Summary & Overview
CPT 90887: Family/Caregiver Education and Explanation of Psychiatric Results
CPT code 90887 covers clinician time spent explaining psychiatric or medical assessment results and care information to a patient’s family members or caregivers, and giving advice on how to assist with the patient’s care. This communication-focused service supports caregiver education, care coordination, and family involvement in treatment plans — elements that can improve adherence, safety, and outcomes in behavioral health and medical settings. Nationally, 90887 is relevant to outpatient behavioral health practices, hospital outpatient departments, and integrated care programs that engage families in care.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the code’s clinical purpose, typical service settings, and how the service fits into care pathways. The publication summarizes common reimbursement and billing considerations, available benchmarks where provided, and policy context affecting coverage and use of family/caregiver explanation services. The content is intended to help administrators, coders, and clinicians understand what 90887 represents, where it is typically used, and the core issues that influence its application across payers.
Data not available in the input for specific rate benchmarks, associated taxonomies, ICD-10 mappings, or payer-specific coverage edits.
Billing Code Overview
CPT code 90887 describes a service in which a clinician interprets or explains results of psychiatric or medical evaluations, other procedures, or information about the patient’s care to family members or caregivers and provides advice on how to help care for the patient. The service focuses on family/caregiver education, support, and guidance related to the patient’s mental health or medical condition.
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Service type: Family or caregiver education and counseling related to patient care
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Typical site of service: Outpatient clinic, psychiatric practice, hospital outpatient department, or other settings where family or caregivers receive explanation and guidance about patient care
Clinical & Coding Specifications
Clinical Context
A typical scenario involves an adult patient recently evaluated by a psychiatrist for worsening mood and cognitive decline following hospitalization for a complex medical condition. The psychiatrist completes a battery of psychiatric assessments and documents findings, then meets with the patient’s spouse and adult child to interpret results, explain the psychiatric diagnosis, discuss prognosis, review medication effects and behavioral strategies, and provide guidance on caregiving responsibilities. The clinical workflow: initial psychiatric evaluation and testing are completed (office or hospital inpatient setting), the psychiatrist reviews chart and test results, and schedules or conducts a focused family/caregiver meeting to communicate findings, clarify treatment plans, address safety concerns, and offer resources. This service commonly occurs in outpatient psychiatric clinics, hospital inpatient units (including psychiatry consults on medical wards), skilled nursing facilities, or via synchronous telemedicine when family caregivers cannot attend in person. Typical participants include the billing psychiatrist or psychiatric advanced practice provider, the patient (when appropriate), family members or caregivers, and occasionally a social worker or case manager who coordinates follow-up care and community resources.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the reporting clinician’s professional service is billed separate from an institutional component. |