A superbill is a detailed invoice outlining the services a client received. Therapists may need to generate a superbill when they are not on a client’s insurance company’s panel. The therapist or client submits the superbill directly to the insurer, giving the insurer all the information they need to pay the claim.
Superbill Definition: Therapy Superbill Basics
You do not need to give a client a superbill when they request their medical records or an invoice. Instead, therapy superbills are documents for insurance carriers. They provide detailed, specific information about the services a therapist or other health care provider rendered to a client. They may also provide information about the client’s diagnosis.
In most cases, you will need to submit a separate superbill for each treatment session.
In 2015, the 10th edition of the International Statistical Classification of Diseases (ICD-10) went into effect. This means that all providers must issue ICD-10 superbills that use updated diagnostic codes. Some therapists may also have to update their forms or treatment notes to make it easier to comply with ICD-10 and provide the right code for each service and diagnosis. A superbill without the correct codes may be rejected, delaying payment.
Either the client or the therapist can submit a superbill. Discuss your expectations for submitting a superbill before beginning a therapeutic relationship. Because creating a superbill can be time-consuming, it is also important for every therapist to assess whether they have the time to do so.
Therapists with very busy practices may opt only to accept clients who pay in cash or who have insurance that directly pays for the therapist’s services. This may decrease access to services for some clients, especially those with fewer resources, so every therapist must weigh the costs and benefits of their insurance and payment policies.
Why Some Therapists Choose Superbills
Getting listed on an insurer’s provider panel is a great way to be promptly paid for therapy, while making services more accessible to clients who cannot afford to pay out-of-pocket. Joining a provider panel, however, can be a long and involved process, especially since you have to apply for each individual panel and there may be dozens of insurers in your area.
A superbill allows you to accept insurance without being listed on a provider panel. This is a great option for therapists who:
- Do not want to join a provider panel
- Are awaiting acceptance to a provider panel
- Only want to join some provider panels
- Want to accept payments from smaller or lesser known insurers but do not have the time or resources to join these insurers’ panels
How Superbill Payments Work
A superbill is distinct from a traditional invoice submitted to the client or insurance. This is because the insurer pays the client, not the therapist, even if the therapist is the one who submits the superbill. With a superbill, the insurer assumes the client has already paid, and that any payment is therefore a reimbursement.
Therapists who routinely draft superbills or who do not directly accept insurance payments should bill clients at the end of each session. Otherwise, there is no guarantee of payment, even if a client eventually receives reimbursement after submitting a superbill. A clear and specific discussion of billing practices—including whether you offer discounted or sliding-scale rates—can protect the therapeutic relationship and protect the client form harmful financial surprises.
Superbill Template: What to Include in Your Mental Health Superbill
Numerous companies make superbilling software designed to help you quickly fill out superbills. If you go this route, it’s important to ensure the program protects client confidentiality and asks for the correct information. You can also make your own counseling superbill template.
A complete superbill includes all of the following information:
- Identifying information about your client: This includes their name, date of birth, address, phone number, and any other information the insurer requires. Double-check this information with your client, since small differences and errors—such as a recently changed name or an incorrect middle initial—may trigger a rejection.
- Practice information: This is the name of your practice and office address, as well as any other identifying information the insurer routinely requests.
- Referrer identification: If a medical provider referred the client to you, include this provider’s information and address, as well as their National Provider Identification (NPI) number. All providers practicing in the U.S. have this 10-digit identification code.
- ICD code: Most insurers will not cover treatment without a diagnosis, and some will only cover specific treatments for specific diagnoses. You must use ICD-10 codes. If you have not previously discussed a specific diagnosis with your client, do so before submitting the superbill. Some clients are troubled to see their diagnosis, and others want to know that the diagnosis is correct.
- CPT code: The Current Procedural Terminology (CPT) code uses a list of American Medical Association codes to identify treatment procedures. List all relevant CPT codes, not just the first one you find, since reimbursement rates may be based on the specific codes.
Accepting insurance can be a challenging process that requires a therapist to apply to numerous panels. Superbilling offers a halfway point, empowering more clients to pay for therapy with their insurance but without requiring the therapist to jump through the many hoops provider panels require.
GoodTherapy offers therapists numerous resources to run more efficient, profitable, and helpful practices. Membership is a great way to invest in your practice and your clients. Consider joining today!
- Endicott, M. (2015, June 5). Superbill and forms revision for ICD-10. Physicians Practice, 25. Retrieved from https://www.physicianspractice.com/icd-10/superbill-and-forms-revision-icd-10
- Superbills: ICD-9 vs. ICD-10. (n. d.). Retrieved from https://www.aapc.com/icd-10/superbills.aspx
- What is a superbill, and how do they work? (n. d.). Retrieved from https://www.carecloud.com/continuum/what-is-a-superbill
- What is a superbill and why should I provide one? (n. d.). Retrieved from https://blog.gethealthie.com/2016/07/24/what-is-a-super-bill-and-why-should-i-provide-one