What Is a Superbill for Therapy?

BetterHelp insurance availability, coverage, and cost may vary by state, plan, provider network, therapist availability, and deductible status.

A superbill for therapy is a detailed receipt issued by an out-of-network therapist describing the services they provided, which you can then submit to your insurance company for potential reimbursement. 

If your insurance plan includes out-of-network benefits, a superbill can be a key part of accessing those benefits, as it bridges the gap between out-of-network care and insurance reimbursement. 

What is a therapy superbill?

Understanding the ins and outs of therapy billing, health insurance, and reimbursement can be confusing. All the complex jargon, rules, and restrictions can feel like a dizzying maze at times, but figuring out how to navigate these complexities can make a huge difference when you’re trying to find mental health care that fits your needs and budget.

 When you know your way around this maze, it can help you get the most out of your insurance benefits. 

Now, to fully understand what all of this means, it can help to clarify a few terms and concepts: 

• In-network therapist: An in-network therapist is a therapist who has a contract with your health insurance plan that sets discounted, pre-negotiated rates for covered services. With an in-network therapist, the provider bills your insurance, and costs are typically lower.
• Out-of-network therapist: An out-of-network therapist is a therapist who does not have a contract with your particular health insurance plan, which means there are no pre-negotiated rates. With an out-of-network therapist, you typically pay the full fee directly to the provider. 
• Out-of-network benefits: Some health insurance plans (not all) may include out-of-network benefits, which means that they will cover some portion of the cost of services you receive from out-of-network providers.  

Here’s how it all comes together: if your health insurance plan includes out-of-network benefits and you visit an out-of-network therapist, you would pay for the visit yourself upfront, and the therapist could give you a superbill detailing the services you received. 

Then, you could submit that superbill to your insurance company to (potentially) be reimbursed for some portion of that cost. 

What does a therapy superbill include?

A superbill is highly detailed and includes extensive information about you (the client), your therapist, and the services you received. Typically, a therapy superbill includes the following: 

• Client information, such as your full name and date of birth
• Therapist information, such as their name, credentials, license number, National Provider Identifier, Tax ID, address, phone number, and email address 
• Information about the services provided, such as the date of service, the procedure codes (CPT codes) for the therapy session, a diagnostic code, the total charge for the service, and the amount paid by the client

To learn more about what should be included, you can contact your insurance company to confirm exactly what information they need; you can also find superbill example templates online. 

Having a clear sense of what needs to be included in a superbill—from therapist details to procedure codes—can help ensure you have all the information your insurance needs to process your reimbursement request.

How does a superbill work for therapy reimbursement?

If you plan to see an out-of-network therapist and hope to be reimbursed by your insurance company for your sessions, here’s a step-by-step breakdown of the process you can follow: 

1. Verify your out-of-network benefits.
2. Pay for your therapy session upfront. 
3. Ask your therapist for a superbill.
4. Submit the superbill to your insurance. 
5. Track your claim.

For out-of-network therapy, insurance reimbursement rates can vary widely and can depend on a range of factors. These can include:

• Your out-of-network deductible: This is the amount you must pay for out-of-network care before your insurance starts to offer reimbursement. 
• Your plan’s “allowed amount” for the service: This is how much your insurance company deems to be a reasonable rate for the service and is what your reimbursement would be based on.
• Your coinsurance rate: This is the percentage of the cost your insurance company expects you to pay for out-of-network care after you’ve met your out-of-network deductible. This is typically based on the allowed amount, which may be less than the actual amount your therapist charged. If so, you (the client) must then pay the difference; this is called balance billing.

How to request a superbill from your therapist

Making sure your therapist provides you with a detailed superbill is a crucial piece of the puzzle. Your therapist may not automatically provide one, so it is important to ask. 

To get a superbill, you can simply ask your therapist for one after your visit. However, therapists are not required to provide superbills; some may not offer them or may provide them only in certain scenarios.

 So, asking your therapist ahead of time whether they are willing to provide superbills can help ensure you are able to get what you need. If your therapist does offer superbills, they may send you one after each session or in batches (such as on a monthly basis). 

Once you have received the superbill from your therapist, it’s time to submit it to your insurance provider for potential reimbursement. 

How to submit a superbill for therapy

Figuring out exactly how to submit a superbill to insurance for reimbursement will depend on your specific insurance plan, but in some cases, there may be additional forms you have to submit to your insurance alongside the superbill, such as a medical claim form. 

To send these forms in, you may have to upload them online through your insurance company’s member portal, physically mail them in, or send the documents via fax. 

Be sure to review the submission guidelines and deadlines for your particular plan and follow them exactly. However, it’s important to remember that simply submitting a superbill does not guarantee that it will be covered and you will be reimbursed. 

Can you submit a superbill for online therapy?

For many people, part of the reason for getting out-of-network care is that you found a better match for your mental health needs outside of your network than you could find inside your network.

Online therapy often expands your options further, allowing you to connect with additional qualified providers and receive effective mental health treatment, without having to travel for appointments.

If your insurance plan includes out-of-network benefits, you may be able to submit superbills for online therapy, depending on the platform, therapist, and how you pay. 

That said, if you are not able to submit a superbill for whatever reason, there are other ways to find affordable online therapy. 

With a platform like BetterHelp, you can get online therapy at an affordable price, with or without insurance. BetterHelp accepts insurance through many major insurance plans, and eligible members’ average copay is $23 per session. 

Insurance availability and coverage may vary by state, plan, provider network, therapist availability, and deductible status. 

Without insurance, BetterHelp also offers a flexible subscription model starting at $70 to $100 per week (exact pricing is based on factors such as location, referral source, preferences, therapist availability, and applicable promotions). 

What happens if your insurance company denies your superbill?

After you submit your superbill and any other required documents, you wait for your insurance company to process your claim. 

In some cases, your insurance may approve your claim and send you a reimbursement check for some portion of the therapy cost. 

But what happens if you submitted a superbill that your insurance denied? Superbill claims can be denied for various reasons, but a denial is not necessarily the end of the road. 

If your superbill was denied, your insurance must explain why. To find out the reason, look for the Explanation of Benefits (EOB) statement. Some common reasons a superbill may be denied include: 

• There were minor errors or missing details in the superbill.
• Your care needed prior approval.
• Your care was not considered medically necessary.
• The claim was not received on time.

After being notified of the denial, you do have another available course of action: appealing the decision. Often, the EOB statement explains how to file an appeal and have your claim reviewed again. 

The exact appeals process will depend on your insurance company, but it typically involves gathering additional information, completing required paperwork, and filing the appeal by their deadline. 

Now, if that internal appeal is also denied, you may have one more route you can try: filing an external review with a third party. This gives you the chance to have your claim independently reviewed; the decision in this case is typically final.