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Superbill Generator

Create a clean superbill statement with provider details, CPT and ICD-10 codes, charges, amount paid, and balance so clients can claim reimbursement.

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CurrencyUsed for every money amount.

1Provider

Provider nameThe licensed person who gave the service.Credentials or licenseLetters and license number.NPI number10 digits. US providers only; leave blank if not used.Tax ID or EINBusiness tax number insurers ask for.Practice addressOne line per address part.

2Client

Client nameAs written on the insurance card.Client date of birthUse YYYY-MM-DD.

3Services

Services, one per lineWrite: date, CPT code, description, fee.Diagnosis codesICD-10 codes separated by commas.Place of serviceWhere the service happened.

4Money

Amount client paidTotal the client has already paid.

Total charges

CA$510.00

3 service lines totalling $510.00 CAD; client paid $510.00 CAD, leaving $0.00 CAD. All codes passed the format checks.

Total charges: CA$510.00
Amount paid: CA$510.00
Balance: CA$0.00
Service lines: 3
Validation warnings: 0
NPI check: Passes

Transparent breakdown

Diagnosis codes: 2
Place of service: 11 Office
Overpaid: CA$0.00

Service lines
Date	CPT	Description	Fee
2026-08-04	90837	Psychotherapy 60 min	CA$180.00
2026-08-11	90837	Psychotherapy 60 min	CA$180.00
2026-08-18	90834	Psychotherapy 45 min	CA$150.00

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Copy-ready draft

SUPERBILL / STATEMENT FOR INSURANCE REIMBURSEMENT
Statement date: 2026-08-22

PROVIDER
Dr. Avery Chen
RP, CRPO #012345
North Star Wellness
100 Queen St W, Suite 210
Toronto, ON M5H 2N2
(416) 555-0123
NPI: 1234567893
Tax ID / EIN: 12-3456789

CLIENT
Name: Jordan Lee
Date of birth: 1990-04-12

DIAGNOSIS (ICD-10)
A. F41.1
B. F43.23

PLACE OF SERVICE: 11 Office

SERVICES
Date        CPT     Dx    Description                     Fee
2026-08-04  90837   A     Psychotherapy 60 min            $180.00 CAD
2026-08-11  90837   A     Psychotherapy 60 min            $180.00 CAD
2026-08-18  90834   A     Psychotherapy 45 min            $150.00 CAD

Total charges: $510.00 CAD
Amount paid by client: $510.00 CAD
Balance due: $0.00 CAD

Client has paid the amounts shown above. Submit this statement to your insurer for possible reimbursement. Reimbursement depends on your plan.

Provider signature: __________________________   Date: ______________

This statement is for information only and is not billing or insurance advice. Check your payer's requirements.

144 words · 1055 characters

Use the result well

A clear answer, with the assumptions visible

These recommendations turn the result into an operational next step without hiding the inputs behind a score.

1
Save a PDF copy with the client's file and send one to the client.
2
Ask the client to confirm their name and date of birth match their insurance card exactly.
3
Include your license number and NPI if the insurer requires them; some plans reject statements without both.
4
Keep your session notes separate from the superbill; insurers only need codes, dates, and fees.

How this tool works

Read each service line as date, CPT code, description, and fee, and add fees in whole cents.
Check the NPI with the Luhn formula (with the 80840 prefix) and flag it if it does not pass.
Check each diagnosis code against the ICD-10 pattern, such as F41.1.
Lay out provider, client, service lines, totals, amount paid, and balance in one statement.

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A clear answer, with the assumptions visible

How this tool works

Keep records and bookings together

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