CPT code 90887 – Interpretation of psychiatric examination results

Key takeaways

CPT code 90887 covers explaining exam findings, the treatment plan or the prognosis to a patient’s family or another responsible person, with no therapy delivered.

The patient is not present for a 90887 service. Patient presence and therapeutic intent are what separate 90846 and 90847 from it.

Each note must record the date, duration, who attended and their relationship, the findings explained, the clinical rationale and the consent basis.

Pabau’s medical claims management sends 90887 claims through Claim.MD, with real-time eligibility checks and ERA remittances tracked in the same dashboard.

CPT code 90887: Official descriptor and code set placement

CPT code 90887 is the code for explaining psychiatric or medical examination results to a patient’s family or another responsible person. It also covers advising them on how to help the patient.

It sits in the Psychiatry section (90785-90899) of the AMA CPT code set, under Other Psychiatric Services or Procedures. It is an active, billable code with no scheduled deletion.

The official AMA descriptor has three parts, and each one matters for billing:

• Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data. The findings can come from a psychiatric evaluation, other examinations, or prior records and collateral history.
• To family or other responsible persons. The recipient is a family member or another legally responsible person.
• Or advising them how to assist patient. The service is explanatory or advisory, and no therapy is delivered.

What CPT code 90887 covers and what it does not

CPT 90887 covers a discrete collateral contact with a family member or responsible person. The clinician explains examination results, the treatment plan or the prognosis, or advises the family on how to help. The patient is not present, and the clinician provides no therapy.

Common covered scenarios include:

• A psychiatrist explaining a schizophrenia diagnosis to a patient’s spouse
• A psychologist reviewing ADHD testing results with a parent
• A licensed clinical social worker advising a caregiver on how to support a patient after an inpatient discharge

The code does not cover:

• Direct therapy with the patient (use 90832, 90834 or 90837, depending on session length)
• Family psychotherapy, where the family interaction itself is the treatment (use 90846 without the patient, or 90847 with the patient)
• Telephone calls or informal check-ins not documented as a structured clinical contact
• Case management or care coordination not tied to explaining examination results

CPT 90887 vs 90846 vs 90847: Choosing the right code

90887 is easily confused with the family psychotherapy codes 90846 and 90847. The choice turns on two questions. Is the patient present, and does the session have therapeutic intent?

Here is the practical test. If the session’s main goal was to change the family’s behavior or relational patterns, use 90846 or 90847. If the goal was to explain what the clinician found and advise the family on how to help, use 90887.

Who can bill CPT code 90887?

Psychiatrists, psychologists, licensed clinical social workers (LCSWs) and licensed professional counselors (LPCs) can bill 90887. So can nurse practitioners with psychiatric scope and physician assistants working in a psychiatric practice. Eligibility varies by state and plan, so check each payer’s behavioral health provider list before billing.

Several rules apply regardless of payer:

• The billing provider must have an established clinical relationship with the patient. 90887 is not used for collateral contacts before any evaluation has taken place.
• The patient must be the billing provider’s own patient. You can’t bill 90887 for a contact about another clinician’s patient.
• Supervision rules for mid-level providers follow state licensing rules and the payer contract. Incident-to billing under a physician’s National Provider Identifier (NPI) is common in outpatient settings.
• Medicaid programs vary. Some state plans restrict 90887 to psychiatrists or licensed psychologists.

Documentation requirements for CPT 90887

A 90887 claim stands or falls on its progress note. Good medical billing compliance means the note captures every element payers check at audit.

Every 90887 note needs six elements. The checklist after this list sets them side by side with example entries.

• Date of service and duration of the contact (start and end times are best practice)
• Identity and relationship of the family member or responsible person (for example, “patient’s mother, Jane Doe”)
• Specific findings explained, naming the test, diagnosis or clinical data reviewed during the contact
• Clinical rationale for the contact and why it was medically necessary
• Patient authorization or legal basis, meaning the patient’s consent to disclose or the legal authority if the patient lacks capacity
• No therapeutic intervention conducted, stated explicitly to distinguish the contact from 90846

HIPAA (the Health Insurance Portability and Accountability Act) governs disclosure of protected health information in collateral contacts. Record the consent basis in every note, whether that is patient authorization, a treatment exception or legal guardianship. A missing consent basis is both a billing compliance risk and a HIPAA exposure.

Medicare coverage and 90887 reimbursement rate for 2026

Medicare coverage of CPT 90887 depends on your Medicare Administrative Contractor (MAC). Under some Local Coverage Determinations (LCDs), MACs have limited or bundled payment for collateral contacts without a direct patient service on the same date.

Before you submit, check CMS’s Physician Fee Schedule lookup tool and your MAC’s LCD for psychiatry and psychology services. One example is WPS’s LCD L30489, so check the equivalent from your own MAC.

For 2026 rates, look up the national non-facility and facility amounts in the FastRVU 2026 RVU lookup tool, which mirrors current CMS fee schedule data. Third-party rate estimates for 90887 exist, but confirm them against the official CMS source before quoting them to payers or patients. Rates vary by locality, place of service (office or facility) and any MAC payment policy on collateral contact codes.

Key Medicare billing considerations for 90887 include:

• The place of service code must match where the contact happened (11 for office, 02 for telehealth where applicable)
• Pair the claim with the ICD-10 F-series diagnosis code for the patient’s established condition
• Check whether your MAC requires a modifier when 90887 is billed without a patient-facing service on the same date
• Submit claims electronically through a clearinghouse

Medicaid and commercial payer coverage rules

Medicaid coverage of CPT 90887 varies by state. Aetna Better Health Medicaid has published provider education materials that reference 90887 as a covered collateral therapy code. Wisconsin ForwardHealth includes 90887 in its outpatient mental health procedure code schedule. Both show that Medicaid managed care organizations (MCOs) can cover the code, though coverage is not universal.

