and heavy weapon systems are associated with increased risk of LLB exposure and learn how to best document, manage, and care for your patients—to optimize warfighter brain health.

TBI educators, known as regional education coordinators, are available to provide training on our clinical recommendations and tools. Check out TBICoE's Education and Training Events page for details or email the team to schedule specific trainings for yourself or your team. Supplemental Provider Education materials are also available.

Acute Concussion Care Pathway

In order to standardize acute concussion assessment and care across the MHS, DHA established the Acute Concussion Care Pathway as part of the FY21 Quadruple Aim Performance Plan.

The goal of the ACC Pathway is to improve recovery times and outcomes by utilizing a multi-modal assessment tool at the time of injury—the Military Acute Concussion Evaluation version 2—and to ensure timely access to repeat evaluations with personalized treatment protocols in alignment with a progressive return to activity process. By establishing a standard pathway of care for mild TBI, providers across the MHS can ensure a reduction in unwarranted variation and foster an integrated system of readiness and health.

Supporting the goal of the ACC Pathway, the DHA Procedural Instruction 6490.04, titled “Required Clinical Tools and Procedures for Assessment and Clinical Management of Mild Traumatic Brain Injury /Concussion in Non-Deployed Setting,” establishes the DHA's required clinical tools and procedures for management of mild TBI, or concussion, in a non-deployed setting. Specifically, the use of the MACE 2 and a PRA framework for the assessment, management, and rehabilitation of all patients with a mild TBI.

The ACC Pathway—a standardized assessment and treatment plan for acute concussion, mandates:

  1. Use of the MACE 2 for acute assessment at the initial appointment 
  2. Follow-up within 72 hours after diagnosis of mild traumatic brain injury
  3. Completion of a progressive return to activity process prior to return to full duty

This infographic and educational video focus on standardizing the nomenclature for the ACC Pathway, delineating how each element intertwines to meet the objective of improving concussion outcomes across the MHS. 

What is the Acute Concussion Care Pathway? The Acute Concussion Care Pathway is one of the DHA Director’s Quadruple Aim Performance Plan projects. The intent is to equip providers with state-of-the-science tools to standardize concussion assessment and care across the MHS. It is supported by the DHA Procedural Instruction 6490.04 which establishes the infrastructure to ensure patients achieve optimal concussion clinical outcomes.  What is the Acute Concussion Care Pathway?

Download the ACC Pathway Infographic

TBICoE also offers a quarterly "Application of Acute Concussion Care Pathway: MACE 2 & PRA" virtual training. Attendees may earn two CEUs through the Defense Health Agency Continuing Education Program Office.

The DOD published the DODI 6490.11, "DOD Policy Guidance for Management of Mild Traumatic Brain Injury/Concussion in the Deployed Setting" establishing policy, assigning responsibilities, and providing procedures on the management of mild TBI, also known as concussion, in the deployed setting.

TBICoE's MACE 2, PRA clinical recommendation, Recurrent Concussion Evaluation, and ICD-10 Coding Guidance for TBI support the ACC Pathway, the DHA-PI 6490.04, and the DODI 6490.11 and are available for download below.



The 2018 MACE 2 is an acute assessment tool for all medically trained personnel who treat service members involved in a potentially concussive event. The clinical tool incorporates current state-of-the-science traumatic brain injury information, including vestibular-ocular-motor screening.

Download the MACE 2 and supporting materials.


Progressive Return to Activity

The 2021 Progressive Return to Activity: Primary Care for Acute Concussion Management clinical recommendation is an evidence-based return to activity protocol for primary care managers and concussion/TBI clinic providers.

Download the Progressive Return to Activity: Primary Care for Acute Concussion Management clinical recommendation and Patient and Leadership Guide.


