Superbill Template for Therapy

Plans look for the same details on every superbill:

• Provider block: practice name, clinician and license, NPI, tax ID, address and phone.
• Client block: name, date of birth, member ID and policyholder.
• Diagnosis: the diagnosis you have made, as an ICD-10 code with its description.
• Service lines: one line per session, never a date range, each with the date, CPT code, any telehealth modifier, place-of-service code and fee.
• Totals and payment: total charges, amount paid, balance due, and a note that this is not a claim and that reimbursement is the plan's decision.

• Consistent, statement after statement. Superbills get read by people who compare them with your notes. The same structure every month, one line per session, codes that follow from the service you picked: your records and your statements tell the same story.
• Your details stay put. Practice, license, NPI and tax ID are typed once and appear on every statement. No more copying last month's document and fixing the dates by hand.
• Menus for what varies. Session length and location are drop-downs, and the CPT code, modifier and place-of-service code follow from them.
• One line per session. Add a second, third or fourth line with a checkbox instead of copying a row.
• Arithmetic done for you. Total charges, amount paid and balance due computed from the lines.
• Editable output. It lands as a table in rich-text fields (Gmail, Google Docs, most EHR note and message fields) and as plain lines in plain-text fields, so you can change anything before it goes out.
• Honest wording. A line that says the statement is not a claim and that the plan decides reimbursement.

Inside the pop-up

Statement date, practice, provider, license, NPI, tax ID, address and phone at the top, with your defaults saved once. There is one NPI field and one tax ID field. A group practice that lists both a billing and a rendering NPI adds the second on the line after insert. Client name, date of birth, member ID and policyholder next. Then the diagnosis you have made, as an ICD-10 code with its description. There is one diagnosis field, so a secondary code goes in the description field or on the line after you insert.

The session lines: each line's Service menu starts on [choose the service], so no session length is picked for you. The line reads [CPT] until you pick what that session actually was:

• Individual psychotherapy, 16-37 min reads CPT 90832
• Individual psychotherapy, 38-52 min reads CPT 90834
• Individual psychotherapy, 53+ min reads CPT 90837
• Diagnostic evaluation reads CPT 90791
• Family psychotherapy, client present reads CPT 90847

Pick Telehealth, client at home and the line reads modifier 95 and POS 10 (Telehealth, client elsewhere gives POS 02, and In office gives POS 11 and no modifier). Tick second, third or fourth to add lines, up to four per statement. For a fifth session, insert a second statement or add a row after you insert. The total, amount paid and balance are computed, and the closing note says what a superbill is and is not.

The other three templates

• /gfe, a good faith estimate under the No Surprises Act that a client can sign: pick the session length you plan to offer (this menu also starts on [choose the service]), then the period, frequency and fee. The expected number of sessions and the total are computed, with the standard notice paragraph. Review it against current requirements before you use it.
• /verify, an insurance verification form in email shape: what to send you (card photos, member number, policyholder) and what you will ask the plan.
• /benefits, the benefit check summary: deductible left, coinsurance, an estimated reimbursement per session and a not-a-guarantee close.

Shorter snippets for the replies you send most

• /cai when you cannot accept insurance, for a prospective client who asks.
• /oon, the out-of-network explanation: how superbills work, for a client who is deciding.
• /askplan, the questions a client asks their plan before the first session.
• /plainterms, deductible and coinsurance in plain words, for a client who is confused by the plan's letter.
• /noguarantee, the disclaimer, for any message that quotes a reimbursement estimate.
• /sbnote, the note that goes out with each superbill.
• /fee.paperwork, /fee.docs and /fee.reminder: paperwork fees, documentation fees and payment reminders.