A superbill is the itemised receipt you give a patient so they can claim reimbursement from an out-of-network insurer. The practice does not file it. The patient does, which means every field has to be right before it leaves your hands, because you will not see the rejection.
Below is a superbill template you can copy field by field, the CPT codes that belong on a behavioral health line, and the five checks that catch rejections before they happen.
A Superbill Is Not a Claim, and Not a Receipt
These three documents get used interchangeably and they are not the same thing. Sending the wrong one is why some patients are told their practice never filed anything.
| Document | Who sends it, and to whom | What it is for |
|---|---|---|
| Superbill | Practice gives it to the patient. The patient files it with the insurer. | Out-of-network reimbursement paid back to the patient. |
| CMS-1500 claim | Practice files it with the payer, usually through a clearinghouse. | In-network billing paid to the practice. |
| Invoice or receipt | Practice gives it to the patient. | Proof of payment. Carries no codes, so an insurer cannot reimburse from it. |
The Superbill Template: Every Field, and What Goes Wrong
A superbill template is only useful if it carries every field an insurer matches on. Use the table below as the field list and check yours against it.
A superbill is a receipt rather than a claim form, so it does not have to look like a CMS-1500. It does have to carry every field an insurer needs to match the service to a member and a benefit. Missing any of these is what sends it back.
Block one: the practice and the clinician
This block tells the insurer who delivered the care and who to credit it to.
| Field | What goes in it | Where practices get it wrong |
|---|---|---|
| Practice name and address | The billing address the practice operates under. | Using a home address that does not match the one registered with the payer. |
| Practice Tax ID (EIN) | The employer identification number the practice bills under. | Leaving it blank. Most insurers will not process a superbill without it. |
| Rendering provider name and credentials | The clinician who delivered the session, with licence type (LCSW, LMFT, PsyD, MD). | Listing the practice owner instead of the clinician who actually saw the patient. |
| Rendering provider NPI | The individual NPI of the treating clinician. | Substituting the group or practice NPI. |
| Supervising provider NPI | Required when the treating clinician is an associate, intern or provisionally licensed. | Left blank. There is no equivalent field on an in-network claim, so it is easy to miss. |
| Provider licence number | State licence number for the rendering clinician. | Omitted, or the supervisor's licence used instead. |
Block two: the patient and the policy
Copy these three straight from the insurance card, not from your chart.
| Field | What goes in it | Where practices get it wrong |
|---|---|---|
| Patient full legal name | Exactly as printed on the insurance card. | Using a preferred or shortened name that will not match the member record. |
| Patient date of birth | The patient's date of birth. | Transposed digits. |
| Insurance member ID | The member ID as printed on the card, including any alpha prefix. | Dropping the prefix. |
Block three: the service line
One line per session. A patient claiming six sessions needs six lines, each complete.
| Field | What goes in it | Where practices get it wrong |
|---|---|---|
| Date of service | The date the session took place. | Using the date the note was signed or the superbill was issued. |
| Place of service code | 10 for telehealth in the patient's home, 11 for the office. | Leaving 11 on a telehealth session. |
| CPT code | The procedure code matching the documented service and duration. | A code the documented session time does not support. |
| Modifier | 95 for synchronous telehealth, where the payer requires it. | Omitted on a telehealth line. |
| ICD-10 diagnosis code | The primary diagnosis from the clinical record for that date. | A diagnosis that does not appear in the note for that session. |
| Units | Normally 1 per psychotherapy session. Group and some add-on codes differ. | Left blank. |
| Fee charged | The practice's full fee for the service. | Showing the discounted or sliding-scale rate as the full fee. |
| Amount paid and balance | What the patient paid on the day, and anything still owed. | Missing, which prevents the insurer calculating reimbursement. |
| Provider signature and date | Signature of the rendering clinician. | Unsigned. Some payers reject on this alone. |
The three provider fields that cause the most rejections
- Rendering NPI. The individual NPI of the clinician who delivered the session, never the group or practice NPI.
- Supervising NPI. Required whenever the treating clinician is an associate, an intern or provisionally licensed. Associates generating their own superbills is where this one goes missing.
- Licence number. The rendering clinician's own, not the supervisor's.
Which CPT Codes Belong on a Behavioral Health Superbill
Psychotherapy codes are time based. The code has to match the minutes documented in the note for that session, not the length the appointment was booked for.
| CPT code | What it covers | Documented time | Typical use |
|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation, no medical services | Not time based | Intake session with a non-prescriber. |
| 90832 | Individual psychotherapy | 16 to 37 minutes | Brief session. |
| 90834 | Individual psychotherapy | 38 to 52 minutes | The standard therapy hour. |
| 90837 | Individual psychotherapy | 53 minutes or more | Extended session. |
| 90833 | Psychotherapy add-on to an E/M visit | 16 to 37 minutes of therapy | Prescriber combines med management with therapy. Never billed alone. |
| 90846 | Family psychotherapy, patient not present | 50 minutes typical | Session with parents or partner only. |
| 90847 | Family psychotherapy, patient present | 50 minutes typical | Couples and family sessions with the identified patient in the room. |
| 90853 | Group psychotherapy | Per session, per patient | One line per group member. |
Defaulting to 90837 for every session is the pattern payers look for. If the note does not document 53 minutes or more, the code is unsupported, and a run of them across one clinician is what triggers a review. Our guide to the 90837 CPT code covers the documentation it needs in more detail.
Add-on 90833, and why it never stands alone
90833 covers 16 to 37 minutes of psychotherapy delivered alongside an evaluation and management service, so it belongs on a prescriber's superbill next to the E/M code for the same visit. The note has to show both the medical work and the therapy, with the therapy time called out separately.
