What Is a Superbill for Therapy? A Guide to Reimbursement

You just found a therapist you like, and then you see that they are “out-of-network.” But what does this mean? You’re not alone if insurance language feels confusing or overwhelming – but I’ll encourage you to take the time to read further, because understanding some important aspects of insurance can save you a lot of money and open up options for which therapists you’re able to see!

Below I’ll walk you through what it means for a therapist to be out-of-network vs. in-network, what a superbill for therapy is and why it can help, and how to get reimbursed for therapy if you see an out-of-network therapist.

Out-of-Network vs. In-Network Therapy: What's the Difference?

When your therapist is in-network, this means that they have a contract with your insurance company to give services to you and other insurance members.

As a therapy client, your experience includes finding a therapist from the limited provider list your insurance provides. You may need to pay out of pocket for therapy until you’ve met your deductible. After that, you will owe either a copay (a flat dollar amount – often $20-50) or coinsurance (a percentage of the session cost) for each visit.

Behind the scenes, insurance companies determine an appropriate payment for therapy services and agree to pay contracted therapists this rate when they see insurance members. The insurance company pays your therapist the difference between what you’ve paid and the contracted rate they determined. The therapist and insurance company handle all of the paperwork and fee arrangements.

Your in-network options for therapists are often more limited than the full pool of therapists in your area. Insurance companies contract with limited numbers of therapists, and therapists do not always decide to work with insurance companies. These decisions may be made based on administrative load, flexibility of services, and associated costs.

When your therapist is out-of-network, this means that they do not contract with your insurance company. There is no direct relationship between your insurance company and your therapist, and so nothing happens behind the scenes. You are responsible for engaging with both your insurance company and your therapist.

Many insurance companies offer benefits that include reimbursement for out-of-network therapy. Your plan may require you to meet a separate out-of-network deductible before coverage begins.

Insurance companies also set what’s called an “allowed amount” for therapy services. This is the maximum amount they'll recognize for a therapy session, and is often lower than what a therapist may charge for sessions. Your reimbursement is based on that allowed amount, not on what you actually paid. Reimbursement varies based on your specific policy and insurance company, but it often ranges from 30-80% of the allowed amount when you submit a superbill after out-of-network care.

Example:

Your therapist charges $200

Your insurer’s allowed amount is $120

Your insurer reimburses 60% for out-of-network mental health services

You would get back $72. You would end up paying $128 for a session.

What Is a Superbill for Therapy?

A superbill for therapy is an itemized receipt for services provided. It is a document that you can provide to your insurance company to request reimbursement. Superbills are used in many medical settings, including in mental health therapy.

A superbill for therapy includes information about you and your therapist. It includes your therapist’s name, identification and license numbers, and contact information. It also includes your contact information, dates of service, service codes, diagnosis information, and information about fees paid.

You can ask a therapist to provide a superbill for therapy sessions. You are then responsible for submitting this to your insurance company.

How Out-of-Network Reimbursement Works

Each insurance company will have different processes for seeking reimbursement. However, if you want to seek reimbursement, the general process is as follows:

You pay your therapist for a therapy session at the time of services with your own credit card, cash, or check.
You request and receive a superbill for therapy from your therapist.
You submit the superbill to your insurance company (often through an online portal, sometimes by mail). Some insurers also require you to complete their own claim form along with the superbill.
Your insurance company reviews and determines if you are eligible for reimbursement.
If your insurance company determines that your services fit under benefit guidelines, you will receive reimbursement. This sometimes occurs through a check or direct deposit.

Does Insurance Reimburse Couples Therapy?

Insurance companies decide coverage based on "medical necessity." This is why a superbill for therapy always includes a diagnosis code: it tells your insurance company why you're receiving services. Are you going to therapy because you're struggling with anxiety? Because of a recent traumatic event? To work on your relationship?

Coverage for couples therapy varies a lot because relationship distress isn't always considered "medically necessary" treatment by insurance companies. If you're seeking couples therapy, ask your insurance company about couples therapy reimbursement specifically, so you know whether your plan covers it.

You'll also need to decide as a couple whose insurance to use. The superbill for therapy goes under the name of the member on the plan, and the diagnosis assigned becomes part of that person's insurance record. The questions below can help you find out what your plan covers before your first session.

Questions to Ask Your Insurance Company Before Your First Session

Before you begin sessions with an out-of-network therapist, it is important that you understand your insurance benefits. You can often find information about what you have access to in your summary of benefits and coverage or by calling your insurance company directly. These are some great questions to ask your insurance company:

Do I have out-of-network mental health benefits?
What is my out-of-network deductible, and how much have I met?
What percentage is reimbursed?
What is the allowed amount for a therapy session?
Do I need a specific diagnosis or pre-authorization?
Is there a session limit?
How do I submit claims (portal, mail)?
Does couples therapy qualify under my plan?

How to Submit a Superbill for Therapy (Tips for Getting Reimbursed)

Submit claims monthly rather than saving them up. Check how long you have to submit claims – deadlines vary by insurer and can range from 90 days to a year.
Keep copies of your superbills until you get confirmation that your claim was received and accepted.
Follow up if your claim is denied and ask questions. Sometimes claims get denied because a small piece of information is missing or because something went wrong in the process – not because you can’t get reimbursed

Insurance language can feel like a lot, but you don't have to figure it out alone. If you're looking for a therapist who's the right fit, out-of-network care can open the door to that, and a superbill makes reimbursement much easier to navigate.

Ready to get started? Here's your next step:

Call the number on your insurance card and ask the questions listed above.
Schedule a free consultation to see if we're a good fit.
Ask for a superbill for therapy after each session and submit it monthly.

book a consult

FAQ

It can be, if fit and flexibility matter more to you than lower costs. Working with an out-of-network therapist gives you a wider pool to choose from, so you can find someone who matches your needs in specialty, availability, and style. The trade-offs are that you'll pay upfront, handle the paperwork to request reimbursement, and may not be reimbursed in full, or at all. Before committing, check whether your plan includes out-of-network benefits. To learn more, see our FAQs on superbills and how long reimbursement takes.
A superbill is an itemized receipt for therapy services that you can submit to your insurance company to request reimbursement. It includes your therapist's name, license and identification numbers, and contact information, along with your contact information, dates of service, service codes, diagnosis information, and the fees you paid. You can ask your therapist to provide one, and you're then responsible for submitting it to your insurer.

Before starting sessions, review your summary of benefits and coverage or call the number on your insurance card. Helpful questions to ask include:
- Do I have out-of-network mental health benefits?
- What is my out-of-network deductible, and how much have I met?
- What percentage of the cost is reimbursed, and what is the allowed amount for a session?
- Do I need a specific diagnosis or pre-authorization?
- Is there a session limit?
- How do I submit claims (portal or mail)?
- Does couples therapy qualify under my plan?
Most claims are processed in about two to four weeks, though timing varies by insurer and by how you submit your claim. Online submissions tend to be faster, and errors or missing details can add time. If a follow-up or resubmission is needed, reimbursement can take up to twelve weeks. Submitting promptly and double-checking that your superbill is complete can help avoid delays.