Therapists in private practice, including licensed counselors, clinical social workers, marriage and family therapists, and psychologists, bill clients for sessions, assessments, and related services. Many are solo practitioners who take self-pay clients, provide superbills for out-of-network reimbursement, or bill insurance through a separate system. This page covers self-pay invoicing and superbills.
Create an invoice for payment collection
Upload logo
PDF will be generated with filename:
Invoice_1001_Client_2026-10-14.pdf
Most therapists charge a flat fee per session, usually for a 45 to 55 minute hour, with a higher fee for intake sessions and longer sessions of 75 to 90 minutes. Couples and family sessions typically cost more than individual sessions. Many practices offer a sliding scale for clients with limited income and set aside a limited number of reduced-fee slots. Other billable items include psychological testing and report writing (often hourly or a flat package), letters and forms, court-related work such as record preparation or testimony (hourly, often at a much higher rate), and late cancellation or no-show fees. Some therapists bill by the month for weekly sessions, which simplifies payment but still requires dated session records. Rates vary widely by license type, specialty, region, and whether you accept insurance.
| Service | Priced | Typical range |
|---|---|---|
| Individual therapy session (45-55 min) | per session | $100-225 |
| Initial intake / diagnostic evaluation | per session | $125-275 |
| Couples or family therapy session (60-90 min) | per session | $130-275 |
| Sliding scale session | per session | $60-120 |
| Psychological testing and report | flat fee | $1,200-3,500 |
| Letters, forms, and records summaries | per hour | $100-250 |
| Group therapy | per person per session | $40-90 |
| Late cancellation or no-show fee | per missed session | $50-150 or full session fee |
Typical US ranges. Rates vary by region, experience, and job size.
| Description | Qty | Rate | Amount |
|---|---|---|---|
| Individual psychotherapy, 53 min (CPT 90837), dates of service: 3/4, 3/11, 3/18, 3/25 | 4 session | $160.00 | $640.00 |
| Late cancellation fee, session of 3/20 (less than 24 hours notice) | 1 fee | $80.00 | $80.00 |
| Letter of treatment participation for employer | 0.5 hour | $150.00 | $75.00 |
| Total | $795.00 | ||
Notes: Payment due within 14 days of invoice date. Cards, HSA/FSA cards, and ACH are accepted. A superbill with diagnosis and CPT codes is available on request for out-of-network reimbursement. Please contact the office with billing questions rather than through session time.
Clients submitting to insurance, HSA, or FSA plans need exact dates, and it ties each charge to your clinical records.
Codes such as 90791, 90834, 90837, and 90847 are needed on superbills for out-of-network reimbursement and show what service was provided.
Include an ICD-10 code only on a superbill the client requests for reimbursement, since clients may not want a diagnosis on a general invoice.
Insurers and flexible spending plans typically require credentials to process a claim.
Needed on superbills so the client's plan can identify the provider; consider using an EIN to avoid sharing your SSN.
Shows copays or prepayments already collected so the client is not billed twice.
Identifying the missed appointment date and referencing the policy the client agreed to reduces disputes.
Many therapists collect payment at the time of service by card on file, which avoids chasing balances. Others send a monthly invoice or superbill with payment due in 7 to 30 days. Prepayment is common for psychological testing, often half up front, and for court-related work, often through a retainer. Late fees are less common in therapy than in other trades and should be stated in your written policies and signed informed consent paperwork before they are applied. Typical payment methods are credit and debit cards, HSA and FSA cards, ACH, and checks. Keep billing communications separate from clinical conversations and send invoices through a secure channel because they can reveal that someone is in treatment.
Have clients sign your fee schedule and late cancellation policy with the intake paperwork. A fee you can point to in a signed document is much easier to enforce, and clients are more comfortable when charges are not a surprise.
Storing a card with written consent lets you charge the session or a missed appointment fee without an awkward conversation. Make sure the authorization states exactly what you may charge.
Use a neutral business name on statements and payment descriptors if possible, and send invoices over secure email or a client portal. Limit diagnosis details to what a superbill requires.
Decide in advance who qualifies for reduced fees and how often you review them. Give clients written notice, often 30 days, before raising rates so the change does not strain the relationship.
Decide which paperwork you will charge for, such as forms, letters, and phone calls over 10 minutes, and list those rates up front. Unpaid admin work adds up quickly for solo practitioners.
A superbill is an itemized statement with your credentials, dates of service, CPT codes, diagnosis code, and fees paid. Out-of-network clients submit it to their insurance for possible reimbursement. Provide one when a client asks, and note that reimbursement is not guaranteed.
Generally yes, if your policy is in writing and the client agreed to it ahead of time. Many therapists require 24 to 48 hours notice. Insurance usually does not pay for missed sessions, so the fee is typically the client's responsibility. Check your licensing board's rules and any insurance contract terms.
Usually not on a standard invoice. Include an ICD-10 code only on a superbill the client requests, since the document may be shared with an insurer, employer, or HSA administrator.
Yes, if you disclose it in your informed consent or fee policy. Many therapists allow short check-ins for free and charge a prorated hourly rate for calls longer than 10 to 15 minutes, forms, and letters.
In general, yes. Self-pay fees are business income, and sole proprietors usually owe self-employment tax in addition to income tax. Session fees are usually not subject to sales tax, but rules vary by state, so confirm with a tax professional.
Send a Therapist estimate for approval, then turn it into an invoice when the work is done.
Therapist estimate template