AvoTherapist Invoice Template (Free Fillable PDF)
Private-pay therapy clients need an invoice that their insurer will accept for out-of-network reimbursement, which means a superbill: each session with its date, CPT code and fee, plus your license, NPI, tax ID and the diagnosis code. A plain “counseling, $150” invoice is returned. This template has the superbill fields in the header and one line per session, so a monthly statement is also a claim-ready document.
Free, fillable, US Letter. No email, no sign-up. Fill in your credentials once and keep the file as your master. For each client change the sessions and the client fields.
What the PDF looks like. The hints in the line table show the lines a therapist typically bills; type over them.
Why therapy invoices get paid late
Superbill missing a field
Insurers need provider NPI, tax ID, license, CPT code, date of service, fee and diagnosis code. One missing item and the client gets nothing back and calls you.
Sliding-scale fees unexplained
If the invoice shows $90 for a service listed at $150, the client's insurer may question it. State “sliding-scale fee” on the line.
Late cancellation fees without notice
A no-show fee must be in the informed consent and on the invoice terms. It is also not reimbursable, so it goes on its own line.
What to include on a therapy invoice
- Your name, credentials, practice name, address, license number, NPI and tax IDAll of these are required on a superbill.
- Client name, date of birth and insurance ID if the client will file a claimOnly on the client's copy; keep your records minimal otherwise.
- Invoice number, date, due date and statement period“Sessions, March 2026”.
- One line per session: date of service, CPT code, length, fee“Mar 3, 90837 psychotherapy 60 min, $150”.
- Diagnosis code fieldICD-10 code, required for reimbursement claims; include only when the client requests a superbill.
- Sliding scale or adjustmentsStated on the line so the fee is understood.
- Payments received and balanceCard on file, Zelle, check; credits as negative lines.
- Cancellation and no-show termsRepeated from the informed consent; fees on their own lines.
Example therapy invoice
Lines a typical job produces. Labor and materials are separate, and anything already paid is a negative line so the total is the balance due.
| Description | Qty × rate | Amount |
|---|---|---|
| Mar 3: Psychotherapy, 60 min, CPT 90837 | 1 × $150.00 | $150.00 |
| Mar 10: Psychotherapy, 60 min, CPT 90837 | 1 × $150.00 | $150.00 |
| Mar 17: Psychotherapy, 45 min, CPT 90834 | 1 × $130.00 | $130.00 |
| Mar 24: Late cancellation (under 24 h, not reimbursable) | 1 × $75.00 | $75.00 |
| Payments received Mar 3, 10, 17 | −$430.00 | |
| Total due | $75.00 | |
How to use the template
- Download the PDFIt is a fillable form: open it in any PDF reader, on a computer or a phone.
- Fill in your details onceBusiness name, contact, license number, terms. Save it as your master copy.
- Add the job and sendChange the client, the lines and the invoice number for each therapist job. Export and send by email or text.
Fill it on your iPhone in a minute instead
Avo keeps your clients and your usual line items, so the next invoice is three taps. Your first three documents are free, full-quality PDF, no watermark. Premium from $59.99/year if you invoice often.
Scan the code with your iPhone camera to open Avo in the App Store, or email yourself the link.
Questions
What is a superbill and how is it different from an invoice?
A superbill is an invoice with the fields an insurer needs to reimburse a client out of network: provider NPI, license and tax ID, date of service, CPT code, fee, and the diagnosis code. This template becomes a superbill when those fields are filled; without them it is a normal private-pay invoice.
Which CPT codes do therapists put on invoices?
The most common are 90791 (initial evaluation), 90834 (45-minute psychotherapy), 90837 (60-minute psychotherapy), 90847 (family therapy with the client present) and 90853 (group). Use the code that matches the session length and type.
Can I charge for a missed session?
Yes if your informed consent states the policy, and the invoice terms repeat it. The fee is billed on its own line, marked not reimbursable, because insurers do not pay for missed sessions.
How do I show a sliding-scale fee?
Bill the reduced fee and write “sliding-scale fee” on the line. Do not show the full fee with a discount unless your policy requires it; insurers reimburse based on what was charged.
Should I send monthly statements or per-session invoices?
Monthly statements listing every session with its CPT code and the payments received are what most clients want for claims; per-session receipts are useful when a card is charged each visit. Both come from the same template.