Recurrent Concussion Evaluation

Download the Recurrent Concussion Evaluation


ICD-10 Coding Guidance for TBI

Download the ICD-10 Coding Guidance for TBI

Clinical Recommendations and Support Tools for Mild TBI

TBICoE optimizes clinical care by combining evidence from medical literature, health care research, and expert opinion to develop and provide clinical recommendations and tools to help providers deliver evidence-based treatment and address the challenges associated with mild TBI.

  • Clinical recommendations provide guidance on assessing and managing mild TBI symptoms.
  • Clinical support tools offer an algorithmic approach to evaluating, managing, and referring mild TBI patients for specialty care.
  • Training material to show providers how to identify and treat patients with mild TBI-related symptoms.
  • Fact sheets and patient guides that provide tips and tools to help service members and veterans cope with a mild TBI.

*NEW* Neuroendocrine Dysfunction Following Concussion/Mild TBI Provider Fact Sheet

Learn more and download this new provider tool here!

Neuroendocrine Dysfunction Screening Following Concussion/Mild TBI


Neuroimaging Following Concussion/Mild TBI


Dizziness and Visual Disturbances Following Concussion/Mild Traumatic Brain Injury


Sleep Disturbances Following Concussion/Mild TBI


Headache Following Concussion/Mild TBI


Cognitive Rehabilitation Following Mild to Moderate TBI


Neurocognitive Assessment Tool (NCAT) Testing Following Concussion/Mild TBI


Additional Clinical Support Tools

TBICoE also offers the following tools to assist in the identification, treatment and management of patients with mild TBI in deployed and non-deployed settings.

Find and download the additional tools here.

You also may be interested in...

Aug 4, 2020

TBI Hot Topics Bulletin September 2020

.PDF | 236.67 KB

Are you a busy health care provider? Not enough time to keep up with research? Stay informed with the TBI Hot Topics Bulletin. We track the latest TBI scientific studies, advances, and discoveries most relevant to health care providers. This issue covers the second quarter of calendar year 2020.

Aug 4, 2020

SCORE Chapter 2

.PDF | 409.36 KB

Psychoeducational Interventions for Persistent Post-Concussion Symptoms Following Combat-Related Mild TBI Chapter two summarizes the psychoeducational interventions used for the control group in the first SCORE treatment arm (SCORE Arm 1). This educational material has been specifically adapted for use with service members and veterans who experience ...

Jul 31, 2020

Management of Headache Following Concussion/mTBI Clinical Recommendation

.PDF | 229.14 KB

This clinical recommendation outlines the assessment and management of headache following mild TBI. It includes specific recommendations regarding how health care providers can help patients manage pharmacologic and non-pharmacologic treatment of post-traumatic headache (PTH).

Jul 31, 2020

Indications and Conditions for In-Theater Post-Injury Neurocognitive Assessment Tool (NCAT) Testing

.PDF | 90.21 KB

This clinical recommendation provides background of pre-deployment neurocognitive testing and the use of automated neuropsychological assessment metrics (ANAM).

Jul 31, 2020

Management of Headache Following Concussion/mTBI Clinical Support Tool

.PDF | 154.16 KB

This clinical support tool uses an algorithmic approach for health care providers to help assess and manage headache in service members and veterans who sustain a mild TBI and experience post-traumatic headache (PTH). The tool offers providers a step-by-step process to determine the type of headache following mild TBI and indications for emergency or ...

Jul 31, 2020

ICD-10 Coding Guidance for TBI

.PDF | 193.46 KB

TBICoE developed this quick reference resource based on the latest coding guidance and the Military Health System Professional Services and Specialty Medical Coding Guidelines Version 5.0, to facilitate consistent and accurate coding for TBI diagnoses and related symptoms and conditions.

Jul 31, 2020

Management of Sleep Disturbances Following Concussion/mTBI Clinical Recommendation

.PDF | 200.64 KB

This TBICoE clinical recommendation outlines how to identify and assess sleep disturbances following a concussion; primary care manager initial treatment options; and recommended conditions for referral to sleep medicine.

Last Updated: November 30, 2023
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