Updated 1/21/2022

When it comes to insurance, premiums, medical bills, and anything else that’s healthcare-related, many people feel confused and overwhelmed. While yes, thingscanbe convoluted and confusing, most of the time you just need a quick, simple, and easy-to-understand explanation to make sense of it all. This is true when it comes to the idea behind a Superbill, too. If you’ve heard the term, but you still find yourself askingwhat is a Superbill, keep reading.We’re explaining what a Superbill is, how it works with your insurance plan, and how you can submit one if you’re looking to be reimbursed for out-of-pocket costs to on-site oronline therapyorpsychiatry. Are you a therapist or psychiatrist who needs help creating a Superbill? We’ll look at that, too.Psychiatry and prescriptions onlineReceive an evaluation and prescription for mental health medication (if needed) from a psychiatry-trained medical provider.Get startedRead on for the ultimate guide to Superbills.

When it comes to insurance, premiums, medical bills, and anything else that’s healthcare-related, many people feel confused and overwhelmed. While yes, thingscanbe convoluted and confusing, most of the time you just need a quick, simple, and easy-to-understand explanation to make sense of it all. This is true when it comes to the idea behind a Superbill, too. If you’ve heard the term, but you still find yourself askingwhat is a Superbill, keep reading.

We’re explaining what a Superbill is, how it works with your insurance plan, and how you can submit one if you’re looking to be reimbursed for out-of-pocket costs to on-site oronline therapyorpsychiatry. Are you a therapist or psychiatrist who needs help creating a Superbill? We’ll look at that, too.

Psychiatry and prescriptions onlineReceive an evaluation and prescription for mental health medication (if needed) from a psychiatry-trained medical provider.Get started

Psychiatry and prescriptions onlineReceive an evaluation and prescription for mental health medication (if needed) from a psychiatry-trained medical provider.

Psychiatry and prescriptions online

Receive an evaluation and prescription for mental health medication (if needed) from a psychiatry-trained medical provider.

Read on for the ultimate guide to Superbills.

Superbill Definition

A Superbill definition is simple to understand. Superbills are essentially just receipts for therapy or other healthcare services you get from an out-of-network therapist, psychiatrist, counselor, or doctor. Therapy and psychiatry Superbills are created so you can submit an official receipt of your qualified expenses to your health insurance company for reimbursement. Once the insurance company receives your Superbill, they’ll determine how much, if any, the money you’re entitled to.

How do Superbills work?

If an insurance company gets a Superbill, they generally assume the health care provider has been paid and that the amount submitted on the Superbill should be paid out to you.

For specific information regarding Superbills for Talkspace services, refer to thisarticle.

Why are Superbills used for therapy and psychiatry?

Sometimes therapists and psychiatrists want to use Superbills because the process can be quicker and easier than becoming an in-network provider. Of course, actuallybeingon an insurance provider panel can be great — it allows therapists and psychiatrists to be more accessible to those who have insurance or to those who can’t afford to pay out-of-pocket for therapy or psychiatry.

“Superbills can be a great way to be fully or partially reimbursed for the cost of your out-of-pocket therapy and psychiatry expenses. Therapy can often be a luxury reserved for those with the privilege to afford it; however, the option of using a superbill can truly make therapy completely affordable to all.”

Talkspace Therapist Ashley Ertel, LCSW, BCD, CDBT

The process to get on an insurer’s provider panel isn’t always as easy as it could be. It can take a long time, and it can be complicated. Especially if there are multiple insurers in the area. Each provider panel requires a separate and individual application. Superbills let therapists and psychiatrists take insurance from patients even if they’re not on a preferred provider in-network list.

Superbills can be an effective option for therapists and psychiatrists who:

What’s Included in a Superbill?A Superbill receipt (also known as a statement) will have a few key pieces of information, including:Date or dates of service or servicesFee for servicesInformation about the therapist, psychiatrist, or practiceInformation about the person receiving treatmentA formal CPT code or codes — based on the American Medical Association code; used to identify and treat medical procedures and illnessesA diagnosis code or codes — ICD-10 code; DXInformation about a referring doctor (if any)Total amount billedThe therapist’s or psychiatrist’sHow to interpret one as a clientIf you’re getting a Superbill from your therapist or psychiatrist, there’s some important patient information that needs to be included. All the above must be present, along with specific demographic information that your therapist may or may not have about you.Keep in mind, if they don’t take insurance, a therapist or psychiatrist might not have all the necessary patient information from you to completely fill out the Superbill. Make sure that your Superbill has your first and last name, address, phone number, date of birth, and ICD-10 code.If you need a Superbill from your therapist or psychiatrist, know that many don’t openly offer them. It’s perfectly fine for you to request one, though. Once you have the Superbill and you’ve verified all the information is there, you can easily submit it to your insurance. It is important to note that a Superbill does not guarantee reimbursement from your insurance company. Reimbursement depends on several factors, including your insurance provider policies.“Medical documentation can sometimes feel overwhelming. Think of your superbill as a receipt for the services you have paid for. It will include the dates of your sessions along with the billing codes and the price paid. It will also include contact information for your therapist or psychiatrist in case the insurance company has additional questions.”Talkspace Therapist Ashley Ertel, LCSW, BCD, CDBTHow to make one as a therapist or psychiatristOnce you understand the Superbill definition, making one for a client isn’t hard. You can find software that makes the process incredibly simple. If you go this route, be sure that the software’s designed with privacy protection safeguards in place. Any name brand, good quality software will do this, but it’s something to be aware of when you’re looking.You can also make your own Superbill template easily. To create this document for insurers, you just need to list some detailed, specific information about the services you’ve provided. You will want to include some or all the following information.Information about you and your services:Your first and last nameYour business nameYour mailing address and other contact information (email and phone number)Your Employer Identification Number (EIN) or Federal Tax ID NumberYour license number authorizing you to practice in your stateYour signatureInformation about your client:Your client’s first and last nameYour client’s date of birthThe diagnosis code (ICD-10 Code)Information about the services:Date of serviceTheCurrent Procedural Terminology (CPT)to accurately describe services — note thecodes for psychological servicescan be differentA detailed description of servicesCharges for servicesThe Place of Service Code — commonly used codes for therapists are:2 (telehealth)11 (office)12 (home)Note some of the following additional tips:You might also include details about diagnosesYou’ll likely need to submit individual Superbills for each sessionBe sure you’re issuing ICD-10 Superbills using the latest versions of diagnostic codes

