TBI Recognized as Chronic Condition by the CMS

By Michael Kaplen, of De Caro & Kaplen, LLP,

In a victory for the brain injury community, the Centers for Medicare and Medicaid Services (CMS) has recognized traumatic brain injury (TBI) as a chronic health condition.

CMS has added TBI to its list of chronic conditions for chronic special needs through its Medicare Advantage program effective for the January 2025 plan year  This significant addition was made though the advocacy efforts of The Brain Injury Association of America who will continue to fight to expand coverage for all types of brain injury with the ultimate goal of greater coverage across all forms of public and private insurance.

This is an important first step in advocacy efforts to expand coverage for brain injury beyond acute care and helps to make the case that brain injury should be treated by healthcare providers as a chronic condition like heart disease or diabetes.