A therapist invoice needs the right billing fields, a secure delivery method, and a clear path from client or insurer payment to your business checking account. This page covers each piece: what to put on the document, how a superbill differs from a plain invoice, how to send both without breaking HIPAA, and how card and insurance EFT payments reach your account.

What makes therapist and counselor invoicing different?

Clients paying out of pocket often need an itemized invoice or superbill to submit for out-of-network insurance reimbursement. That single requirement drives most of the differences from a generic freelance invoice.

You're balancing clinical confidentiality against the specificity insurers demand: CPT service codes, ICD-10 diagnosis codes, dates and length of service, place of service, and provider identifiers. Self-pay sessions with no reimbursement request can stay lean. Sliding-scale sessions need to show the adjusted fee cleanly. Superbills for insurance need the provider identifiers, CPT service codes, ICD-10 diagnosis codes, dates of service, and payment details an insurer uses to review a claim.

And because most private-practice clinicians collect payment at time of service, usually via a card on file, the "invoice" is often really a receipt after the fact. That changes what it needs to communicate: not "please pay," but "here's what you paid and here's the documentation your insurer will want."

What should a therapist invoice include?

At a minimum, every therapist invoice or superbill should carry the following fields. Add or remove based on whether the client will submit it to an insurer.

Practice and provider identifiers

• Practice name, address, and phone
• Provider name and license type (LMFT, LCSW, LPC, LMHC, PsyD, PhD)
• NPI (National Provider Identifier)
• Tax ID (EIN or SSN for sole proprietors)
• State license number

Client and session detail

• Client name (and date of birth if the insurer requires it)
• Date(s) of service
• CPT code for each session (for example, 90837 for individual psychotherapy of 53 minutes or longer)
• Place of service code (11 for office, 02 for telehealth from a non-home location, 10 for telehealth from patient's home)
• ICD-10 diagnosis code, included only on superbills intended for reimbursement

Money

• Fee per session
• Amount paid and date paid
• Balance due, if any
• Accepted payment methods (card, ACH, HSA/FSA)

Policies

• Payment terms (due at session, Net 15, late fees)
• Cancellation and no-show policy reference (24-hour notice is a common standard)
• A provider signature and date on superbills

Where can therapists and counselors get a free invoice template?

Paste the template below into your document editor of choice. It works for solo-practice invoices, group-practice invoices, and out-of-network superbills; fill in the coding fields only when the client is submitting the document to insurance.

[PRACTICE NAME]
[Address, City, State ZIP] · [Phone] · [Email]
Provider: [Name, Credentials]  License #: [___]  NPI: [__________]  Tax ID (EIN): [__-_______]

INVOICE / SUPERBILL
Invoice #: [_____]        Date issued: [__________]
Client: [Client Name]     Client DOB: [__________]

Diagnosis (ICD-10) — include only if client is submitting for reimbursement:
  [F__.__]  [Description]

Sessions:
  Date         CPT     Place of Service   Duration   Fee        Paid       Balance
  __________   _____   ______             _____ min  $ _____    $ _____    $ _____
  __________   _____   ______             _____ min  $ _____    $ _____    $ _____

                                          TOTALS:    $ _____    $ _____    $ _____

Payment methods accepted: Card, ACH, HSA/FSA
Payment terms: Due at time of service unless otherwise agreed.
Cancellation policy: [e.g., 24-hour notice required; full session fee charged for late cancellations and no-shows.]

Provider signature: ______________________   Date: __________

Tip: paste the blank template above into ChatGPT or Claude and ask it to render a working file. A prompt that works: "Turn this therapist invoice/superbill template into a fillable PDF with calculated totals, plus a Google Sheets version where the Balance column auto-calculates from Fee minus Paid. Keep every field label and add data validation on the CPT column with options 90791, 90832, 90834, 90837, 90846, 90847." Use only the blank template with an AI tool, never client information or PHI; review any generated spreadsheet or PDF before adding it to your client portal.

Superbill vs. invoice: which do therapy clients need?

An invoice documents what a client owes or paid. A superbill is a specialized receipt formatted so the client can submit it to their insurance company for out-of-network reimbursement.

The two overlap, but they aren't interchangeable:

Invoice. Names the practice, the client, the dates and fees, and the balance. Does not require diagnosis codes. Fine to send for self-pay clients, employer-reimbursed sessions, or clients who just want documentation for their records.

