Understanding Superbills for Therapy: A Complete Guide

Paying out of pocket for therapy? A superbill could help you get money back. But only if you know how to use it right.

But what exactly is a superbill, and how does it help with insurance reimbursement?

This guide breaks down everything you need to know about therapy superbills: what they are, what they include, and how to use them correctly to get paid by insurance.

What Is a Superbill (and Why Do They Matter in Mental Health Care)?

A superbill is a special receipt that therapists give to clients who pay out of pocket. It's used so the client can ask their insurance for partial reimbursement.

Unlike a normal invoice, a superbill includes specific medical codes and details that insurance companies require before they’ll consider paying you back.

In therapy, superbills are especially important when the therapist is out-of-network with a client’s insurance. Instead of billing the insurance directly, the therapist collects payment from the client. The client then uses the superbill to try to get reimbursed.

For many people, this is the only way to use insurance benefits while still choosing a therapist they truly connect with. Because in many cases, the therapist that feels best to work with doesn’t accept insurance.

In fact, according to our 2025 survey, 47% of therapists say accepting insurance is not worth it.

And for therapists, offering superbills is one way to make private-pay care more accessible.

What Information Needs to Be on a Therapy Superbill

A superbill is a detailed medical document. If anything is missing or incorrect, the insurance company may reject it. To be accepted, a therapy superbill must include specific details that support the claim.

Here’s what it should contain:

• Client Information: Full name, date of birth, and address
  
  
• Therapist Information: Full name, credentials (e.g., LCSW, LMFT), NPI number, practice address, and contact info
  
  
• Session Details: Date of each session, CPT code (such as 90837 for a 60-minute session), and fee charged
  
  
• Diagnosis Code: ICD-10 code showing the client’s diagnosis (e.g., F41.1 for generalized anxiety disorder)
  
  
• Total Paid: The full amount the client paid
  
  
• Tax ID and Signature (optional but recommended): Some insurers ask for a provider signature and EIN or SSN

The diagnosis and CPT codes must make sense together, and all session dates should match the dates of service. If you’re a therapist, use the same codes consistently unless a client’s condition or treatment changes.

Thrizer can submit superbills on behalf of clients. See our free interactive demo here.

When to Use a Superbill in Mental Health

Superbills are used when a client sees a therapist who isn’t in their insurance network but still wants to use their out-of-network benefits. This usually happens in private-pay therapy practices, where clients pay the full session fee up front and submit a superbill afterward to request reimbursement.

Some common situations where superbills come into play:

• The therapist doesn’t accept any insurance but wants to support clients in getting partial reimbursement.
  
  
• The client has a PPO or similar plan that offers out-of-network benefits.
  
  
• The client wants to work with a therapist who specializes in a niche area not widely covered in-network.

It’s important to note that not all insurance plans cover out-of-network therapy, and those that do often only reimburse a portion of the fee. (Though, being reimbursed up to 70% is nothing to sneeze at.)

Clients should check with their insurance first to understand what’s covered and what documentation is needed.

For therapists, offering superbills can make care more accessible without dealing directly with insurance billing. For clients, they’re a tool that may offset the cost of therapy.

How to Submit a Superbill to Insurance (and What to Expect)

After receiving a superbill from your therapist, the next step is submitting it to your insurance company. This usually involves logging into your member portal and uploading the document. Some plans allow you to submit it by mail or email.

Here’s what typically happens:

1. Client pays the therapist at the time of service.
2. Therapist provides a superbill that includes all required codes and session details.
3. Client submits the superbill to their insurer along with any required claim form.
4. Insurance processes the claim and, if approved, sends a reimbursement check (or explanation of benefits).
5. If denied, the client or therapist will have to spend time resubmitting the claim and hope for approval.

Turnaround time can vary, but many insurers take two to four weeks to process a superbill. If any information is missing, like an incorrect code or missing NPI number, the reimbursement may be delayed or denied.

Clients should keep a copy of everything submitted and follow up if there’s no response within the expected window. If the claim is denied, they can usually appeal.

For therapists, it’s a good idea to help clients understand how superbills work early on, maybe even walking through the first submission together if needed.

Alternatively, you and/or your clients can use a service like Thrizer. We automatically submit superbills at the time of session payment. Then, we track the claim, manage reimbursement, and follow up on denials, which are low compared to manual submissions. Interested? See our info here.

Common Mistakes That Delay Reimbursement

Even a small mistake on a superbill can cause major delays. Insurers often won’t explain much beyond “denied,” so avoiding errors from the start is key.

Here are common issues that lead to rejections or delays:

• Wrong or missing diagnosis codes
• Incorrect CPT codes (using a code that doesn’t match the service provided)
• Missing NPI or Tax ID
• Inconsistent dates between the session and what’s listed on the superbill
• Client name doesn’t match insurance records (nicknames, middle initials, etc.)
• Submitting too late (many plans have a time limit for claims, like 90 days)

Therapists should double-check superbills before sending them to clients. Clients should compare the document to their own session records and insurance requirements before submitting.

A well-prepared superbill saves everyone time and improves the chance of getting reimbursed on the first try.

Make Superbills Work for You

Superbills can unlock thousands of dollars in out-of-network benefits, but only if they’re done right.

Whether you’re a therapist creating them or a client submitting them, accuracy and consistency matter.

If the process feels overwhelming, Thrizer makes it easy. Our platform helps therapists generate compliant superbills in just a few clicks, and lets clients submit them directly to insurance with zero guesswork.

We also offer full-service out-of-network billing for practices that want to skip the hassle altogether.

Spend less time on paperwork, and more time on what matters most when you give Thrizer a free trial.