Practice & provider
Who is issuing this superbill. Fields marked * are required.
Client & insurance
Who the superbill is for. Insurance fields help the client submit for out-of-network reimbursement.
Diagnosis codes
Add ICD-10 codes. Each is labeled A–L so services can point to them. At least one is required.
Services
Add each service line. Fees are entered as the total charge for the line; balances calculate automatically.
Payment summary
Totals below are calculated from your service lines.
Review & generate
Confirm the summary, then generate your printable superbill.
Get the Behavioral Health Superbill Checklist
A free checklist to make sure every superbill you give a client has what their payer needs for out-of-network reimbursement — the first time.
- Every field payers look for on a superbill
- CPT + ICD-10 pairing tips for behavioral health
- Common reasons out-of-network claims get denied
- A client-friendly "how to submit" one-pager
Disclaimer
This tool provides a general superbill template for informational and administrative use only. It does not verify insurance benefits, guarantee reimbursement, determine medical necessity, or provide billing, legal, tax, or compliance advice. Providers are responsible for ensuring that all codes, diagnoses, fees, documentation, and payer requirements are accurate and appropriate.