What Is a Superbill?

What is a superbill and who uses one

A superbill for therapy is an itemized statement of services that a client can send to their health plan to request out-of-network reimbursement. It lists who provided the care, what was done, why it was medically necessary and what the client paid. Unlike a claim, the therapist does not submit it to the payer; the client does.

So, what is a superbill in practical terms? It is a detailed receipt that carries the same core data elements a claim form would carry: provider identifiers, procedure codes, diagnosis codes, dates and charges. Health plans use those elements to decide whether the session qualifies for out-of-network benefits and how much to repay the client.

Superbills are most common in private-pay psychotherapy practices that are not in network with a client's plan. They also appear in other cash-based outpatient care, but the details below focus on counselors, psychologists, social workers and marriage and family therapists.

Superbill vs. claim vs. receipt

Three documents get confused at the front desk. Each serves a different purpose, and using the wrong one is a common reason clients come back asking for something else.

Document	Who submits it	What it contains	Typical use
Simple receipt	Nobody; client keeps it	Date, amount paid, practice name	Proof of payment, HSA/FSA records
Superbill	Client sends it to their plan	Provider IDs, CPT and ICD-10-CM codes, dates, fees, payments	Out-of-network reimbursement request
Claim (CMS-1500 / 837P)	Provider or billing service sends it to the payer	Standardized claim fields with payer-specific rules	In-network billing or courtesy billing

A plain receipt usually lacks codes and the clinician's identifiers, so most plans will not process it as a reimbursement request. A superbill fills that gap without the practice taking on claim follow-up.

What a superbill for therapy must include

Plans vary in their claim-form requirements, but the elements below appear on nearly every reimbursement request. Missing any of them is the fastest route to a letter asking the client for more information.

Provider and practice details

• Rendering clinician's full name and credentials (for example, LPC, LCSW, LMFT, PhD)
• Individual NPI, and the group NPI if the practice bills under one
• Tax ID (EIN or SSN; many practices use an EIN to protect the owner's SSN)
• State license number and state
• Practice name, service address, phone and email

Client details

• Client name, date of birth and address
• Policyholder name and relationship if the client is a dependent
• Insurance member ID (optional on the superbill, but it speeds processing)

Service details

• Date of each session
• CPT code for each session, such as 90791, 90834 or 90837
• ICD-10-CM diagnosis code(s) supporting medical necessity
• Place of service code (for example, 11 for office; 02 or 10 for telehealth)
• Modifiers where needed, such as a telehealth modifier the client's plan requires
• Fee charged per session, amount paid, date paid and balance due

Finish with the clinician's signature (or a typed attestation) and the date the superbill was issued. Some plans also ask for the referring provider when a referral was required, so add that field if your clients' plans call for it.

Superbill template: field-by-field

You do not need a downloadable form. Use this superbill template as the layout for a statement in your practice management system, a word-processing document or a spreadsheet. The example values are illustrative only.

Section	Field	Example entry
Header	Document title and statement date	Superbill / Statement for insurance reimbursement, issued 03/31
Provider	Clinician name and credential	Jordan Lee, LPC
Provider	Individual NPI / group NPI	10-digit NPI(s)
Provider	Tax ID	Practice EIN
Provider	License number and state	LPC license no., Texas
Provider	Service address and phone	Office address used for in-person sessions
Client	Name, date of birth, address	As listed on the client's insurance card
Client	Member ID and policyholder	Optional; include if the client provides it
Diagnosis	ICD-10-CM code(s)	F41.1 Generalized anxiety disorder
Service line	Date of service	03/04, 03/11, 03/18, 03/25
Service line	CPT code and description	90837 Psychotherapy, 60 minutes
Service line	Place of service and modifier	10 (telehealth in patient's home), plus any modifier the plan requires
Service line	Fee, amount paid, date paid	Full fee per session; paid at time of service
Totals	Total charges, total paid, balance	Sum of service lines
Attestation	Signature and date	Clinician signature

Keep one service line per date of service. Bundling a month of sessions into a single line with a combined amount is a frequent cause of rejected reimbursement requests, because the plan cannot match each session to a code and a date.

