What a superbill template should include
Insurers process superbills by hand or by keying them into a claim, so a good template puts every field they look for where they expect it. These templates include:
- Provider: practice name, rendering provider and credentials, address, phone, NPI, tax ID (EIN) and license number.
- Patient: full name, date of birth, address, and insurance carrier, member ID and group number.
- Diagnoses: up to 12 ICD-10-CM codes, lettered A–L so each service can point to the diagnosis it treats.
- Services: date of service, CPT or HCPCS code, modifier, description, place of service, diagnosis pointer, units and fee.
- Payment: total charges, amount paid and balance due, which is what reimbursement is based on.
- Signature: the provider’s signature and date, certifying the services were rendered.
See the full superbill checklist for why each field matters, or walk through anannotated superbill example.
Online template or blank PDF?
The online template is faster and harder to get wrong: descriptions fill in from the code, totals add up, NPIs are validated, and you can import a month of sessions from your EHR. The blank PDF is useful if you prefer to hand-write superbills. In the generator, choose More → Print blank template to print one with your practice header already filled in.
Using a template for monthly superbills
- Fill in your provider details once. They stay in your browser.
- Add the client and their diagnosis codes.
- Add a line for each session, or use Duplicate to copy the last one and change the date.
- Save as PDF and send it to your client. Next month, click New to keep the client and start fresh services.
Have a caseload of out-of-network clients? Import a CSV export and print every client’s superbill in one go. Clients can then follow our guide to submitting a superbill to insurance.