Before billing a Medicaid MCO for 90887, check these points:

• Whether behavioral health services are carved out to a separate plan with its own billing rules
• Whether the plan requires a specific modifier for collateral contacts
• Prior authorization requirements, since some plans require it for collateral sessions above a set frequency
• The plan’s provider manual, whose documentation standards may be stricter than Medicare’s

Commercial insurers generally follow AMA CPT guidance but may have their own coverage policies. Treat each payer contract separately, and run insurance eligibility verification before each encounter to confirm active behavioral health benefits.

Can CPT 90887 be billed on the same day as a therapy session?

Yes, in many cases, but with conditions. CPT 90887 is generally not subject to a National Correct Coding Initiative (NCCI) edit that blocks it alongside 90837, 90834 or 90791. Payer-specific policies can still bundle it at the MAC or plan level.

When you bill 90887 on the same date as a patient therapy session:

• The collateral contact must be a separate, distinct encounter from the therapy session
• Each encounter needs its own time-stamped progress note
• Some payers require modifier 59 (distinct procedural service) or modifier XP (separate practitioner) to bypass same-day bundling edits
• Check the NCCI edit status for the code pair with the AAPC Codify CPT lookup before submitting

Billing 90887 with 90791 (psychiatric diagnostic evaluation) on the same date is common when a clinician finishes an evaluation and then meets the family. The pairing is often allowed. Document the two encounters separately, and check payer guidance before assuming approval.

Can you add interactive complexity (CPT 90785) to 90887?

No. CPT 90785 is an add-on code for interactive complexity, and CPT guidelines limit it to 90791, 90792, 90832-90838 and 90853. 90887 is not on that list, so 90785 is not reported with 90887.

CPT also excludes translation and interpreter services from interactive complexity. If a collateral contact was unusually difficult, describe the circumstances in the 90887 note itself.

Common denial reasons for CPT 90887 claims

90887 denials follow predictable patterns. Strong denial management workflows start with knowing why claims fail before they’re submitted.

• Lack of medical necessity narrative: The note doesn’t explain why the family contact was clinically necessary for the patient’s care. Add a sentence linking the contact to a specific treatment goal.
• Missing consent documentation: There is no record of patient authorization for disclosure to the family member. Include the consent basis in every note.
• Incorrect place of service: An office code was submitted for a phone contact, or the reverse. Telehealth modifiers and POS 02 apply to remote contacts where the payer covers them.
• Same-day bundling without modifier: The payer’s system bundles 90887 into a same-day therapy code. Append modifier 59 or XP, and attach a brief note explaining the separate encounters.
• Non-covered service: The payer doesn’t cover 90887, or a behavioral health carve-out plan needs a different submission path.
• Missing relationship notation: The note doesn’t say who the family member is or how they relate to the patient. Reviewers then can’t confirm the contact qualifies.

Tracking denials by their Claim Adjustment Reason Codes (CARCs) shows these patterns early. Our guide to denial codes in medical billing explains what each code means. The aim of submitting a clean claim is a complete note before submission, so you aren’t appealing after a denial.

How Pabau supports 90887 billing, from note to remittance

When the note lives in one tool and the claim in another, details such as the consent basis or the insurer get lost. Pabau, the practice management platform we build, keeps the note, the invoice and the claim on the same patient record. Its medical claims management tools then carry the claim through to payment.

Setting up 90887 in Pabau takes five steps:

1. Add 90887 as a procedure code. Enter the code and its full official descriptor, then map it to the right fee schedule. Set the billing type as professional (CMS-1500 or 837P format).
2. Attach diagnosis codes. Link the patient’s active ICD-10 F-series diagnosis to the procedure. Use the condition being explained to the family, such as F20.9 for schizophrenia or F41.1 for generalized anxiety disorder.
3. Verify patient eligibility before service. Run Pabau’s real-time eligibility check to confirm active behavioral health benefits. Then confirm the plan covers collateral contacts.
4. Document in a separate encounter note. Create a distinct note for the collateral contact, time-stamped apart from any same-day therapy session. A note template that prompts for all six elements keeps every note complete.
5. Submit through Claim.MD. Pabau sends the claim through Claim.MD, its US clearinghouse partner, to thousands of US payers. Validation checks run before the claim goes out, and claim statuses and electronic remittance advice (ERA) come back to the same dashboard.

Your team spends less time re-keying insurer details and chasing claims that bounced for a missing field. More 90887 claims get paid on the first submission.

Submit cleaner 90887 claims from day one

Pabau sends 90887 claims through Claim.MD to thousands of US payers, with real-time eligibility checks and validation before every claim goes out. Fewer rejections means less time chasing payments.

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Conclusion

CPT 90887 is a legitimate, billable service, but it only gets paid when the note proves what kind of contact took place. If the note reads like a therapy session, the claim will be treated like one.

So start with the note. Use a collateral contact template that captures all six elements, check each payer’s coverage before the first claim, and keep same-day contacts in separate notes. Do that, and 90887 becomes a routine line item rather than a recurring denial.

Book a demo to see how Pabau takes a 90887 claim from the collateral note to the remittance.

Continue your research

Want to understand how clearinghouse submissions work? Medical claims clearinghouse guide explains how 837P electronic claims are routed, validated, and returned with ERA responses.

Billing the initial psychiatric evaluation? CPT code 90791 covers the psychiatric diagnostic evaluation and what its documentation needs to show.

Checking which codes take the interactive complexity add-on? CPT code 90785 explains when interactive complexity applies and which primary codes it attaches to.

Frequently asked questions