Superbills and Network Benefits

What is a Superbill?

A Superbill is a detailed invoice that includes information insurance companies need to consider reimbursing you directly for services you’ve already paid for. Unlike a standard invoice, a Superbill includes your specific diagnosis code(s) and other details (session dates,  provider credentials, etc.) that insurance companies require.

While we cannot guarantee reimbursement, you may receive a partial repayment for therapy costs when you submit a Superbill to your insurance provider.

How Does It Work?

1. You pay for your sessions to our practice at the time of service.
2. We provide a Superbill through the client portal each month.
3. You submit the Superbill to your insurance company.
4. Your insurance company processes the Superbill and, if eligible, the insurance company reimburses you directly at your out-of-network benefit rate.

Questions to Ask Your Insurance Company

Before submitting a Superbill, it may be helpful to understand your out-of-network mental health outpatient benefits. Call the number on the back of your insurance card and ask about:

1. Out-of-Network Coverage
   • Do I have out-of-network benefits for outpatient mental health therapy? If so, are the following codes covered:
     1. For intake (the first session), refer to the code 90791.
     2. For follow up sessions, refer to the code 90837.
     3. For couples/family counseling, refer to the code 90847.
   • If so, what percentage of the session fee is reimbursed?
   • Does my plan cover Z codes for couples therapy?
2. Deductible
   • What is my out-of-network deductible? (The deductible typically has to be met prior to coverage).
   • How much of it have I met so far this year?
3. Session Limits & Requirements
   • What is the limit to the number of sessions covered per year?
   • Do I need pre-authorization for out-of-network therapy?
   • Does my plan cover Z codes for couples therapy?
   • Is a referral from my primary care doctor required?
4. Superbill Submission
   • How do I submit a Superbill (online portal, mail, fax)?
   • Is there a time limit to submit my Superbill?
   • How long does it typically take to process the Superbill?