A superbill is a detailed, itemized receipt that a healthcare provider gives to a client who paid out of pocket. It lists who provided the care, what was done (CPT codes), why it was done (ICD-10-CM diagnosis codes), when and where it happened, and how much was paid, so the client can submit it to their insurance company and ask for out-of-network reimbursement. If you are a therapist, psychologist, counselor or physical therapist who does not bill insurance directly, a clean superbill is the single document that decides whether your clients get money back quickly or end up in a back-and-forth with their insurer.
Below you will find what a superbill is (and is not), every field it should include, the basic codes you will see most often, a ready-to-copy superbill template layout, and the mistakes that most often get superbills rejected.
What is a superbill?
The term “super bill” (also written “superbills” or “super-bill”) is industry jargon rather than a legal form name. In practice it is a statement generated by the provider after the client has paid, containing enough coded clinical and billing information for an insurer to process an out-of-network claim. The provider does not submit it; the client does, usually through the insurer’s member portal or together with the plan’s own claim form.
It helps to separate the superbill from the documents it is often confused with:
| Document | Who creates it | Who sends it to the insurer | Main purpose |
|---|---|---|---|
| Superbill | Provider | Client | Lets the client request out-of-network reimbursement for services already paid |
| Invoice | Provider | Nobody (it goes to the client) | Requests payment from the client |
| Receipt | Provider | Nobody | Confirms a payment was received; usually lacks codes |
| Claim form (e.g., CMS-1500) | Provider or biller | Provider | Bills the insurer directly as an in-network or participating provider |
| Good Faith Estimate | Provider | Nobody | Tells self-pay clients the expected cost before care |
A simple way to remember it: an invoice asks for money, a receipt proves money was paid, and a superbill proves money was paid in a format an insurer can read.
What is a superbill for therapy and who uses it?
Private-pay practices are common in mental health and rehabilitation. Many psychologists, licensed therapists and physical therapists choose not to join insurance networks, but their clients still have health plans with out-of-network benefits. A superbill bridges that gap: you get paid in full at the time of service, and the client can still use their coverage.
- Psychotherapists and psychologists: individual, family and group sessions, intake evaluations and testing.
- Physical therapists: evaluations and timed treatment such as therapeutic exercise or manual therapy.
- Other cash-based clinicians (for example, counselors, speech or occupational therapists) whose clients have out-of-network benefits.
Whether the client is actually reimbursed depends on their plan: many PPO and POS plans include out-of-network benefits, while many HMO and EPO plans cover little or nothing outside the network except in emergencies. That is why it is worth asking clients to check their benefits before the first session.
What to include on a superbill for insurance
Insurers do not publish one universal superbill format, but they all look for the same core data. Missing any of the items below is the most common reason a superbill comes back unpaid.
1. Provider information
- Your full name and professional credentials (for example, PhD, PsyD, LCSW, LPC, PT, DPT).
- License number and the state that issued it.
- Practice name, address and phone number.
- National Provider Identifier (NPI): a 10-digit identifier issued through the CMS National Plan and Provider Enumeration System (NPPES). Include your individual NPI and, if you have one, your organization’s NPI.
- Tax identification number. Many solo providers use an Employer Identification Number (EIN) so they do not have to print their Social Security number on every document.
2. Client information
- Client’s full legal name, date of birth, address and phone number.
- Insurance member ID and, if different, the name of the policyholder (optional but speeds up processing).
3. Service details (one line per visit)
- Date of service.
- CPT code for each service, plus any modifier the client’s plan requires (some payers ask for a telehealth modifier).
- Place of service (POS) code: 11 for an office visit, 10 for telehealth when the client is at home, 02 for telehealth when the client is somewhere other than home.
- Units or duration where the code is time-based.
- Fee charged for each line.
4. Diagnosis codes
List the ICD-10-CM code(s) that support the services and indicate which diagnosis applies to each line (often shown as a “diagnosis pointer” such as A, B, C). The code must come from your own clinical assessment and be as specific as your documentation supports.
5. Payment information and signature
- Total charged, amount paid, payment date and method, and remaining balance (usually zero).
- Your signature (handwritten or electronic) and the date the superbill was issued.
Basic CPT and ICD-10 codes explained
CPT codes (Current Procedural Terminology, maintained by the American Medical Association) describe what you did. ICD-10-CM codes describe why you did it. Insurers need both, and they need them to make sense together.
Common CPT codes on therapy and physical therapy superbills
| CPT code | Typical use | Notes |
|---|---|---|
| 90791 | Psychiatric diagnostic evaluation (intake) | Usually billed once at the start of care |
| 90832 | Individual psychotherapy, about 30 minutes | Time rule: 16–37 minutes |
| 90834 | Individual psychotherapy, about 45 minutes | Time rule: 38–52 minutes |
| 90837 | Individual psychotherapy, about 60 minutes | Time rule: 53 minutes or more |
| 90846 / 90847 | Family psychotherapy without / with the patient present | Typically 26 minutes or more |
| 97161–97163 | Physical therapy evaluation (low, moderate, high complexity) | Choose the level your documentation supports |
| 97110 | Therapeutic exercise | Timed code, billed per 15-minute unit |
| 97140 | Manual therapy techniques | Timed code, billed per 15-minute unit |
Psychotherapy time ranges above follow the guidance published by APA Services. Always bill the code that matches the time and content documented in your notes, not the code you scheduled.
