If you're a therapist who works outside insurance networks — and a growing number of therapists do — superbills are one of the most important documents you provide to patients. A superbill is an itemized receipt that patients submit to their insurance company to seek out-of-network reimbursement. Getting them right is essential for patient satisfaction and retention.
What Is a Superbill?
A superbill is a detailed invoice that contains all the information an insurance company needs to process an out-of-network reimbursement claim. Unlike a regular receipt, a superbill includes clinical and procedural codes that map directly to the insurance claim format.
Think of it this way: when you're in-network, you submit claims directly to insurance. When you're out-of-network, the patient submits the claim — and the superbill is the document that makes that possible.
What Must a Superbill Include?
A complete superbill includes:
Provider Information
- Your full name and credentials (e.g., "Jane Smith, LCSW")
- Your National Provider Identifier (NPI)
- Your Tax Identification Number (TIN) or SSN
- Your practice name and address
- Your phone number
- Your license number and state
Patient Information
- Patient's full legal name
- Patient's date of birth
- Patient's address
- Insurance member ID (if applicable)
Service Information
- Date of service
- CPT code: The procedure code for the service provided (90834, 90837, etc.)
- ICD-10 diagnosis code: The diagnosis justifying the service (e.g., F32.1 for Major Depressive Disorder, moderate)
- Place of service code: 11 for office, 02 for telehealth
- Units: Typically 1 per session
- Fee charged: Your full session rate
- Amount paid: What the patient actually paid
Common CPT Codes for Therapy Superbills
Using the correct CPT code is critical — an incorrect code leads to claim denials:
- 90791: Psychiatric diagnostic evaluation — used for the intake/initial assessment session
- 90834: Individual psychotherapy, 38–52 minutes — the most commonly billed therapy code
- 90837: Individual psychotherapy, 53+ minutes — for longer sessions
- 90847: Family psychotherapy, conjoint, with patient present
- 90846: Family psychotherapy without patient present
- 90853: Group psychotherapy
- 96127: Brief emotional/behavioral assessment — for administering instruments like the PHQ-9
The time ranges matter. If your session was 50 minutes, use 90834 (38–52 minutes). If it was 55 minutes, use 90837 (53+ minutes). Upcoding — using a higher code than the session duration justifies — is a compliance violation.
Common Superbill Mistakes
Wrong or Missing Diagnosis Code
Insurance requires an ICD-10 code that justifies medical necessity. "Adjustment Disorder" or "Generalized Anxiety Disorder" must be coded correctly. Missing or incorrect codes are the number one reason for superbill claim denials.
Mismatched Dates
The date of service on the superbill must match the actual session date. This seems obvious, but when superbills are generated manually — especially in batches — date errors creep in.
Missing Provider Identifiers
Both NPI and TIN are required. Some therapists include one but not the other. Insurance will reject claims with incomplete provider information.
Inconsistent Fees
If you tell insurance your rate is $200 per session but your superbill says $175, it creates confusion and may trigger an audit. Use your standard rate consistently.
Automating Superbill Generation
Creating superbills manually — opening a template, filling in details for each session, checking codes, emailing to patients — takes 5–10 minutes per patient per month. For a practice with 25 patients, that's 2–4 hours monthly of pure administrative work.
Automated billing systems eliminate this entirely:
- After each session, the system generates a superbill using the session date, CPT code (based on session duration), diagnosis code from the patient's chart, and your standard fee.
- Superbills are automatically delivered to the patient via the patient portal.
- Patients can download superbills at any time — individually or as a batch for tax purposes.
- You never touch a superbill unless there's something unusual to adjust.
Superbills and Patient Retention
Here's something many therapists don't realize: superbill quality directly affects patient retention. Patients who struggle to get reimbursed — because of superbill errors, delays, or missing information — often blame the therapist's practice, even when the insurance company is the bottleneck.
Conversely, patients who receive accurate, timely superbills and successfully get reimbursed feel that the practice is well-run and professional. They're more likely to continue therapy and refer others.
Helping Patients Submit Superbills
Consider providing a brief guide to help patients submit superbills to their insurance. Key tips for patients:
- Submit within the insurer's timely filing deadline (typically 90–365 days)
- Submit electronically through the insurer's portal if available
- Keep copies of everything submitted
- Follow up if reimbursement isn't received within 30 days
Superbills and Good Faith Estimates
Superbills and Good Faith Estimates work together for self-pay patients. The GFE sets expectations before treatment begins; the superbill documents what was actually provided. For patients seeking reimbursement, both documents are part of a professional, transparent billing process.
Getting Started
If you're still creating superbills manually, switching to an automated system is one of the highest-ROI changes you can make. The time savings are immediate, error rates drop to near zero, and patient satisfaction with your billing process improves noticeably.
Explore Mediyn's automated superbill generation — superbills are created and delivered to patients automatically after each session, with no manual effort required.