Superbill template for therapists
A complete superbill gets your clients reimbursed faster. Here is every field a mental health superbill needs, with examples.
Skip the template. Our free generator fills these fields in for you and produces a PDF in your browser.
Open the superbill generatorProvider section
- Your name and credentials (for example, Jane Doe, LCSW)
- Practice name, address and phone
- Individual NPI (10 digits)
- License number and state
- Tax ID (EIN), or the identifier your practice bills under
Client section
- Full name and date of birth
- Address and insurance member ID (helpful but not always required)
- ICD-10 diagnosis code, such as F41.1 (generalized anxiety disorder) or F43.23 (adjustment disorder with mixed anxiety and depressed mood)
Services section
One line per session: date of service, CPT code, short description, place of service and fee.
| CPT | Service | Typical use |
|---|---|---|
| 90791 | Psychiatric diagnostic evaluation | Intake session |
| 90832 | Psychotherapy, 30 min | 16–37 minutes |
| 90834 | Psychotherapy, 45 min | 38–52 minutes |
| 90837 | Psychotherapy, 60 min | 53 minutes or more |
| 90847 | Family psychotherapy with patient | Couples or family session |
| 90853 | Group psychotherapy | Group session |
Place of service codes: 11 for office visits, 10 for telehealth when the client is at home, 02 for telehealth elsewhere. Some insurers also want modifier 95 for telehealth; check the plan's rules.
Payment and signature
Show total charges, the amount the client paid and any balance, then sign and date the superbill.
Common reasons superbills get rejected
- Missing NPI or diagnosis code
- One total amount instead of a line per session
- Time-based code that doesn't match the session length
- Missing signature or date of service
Want your client to know what to do next? Share our guide to submitting a superbill.