ICD-10-CM diagnosis codes
ICD-10-CM codes are updated every year on October 1. The current set (FY 2027) applies from October 1, 2026, according to CMS, so check that the codes in your templates are still valid after each update. Two common examples: F41.1 (generalized anxiety disorder) on a psychotherapy superbill, or M54.50 (low back pain, unspecified) on a physical therapy superbill. Avoid vague “unspecified” codes when your evaluation supports a more specific one.
Superbill template: a layout you can copy
Use this structure for a monthly or per-session superbill. The values in the example rows are illustrative only.
| Section | Field | Example |
|---|---|---|
| Header | Document title and issue date | SUPERBILL – issued 10/31/2026 |
| Provider | Name, credentials, license # and state | Jane Smith, PsyD – License PSY-00000 (CA) |
| Provider | Practice address and phone | 123 Main St, Suite 4, Anytown, CA |
| Provider | NPI (individual / organization) | 10-digit NPI |
| Provider | Tax ID (EIN) | XX-XXXXXXX |
| Client | Name, date of birth, address | Client name, DOB 01/15/1990 |
| Client | Insurance member ID (optional) | From the client’s insurance card |
| Diagnosis | ICD-10-CM code(s) with pointer | A: F41.1 |
| Service line | Date · CPT · POS · Dx pointer · Fee | 10/07/2026 · 90837 · 10 · A · $180.00 |
| Service line | Date · CPT · POS · Dx pointer · Fee | 10/14/2026 · 90837 · 10 · A · $180.00 |
| Totals | Total charged · Paid · Balance | $360.00 · $360.00 · $0.00 |
| Signature | Provider signature and date | Signed electronically 10/31/2026 |
How to create and send a superbill, step by step
- Collect the right data at intake. Get the client’s legal name, date of birth, address and insurance member ID on your intake form so you are not chasing it later.
- Encourage a benefits check. Ask the client to call their insurer and confirm out-of-network coverage, deductible, coinsurance, whether superbills are accepted and the deadline for submitting claims.
- Document each session. Record start and end times and the services provided, so the CPT code you choose is supported by your notes.
- Generate the superbill after payment. Many practices issue one per month that lists every session; others issue one per visit.
- Deliver it securely. A superbill contains protected health information, so use a client portal or another secure method rather than plain email.
- Keep a copy. Store it with the client’s billing records in case the insurer asks for clarification or the client needs it re-issued.
How clients get reimbursed with a superbill
The client submits the superbill (and sometimes the insurer’s own claim form) to their plan. The insurer then compares your fee with its “allowed amount” for that service, applies the out-of-network deductible and coinsurance, and sends any reimbursement directly to the client. Reimbursement is often less than what the client paid, so set expectations early and never promise a specific refund.
Don’t forget the Good Faith Estimate
Under the No Surprises Act, clients who are uninsured or choose not to use insurance are generally entitled to a Good Faith Estimate of expected charges, typically when care is scheduled at least three business days ahead or when they ask for one. If the final bill is at least $400 more than the estimate, they may be able to dispute it. CMS explains these rights for self-pay patients. The estimate is separate from the superbill, but private-pay practices usually need both.
Common superbill mistakes to avoid
- Missing NPI, license number or Tax ID. Insurers use these to identify the provider; without them the claim is often returned.
- CPT code that does not match the documented time. A 45-minute session billed as 90837 is a red flag in any audit.
- Outdated ICD-10-CM codes. Codes that were deleted or expanded on October 1 cause denials.
- No diagnosis pointer. Each service line should link to the diagnosis it treats.
- Wrong place of service for telehealth. Use 10 or 02 according to where the client was, not where you were.
- Issuing it before the client has paid. A superbill documents services the client has already paid for. If a balance is still open, send an invoice first and issue the superbill once it is settled.
- Sending it insecurely. Unencrypted attachments with diagnoses create privacy risks.
Frequently asked questions
Is a superbill the same as an invoice?
No. An invoice requests payment from the client. A superbill is issued after payment and adds the coded information (CPT, ICD-10-CM, NPI, place of service) an insurer needs to process an out-of-network reimbursement.
Do insurance companies accept superbills for therapy?
Many do, but only if the client’s plan includes out-of-network benefits for that service. The client should confirm coverage, deductible, coinsurance and submission deadlines with their insurer before relying on reimbursement.
Who submits the superbill to insurance?
The client does, usually through the insurer’s member portal, app or by mail, sometimes together with the plan’s own claim form. The provider’s job is to issue an accurate, complete superbill.
How often should I issue superbills?
It depends on your workflow. Monthly superbills listing every session are common because they reduce paperwork for both you and the client, but per-session superbills are fine if clients prefer them.
Can a superbill be used for an HSA or FSA?
Clients often use a superbill or itemized receipt as supporting documentation for health savings account or flexible spending account claims. Eligibility rules are set by the IRS and the plan administrator, so clients should confirm with their administrator.
Does a superbill guarantee reimbursement?
No. The insurer decides based on the client’s plan, medical necessity and its allowed amounts. An accurate superbill simply removes avoidable reasons for denial.
Keep your private-pay practice organized
Superbills are much easier when client details, appointments and payments already live in one place. Gremio Software helps you organize clients, appointments, quotes and invoices in a single cloud tool, so the information you need for each superbill is ready when the session ends instead of scattered across spreadsheets and email.