What Is a Superbill? How to Get Reimbursed for Out-of-Network Therapy

Your therapist hands you a piece of paper after your session. It has codes, dollar amounts, and your therapist’s tax ID on it. You have heard the word “superbill” from your therapist’s office but you are not sure what to do with it, how to submit it, or whether your insurance will actually pay you back.

A superbill is the single most important document for anyone seeing an out-of-network therapist. It is also one of the most poorly explained concepts in mental health billing.

What a Superbill Is

A superbill is a detailed receipt that your therapist gives you after each session. It contains all the information your insurance company needs to process an out-of-network reimbursement claim. It is not the same as a regular receipt or a credit card statement. It is a standardized clinical document.

What a Complete Superbill Must Include

If any of these fields are missing, your insurance company will deny or delay the claim. Before leaving your first session, review the superbill and confirm every field is populated.

How Reimbursement Works

When you submit a superbill, your insurance company does not reimburse 100% of what your therapist charged. The reimbursement calculation works like this:

1. Your therapist charges their full rate. Example: $200 per session.
2. Your insurance has an “allowed amount” for that CPT code in your area. Example: $150.
3. You pay toward your out-of-network deductible first. Until the deductible is met, insurance pays nothing. Example: $1,000 deductible.
4. After the deductible is met, insurance reimburses a percentage of the allowed amount. Example: 70% of $150 = $105 reimbursed per session.
5. Your actual cost per session after reimbursement: $200 - $105 = $95.

The gap between the therapist’s rate and the insurance allowed amount is called “balance billing.” You are responsible for this difference. In this example, insurance considers $150 reasonable for the service, your therapist charges $200, and you absorb the $50 difference plus your coinsurance share.

Finding Your Reimbursement Rate

Call your insurance company and ask:

• “What is my out-of-network deductible, and how much have I met?”
• “What is the allowed amount for CPT code 90837 in my zip code?”
• “What percentage does my plan reimburse for out-of-network mental health services?”

With these three numbers, you can calculate exactly what each session will cost you after reimbursement.

How to Submit a Superbill

Option 1: Online Member Portal (Fastest)

Most major insurers allow online claim submission:

1. Log into your insurance company’s member portal
2. Navigate to “Claims” or “Submit a Claim”
3. Select “Out-of-Network Claim” or “Member-Filed Claim”
4. Upload a photo or scan of the superbill
5. Complete any required fields on the online claim form
6. Submit and save the confirmation number

Option 2: Mail

1. Download a claim form from your insurer’s website (search for “out-of-network claim form” or “CMS-1500”)
2. Fill out the form with your policy information
3. Attach the superbill
4. Mail to the claims address listed on the form
5. Send via certified mail if the amount is significant, so you have proof of delivery

Option 3: Superbill Submission Services

Services like Reimbursify, Mentaya, and Better automate superbill submission for $30 to $50 per month. They photograph the superbill, submit the claim, and track reimbursement. If you see a therapist weekly, the time savings may justify the cost.

Common Superbill Mistakes That Cause Denials

• Wrong or missing diagnosis code. The ICD-10 code must describe a covered mental health diagnosis (F32.x for depression, F41.x for anxiety, etc.), not a situational code (Z63.x for relationship problems).
• Missing NPI number. Claims without the provider’s NPI are automatically rejected.
• Submitting after the timely filing deadline. Check your plan’s deadline. If you have accumulated months of superbills, submit them immediately.
• Mismatched session dates. If the date on the superbill does not match your appointment record, the claim is flagged.

Ask Your Therapist for a Superbill

If your therapist does not provide superbills automatically, ask. Many therapists who do not take insurance are familiar with superbills and can generate them from their practice management software (SimplePractice, TherapyNotes, and similar systems produce superbills with a single click). Some therapists provide monthly superbills that batch all sessions for the month into one document. Either format is acceptable to insurers.