Free Invoice Template for Therapists and Counselors

Billing for Therapy: Private Pay vs. Insurance vs. Superbills

Therapists and counselors deal with three different billing situations, and each one requires a slightly different approach. Private pay clients get a standard invoice. Insurance clients need claims submitted directly to the payer (usually through billing software or a clearinghouse). Clients who are out-of-network but want to seek reimbursement from their insurance need a superbill. This guide covers the private pay and superbill sides of that equation, since insurance direct billing is handled through specialized medical billing software rather than a standard invoice template.

Even if most of your clients use insurance, you'll likely have at least some private pay clients, and many therapists in private practice are intentionally moving away from insurance panels to simplify their practices.

What to Include on a Therapist Invoice

A therapy invoice for a private pay client needs several elements that a standard freelance invoice doesn't. The specifics matter because clients may use your invoice to seek reimbursement from their insurance or Health Savings Account (HSA), and those entities have requirements.

Provider Information

• Your full legal name
• Your credentials (LCSW, LPC, LMFT, PhD, PsyD, etc.)
• Your practice name (if different from your name)
• Business address
• Phone number
• Your NPI number (National Provider Identifier) - this is required for any invoice that a client might submit to insurance or an HSA administrator
• Your Tax ID or EIN (needed for HSA reimbursement and insurance submissions)

Client Information

Client's full legal name, date of birth (for any insurance-related submissions), and billing address. Some therapists also include a client ID or case number for their own records.

Service Date and Session Details

Each session should be listed as a separate line item with:

• Date of service
• CPT code (see below)
• Description of service (e.g., "Individual psychotherapy, 50 minutes")
• Fee per session

CPT Codes for Therapists

CPT (Current Procedural Terminology) codes identify the type of service provided. If your client is using the invoice for insurance reimbursement or HSA claims, they need the correct code. The most common therapy CPT codes are:

• 90837: Individual psychotherapy, 60 minutes (actually 53 minutes or more)
• 90834: Individual psychotherapy, 45 minutes (38-52 minutes)
• 90832: Individual psychotherapy, 30 minutes (16-37 minutes)
• 90847: Family psychotherapy with patient present, 50 minutes
• 90846: Family psychotherapy without patient present, 50 minutes
• 90853: Group psychotherapy

Check with your professional association and state licensing board if you're uncertain which codes apply to your services, as some credentials limit which codes you can use.

Diagnosis Code (ICD-10)

For superbills and any insurance-adjacent document, include the ICD-10 diagnosis code. This is the client's diagnosis. For a regular private pay invoice where the client is not submitting to insurance, you may omit this, but include it on superbills.

Fees and Payment

List your standard fee per session (even if the client is paying a reduced sliding scale rate - insurance requires you to show the standard fee). Then list any adjustments, discounts, or sliding scale reduction as a separate line. The final amount owed should be clear.

Create a professional therapy invoice in minutes using WaffleInvoice's free invoice generator. You can save session types, fees, and client information for quick monthly billing.

What Is a Superbill and When Do Therapists Use It?

A superbill is a detailed receipt that an out-of-network client can submit to their insurance company to request reimbursement. You're not billing insurance directly. You're giving the client everything their insurance needs to process a claim on their end.

A proper superbill includes everything on a standard invoice plus:

• Your NPI number
• Your Tax ID or EIN
• Your license number and credential type
• CPT codes for each session
• ICD-10 diagnosis codes
• Place of service code (typically 11 for office or 02 for telehealth)
• Your standard fee (not just what the client paid)
• What the client actually paid

Many clients will specifically ask for a superbill at the end of each month so they can file with their insurance. Having a template that automatically includes all of this information saves you a lot of time.

Sliding Scale Fees: How to Invoice Them

If you offer sliding scale pricing, invoicing it clearly matters for transparency and for any insurance submissions. The best approach:

List your standard (full) fee as the rate. Then add a line item for the sliding scale adjustment as a negative amount. The total reflects what the client actually owes. This is also what insurance companies want to see on a superbill - they need to know your full standard fee even if the client is paying less.

Example:

• Individual psychotherapy, 50 min (CPT 90837) - 4 sessions at $175/session = $700
• Sliding scale adjustment = -$280
• Total = $420

Payment Timing and Collection

Most therapists in private practice collect payment at the time of service. This is the cleanest approach: swipe a card, process a payment, done. No invoicing required for each session. Monthly statements summarizing sessions and payments can serve as the invoice and superbill in one document.

Some therapists bill weekly or monthly instead of collecting at session. If you do this, invoice on a consistent schedule so clients know when to expect it. Monthly billing on the first of the month for the prior month's sessions is a common approach.

HSA and FSA Cards

Therapy is generally an eligible expense for Health Savings Accounts and Flexible Spending Accounts. Many clients will want to pay with their HSA or FSA card. Some HSA administrators will ask clients to provide a receipt or invoice for the expense. Your invoice (with your NPI number included) is usually sufficient for this.

Cancellation and No-Show Fees

Most therapists have a cancellation policy (typically 24-48 hours notice required to avoid a cancellation fee). If you charge for late cancellations or no-shows, include it on the invoice as a separate line item. Be aware that insurance will not reimburse cancellation fees, so if a client is billing their insurance, make it clear that this fee is their responsibility.

Privacy and HIPAA Considerations for Invoicing

Invoices for therapy services contain protected health information (PHI). That means:

• Email invoices only to the client's confirmed email address
• Do not leave voicemails or mail invoices to addresses that haven't been verified by the client as safe
• If you use invoicing software, verify that it handles data with appropriate security practices
• Keep invoice records for at least 7 years (longer in some states) as part of your clinical record

For most private practice therapists using standard invoicing tools for private pay clients, this means being thoughtful about where you're sending documents and who can see them, not that you need a specialized HIPAA-compliant billing platform. Consult with a healthcare attorney if you have specific questions about your situation.

How to Handle Unpaid Therapy Invoices

Late payment in private practice is uncomfortable but more common than it should be. A few things that help:

• Keep a credit card on file and charge it at the time of service or at the end of each month
• Have a clear written financial agreement that clients sign at intake, covering your fees, cancellation policy, and what happens with unpaid balances
• Send invoices promptly - delays in sending create delays in payment
• For outstanding balances, address them directly in session or via email before they grow large

Read more about charging late fees if you want to add a late payment policy to your billing agreement.

Getting Started with a Therapy Invoice Template

Start with a template that includes all the required fields for your client population. If you have any out-of-network clients who submit to insurance, build the NPI number, Tax ID, and CPT codes into your template from the beginning. Adding them later to every invoice is tedious.

The Word invoice template is a good starting point to customize for therapy billing. For ongoing client management and monthly superbills, WaffleInvoice lets you save client details and session types so monthly billing takes minutes instead of hours. See what's included on the pricing page.