Rehabilitation after stroke, spinal cord injury and surgery: state programmes and services for children

What is rehabilitation and who decides on the plan?

Rehabilitation is the stage of treatment when the acute condition has stabilised and the aim is to restore lost function or adapt to new circumstances: walking, self-care, speech, swallowing, everyday activities. It is delivered by an interdisciplinary team: a physical medicine and rehabilitation doctor, a physical and an occupational therapist, a speech therapist and a psychologist. With children we often speak of "habilitation", because the task is to develop a skill that has not yet formed rather than to restore one that has been lost.

This page does not give medical advice. The intensity and length of rehabilitation and the facility where it should take place are decided by the treating doctor and the rehabilitation team. We explain which state programme covers their prescription, on what conditions and with which documents.

After stroke and spinal cord injury: what does the state cover?

Annex 1.13 of the Universal Healthcare Programme separately funds rehabilitation for conditions resulting from cerebrovascular accident (stroke) and from traumatic injury to the brain and spinal cord. A course may include: a team assessment and an individual plan, medical supervision, occupational therapy, physical therapy on land and in water, education for the patient and family, psychological support, speech and swallowing therapy, selection of assistive devices and training in their use, and lymphatic drainage massage.

Who is eligible

Form IV-100/a must state a diagnosis with an ICD-10 code from the list: after-effects of stroke (I69.0-I69.4, I69.8), after-effects of intracranial and head injury (T90.5, T90.8, T90.9), after-effects of spinal fracture and spinal cord injury, and after-effects of injuries to the neck and trunk (T91.1, T91.3, T91.8, T91.9). The diagnosis must be no more than 24 months old. In addition, the patient must be medically stable: not needing 24-hour medical care, a tracheostomy, a nasogastric tube, mechanical ventilation or intravenous medicines for pain or blood pressure. They must be able to take part in active therapy for at least 3 hours a day, 2-6 days a week, and to follow a one-step instruction, with communication support where needed. The family arranges transport between home and the clinic itself.

What share the state pays

The programme sets the cost of one course at GEL 4,177 after stroke and brain injury and GEL 5,031 after spinal cord injury; your share is the remainder of that cost. If you belong to several categories, the one with the higher state share applies.

How do you enrol in a course and what happens next?

1. Application to the National Health Agency

   For first enrolment you submit to the Agency an application, a copy of the patient's ID card and Form IV-100/a with the appropriate code. Rehabilitation is often planned right at discharge from hospital, so ask for the certificate on the day of discharge.

2. Written answer

   The Agency issues a positive or negative written answer. The clinic starts the course only on the basis of this letter, so keep it to hand, in the original or electronically.

3. A course of up to 90 days

   A course lasts no more than 90 calendar days from start to finish. At the end, the clinic issues a new Form IV-100/a with the initial and final functional status scores and a list of the interventions carried out.

4. A repeat course on the commission's conclusion

   Each further course is funded only if the total functional independence score has risen by more than 10% after the previous course. The matter is considered by a special commission at the Agency.

Two details often take families by surprise. First: if only half of the prescribed procedures are carried out, the state reimburses 50% of the cost of the case, and if fewer than half, nothing at all, including when sessions were missed for reasons on the patient's side. Before signing the contract, ask the clinic what financial consequences missed sessions will have for you. Second: if the clinic considers the patient's enrolment inappropriate, it informs the Agency in writing and the commission considers the matter. If you are refused, the appeal procedure is described in the guide to appealing a refusal.

How to check a clinic

A programme provider must hold a licence for an inpatient facility or an inpatient rehabilitation and health facility, and have on its staff at least one certified specialist doctor who has completed an accredited course in managing comprehensive rehabilitation after stroke and brain injury. One physical medicine and rehabilitation specialist may treat no more than 10 patients a day. When choosing a clinic, ask whether it takes part in this component, who will lead your team and how many hours a day the patient will spend in active therapy.

Cerebral palsy and other conditions in children: the rehabilitation/habilitation sub-programme

Rehabilitation for children is funded by the 2026 state programme for social rehabilitation and childcare (Government Resolution No. 640 of 30 December 2025), implemented by the State Care Agency. The sub-programme covers children with disabilities from the age of 3 who have one of the diagnoses listed in the programme's annex, and children under 3 with the same conditions, even without disability status. The list includes forms of cerebral palsy (G80) as well as other neurological and developmental conditions.

The basic package includes physical therapy, occupational therapy, speech and language therapy and psychological support, and where needed behavioural therapy, aquatherapy, the services of a special education teacher and training for parents. Up to 192 sessions a year are funded per child, 16 a month, or up to 20 by written agreement with the provider, each lasting at least 40 minutes. The voucher is issued for 12 months, but no later than the child's 18th birthday.

Documents for the Care Agency

• the legal representative's ID card and a copy of it, and where needed a document confirming the right of representation;
• a copy of the child's birth certificate or ID card;
• Form IV-100/a (not required for a child who was a beneficiary in the previous year, except with a diagnosis of delayed developmental milestones);
• from the age of 3, an extract from the medical and social assessment confirming the child's disability status, which the Agency checks in the register.

