A superbill is an itemized receipt a practice gives a patient who paid out of pocket. It carries the details an insurer needs to consider paying the patient back for out-of-network care: who provided the service, what the service was, the diagnosis, what it cost and what was paid.
Superbills are routine in private-pay therapy, psychiatry and other cash-pay specialties. This guide covers what goes on one, a template you can adapt, how patients use it, and why it belongs in your marketing as much as your billing.
What a superbill is, and what it isn't
A superbill documents a visit the patient has already paid for. The patient, not the practice, sends it to their insurer, usually with the insurer's own claim form, and asks to be reimbursed under their out-of-network benefits.
- It is not a claim. The practice isn't billing the insurer and isn't in its network.
- It is not a promise. Whether the patient gets anything back depends on their plan: whether it has out-of-network benefits, the deductible, and the share it pays. Never tell a patient they will be reimbursed.
- It is not a plain receipt. A receipt shows a payment. A superbill adds the provider identifiers and the service and diagnosis codes an insurer asks for.
What a superbill includes
| Section | What goes in it |
|---|---|
| Practice | Practice name, address and phone number; the practice's tax ID; the group NPI if the practice has one |
| Provider | The treating clinician's name, credentials and individual NPI; license number if the patient's plan asks for it |
| Patient | Name, date of birth, address; the insurance member ID and group number if they have them |
| Each service | Date of service, place of service, the procedure (CPT) code, units and the fee charged |
| Diagnosis | The diagnosis code (ICD-10-CM) that supports each service |
| Payment | Amount paid, date paid and any balance, which is usually zero in a private-pay practice |
| Sign-off | The provider's signature and the date the superbill was issued |
Use the codes you actually billed and documented. A superbill has to match the record of the visit, so it is the clinician's or biller's document to complete, not the front desk's to improvise.
Superbill template
A layout you can copy onto your letterhead or set up in your practice management system. Replace everything in brackets.
Superbill
[Practice name] · [Address] · [Phone]
Tax ID: [EIN] · Group NPI: [if any]
Provider: [Name, credentials] · NPI: [individual NPI] · License: [state and number, if requested]
Patient: [Name] · Date of birth: [date] · [Address]
Insurance member ID: [ID] · Group number: [number]
Services:
[Date of service] · Place of service: [code] · CPT: [code] · Units: [n] · Diagnosis: [ICD-10-CM code] · Fee: [$ amount]
[One line per service]
Total charged: [$] · Total paid: [$] on [date] · Balance: [$]
[Provider signature] · Issued [date]
Most practice management and EHR systems can generate this automatically from the visit record, which is safer than typing it by hand each month.
Superbills for therapy
Therapy practices issue more superbills than almost anyone, and one point deserves a conversation before the first one goes out: a superbill shares a diagnosis with the client's insurer. Insurers generally need a diagnosis code to consider reimbursement. Some clients pay privately precisely so that no diagnosis reaches their insurer, and they should know that submitting a superbill changes that.
Agree how often you'll issue them (per session or monthly both work), and deliver them the way you deliver any record with health information: through your portal or another channel your compliance adviser has approved, not an ordinary email.
How patients use a superbill
Encourage patients to check their out-of-network benefits before the first session, not after the fifth. The questions worth asking their insurer:
- Does my plan have out-of-network benefits for this kind of care?
- What is my out-of-network deductible, and how much of it have I met?
- What share of the allowed amount does the plan reimburse, and how is the allowed amount set?
- Do I need pre-authorization, or a referral?
- How do I submit, and is there a deadline?
You can publish those five questions on your fees page. It saves your front desk the same conversation every week, and it makes the fee easier to say yes to.
Superbills and the good faith estimate
A patient who plans to submit a superbill still pays you directly, and you don't submit a claim for them. Federal rules count someone who has coverage but doesn't have a claim submitted as self-pay, and self-pay patients are generally entitled to a written good faith estimate of expected charges under 45 CFR 149.610. Treat superbill patients as entitled to one unless your healthcare attorney tells you otherwise. Our guide to good faith estimates covers when one is due and what it has to include.
Why this is a marketing question too
"Do you take my insurance?" is the question a cash-pay practice hears most, and "no" ends the conversation. "We're out of network, and we provide a superbill each month that you can submit to your insurer; here are the questions to ask them" keeps it going, and it is true.
Put that answer where the question gets asked: on the fees section of your site, on the booking page, and in the script for the first call. Our guide to therapist website examples shows where a fees section works best, and booking pages covers how we build them.