What Is a Superbill for Therapy — and How Do You Use One?

What information does a superbill contain?

A complete superbill functions as a pre-formatted insurance claim. It must include:

• Your therapist's information: name, license type, National Provider Identifier (NPI) number, and practice address
• Your information: name, date of birth, and insurance member ID
• Diagnosis code (ICD-10): a standardized code for the condition being treated — assigned by your therapist after a clinical assessment
• Procedure code (CPT): a standardized code for the type of service rendered (for example, a 45-minute individual psychotherapy session)
• Date of service and the fee charged

If any of these elements are missing, your insurer may reject the claim. Check the document before you submit.

How do you use a superbill to get reimbursed?

Step 1. Before your first session, call your insurer (the member services number on your insurance card) and ask: 'Do I have out-of-network mental health benefits? What is my out-of-network deductible? What percentage is reimbursed after the deductible is met?' Note the date, time, and representative's name.

Step 2. Pay your therapist at the time of service. Out-of-network providers typically collect full payment upfront.

Step 3. Request a superbill. Most therapists provide one monthly, or you can request one per session.

Step 4. Submit it to your insurer through the member portal, by mail, or by fax. Some insurers have a dedicated reimbursement form — attach the superbill to it.

Step 5. Track your submissions. Keep copies of everything with the submission date. Most insurers process claims within 30 to 45 days.

Step 6. If you have not yet met your out-of-network deductible, the payment applies to it. Once met, you typically receive a check or direct deposit for the covered percentage.

What does 'out-of-network benefits' actually mean in practice?

Not all plans have out-of-network mental health benefits. HMO plans typically do not. PPO and POS plans usually do, subject to an out-of-network deductible and coinsurance.

Out-of-network reimbursement is often a percentage of what the insurer considers a "usual, customary, and reasonable" (UCR) fee for your area — which may be lower than what your therapist actually charges. Even after reimbursement, you may still owe a meaningful portion out of pocket.

Federal law — the Mental Health Parity and Addiction Equity Act (MHPAEA) — generally requires that out-of-network mental health benefits be no more restrictive than out-of-network medical or surgical benefits. 1Ref 1U.S. Department of Labor, Employee Benefits Security Administration (2024).Mental Health Parity and Addiction Equity Act (MHPAEA).Federal requirement that out-of-network mental health benefits be no more restrictive than out-of-network medical or surgical benefits Research has found that despite this legal requirement, patients are still significantly more likely to seek out-of-network care for mental health needs than for physical health services — reflecting persistent gaps in network adequacy. 2Ref 2Centers for Medicare and Medicaid Services (2024).The Mental Health Parity and Addiction Equity Act (MHPAEA).Studies show patients are significantly more likely to seek out-of-network care for mental health than physical health, reflecting persistent gaps despite MHPAEA; CMS oversight and enforcement If you believe your insurer is applying stricter limits to mental health claims, you can file a complaint with your state insurance commissioner or the U.S. Department of Labor.

What about privacy when you submit a superbill?

When you submit a superbill, your insurer receives your diagnosis code. For some people — particularly those paying out of pocket specifically to keep their mental health care private — this is worth weighing. Your therapist can discuss whether submitting for reimbursement is the right choice for your situation.

If you see a therapist through Gale and need a superbill, your care team can generate one.