Super Bill

A “Super Bill” is a specific type of receipt for services which includes diagnosis codes and treatment codes on it.

We give out this receipt to clients who would like to get try to get Reimbursement/Credit from their Health Insurance company for Out-of-Network Services.

If we give you a Super Bill, you should:

  1. Contact your Insurance company
  2. Check if your Health Insurance covering following services:

99201, 99202, 99203– (office visit new patient)

97810, 97811– acupuncture

97813, 97814– electrical stimulation

97026– application of a modality- infrared

97812– cupping

97813– moxa

  1. Get Address for mailing in/faxing your Super Bill in — Tell them you have a Super Bill for services provided Out of Network and ask them where to send that bill.
  2. Ask if there is are any forms you need to fill out to accompany your submission
  3. Ask if you needed to put a cover letter or other info with your bill.  They will need your Subscriber ID somehow.  You might just be able to hand write that on the Super Bill, but we might suggest a short cover letter as outlined below:


RE:  Super Bill for {Your Name} – Subscriber ID xxxxxxxxxx

Dear Sir/Madam —

Please see Super Bill attached for Acupuncture Services.  Please contact me with any questions.