What is a superbill?

A superbill is a document that provides a detailed receipt of services rendered, which clients can submit to their insurance company for reimbursement. It is important to note that insurance reimbursement is not guaranteed and depends on your insurance plan.

What information is included in a superbill?

A superbill typically includes the client’s name, date of service, service provided, diagnosis code, and the associated fees for the session. The superbill may also include the provider’s name, credentials, and tax ID number.

Will my insurance reimburse me if I submit a superbill?

It depends on your specific insurance plan. Many insurance plans offer out-of-network benefits, which means that they may cover a portion of the cost of therapy services even if the therapist is not in their network. However, the amount of reimbursement varies widely and is dependent on the individual plan. It is important to contact your insurance company to understand your specific benefits.

How to check if you have OON coverage:

  • First, check your insurance card for a phone number or website for member services. Call or visit the website and ask if you have out of network mental health coverage.

  • If you do have out of network coverage, ask what your deductible is and if you have met it. Also, ask what percentage of the session fee will be reimbursed by your insurance company.

  • Once you have this information, you can decide if you want to use your out of network coverage or pay for therapy out of pocket and receive a superbill for potential reimbursement.

Use this script as a guide:

(Printable version here)

  • Do I have OON Benefits?

  • Do my OON benefits cover routine outpatient mental health services?

  • My therapist uses the following CPT codes, can you tell which are covered? Is prior authorization required?

    • 90791

    • 90837

    • 90834

    • 90832

    • 90839

    • 90840

  • Do I have a deductible?

  • How much does my plan cover?

  • Does that cover full billed charges or is it an estimated allowable amount?

  • Will telehealth be covered?

  • Does my therapist have to use a special telehealth platform?

  • How do I submit the claim?

  • Do I need a special form along with my superbill?

  • How will I be reimbursed?