What’s Included in a Superbill?

A Superbill receipt (also known as a statement) will have a few key pieces of information, including:

How to interpret one as a client

If you’re getting a Superbill from your therapist or psychiatrist, there’s some important patient information that needs to be included. All the above must be present, along with specific demographic information that your therapist may or may not have about you.

Keep in mind, if they don’t take insurance, a therapist or psychiatrist might not have all the necessary patient information from you to completely fill out the Superbill. Make sure that your Superbill has your first and last name, address, phone number, date of birth, and ICD-10 code.

If you need a Superbill from your therapist or psychiatrist, know that many don’t openly offer them. It’s perfectly fine for you to request one, though. Once you have the Superbill and you’ve verified all the information is there, you can easily submit it to your insurance. It is important to note that a Superbill does not guarantee reimbursement from your insurance company. Reimbursement depends on several factors, including your insurance provider policies.

“Medical documentation can sometimes feel overwhelming. Think of your superbill as a receipt for the services you have paid for. It will include the dates of your sessions along with the billing codes and the price paid. It will also include contact information for your therapist or psychiatrist in case the insurance company has additional questions.”

How to make one as a therapist or psychiatrist

Once you understand the Superbill definition, making one for a client isn’t hard. You can find software that makes the process incredibly simple. If you go this route, be sure that the software’s designed with privacy protection safeguards in place. Any name brand, good quality software will do this, but it’s something to be aware of when you’re looking.

You can also make your own Superbill template easily. To create this document for insurers, you just need to list some detailed, specific information about the services you’ve provided. You will want to include some or all the following information.

Information about you and your services:

Information about your client:

Information about the services:

Note some of the following additional tips:

Does Insurance Cover Superbills?

Either you or your provider might submit a Superbill. Regardless of who does so, the insurer will remit payment to the client. They’ll assume that it’s for reimbursement of services you’ve already paid. Your insurer will verify any healthcare benefits you have to determine any amount that’s due.

Your insurance will consider the following:

How to Submit a Superbill

Frist, you’ll want to verify:

Next, you should ask:

*NOTE: You may want to review the above questions with your insurance provider before you have your first appointment so you’ll be able to estimate what yourtherapy will cost you.

To submit the Superbill:

You might be able to submit your Superbill in the following ways:

“For my clients who have been able to utilize a superbill for reimbursement, it was as simple as faxing the required documentation to their insurance company for reimbursement. The first step is to call your insurance provider to determine how they would like to receive the superbill and if they have any additional requirements.”

With the help of a Superbill, you may be able to more affordablystart getting the therapyyou need and start seeing a therapist or psychiatrist who can help you change your life for the better. If you’re looking foronline therapy that takes insurance, get connected at Talkspace and check your eligibility today.

Sources:1. Are You a Covered Entity? | CMS. Cms.gov.https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/HIPAA-ACA/AreYouaCoveredEntity. Published 2021. Accessed December 4, 2021.2. ICD-10-CM Official Guidelines For Coding And Reporting FY 2020. Centers for Medicare & Medicaid Services; 2020.https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2020-Coding-Guidelines.pdf.  Published 2020. Accessed December 4, 2021.3. CPT – CPT Codes – Current Procedural Terminology – AAPC. Aapc.com.https://www.aapc.com/resources/medical-coding/cpt.aspx. Published 2021. Accessed December 6, 2021.

Sources:

  1. Are You a Covered Entity? | CMS. Cms.gov.https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/HIPAA-ACA/AreYouaCoveredEntity. Published 2021. Accessed December 4, 2021.

  2. ICD-10-CM Official Guidelines For Coding And Reporting FY 2020. Centers for Medicare & Medicaid Services; 2020.https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2020-Coding-Guidelines.pdf.  Published 2020. Accessed December 4, 2021.

  3. CPT – CPT Codes – Current Procedural Terminology – AAPC. Aapc.com.https://www.aapc.com/resources/medical-coding/cpt.aspx. Published 2021. Accessed December 6, 2021.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.

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