A superbill is a statement of services provided by me the therapist which you the patient are able to submit to your insurance carrier for reimbursement.

All services will be determined based on the types of activities are performed in each session. these activites are broken down into Current Procedural Terminology (CPT) codes. I use most commonly include:

97112 Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities

97110 Therapeutic exercises that a patient participates in during an OT therapy session. These exercises help build strength or endurance to support a return to normal functioning. 

97140 Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction) 1 or more regions, each 15 minutes

97150 Therapeutic procedure(s), group (2 or more). It is important to note that group therapy is not based on time and is reported for each member of the group)

97530 Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes

97633 Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes
97535 Self-care/home management training (e.g., activities of daily living [ADLs] and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment), direct one-on-one contact, each 15 minutes

97537 Community/work reintegration training (e.g., shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes

CPT CODE 97165 Occupational therapy evaluation, low complexity

CPT CODE 97166 Occupational therapy evaluation, moderate complexity

CPT CODE 97167 Occupational therapy evaluation, high complexity

Each policy is different, and each carrier will have different policies on what is needed to submit out of network claims, some companies also require a referral or prescription for therapy from your doctor.

As a patient you will need to call your insurance company to ask what is needed to submit out of network claims for Occupational Therapy. You will also need to know what your reimbursement rate is for each specific CPT code and if there is a limit to the number of each code being billed. For example "Do you reimburse for 9711 (therapeutic exercises) will you cover, is there a limitation to the number of units billed per session?"