Occupational therapists who bill clients directly are usually in private practice, run a small pediatric or adult clinic, or contract with families, schools, and employers. They invoice for evaluations, individual treatment sessions, home visits, and written reports. Many also send self-pay clients a superbill so the client can seek reimbursement from their own insurance.
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Invoice_1001_Client_2026-10-14.pdf
Most private-pay OTs charge per session, with a higher fee for the initial evaluation and a standard fee for 45 or 60 minute treatment sessions. Some bill per 15-minute unit to match CPT coding, especially when also billing insurance. Home visits, school observations, and workplace or home ergonomic assessments are often priced separately and may include travel time or mileage. Report writing, IEP or team meetings, and phone consultations are commonly billed hourly or as a flat fee. Some practices sell packages of sessions at a small discount, and sensory gym or group programs are priced per child per class. Contract OTs working for agencies or schools may bill hourly or per diem. Cancellation and no-show fees are usually part of the fee schedule.
| Service | Priced | Typical range |
|---|---|---|
| Initial evaluation (adult or pediatric) | flat fee | $150-350 |
| Individual treatment session (45-60 min) | per session | $100-225 |
| Home or school visit | per hour | $100-200 |
| Home safety or ergonomic assessment with report | flat fee | $250-600 |
| Written report, letter of medical necessity, or progress report | per hour | $100-200 |
| IEP, team meeting, or caregiver consultation | per hour | $100-200 |
| Small group session (social skills, handwriting, feeding) | per child | $40-90 |
| Contract OT services for a school or agency | per hour | $55-100 |
Typical US ranges. Rates vary by region, experience, and job size.
| Description | Qty | Rate | Amount |
|---|---|---|---|
| Individual OT treatment session, fine motor and sensory regulation (CPT 97530), 60 min | 4 session | $150.00 | $600.00 |
| Home visit and environment observation, 60 min | 1 visit | $150.00 | $150.00 |
| Travel mileage to home visit | 18 mile | $0.70 | $12.60 |
| Progress report for school team | 1.5 hour | $125.00 | $187.50 |
| Caregiver consultation by phone | 0.5 hour | $125.00 | $62.50 |
| Total | $1,012.60 | ||
Notes: Dates of service: March 4, 11, 18, 25 and March 20 (home visit). Payment due within 14 days. A superbill with diagnosis and CPT codes is attached for out-of-network reimbursement. Cancellations with less than 24 hours notice are billed at 50% of the session fee.
Clients and insurers need exact dates to reconcile reimbursement, and it supports your treatment records.
Self-pay clients submitting to insurance need codes such as 97165, 97166, 97530, or 97535 and the time spent.
Insurers generally require it for out-of-network reimbursement, and it must match the referral or evaluation.
Reimbursement claims usually require the provider identifiers, and it shows you are a licensed OT.
Identifies the correct patient and the responsible party for payment without exposing more health detail than needed.
These are often not reimbursable by insurance, so listing them separately avoids confusion and denials.
Shows the charge is based on a policy the client agreed to in writing.
Many private-pay OT practices collect payment at the time of service by card, HSA or FSA card, or bank transfer, and send an invoice or superbill after each session or monthly. For evaluations or large packages, a deposit or prepayment is common. Invoices for reports, school contracts, or agency work are often net 15 to 30. Late fees of 1 to 1.5 percent per month are used by some practices if stated in the signed service agreement. Cancellation policies of 24 to 48 hours notice are standard. Keep invoices free of unnecessary clinical detail, and check HIPAA and state rules on how you send billing documents.
Put sessions, reports, meetings, and travel on separate lines. Clients submitting superbills avoid denials when only treatment time appears with codes, and non-clinical time is clearly yours to collect.
Have clients sign a policy covering late cancels, no-shows, and missed home visits before the first session. Refer to it on the invoice when you apply a fee.
Many families reimburse part of your fee through their own plan. A clear superbill with codes, NPI, and diagnosis saves you repeated requests for documents.
Letters of medical necessity, school reports, and forms take real time. State your hourly or flat fee in your fee schedule and invoice before releasing the document where your rules allow.
Record start and end addresses and miles driven. You can bill travel as a line item at a stated rate, and the records help at tax time.
For private-pay clients, a flat fee per session is simpler and easier to explain. Use 15-minute units if you also bill insurance or the client needs a superbill that matches CPT time-based codes.
Yes, for private-pay work. Put your rates in the service agreement and invoice the time as separate lines. Insurance usually does not cover these, so families should know before you start.
Provider name, credentials, license number, NPI, tax ID, client name and date of birth, dates of service, CPT codes, ICD-10 diagnosis codes, fees charged, and amounts paid. Requirements vary by plan, so ask the client to check with their insurer.
In most places yes, if you disclosed the fee in writing before providing services. Check your state rules on interest caps, and be careful about applying fees to families in hardship.
Healthcare services are generally not subject to sales tax in most states, but rules vary. If you sell products such as adaptive equipment or sensory tools, those may be taxable, so check with your state department of revenue.
Send a Occupational Therapist estimate for approval, then turn it into an invoice when the work is done.
Occupational Therapist estimate template