Superbills Explained: A Patient's Guide to Insurance Reimbursement

If your therapist doesn't accept your insurance directly, you can still get money back from your insurance company — through a document called a superbill. This guide explains what a superbill is, how to get one, and exactly how to use it to lower the cost of out-of-network therapy.

What Is a Superbill?

A superbill is a detailed receipt that your therapist provides after each session (or monthly). It contains all the information your insurance company needs to process a reimbursement claim — including medical codes that describe the service and your diagnosis.

Think of it like this: when your in-network doctor sees you, they handle the insurance paperwork themselves. When you see an out-of-network therapist, you become the bridge between your provider and your insurer. The superbill is the document that makes that possible.

For a deeper dive into what superbills contain and why they exist, see our complete guide to superbills.

What's on a Superbill?

A complete superbill includes:

• Your therapist's information — Name, license type and number, NPI (National Provider Identifier), and address
• Your information — Your full legal name, date of birth, and insurance member ID
• Date of service — The specific date of each therapy session
• CPT code — A 5-digit number that tells your insurer what type of service was provided (for example, 90837 means a 60-minute individual therapy session)
• ICD-10 diagnosis code — A medical code for your diagnosis (for example, F41.1 for generalized anxiety disorder). This confirms to your insurer that the service was medically necessary.
• Fee charged and amount paid — What the session cost and how much you paid

How Does Reimbursement Actually Work?

Here's the process, step by step:

1. You pay your therapist their full fee at or after each session.
2. Your therapist provides a superbill — typically monthly, or upon request after each session.
3. You submit the superbill to your insurance company — through their online portal, mobile app, or by mail.
4. Your insurer processes the claim and applies any outstanding out-of-network deductible.
5. Once your deductible is met, your insurer sends you a check (or direct deposit) for their share — typically 50-70% of their "allowed amount."
6. You receive an Explanation of Benefits (EOB) showing the breakdown of what was paid and what you owe.

Do You Have Out-of-Network Benefits?

Not every insurance plan covers out-of-network care. Before you start seeing an OON therapist, call the member services number on the back of your insurance card and ask:

• Do I have out-of-network mental health benefits?
• What is my OON deductible for behavioral health?
• What percentage of the allowed amount does the plan pay after the deductible?

If you have a PPO plan, you almost certainly have OON benefits. HMO plans typically do not.

How Much Will You Actually Get Back?

Here's a realistic example. Your therapist charges $180 per session. Your plan has a $600 OON deductible and pays 60% after that. Your insurer's allowed amount for a 60-minute therapy session in your area is $150.

Once you've met the $600 deductible (roughly the first 4 sessions, which you pay in full), your insurer will pay 60% of $150 = $90 per session. You pay the remaining $90 plus the $30 gap between the allowed amount and your therapist's actual fee. Net cost to you: about $120 per session — down from $180.

Can You Use HSA or FSA Funds?

Yes. Both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) cover out-of-network therapy sessions. You can use these pre-tax funds to pay your therapist directly, further reducing your effective cost. Learn more in our HSA and FSA reimbursement guide.

What If Your Claim Is Denied?

Superbill claims are sometimes denied — usually because of a missing field or an administrative error. Don't give up: most denials are fixable. Check your Explanation of Benefits for the denial reason, then contact your therapist to correct any issues on the superbill and resubmit. You also have the right to file a formal appeal. Most appealed denials are resolved in the patient's favor.