How to Bill Insurance for Therapy:

A Friendly Guide for Therapists and Practice Owners

So you’ve started (or are thinking about starting) a private practice. Congrats! You’re doing the work, changing lives, and holding space.

But now you also have to deal with the backend admin work of therapy – which includes billing. Some therapists choose to only accept Private Pay clients. This is a choice you get to make. However, if you want to run a large group practice that serves a wide target audience, you’ll need to accept insurance. 

We get it. Insurance billing can feel like an overwhelming combo of paperwork, codes, portals, and phone calls with jazzy hold music. 

But here’s the truth: billing insurance for therapy doesn’t have to be scary. With the right guidance, it can be totally manageable—and even (dare we say?) empowering.

This blog is your therapist-friendly breakdown of how to bill insurance for therapy—without the jargon overload. 

Let’s dive in, step-by-step, so you can spend less time decoding insurance policies and more time doing what you love: helping people.

Oh, and if you’re ready to go even deeper after this, check out an old blog of ours here.

How Are Therapy Sessions Billed?

Let’s start with the basics. 

When you bill insurance for a therapy session, you’re basically sending a receipt (called a claim) to the insurance company saying: “Hi! I saw this client. Here’s what we did. Please pay me.”

But to do that successfully, you need three key ingredients:

1. A verified client insurance plan

    

2. The correct CPT (Current Procedural Terminology) code for the session

    

3. A way to submit the claim (electronically or via paper)

    

Here’s how it generally works:

• The client shows up for their session (yay!)

   

• You document the session and note the correct CPT code (like 90837 for a 60-minute individual therapy session)

   

• You check the client’s copay and collect it at the time of service (if needed)

   

• You submit the claim to insurance and wait for reimbursement

   

Each session is billed individually using the client’s insurance policy information, your NPI number, and your tax ID. 

Depending on the insurance plan, reimbursement might take a few days—or a few weeks (insurance companies like to keep things interesting, don’t they?).

How to Submit a Claim to Insurance for Therapy?

Ah, the million-dollar question: how to bill insurance for therapy by actually submitting a claim. There are two main options here:

1. Submit Electronically (Most Common + Preferred)

You can use a clearinghouse or an EHR (electronic health record) platform like SimplePractice, TherapyNotes, or Alma that’s built to handle insurance claims. These platforms walk you through the process step by step and make things way less intimidating.

Here’s a general overview:

• Enter the client’s insurance details into your EHR

   

• Select the correct CPT code and diagnosis code (ICD-10)

   

• Submit the claim via the platform

   

• Track the claim to see when it’s paid

   

Most EHR systems will also alert you if something is off (like a missing modifier or invalid ID number), which saves you from the dreaded rejected claim.

2. Submit Paper Claims (Old-School, But Still an Option)

If you’re going manual, you’ll need a CMS-1500 form (that iconic red-ink insurance form), which you can fill out by hand or on your computer. 

This method is slower, but it still gets the job done—especially for out-of-network billing.

Pro tip: Always double-check client information, codes, and dates before submitting. One little typo can bounce your claim faster than a therapy dog chasing a squirrel.

How Do Therapists Get Paid by Insurance?

After you submit the claim, the insurance company processes it, determines how much they’ll cover (based on your contracted rate), and then reimburses you for the session. Here’s the general flow:

1. Claim Submitted

    

2. Insurance Reviews It

    

3. You Receive an Explanation of Benefits (EOB)

    

4. Payment is Deposited (often through direct deposit or a mailed check)

    

Now let’s talk numbers. How much you’re paid depends on:

• Your contracted rate with the insurance company (a rate you agree to when you become in-network)

   

• The client’s deductible and copay

   

• The CPT code you use

   

For example: Let’s say your contracted rate is $95 for a 90837 session. 

If the client has a $20 copay, they pay you that at the time of service, and the insurance pays the remaining $75.

Some practices choose to stay out-of-network, meaning the client pays in full upfront and then you or the client submits a superbill for possible reimbursement. 

This can simplify your side of things but may limit who can afford your services.

How to Bill Clients as a Therapist?

Sometimes, insurance won’t cover everything. Or you may be working with clients outside of insurance. 

Either way, here’s what you need to know about billing clients directly:

1. Use Clear, Transparent Invoices

Send a professional-looking invoice through your EHR or accounting software. Include:

• Your name and NPI number

   

• The client’s name and date of service

   

• The CPT code used

   

• Total amount due

   

• Any payments received (copay or deductible)

   

2. Offer Superbills for Out-of-Network Clients

A superbill is a special receipt that clients can submit to their insurance to (hopefully) get reimbursed. It includes all the necessary info the insurance company needs to process an out-of-network claim.

3. Create a Clear Payment Policy

Set expectations from the start. Will you collect copays at the beginning of the session? How do you handle late payments? Having a clear policy helps reduce awkward conversations later.

4. Offer Payment Plans If Needed

Some clients may be cash-pay and need a bit of flexibility. Payment plans or sliding scales can help make therapy more accessible without sacrificing your boundaries.

You’ve Got This—One Claim at a Time

We know the world of insurance can feel like a maze of codes, forms, and confusing emails. 

But remember: learning how to bill insurance for therapy is just another skill—one that gets easier (and maybe even kind of satisfying?) the more you do it.

Take it one claim at a time. 

Use the tools and platforms that support you. And don’t be afraid to ask for help, whether it’s from a billing service, a trusted peer, or a solid blog like this one.

Because when your systems are smooth, your stress is low—and you can focus on what you do best: helping your clients feel seen, safe, and supported.

You’re not just a therapist. You’re also a business owner. And you’re doing amazing.