Superbill. Everything on the invoice plus the pieces an insurer needs to process an out-of-network claim: NPI, tax ID, CPT service code(s), ICD-10 diagnosis code, place of service, provider license, and a provider signature. Out-of-network clients typically submit superbills to their insurer on a monthly cadence, though some plans accept them per session and reimbursement timelines vary.

Some clients need both: an invoice for their internal records and a superbill for their insurer. In practice, most therapists issue one document that functions as both — a receipt with all the coding fields filled in when reimbursement is in play, and the coding fields left blank when it isn't.

How do therapists send invoices without violating HIPAA?

For HIPAA-covered therapy practices, an invoice or superbill that links a client's name with CPT or ICD-10 codes contains protected health information subject to HIPAA Privacy Rule requirements. That means you can't just attach it to a regular Gmail message by default.

Concrete steps:

1. Use a secure client portal or encrypted email. Many practice-management platforms (SimplePractice, TherapyNotes, Jane, and similar) offer secure client portals or messaging; confirm the vendor will sign a BAA and that your settings support HIPAA-compliant use. If you send by email, use an encryption service like Paubox, Hushmail for Healthcare, or Google Workspace with client-side encryption configured.
2. Sign a Business Associate Agreement (BAA) with any vendor that will touch PHI on your behalf: email provider, invoicing tool, cloud storage, and payment processor if the receipt itself contains PHI.
3. Collect payment at time of session using a card on file, then send the receipt or superbill afterward through the secure channel. This decouples the payment from the PHI-bearing document.
4. Accept card, ACH, and HSA/FSA cards. HSA and FSA cards work because psychotherapy from a licensed mental health provider is a qualified medical expense under IRS rules.
5. State your cancellation policy on every invoice. A 24-hour notice window is commonly used; include the policy in your informed consent and repeat it on the invoice so clients see the fee before it is charged.
6. Reconcile weekly against your business bank account so client payments, insurance EFTs, and card processor deposits all tie out.

Use a secure portal or encrypted email by default. If a client specifically requests unencrypted email after you explain the risks, document that request in writing and minimize the PHI included.

How do therapy payments and insurance reimbursements land in your bank account?

Money reaches a private practice through three channels, each with its own timing.

Client card payments. Settlement timing and processing fees vary by processor, card type, and account setup. Common processors used by therapists include Stripe, Square, Ivy Pay, and processors built into practice-management software; funds typically settle in the practice's business checking account within a few business days, net of processing fees.

HSA/FSA card payments. These run on the same card rails and settle on the same schedule. Some HSA/FSA administrators require a superbill to substantiate the charge later; keep records for the client.

Insurance EFT. Many in-network insurers reimburse enrolled providers by Electronic Funds Transfer, which typically arrives in a business checking account as an ACH deposit. You have to enroll with each payer's EFT program using your business checking ACH routing number and account number. Payer timing varies by insurer, contract, claim status, and ERA/EFT setup; use each payer's portal to confirm expected payment timing.

A few practical rules keep the books clean:

• Route all three streams into a single business checking account. One account means one reconciliation and cleaner bookkeeping at tax time.
• Keep personal and practice money separate. For an LLC or PLLC, mixing personal and business funds can complicate bookkeeping and make it harder to maintain a clear separation between personal and practice finances.
• Set aside a percentage of every deposit for taxes. A common rule of thumb is 25% to 30% of net income, adjusted for your bracket and state. Self-employed therapists generally owe quarterly estimated federal taxes if they expect to owe at least $1,000 for the year.

What's a good bank account for a private therapy practice?

A therapy practice usually needs a business checking account that can receive card processor deposits and insurance EFTs, connect to bookkeeping software, and separate tax money without requiring another account.

Novo business checking has no monthly fee, no minimum balance, and unlimited free ACH transfers, direct integrations with QuickBooks, Xero, and Wave, and Reserves for separating money for quarterly taxes and payroll. That matches how a therapy practice actually gets paid: card processor payouts and insurer EFTs.

• QuickBooks, Xero, and Wave integrations. Novo's integrations can send deposit activity into your bookkeeping software, which reduces manual entry during weekly reconciliation.
• Novo Reserves. Split funds into up to 20 buckets without opening separate accounts: one for quarterly estimated taxes, one for payroll, one for continuing education and licensure renewals, one for a malpractice premium.
• Free incoming wires and free ACH. Useful when a payer sends a large monthly reimbursement or when you're moving funds between accounts.
• FDIC insurance through Middlesex Federal Savings. Deposits are insured for up to $250,000 through our partner bank, Middlesex Federal Savings, Member FDIC.

