- September 6, 2026
- John
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What Is a Superbill and How Do You Use It for Out-of-Network Therapy in California?
You found a therapist you want to work with. They do not take your insurance. Before you decide you cannot afford it, there is a mechanism worth understanding, because for many people it cuts the real cost substantially.
What a Superbill Is
A superbill is an itemized receipt from your therapist, formatted with the specific codes your insurance company needs to process a claim. You pay your therapist directly, then submit the superbill to your insurer, and your insurer reimburses you according to your out-of-network benefits.
The therapist is not billing your insurance. You are, using documentation they provide.
What It Contains
A complete superbill includes:
- Your therapist’s name, credentials, license number, and National Provider Identifier
- The practice name, address, and tax identification number
- Your name and date of birth
- Each session’s date, the CPT procedure code, and the fee you paid
- A diagnosis code, typically an ICD-10 code
- Confirmation that you paid in full
The diagnosis code is worth understanding. To reimburse, your insurer needs a billable diagnosis, which means your therapist has to assign one and your insurer will have it on record. Most people are comfortable with that. If you are not, discuss it with your therapist before starting, because it is a reasonable thing to weigh.
Before You Start: Confirm Your Benefit
Do this before your first session, not after three months of accumulated bills. Call your insurer and ask:
- Do I have out-of-network benefits for outpatient behavioral health? Some plans, notably many HMOs and some EPOs, have none. If the answer is no, superbills will not help and you need a different plan of action.
- What is my out-of-network deductible, and how much have I met? You typically pay everything yourself until it is met.
- What percentage do you reimburse after the deductible? Often somewhere around half to three-quarters of an allowed amount.
- What is the allowed amount for CPT code 90837? This is the key question most people miss. Reimbursement is a percentage of what your insurer considers reasonable, not of what you actually paid. If your therapist charges more than the allowed amount, you absorb the difference.
- How do I submit, and what is the deadline? Usually a portal upload or a claim form, often with a filing window of 90 days to a year.
Common CPT codes: 90791 for a diagnostic intake, 90834 for a 45-minute session, 90837 for a 60-minute session, and 90847 for family or couples therapy with the patient present.
Doing the Math
Work out your actual per-session cost before committing. The calculation is: what you pay your therapist, minus the reimbursement percentage applied to the allowed amount, once your deductible is met.
The two things that trip people up are that reimbursement applies to the allowed amount rather than your therapist’s fee, and that nothing gets reimbursed until the out-of-network deductible is satisfied. A plan can look generous on paper and deliver very little if the deductible is high and you attend a modest number of sessions.
How to Submit
- Ask your therapist for superbills monthly. Most practices generate them routinely on request.
- Check every field. A missing NPI or tax ID is the most common reason a claim gets rejected.
- Submit through your insurer’s portal if possible, since it is faster and creates a record.
- Keep copies of everything, including submission confirmations.
- Follow up after three to four weeks if you have heard nothing.
Reimbursement typically arrives as a check or direct deposit within a few weeks to a couple of months.
If a Claim Is Denied
Denials are frequently administrative rather than substantive. Read the explanation of benefits, find the specific reason, and fix it. Missing information can simply be resubmitted.
If the denial is substantive, you have appeal rights. In California, you can also file a complaint or request an independent medical review through the Department of Managed Health Care for plans under its jurisdiction, or through the Department of Insurance for others. Mental health parity requirements give you real standing if a plan is treating behavioral health worse than medical care.
Other Routes Worth Asking About
Network adequacy exception. If your plan has no available in-network therapists who fit your needs, some plans will authorize out-of-network care at in-network rates. Document who you contacted and what they said, then ask.
HSA and FSA funds. Therapy is generally an eligible expense, so you can use pre-tax dollars whether or not you are also seeking reimbursement.
Sliding scale. Ask directly. Many practices hold reduced-fee slots quietly.
Where Being Well Fits
Being Well Therapy Group accepts most major insurance plans directly, including Blue Cross Blue Shield, Aetna, and United Healthcare, which means many clients never need a superbill. For clients whose plans we are out of network with, we provide superbills on request.
Contact us before your first session and we will verify your specific coverage, so you know your real cost before you begin. Call (310) 633-5733.
If you or someone you know is in immediate danger, call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours a day, seven days a week. In a medical emergency, call 911.
