Understanding Superbills: A Simple Guide for Therapy Clients
When you’re considering therapy, the logistics of cost and insurance can quickly feel confusing. Terms like out of network, deductible, or superbill might come up, but rarely get explained in a way that actually makes sense.
Let’s slow down and walk through what a superbill is, why it matters, and how you can find out if it could help you get reimbursed for therapy sessions.
What Does “In-Network” vs. “Out-of-Network” Mean?
When a therapist is in-network, it means they have a contract with your insurance company to provide services at a set rate. You pay a copay (and sometimes meet a deductible), and your therapist bills insurance directly.
When a therapist is out-of-network, they don’t have a contract with your insurance company. You pay the therapist directly—at their full or sliding-scale rate—and then, depending on your plan, you can request partial reimbursement from your insurance (aka a superbill).
What Is a Superbill?
A superbill is a detailed receipt your therapist gives you after a session or at the end of each month. It lists key information—your name, your therapist’s credentials, and other session information.
If your therapist is out of network, you pay your therapist their rate for each session, submit the superbill document to your insurance company, then receive a check for a partial reimbursement later on.
In short: a superbill helps you use your out-of-network benefits to get some money back from insurance for therapy sessions after you’ve already paid your therapist.
What Information Does Insurance See When You Submit a Superbill?
When you submit a superbill, your insurance company receives specific details, including:
- Your name and date of birth
Your therapist’s information (name, license, NPI number)
The diagnosis code (ICD-10) associated with your care
The procedure code (CPT) that describes your session type (for example, “individual psychotherapy, 50 minutes”)
The date and fee for each session
It’s important to know that submitting a superbill means sharing your diagnosis with your insurance provider. That diagnosis becomes part of your insurance record and may be visible if you change insurance plans in the future.
If maintaining complete privacy around your mental health information is important to you, you may want to consider private pay.
Superbill Versus Private Pay
Superbills are most often used in private-pay practices, where clients pay their therapists directly.
You can think of your options this way:
Superbill reimbursement → you can potentially reduce your cost through your insurance, but you give up some privacy and predictability about how much you’ll be reimbursed or when.
Full-rate or sliding-scale private pay → you have the most privacy and freedom; your therapist doesn’t share any clinical information with insurance.
Private pay therapists often choose to offer superbills over "paneling with" insurance companies to protect your privacy, offer more flexibility, and keep the focus on therapy rather than insurance paperwork.
For many people, the superbill offers a middle ground—some insurance help without having to give treatment autonomy up to your insurance company.
How to Find Out if Your Plan Covers Out-of-Network Therapy
Every insurance plan is a little different, so it’s worth calling your insurance company directly. You can use these questions to guide your call:
Do I have out-of-network mental or behavioral health benefits?
What percentage of the session fee will be reimbursed?
What is my out-of-network deductible, and how much of it has been met?
Do I need pre-authorization or a referral from my primary care provider?
Where and how do I submit the superbill (email, online portal, fax)?
How long does reimbursement typically take?
Taking notes during that call can help you feel more confident about your next steps—and prevent surprises later on.
Is a Superbill the Right Option for You?
A superbill can be a great option if you:
Want to see a therapist who isn’t in your insurance network
Are able to pay upfront and wait for reimbursement
Are comfortable sharing a diagnosis with your insurance company
Private pay might be the best fit if:
- You prefer to keep all clinical information private
You rely on predictable monthly costs rather than variable reimbursement
Your plan doesn’t include out-of-network mental health coverage
The Bottom Line
Superbills can make therapy more affordable while allowing you to work with the therapist who feels right for you. They bridge the gap between private pay and insurance coverage—offering flexibility and accessibility, but with trade-offs around privacy and cost clarity.
If you’re unsure whether this option makes sense for you, your therapist can walk you through what’s included, what to expect, and how to decide what’s best for your needs and comfort level.