One tradeoff to name plainly: Novo does not accept cash deposits. If your practice regularly accepts cash copays, choose a banking setup that supports cash deposits.

How do therapists enroll for insurance EFT payments?

Every payer you're paneled with runs its own EFT enrollment. The general shape:

1. Log into the payer's provider portal (Availity handles many, others have their own).
2. Locate EFT/ERA enrollment (Electronic Remittance Advice usually enrolls alongside EFT).
3. Enter your business checking account's ACH routing number and account number, tax ID (EIN), and NPI.
4. Verify the bank account: some payers make a micro-deposit, others require a voided check or bank letter.
5. Activate ERA delivery so you receive the electronic explanation of benefits alongside the deposit.

Once enrolled, reimbursements arrive as ACH credits, often with a payer reference on the transaction descriptor, and the ERA tells you which claim each deposit covers.

What are the most common questions about therapist invoices, superbills, and EFT payments?

Do I need to include a diagnosis code on every invoice? No. Include the ICD-10 diagnosis code only when the invoice is a superbill the client will submit for insurance reimbursement. For self-pay clients who don't need reimbursement, leave it off — fewer PHI touchpoints, simpler delivery.

Can I email a superbill to my client? Not through plain email by default. Once the document has a name plus a CPT or ICD-10 code, it's PHI under HIPAA for covered practices. Send it through a secure client portal, an encrypted email service with a signed BAA (Paubox, Hushmail for Healthcare, Virtru), or a HIPAA-compliant practice management platform. If a client specifically requests unencrypted email after you explain the risks, document that request and minimize what you send.

What CPT code should I use for a 45-minute versus a 60-minute session? Use 90834 for individual psychotherapy of 38 to 52 minutes and 90837 for individual psychotherapy of 53 minutes or longer. A 45-minute session is 90834; a 60-minute session is 90837. Family therapy uses 90847 (with patient present) or 90846 (without). Initial diagnostic evaluation is 90791.

How do I invoice for late cancellations or no-shows? Reference your cancellation policy on the invoice and list the fee as a "late cancellation fee" or "missed appointment fee." Do not bill a CPT code for a session that didn't occur. Insurance generally won't reimburse no-show fees, so these charges are the client's responsibility.

What kind of bank account do I need for a private therapy practice? A business checking account in the practice's legal name (or your name as a sole proprietor). Novo business checking has no monthly fee, no minimum balance, unlimited free ACH transfers, direct integrations with QuickBooks, Xero, and Wave, and Reserves for separating money for quarterly taxes and payroll. Confirm the account can receive ACH credits so insurers can send EFT reimbursements.

How do I receive insurance EFT payments as a therapist? Enroll with each payer's EFT program through their provider portal (or Availity, where applicable), using your business checking ACH routing and account numbers, your EIN, and your NPI. Once enrolled, in-network reimbursements arrive as ACH deposits in your business checking account, paired with an electronic remittance advice.

Is therapy an HSA/FSA qualified expense? Yes. Psychotherapy and mental health services from a licensed provider are qualified medical expenses under IRS rules, so clients can pay with HSA or FSA funds and can use superbills to substantiate reimbursement. For more on what a private practice can write off, see our guide to therapist and counselor business expenses.

Disclosures

Novo Platform Inc. ("Novo") is a fintech, not a bank. Banking services provided by Middlesex Federal Savings, F.A., Member FDIC. The Novo Debit Card is issued by Middlesex Federal Savings, F.A., and the Novo Business Credit Card is issued by Continental Bank, pursuant to licenses from Mastercard International Incorporated. Mastercard is a registered trademark of Mastercard International Incorporated and can be used everywhere Mastercard is accepted. The Novo Merchant Cash Advance is offered by Novo Funding LLC. Your eligibility for Novo products and services is subject to final Novo determination.

Deposits are insured for up to $250,000 through our partner bank, Middlesex Federal Savings, Member FDIC.

Novo Reserves is not a separate account. Novo Reserves is a budgeting feature within the Novo checking account. All funds within Reserves remain a part of the overall balance of the Novo checking account.

Novo Platform Inc. ("Novo") strives to provide accurate information but cannot guarantee that this content is correct, complete, or up-to-date. This page is for informational purposes only and is not financial or legal advice nor an endorsement of any third-party products or services. All products and services are presented without warranty. Novo Platform Inc. does not provide any financial or legal advice, and you should consult your own financial, legal, or tax advisors.