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Counseling Invoice Template

Session codes, dates, licence and NPI — a superbill a plan will accept. Free PDF.

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Most private-practice therapy is paid out of pocket and reimbursed afterwards, which makes the invoice a superbill: the patient hands it to their plan and the plan decides on what it can read. Session length, the code and your credentials are what it looks for, and a missing one costs the client the whole claim rather than a phone call.

INVOICE Issued
Invoice number:INV-0001
Date of issue:August 2, 2026
Date due:August 16, 2026
Currency:USD
Issued by
Rosalind Achebe, LCSW
44 Willowmere Street
Suite 210
80206 Denver, CO
United States
office@achebecounseling.example
Bill to
Tobias Lindqvist
912 Cherry Creek Lane
80209 Denver, CO
United States
t.lindqvist@example.com
Amount due
$15.00
Due in 14 days · Aug 16, 2026
For your insurer
Licensed Clinical Social Worker, Colorado LCSW.0009942, NPI 1730294857. Diagnosis F41.1. Place of service 11 for in-person sessions and 10 for the telehealth session. All sessions listed have been paid in full.
Description Qty Rate Tax Amount
90837 — Psychotherapy, 60 minutes
Three sessions, in person
3$185.00—$555.00
90834 — Psychotherapy, 45 minutes
One session, telehealth
1$150.00—$150.00
90791 — Diagnostic evaluation
Intake assessment
1$225.00—$225.00
Late cancellation
Under 24 hours' notice; not reimbursable by insurance
1$90.00—$90.00
Subtotal$1,020.00
Total$1,020.00
Paid to date-$1,005.00
Amount due $15.00
Terms
Paid in full — this document is provided for out-of-network reimbursement. The late cancellation fee is not a covered service.
Invoice #INV-0001 · Rosalind Achebe, LCSW · Page 1 of 1

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What to put on a counseling invoice

  • Your licence type and number, and your NPI
  • Each session by date, with its CPT code and duration
  • The diagnosis code, which most plans require for reimbursement
  • Whether the session was in person or telehealth, and the place-of-service code
  • The amount paid and the date paid, since a superbill documents payment already made
  • Your practice's tax ID, where you bill under a group

Questions

What is a superbill?

An itemised receipt with the codes a plan needs to reimburse an out-of-network claim. The client has already paid you; the document exists so their insurer can pay them, which is why it carries codes and identifiers a normal receipt would not.

Does the session length matter?

Yes — 90834 is a 45-minute session and 90837 is 60, and plans reimburse them differently. Billing the wrong one is a common cause of a clawback months later, so the duration belongs on the line beside the code.

Ready to bill for it?

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