Telehealth: place of service and modifier 95
- Place of service 10 means telehealth delivered to the patient in their home.
- Place of service 11 means the patient attended your office.
- Modifier 95 signals a synchronous telehealth service and attaches to the CPT code, so a telehealth 90837 reads 90837-95.
- Payers vary on whether they want the modifier, the place of service code or both, so confirm with the two or three insurers your out-of-network patients use most.
Five Checks Before the Superbill Leaves the Practice
| Check | Why it gets rejected | How to make it stick |
|---|---|---|
| The CPT code matches the time written in the note | A 45 minute session billed as 90837 is unsupported. 90837 needs 53 minutes documented. | Open the note and read the start and end time before the superbill leaves the practice. |
| The rendering NPI is the treating clinician's own | Group NPIs on the rendering line are rejected or misapplied to the wrong provider. | Keep a single reference sheet of individual NPIs and licence numbers. |
| The supervising NPI is present when it is needed | Associates and provisionally licensed clinicians need the supervisor named. | Make the field mandatory on your template rather than optional. |
| The place of service code matches how the session ran | Code 11 on a telehealth session contradicts modifier 95 and gets flagged. | Set the code from the appointment type, not from habit. |
| The diagnosis matches the note for that date | A diagnosis carried over from a previous session will not match the record if audited. | Pull the diagnosis from the signed note for that date of service. |
Why Superbill Errors Start in the Clinical Note
A superbill can only carry what the note already contains. When a clinician fills one in days later, they are reconstructing the session from a narrative that was never written to answer billing questions. Four details decide whether that reconstruction is accurate.
- Exact start and end time, which decides the CPT code.
- One primary diagnosis, which fills the ICD-10 field.
- The service type, which separates intake from ongoing therapy, and individual from family or group.
- The delivery format, which sets the place of service code and the modifier.
Recording session duration as an estimate rather than a start and end time is the version of this that slips through most often. It reads as thorough and supports neither 90834 nor 90837 cleanly. Writing the actual start and end time at the close of every session removes the ambiguity, and with it most of the rework. The same discipline is what makes structured clinical documentation useful across a whole practice rather than one clinician.
For how superbills sit alongside claims, eligibility and denials, see our behavioral health billing guide. Practices reviewing their billing stack can compare options in mental health billing software.
Streamline Your Practice
Superbills go wrong when the billing fields are reconstructed after the fact instead of captured while the session is fresh. Emma, the mdhub Clinical Assistant, writes the note at the point of care with session time, diagnosis, service type and delivery format already in fixed fields, so filling in a superbill becomes a check rather than a reconstruction. mdhub's published figure is 2+ hours per clinician per day returned from documentation work. Emma drafts the record; the clinician reviews and signs it. If you want to see how that works across a full caseload, book a demo with the mdhub team.
Take the clinical note for the session and copy across six things: the date of service, the CPT code supported by the documented session time, the primary ICD-10 diagnosis, the place of service code, the fee charged and the amount the patient paid. Add the practice name, address and Tax ID, then the rendering clinician's name, credentials, NPI and licence number, plus a supervising NPI if the clinician is supervised. Sign it and hand or send it to the patient. The patient submits it to their insurer themselves, so the practice does not file anything. Generating it from the note at the end of the session rather than in a separate billing pass keeps the codes tied to what was actually documented.
A single page with three blocks. The top block identifies the practice and the rendering clinician: practice name, address, Tax ID, clinician name and credentials, individual NPI, licence number and supervising NPI if applicable. The middle block identifies the patient: full legal name as it appears on the insurance card, date of birth and member ID. The bottom block is the service line or lines: date of service, place of service code, CPT code with any modifier, ICD-10 diagnosis, units, fee charged and amount paid. A signature and date close it. It is a receipt, not a claim form, so it does not need to look like a CMS-1500.
The structure is the same as any superbill, but three fields carry the risk in therapy. The CPT code is time based, so 90832, 90834 and 90837 are decided by the minutes recorded in the note rather than by what was scheduled. Telehealth sessions need place of service 10 and, where the payer requires it, modifier 95. Sessions delivered by a supervised clinician need the supervising NPI. Intake sessions use 90791, couples and family work uses 90846 or 90847 depending on whether the identified patient was present, and group work uses 90853.
Practice name, address and Tax ID. Rendering clinician name, credentials, individual NPI and state licence number, plus the supervising NPI where one applies. Patient legal name, date of birth and insurance member ID. Then for each session: date of service, place of service code, CPT code and modifier, ICD-10 diagnosis code, units, fee charged and amount paid. Finally the clinician's signature and the date. Individual payers ask for small variations, so it is worth checking the reimbursement page of the two or three insurers your out-of-network patients use most.
The patient receives the rejection because the patient filed the claim, but the error is almost always the practice's. Practices that handle this well correct and reissue the superbill themselves rather than asking the patient to negotiate with the insurer over a field the practice filled in. A single wrong field usually needs nothing more than a corrected reissue. A code that does not match the documented service type is different, because the note may need amending before the superbill can be corrected.
Yes, and the billing rules are the same with two additions. Place of service code 10 signals the session was delivered to the patient at home, and modifier 95 signals it was synchronous. Leaving place of service 11 on a telehealth line tells the insurer the patient attended the office, which contradicts the modifier and gets the superbill flagged. Payers differ on modifier requirements, so confirm with the insurers your out-of-network patients actually use.
Thorough is not the same as structured. A detailed narrative can still leave session duration as an estimate rather than a start and end time, which supports neither 90834 nor 90837 cleanly. The fields a superbill needs are specific: exact start and end time, one primary diagnosis, the service type and the delivery format. If those four sit in prose rather than in fixed fields, whoever fills in the superbill is interpreting the note, and interpretation is where the mismatch starts.