Waiting list and priorities

The Agency makes decisions in the order of the register of applicants. First to be enrolled are children in the period after orthopaedic surgery (no more than one year), followed by children from families receiving the reintegration allowance, children in foster care and residential care institutions, beneficiaries of the past 12 months, children under 5 and children from families with a score of up to 120,001. After the decision you must report to the provider within 30 calendar days, or the enrolment is cancelled. If an operation is planned, prepare the rehabilitation application in advance, so that the one-year priority period is not lost.

Early development: children under 7 and the risk of delay

The same programme's "Early Childhood Development Support Sub-programme" covers children from birth to the age of 7 in whom a paediatrician, family doctor, neurologist or other specialist has identified a delay in developmental milestones, a disability or the risk of one, with one of the listed ICD-10 diagnoses. The service is based on an individual plan tailored to the child and family, reviewed every six months. With children under 3, the specialist works mainly in their natural environment, at home or in nursery, and with children aged 3 to 7 also at a centre. Up to 8 visits a month are funded, and for children under 5 the involvement of an early development specialist is mandatory.

The application is submitted to a territorial office of the Care Agency with the legal representative's ID, the child's birth certificate and Form IV-100/a. The voucher is issued for 12 months, but no later than the month in which the child turns 7, and only in a municipality where a registered provider operates. Failing to use the coupon for two consecutive months cancels the voucher automatically.

Early detection also has support from the healthcare side: the 2026 screening programme provides for assessing mild and moderate developmental disorders in children aged 1 to 6 and drawing up an individual plan. If the family doctor sees a delay, ask them to record the finding in Form IV-100/a with a code; it is this certificate that opens the door to the early development sub-programme. Other children's programmes are summarised in the guide to children's treatment.

Rehabilitation after surgery and assistive devices

Rehabilitation for adults after surgery, for example after joint replacement or spinal surgery, has no separate component in the 2026 state programmes unless the condition is linked to the spinal cord or brain injury listed above. In such cases the realistic ways to cover the cost are private insurance, the municipality's healthcare programme, if it provides for rehabilitation, and the referral commission. The Referral Services Programme separately covers two narrow state components: a 20-day rehabilitation course for chronic lung diseases for certain groups, and rehabilitation for cochlear implant recipients for up to 18 months.

Wheelchairs and other assistive devices

The social rehabilitation programme's "Sub-programme for Provision of Assistive Devices" provides wheelchairs, prosthetic and orthopaedic products, hearing aids, crutches and other devices. A manual wheelchair is provided for listed conditions, including hemiplegia, severe hemiparesis, paraplegia and tetraplegia, and for children a paediatric wheelchair with medium or high adjustability. One wheelchair is provided per person per calendar year. The application is submitted to the Care Agency with an ID, a medical and social assessment report stating the need for the device and Form IV-100/a. For organising care and equipment at home, our medical equipment service and caregiver service can help.

When is rehabilitation abroad considered and what does the clinic ask for?

Families most often consider rehabilitation abroad in three cases: when intensive inpatient neurorehabilitation is needed after a severe spinal cord injury or stroke; when a doctor recommends a specialised intensive programme for a child; and when complex orthopaedic surgery and the rehabilitation that follows are planned at one clinic. Frequently mentioned destinations include Germany, Austria, Israel and Turkey. Universal Healthcare does not cover services abroad, so state co-funding is possible only through the referral commission, and only if it has been shown that the relevant service is not available in Georgia.

Before admitting a patient, a rehabilitation clinic assesses the functional picture, not just the diagnosis. It usually asks for: the discharge summary from the acute phase, the neurological status, the MRI or CT report and images, a list of current medicines, information on mobility, feeding, continence and communication, the results of functional scales and, for a child, a developmental assessment. The more precise this description, the more realistic the clinic's cost estimate and the length of the course. For a long course, a visa for the accompanying person must also be planned; our medical visa service can help with that.

Plan the return in advance as well. At the end of a course abroad, ask for a final report with the initial and final functional scale scores, recommended exercises and a list of assistive devices. Translated into Georgian, this document will help the local rehabilitation team continue the therapy, and if the 24-month window for the state course has not yet run out, it will show the Georgian doctor how the condition has progressed when preparing a new Form IV-100/a.

The document package and funding sources in one table

Every agency and clinic asks for the same core: Form IV-100/a with an ICD-10 code (how to obtain it), the discharge summary, test reports, a copy of the ID card or birth certificate and, where needed, a document confirming disability status. For a foreign clinic this material is translated: we translate discharge summaries and test reports, and prepare a notarised translation of the foreign invoice for the referral commission. The Translation price calculator shows an indicative price.

The Universal Healthcare rehabilitation annex sets no age limit, so if a patient under 18 has after-effects of stroke or spinal cord injury, confirm in writing with both agencies which programme applies and in what order.

How we can help

Rehabilitation is often planned while the family is still in hospital, and the deadlines are strict: 24 months from the diagnosis, 30 days to report to the child's provider, one year of priority after an operation. Through our funding search service, Advocat.Ge lawyers check which programme your case falls under, prepare the applications and, if you are refused, the complaint. For rehabilitation abroad, we find a clinic, translate the medical history and plan the trip. Medical decisions, including the choice of rehabilitation method and intensity, are made only by the treating doctor and the rehabilitation team.

Frequently asked questions about rehabilitation