Superbill

Superbill basics

What is a superbill? A plain-English guide for therapists

A superbill is the itemized receipt a private-pay therapist gives a client so the client can ask their own plan for out-of-network reimbursement. It carries the codes and identifiers an ordinary receipt leaves out.

Quick answer

A superbill is an itemized statement of services that a therapist gives a client who paid out of pocket. It lists the provider (name, NPI, tax ID), the client, and for each session the date, CPT code, ICD-10-CM diagnosis code, place of service, fee and payment. The client attaches it to their insurer’s claim form to request out-of-network reimbursement. It is not a claim form, and it does not mean the plan will pay.

Updated · Sources are listed at the end of the page.

Last reviewed October 2026. General information for out-of-network therapists, not legal or billing advice. Payer rules change — confirm with the payer before you bill.

A superbill in one paragraph

Plans pay claims, not receipts. An out-of-network therapist has no contract with the client’s plan and usually sends it nothing, so the client pays the full fee and files their own claim. The superbill gives that claim what a plan typically asks for: who provided the service, what it was in standard codes, the diagnosis it was for, where and when it happened, and what it cost.

The name is informal. There is no federal superbill form and no single required layout; each plan’s member claim form says what it wants attached. In practice a superbill mirrors the fields of the CMS-1500 professional claim form, which is why the same codes appear on both.

Who uses a superbill

Three groups rely on it. Out-of-network therapists use it instead of billing insurance themselves. Clients with out-of-network benefits, typically on a PPO or POS plan, use it to get part of the fee back. Clients paying from an FSA or HSA use it as the itemized receipt their administrator asks for.

For that last group, IRS Publication 502 lists amounts paid for therapy received as medical treatment, and fees paid to a psychologist for medical care, among the medical expenses that can count. Whether a particular session qualifies is up to the plan and the administrator, not the receipt.

Many HMO and EPO plans pay little or nothing out of network outside emergencies. A client should check their benefits before counting on reimbursement.

What a superbill contains

Every plan’s list is slightly different, but a complete therapy superbill usually carries these blocks. The field-by-field template guide explains each one.

  • Provider: name and credentials, individual (Type 1) NPI, tax ID, practice address and phone; the group NPI too if a practice is the billing entity.
  • Client: legal name as on the insurance card, date of birth, address, member ID, and the policyholder if the client is a dependent.
  • Diagnoses: ICD-10-CM codes, each with a letter the service lines point to.
  • One line per session: date of service, CPT code, any modifier, place of service, diagnosis pointer, units and fee.
  • Totals: amount charged, amount paid and the date paid, balance due, then the provider’s signature and date.

How the client uses it

The client downloads their insurer’s member claim form (often called a medical claim or reimbursement form), fills in the member section, attaches the superbill and sends both through the member portal, by mail or by fax. Some portals accept the superbill as an upload with no separate form.

The plan answers with an Explanation of Benefits. Any payment is based on the plan’s allowed amount for the service, not the therapist’s fee, after the out-of-network deductible and coinsurance. The out-of-network clients guide walks through that step by step.

How often to issue one

Per session, monthly or quarterly all work. Monthly is the common compromise: fewer documents for the client, and a long gap is less likely to run into the plan’s filing deadline. Filing windows vary by plan, so confirm with the payer if sessions are older than a few months.

Whatever the rhythm, each session stays on its own line with its own date. A single line for a month of sessions is a frequent reason a claim comes back.

Common mistakes that delay reimbursement

Most returned superbills fail on mechanics rather than on coverage:

  • A CPT code that does not match the session length, such as 90837 for a 45-minute session.
  • A missing or mistyped NPI, or the group NPI where the individual one was expected.
  • Telehealth billed with the in-office place of service, or a telehealth modifier without a telehealth POS.
  • A service line pointing at a diagnosis letter that is empty.
  • The client’s name or member ID not matching the plan’s records.
  • No signature, or no proof that the session was paid.

Superbills and client privacy

A superbill contains a diagnosis, so treat it like any other clinical document: hand it to the client through the same secure channel you use for records, and keep a copy under your own record-keeping rules.

Superbill builds the document in your browser. Client details and codes are not uploaded to us, and the PDF is generated on your device. You choose how to deliver it to the client.

The app only sends your license key and a device id to our license check (which asks Creem) — no patient or practice data ever leaves your browser.

Frequently asked questions

Is a superbill the same as a receipt?

It is a receipt with clinical billing detail added: NPI, tax ID, CPT and ICD-10-CM codes and the place of service. An ordinary receipt usually lacks the codes a plan needs to process an out-of-network claim.

Does the therapist submit the superbill?

Usually not. The client submits it with their own claim form, and any reimbursement normally goes to the client. Some therapists offer courtesy billing instead, which is a different arrangement.

What the free check catches

  • CPT vs. session length (90832 = 16–37 min, 90834 = 38–52, 90837 = 53+; these codes require at least 16 minutes)
  • Telehealth POS 02 / 10 vs. POS 11, and modifier 95 pairing
  • Diagnosis pointers A–D that don’t resolve to a code on the client
  • NPI format and check digit, TIN, member ID, units, signatures
  • DOS age against the 60 / 90 day timely-filing warnings
Make a superbill free

Sources