Choosing codes for therapy superbills

Use the same coding standards you would use on a claim. The CPT code should match the documented service and time, and the diagnosis should be supported by the clinical record.

CPT code	Service (summary)	Common superbill note
90791	Psychiatric diagnostic evaluation	Usually the intake session
90832	Psychotherapy, 30 minutes with patient	Shorter sessions
90834	Psychotherapy, 45 minutes with patient	Standard individual session at many practices
90837	Psychotherapy, 60 minutes with patient	Document start and stop times; some plans review it more closely
90846	Family psychotherapy without the patient present	Note who attended
90847	Family psychotherapy with the patient present	Note who attended

For time-based codes, the documented face-to-face time must support the code chosen. The behavioral health billing guide explains the time ranges and the wider mental health code set.

Telehealth adds one more check. CMS defines place of service 02 for telehealth provided somewhere other than the patient's home and 10 for telehealth provided in the patient's home, and many commercial plans follow the same codes. Plans differ on telehealth modifiers, so ask the client to check their plan's out-of-network telehealth rules.

How clients submit a superbill

Most plans accept superbills through the member portal, a mobile app or a mailed claim form. The client usually completes a short member claim form and attaches the superbill. Give clients a one-page handout with these steps so your front desk is not answering the same questions every week.

1. Call the plan or check the portal to confirm out-of-network outpatient mental health benefits, deductible and coinsurance.
2. Download the plan's member reimbursement claim form.
3. Attach the superbill (monthly is common) and proof of payment if the plan asks for it.
4. Submit within the plan's filing deadline for member-submitted claims, which varies by plan.
5. Watch for an explanation of benefits (EOB) and respond quickly to any request for more information.

Clients are often surprised that payments first go toward a separate out-of-network deductible. Explain this up front so the first EOB showing no payment does not feel like a denial.

Common superbill mistakes

• Missing NPI or tax ID. The plan cannot identify the rendering provider.
• No diagnosis code. Reimbursement requires medical necessity, and the code carries it.
• Wrong time-based code. A 50-minute session documented as 90837 invites a reprocessing request.
• Combined service lines. One line for several dates prevents line-level processing.
• Wrong place of service for telehealth. POS 11 on a video session can trigger a request for clarification.
• Inconsistent names. The client's name must match the insurance card exactly.

A short pre-release review catches most of these. If several clients report problems in the same month, check the template itself before checking individual superbills.

Superbills and the good faith estimate rule

Federal No Surprises Act rules require a good faith estimate for uninsured and self-pay individuals. CMS guidance defines a self-pay individual as someone enrolled in coverage who is not seeking to have a claim submitted to their plan for the scheduled service. Clients who pay you directly and seek reimbursement on their own commonly fall into this group, so many therapists provide estimates to superbill clients.

The estimate and the superbill are separate documents. Our guide to good faith estimates for therapists covers timing, required content and the dispute threshold. For the wider picture of private-pay and out-of-network work, see out-of-network billing for therapists.

When to move from superbills to courtesy billing

Superbills keep claim work off the practice's plate, but they push the paperwork to clients. Some practices switch to filing out-of-network claims on the client's behalf once volume grows, which adds claim follow-up, EOB reconciliation and patient statements to the workload.

If you are weighing that change, Fastora's patient billing and collections team supports therapy practices with statements, payment plans and out-of-network claims, and a free billing assessment is a no-commitment way to review how your current process is working.

Checklist

Print checklist

• Clinician name, credential, NPI, tax ID and license number
• Client name, date of birth and address match the insurance card
• One line per date of service
• CPT code supported by documented time
• ICD-10-CM diagnosis code included
• Correct place of service for in-person or telehealth sessions
• Fee, amount paid and date paid on each line
• Signature and issue date

Frequently asked questions