How to Create a Superbill for Clients

What Is a Superbill?

A superbill is a detailed receipt that a therapist provides to a client so the client can seek reimbursement from their insurance company for out-of-network services. Unlike a simple payment receipt that shows only the date and amount paid, a superbill contains all the clinical and administrative information an insurer needs to process a claim: provider credentials, client details, diagnosis codes, procedure codes, fees, and dates of service.

For therapists who operate as out-of-network providers, the superbill is one of the most important documents you produce. It is the mechanism through which your clients access their out-of-network benefits and recover a portion of the fees they pay you. A correctly formatted superbill leads to smooth reimbursement. An incomplete or incorrectly coded superbill leads to denied claims and frustrated clients.

Why Clients Need Superbills

When you are not contracted with a client's insurance company, there is no direct billing relationship between you and the insurer. The client pays your full fee at the time of service. If the client has out-of-network benefits (common with PPO plans, less common with HMOs), they can submit your superbill to their insurer to recoup a portion of the fee.

The amount reimbursed depends on the client's specific plan — their out-of-network deductible, coinsurance percentage, and the insurer's allowed amount for the service. Without a superbill, the client has no standardized way to file this claim.

Even clients who ultimately choose not to submit for reimbursement may request superbills for their personal records, Health Savings Account (HSA) or Flexible Spending Account (FSA) documentation, or tax purposes.

Required Fields on a Superbill

Every superbill must contain specific information for insurance companies to process the claim. Missing even one required field can result in a denial.

Provider Information

• Provider name and credentials (e.g., Jane Smith, PhD, Licensed Psychologist)
• National Provider Identifier (NPI) — your unique 10-digit NPI number
• Tax Identification Number (TIN) — your EIN or SSN used for tax reporting
• Practice name (if applicable)
• Practice address — the physical address where services were rendered
• Practice phone number
• License number and state

Client Information

• Client full legal name — must match the name on their insurance card
• Client date of birth
• Client address
• Insurance company name
• Insurance ID number — from the client's insurance card
• Group number (if applicable)
• Relationship to policyholder (self, spouse, child)

Service Information

• Date of service — the specific date each session occurred
• Place of service code — 11 for office, 10 for telehealth in the client's home, 02 for telehealth at another location (verify current CMS place of service codes as they are periodically updated)
• CPT code — the procedure code for the service provided (e.g., 90834 for individual psychotherapy 45 minutes, 90837 for individual psychotherapy 60 minutes, 90847 for family therapy with the client present)
• ICD-10 diagnosis code(s) — the diagnostic code(s) supporting medical necessity (e.g., F41.1 for Generalized Anxiety Disorder, F32.1 for Major Depressive Disorder, single episode, moderate)
• Fee charged — the amount you charged for each service
• Units — typically 1 per session
• Amount paid by client — the amount the client paid at the time of service

Additional Information

• Provider signature (electronic or handwritten) — some insurers require this
• Superbill date of issue
• Total charges and total amount paid — for superbills covering multiple dates of service

Sample Superbill Layout

How Clients Submit Superbills to Insurance

Provide your clients with clear instructions for submitting their superbill. The general process is:

Step 1: Verify Out-of-Network Benefits

Before submitting, the client should call the member services number on their insurance card and ask:

• Do I have out-of-network mental health benefits?
• What is my out-of-network deductible, and how much have I met?
• What is my out-of-network coinsurance rate?
• Is there a timely filing deadline for submitting claims?
• What is the process for submitting an out-of-network claim?

Step 2: Submit the Superbill

Depending on the insurer, clients may be able to:

• Mail the superbill to the claims address on their insurance card
• Upload it through the insurer's member portal or mobile app
• Fax it to the claims department

Some clients also attach a completed CMS-1500 form, though many insurers accept the superbill alone for out-of-network claims.

Step 3: Track the Claim

Advise clients to keep copies of everything they submit and to follow up with their insurer if they have not received an Explanation of Benefits (EOB) within four to six weeks.

Common Superbill Mistakes

Missing or Incorrect NPI

The NPI is the single most critical identifier on the superbill. Without it, the claim will be rejected. Double-check that your NPI is correct on every superbill.

Wrong CPT Code

Using a CPT code that does not match the service provided or that does not match your documentation is a common error. Ensure the code reflects the actual duration and type of session. Do not use 90837 (60-minute session) if you provided a 45-minute session (90834).

Missing or Incorrect ICD-10 Codes

Every superbill must include at least one diagnosis code. The diagnosis must be clinically supported and documented in your records. Using an outdated or incorrect ICD-10 code will result in a denial.

Client Name Mismatch

The client's name on the superbill must match the name on their insurance card exactly. Nicknames, maiden names, or misspellings will cause processing problems.

Missing Place of Service Code

The place of service code tells the insurer where the session occurred. Omitting it — or using the wrong code, especially for telehealth sessions — is a frequent reason for claim rejections.

Bundling Multiple Dates Without Detail

When providing a superbill that covers multiple sessions, each date of service must be listed as a separate line item with its own CPT code, diagnosis code, and fee. Do not combine multiple sessions into a single line.

Electronic vs. Paper Superbills

Electronic Superbills

Most modern practice management systems (SimplePractice, TherapyNotes, Jane App, and others) can generate superbills automatically from your session records. Advantages include:

• Accuracy: Fields populate from your session data, reducing manual entry errors
• Efficiency: Generate superbills in seconds rather than creating them manually
• Consistency: Every superbill follows the same format
• Record keeping: The system maintains a copy of every superbill generated
• Client access: Many platforms allow clients to download superbills from a client portal

Paper Superbills

If you do not use a practice management system, you can create a superbill template in a word processor or spreadsheet. This approach requires more manual work and greater attention to accuracy, but it is a viable option for low-volume practices or clinicians who prefer minimal technology.

If using paper superbills:

• Create a standardized template with all required fields
• Fill in client-specific and session-specific information for each encounter
• Keep a copy of every superbill you issue
• Review for accuracy before giving it to the client

Best Practices

• Issue superbills promptly: Generate and provide superbills shortly after each session or at the client's preferred interval
• Verify codes regularly: CPT and ICD-10 codes are updated annually. Make sure you are using current codes
• Keep copies: Maintain a record of every superbill issued in case of questions or audits
• Educate clients: Many clients are unfamiliar with the superbill submission process. Providing brief written instructions alongside the superbill improves the likelihood of successful reimbursement
• Be consistent: The information on your superbill should match your progress notes, your appointment records, and your financial records. Discrepancies can create problems in the event of an audit
• Include your signature: While not all insurers require it, including a provider signature (electronic is acceptable) adds legitimacy and prevents some denials