The therapy superbill: what to include, with a template

How out-of-network reimbursement works

1. The client pays your full fee at the session, or at the end of the month.
2. You give them a superbill with the sessions of the period.
3. The client submits it to their insurance, through the plan's website, app or a claim form.
4. The plan reimburses the client directly, based on their out-of-network benefits and deductible.

The amount the client gets back depends entirely on their plan. Encourage new clients to call their insurer before the first session and ask two questions: do I have out-of-network mental health benefits, and how much of my deductible is left?

What to include on a superbill

About you

• Your full name and credentials (LCSW, LMFT, LPC, PsyD, PhD).
• Your license number and state.
• Your NPI (National Provider Identifier). Insurers use it to identify you. If you don't have one, it is free to get from the NPPES website.
• Your tax ID. An EIN keeps your Social Security number off paperwork that goes to clients.
• Your practice address and phone number.

About the client

• Full legal name, as it appears on the insurance card.
• Date of birth.
• Address.

About each session

• Date of service.
• CPT code: the type and length of the session. The most common in psychotherapy:

• Place of service code: 11 for your office, 10 for telehealth with the client at home, 02 for telehealth from somewhere else. Some plans also ask for a modifier (95) on telehealth sessions.
• ICD-10 diagnosis code. Insurers reimburse based on medical necessity, so the diagnosis is required.
• Your fee for the session and the amount paid.

At the end

• The total for the period and the total paid.
• Your signature and the date.
• A line such as "Submitted by the client for reimbursement. The provider has not filed a claim." It avoids confusion at the insurer.

The diagnosis is the client's information

A superbill carries a diagnosis, so treat it with the same care as the rest of the client's record. Talk about it before you issue the first one: some clients prefer to pay out of pocket rather than have a diagnosis on file with their insurer. Put only what the insurer needs on the superbill. Session notes never go with it.

Superbill template

SUPERBILL
Submitted by the client for reimbursement.
The provider has not filed a claim.

PROVIDER
[Your name], [credentials]
License: [number], [state]
NPI: [number]    EIN: [number]
[Practice address]
[Phone]

CLIENT
[Full legal name]
Date of birth: [MM/DD/YYYY]
[Address]

Diagnosis (ICD-10): [code]

Date        CPT    POS  Fee       Paid
[date]      90834  11   $[fee]    $[paid]
[date]      90834  10   $[fee]    $[paid]
[date]      90834  11   $[fee]    $[paid]

Total charged: $[total]
Total paid:    $[total]

[Signature]
[Date]

Monthly or per session?

Most clients prefer one superbill a month, with every session listed. It is less paperwork for both of you, and insurers accept several dates of service on one superbill. Agree on it at intake: "I'll send your superbill on the first business day of each month."

How to make superbills without retyping

The work in a superbill isn't the layout. It's getting the right dates and amounts for each client, every month. If your sessions and payments are already logged, the superbill can come straight from them.

In Session Flow, the Documents tab has a superbill template. You pick the client and the period, and the app lists the paid sessions with their dates and amounts, along with your details (license or NPI, tax ID, address) and the client's (date of birth, address). It comes out as a PDF or as text, ready to send. Documents are on every plan.

Session Flow isn't an EHR and doesn't store diagnoses, on purpose. The CPT and ICD-10 lines come blank for you to fill in. If you always use the same CPT code, duplicate the template and write the code in once.