Fill in the provider, client and sessions, then print it or save it as a PDF for your client to send their insurer. Nothing about the client is stored.
Not sure of a code, place of service or modifier? Use the CPT code picker.
Superbill
Statement of services for insurance reimbursement
Date issued: 11/01/2026
Provider
—
NPI: — · Tax ID: —
Client
—
Insurance —
Diagnoses (ICD-10-CM)
—
Date
CPT
Mod
POS
Dx
Units
Charge
Paid
11/01/2026
90834
11
A
1
$0.00
$0.00
Total charges
$0.00
Total paid
$0.00
Balance
$0.00
Provider signature
Date
Frequently Asked Questions
What is a superbill?⌄
An itemized statement of therapy sessions that a client sends their insurer to be reimbursed for out-of-network care. It lists the provider with their NPI and tax ID, the client and their insurance, the diagnosis codes, and each session with its CPT code, fee and amount paid.
What does a superbill need to include?⌄
Most insurers ask for the provider’s name, credentials, NPI, tax ID and address; the client’s name, date of birth and member ID; ICD-10-CM diagnosis codes; and for each session the date, CPT code, place of service, any modifier, the fee and the amount paid. A signature is often expected.
Is the client information stored?⌄
No. It stays in your browser while you work and is gone when you close the page. You can choose to remember your own provider details in this browser so you do not retype them; client details are never saved.
I am a Crown Counseling client. Do I need this?⌄
No. We give our clients their superbills. Ask the office, and see how out-of-network reimbursement works on our out-of-network coverage page.
