For providers
Fill in your practice, the client, the codes, and the sessions. A clean superbill builds as you type. Download it as a PDF or print it.
Provider name, credentials
Practice name
Address
NPI
Tax ID / EIN
License number
Client name
Date of birth
ICD-10 code and description
| Date | Code | Service | POS | Dx | Units | Fee | Charge | Paid |
|---|---|---|---|---|---|---|---|---|
| Sessions appear here as you add them. | ||||||||
Made with the free superbill generator at neurodiversion.org
Still missing from the fields this tool checks:
Balance due $0.00 on $0.00 in charges.
A superbill is an itemized receipt for healthcare services, written so an insurance company can process it. Your client pays you, sends the superbill to their insurer, and the insurer reimburses them under their out-of-network benefits. With a superbill, the client submits the claim. You don't.
That's the whole distinction. A superbill is issued to the client, not the payer. It's the document that lets a private-pay practice work with insured clients without joining a panel.
Prefer to fill one in by hand, or keep a blank on file? Same layout as the generator, every field empty.
Payers differ, but most want the same core set:
The "Before you send" list next to the sheet checks the core of these as you fill the form. Anything a specific plan adds on top is yours to confirm.
These are the codes in the tool's menu. Codes are set by the American Medical Association; payers decide what they cover. When in doubt, use the code that matches the time and the service, not the one that pays best.
| Code | Service |
|---|---|
| 90791 | Psychiatric diagnostic evaluation |
| 90792 | Psychiatric diagnostic evaluation with medical services |
| 90832 | Psychotherapy, 30 minutes |
| 90834 | Psychotherapy, 45 minutes |
| 90837 | Psychotherapy, 60 minutes |
| 90839 | Psychotherapy for crisis, first 60 minutes |
| 90846 | Family psychotherapy without the client present |
| 90847 | Family psychotherapy with the client present |
| 90853 | Group psychotherapy |
| 96116 | Neurobehavioral status exam, first hour |
| 96130 | Psychological testing evaluation, first hour |
| 96131 | Psychological testing evaluation, each additional hour |
| 96136 | Test administration and scoring, first 30 minutes |
| 96137 | Test administration and scoring, each additional 30 minutes |
| 97165 | Occupational therapy evaluation, low complexity |
| 97166 | Occupational therapy evaluation, moderate complexity |
| 97530 | Therapeutic activities, each 15 minutes |
| 92507 | Speech, language, or communication treatment |
| 99213 | Office visit, established client, low complexity |
| 99214 | Office visit, established client, moderate complexity |
Before the first session, suggest the client call the member line and ask three questions. Do I have out-of-network mental health benefits? What's my deductible? What's the reimbursement rate for CPT 90837? The answers tell them what to expect.
Most insurers reimburse only licensed providers, so a coaching session on a superbill is unlikely to be reimbursed. This tool still works as an itemized receipt for a client's records or an employer stipend. Leave the NPI and license fields blank and the sheet stays honest.
No. The sheet is built in your browser from what you type, and nothing is uploaded. If you turn on "Remember my practice details," those fields and only those are kept in your browser's storage on this device. Client details and sessions are never stored. Close the tab and they're gone.
For insurance reimbursement, yes. Payers match the claim to a provider by NPI, and most will send back a superbill without one. Health care providers can apply for one free through NPPES, the federal registry. The online application takes about ten minutes, and the number usually follows within a few business days. An NPI doesn't prove licensure or guarantee payment.
For reimbursement, yes. Insurers pay for treatment of a diagnosed condition, so most plans won't reimburse a superbill without an ICD-10 code. Talk it through with the client first: they're the one submitting it, and they should know what it says.
It depends on the payer. Many commercial plans accept modifier 95 with place of service 10 (client at home) or 02 (client somewhere else), some still ask for GT, and audio-only sessions often use 93. Before the first telehealth superbill, have the client ask the member line which combination the plan wants.
Monthly is the usual rhythm: one statement per client, listing every session in the month. Some clients prefer one per session so they can submit as they go. Either works; consistency matters more than frequency.
Not in this version. The sheet is deliberately plain so it reads the same to every payer. If you need your own branding, print to PDF and attach it to your letterhead, or copy the layout into your practice software.
Many clinicians who work with neurodivergent clients run private-pay practices, and superbills are the paperwork that makes that workable for insured clients. This one is free, private, and built the way we would want our own tools built: clear, the same result every time, and no surprises.
For providers
Occasional notes on neurodivergent-affirming practice, new provider tools like this one, and CE courses as they open.
A few emails a year about provider tools and CE. Leave whenever you want.
