invoices - DOCX / PDF
Therapist/Counselor Invoice
Invoice for therapy sessions with CPT codes, insurance superbill format, and sliding scale options
Your Company Name
Your Address
INVOICE
Client Name
Client Address
Invoice #
Date / Due Date
| Description | Qty | Rate |
|---|---|---|
| Provider information | ||
| Client information | ||
| Session date and duration | ||
| CPT codes | ||
| Diagnosis codes | ||
| Session fee | ||
| Sliding scale | ||
| Superbill format | ||
| Good Faith Estimate |
Subtotal
Tax
Total
Notes / Payment Terms
For therapists and counselors billing self-pay or generating superbills for insurance.
What’s Included
- Provider information (name, credentials, NPI, license number)
- Client information (name, DOB, insurance ID)
- Session date and duration (45, 53, 60 minutes)
- CPT codes (90834, 90837, 90847 for couples, 90791 for intake)
- Diagnosis codes (ICD-10 for insurance claims)
- Session fee and amount paid
- Sliding scale notation (if applicable)
- Superbill format for out-of-network reimbursement
- Good Faith Estimate compliance (No Surprises Act)
HIPAA-compliant format. Telehealth modifier for virtual sessions.
Add your practice information and set session rates in PDFb2.
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