What is a superbill for therapy? Physical Therapy, Occupational Therapy, Speech-Language Pathology
A superbill is a document created by the healthcare provider that includes all of the required billing information. It often includes CPT codes for services rendered, charges, units, and the NPI of the rendering provider. It includes the billing provider’s NPI and Tax ID as well.
A superbill may be given to a patient who plans to submit it to an insurance company for the reimbursement of out of network services, or it may be given to an internal billing department who will turn that information into a formal CMS 1500 form and submit that claim to an insurance company.
A superbill is just another way to say invoice and receipt. The best example of a superbill is the CMS 1500 claim form.
What should be included on a superbill?
A superbill should contain the following elements:
- Provider name, address, telephone number, and fax number
- Provider’s group NPI as the billing provider and personal NPI as the rendering provider
- Provider’s tax ID or employer identification number
- Patient information: name, address, telephone, date of birth, gender
- Patient insurance information is available
- Referring provider if available
- Treatment diagnosis
- Date of service
- CPT Codes, Number of Units Billed, Total Amount Charged per CPT Code
- Treatment location listed as facility address or patient’s home address
How does a cash-based therapist create a CMS 1500 superbill?
Watch the video below to see how you can create a free Office Ally account and create CMS 1500 superbills for your cash-based physical therapy or occupational therapy clients.
What does a CMS 1500 form look like?
Here is an image of a CMS 1500 form. These forms may be purchased from Amazon or other retailers.
Can I create my own superbill?
Yes, but it is not recommended.
If you hope to provide your patient with a superbill that will be submitted to an insurance company for possible out of network reimbursement then the best practice advice is to use a CMS 1500 as it is a universally accepted form.
It is also recommended that you submit an IRS W-9 form in addition to a copy of the physician referral, your initial evaluation, and other supporting documentation.
More Lessons...
Marketing Occupational Therapy Direct To Consumer
If you really want to find easy success in marketing, solve important problems. ... As a therapist I was always so frustrated by patients who would refuse to schedule unless they had 10AM on MWF, or patients who would call to cancel a scheduled appointment because...
New Grad Physical Therapist
NEW GRADUATES!!! .. A great way to advance your career is to become a contracted Medicare provider ASAYC! (As Soon As You Can) ... Facts you may not know: ... 6 Tips to Improve Your Success as a New Graduate Physical Therapist in 2021 ... 1.) It is FREE to contract as...
Medicare Enrollment for PT OT SLP
This post teaches physical therapists, occupational therapists, and speech language pathologists how to become Medicare providers.
5 Best Books For Starting A New Physical Therapy Practice in 2021
Here are my Top 10 Recommended Business Books For Starting A Physical Therapy Practice in 2021
How To Build A Physical Therapy Clinic Website
Create A Physical Therapy Website | Full Tutorial | Watch Videos HERE
How To Credential A Physical Therapist With Medicare Part B
If you would like to learn how to enroll in Medicare as a physical therapist, occupational therapist, or speech language pathologist Part B provider then this is the post for you.
Medicare Physical Therapy Claim and Reimbursement Analysis – How to create a profitable practice
Medicare reimbursement for physical therapy has been on the decline for several years now and with the proposed reductions coming in the next year physical therapy clinic owners are looking for new business models. The way it has always been done isn’t going to bring you success in your physical therapy practice moving forward.
How much does medicare part b pay for physical therapy
If you want to learn how to look up the Medicare CMS Physician Fee Schedule for 2020 and specifically for physical therapy, occupational therapy, or speech language pathology, WATCH THIS VIDEO.
Telehealth – Using ScreenCapture, Canva, and A Digital Goniometer To Measure ROM (FREE)
Telehealth for physical and occupational therapy has been growing in popularity lately. Along with this growth, therapists are looking for new and easy to use tools. This simple goniometer can be added to your screen capture to measure joint range of motion.
Medicare Guidelines for Billing Therapeutic Exercise 97110 PT, OT in 2020
“Many therapeutic exercises may require the unique skills of a therapist to evaluate the patient’s abilities, design the program, and instruct the patient or caregiver in safe completion of the special technique. However, after the teaching has been successfully completed, repetition of the exercise, and monitoring for the completion of the task, in the absence of additional skilled care, is non-covered. For example, as part of the initial therapy program following total knee arthroplasty (TKA), a patient may start a session on the exercise bike to begin gentle range of motion activity. Initially the patient requires skilled progression in the program from pedal-rocks, building to full revolutions, perhaps assessing and varying the
seat height and resistance along the way. Once the patient is able to safely exercise on the bike, no longer requiring frequent assessment and progression, even if set up is required, the bike now becomes an “independent” program and is no longer covered by Medicare.”