What is a superbill, in plain terms?

It's an itemized receipt your out-of-network therapist gives you after you pay them directly. It lists the session date, the standard psychotherapy billing code, your diagnosis code, and the fee charged. You submit it yourself to your insurer for possible partial reimbursement, instead of your therapist billing your insurer directly.

Why did I only get reimbursed for part of what I paid?

Insurers reimburse a percentage, often 50 to 80%, of their own 'allowed amount' for that service, not the fee you actually paid your therapist. If your therapist charges more than the insurer's allowed amount, the gap comes out of your pocket regardless of your reimbursement percentage.

Does having a PPO matter here?

Yes. PPO plans typically include out-of-network mental health benefits, which is what makes superbill reimbursement possible at all. HMO and EPO plans usually don't cover out-of-network care except emergencies, so check your specific plan type and benefits before assuming a superbill will get you anything back.

Will my insurer treat the claim differently because it's EMDR?

Not at the coding level. Superbills use standard psychotherapy codes, the same ones used for any talk therapy, so EMDR itself isn't flagged. Your diagnosis still matters, though: some insurers, including Aetna, consider EMDR medically necessary for PTSD but investigational for other conditions.

How long does superbill reimbursement usually take?

It varies by insurer, typically a few weeks after they receive your claim. Submit through your plan's member portal or mailed claim form, keep a copy of everything, and follow up if you haven't heard back within the timeframe your plan states in its policy documents.

My plan has no out-of-network benefit at all. Now what?

A superbill won't help there, since there's no out-of-network claim to submit it to. HSA or FSA funds are a separate system and often still work for therapy regardless of network status. EmEase, a self-guided EMDR app, is a lower-cost option for everyday stress, not a superbill-eligible treatment.

Out-of-Network EMDR: Superbills and Reimbursement 101

A superbill is an itemized receipt your out-of-network EMDR therapist gives you after each session: billing code, diagnosis, and fee charged. You submit it to your insurer yourself. If your plan covers out-of-network mental health, reimbursement commonly runs 50 to 80% of the insurer’s allowed amount, not your full fee, after a separate deductible.

Maybe the EMDR therapist you found isn’t in your insurance network, or the right fit mattered more than network status. Either way, a superbill is how you try to recover some of that cost. Here’s how it actually works, and where people usually get surprised.

What exactly is a superbill?

A superbill isn’t a bill your therapist sends to your insurer. It’s a detailed receipt they hand you after you’ve already paid them directly, which you then submit yourself.

A standard superbill includes, per GoodRx:

Your therapist’s name, license type, and National Provider Identifier
The date of each session
The CPT billing code (commonly 90834 for 45 minutes or 90837 for 60)
Your mental health diagnosis code
The fee you paid

Many out-of-network therapists provide these automatically each month. If yours doesn’t, just ask.

Why is the reimbursement check smaller than you expected?

This is the part that trips people up. Your insurer doesn’t reimburse a percentage of what you actually paid. It reimburses a percentage of its own “allowed amount,” the rate it has decided is standard for that service in your area, per GoodRx.

Say your therapist charges $180 a session and your insurer’s allowed amount is $130. At 70% reimbursement, you get back $91, not $126. The gap between your therapist’s actual rate and the insurer’s allowed amount is yours to cover either way.

You’ll also need to meet a separate out-of-network deductible first, often higher than your in-network deductible, before any reimbursement starts at all.

Does your plan even cover out-of-network therapy?

This is worth confirming before you count on any of this. PPO plans typically include some out-of-network mental health benefit. HMO and EPO plans generally don’t cover out-of-network care at all, except in emergencies, per HealthCare.gov.

Call your insurer and ask specifically about your out-of-network outpatient mental health benefit, not just whether “therapy” is covered. Get the allowed amount, the reimbursement percentage, and your out-of-network deductible in writing if you can.

Does it matter that your therapist bills it as “EMDR”?

Not at the coding level. Insurers don’t have a separate billing code for EMDR. Per APA Services, therapists bill it under the same psychotherapy codes used for any talk therapy: 90832, 90834, or 90837, depending on session length. Your superbill won’t say “EMDR” anywhere on it.

Your diagnosis still matters, though. Aetna’s clinical policy on EMDR, for example, treats it as medically necessary for PTSD but investigational for other uses, including chronic pain and anxiety outside PTSD. That distinction tends to surface only if a claim gets reviewed closely, not at initial submission, but it’s worth knowing before you assume every diagnosis is treated the same way. Does insurance cover EMDR? goes deeper on how diagnosis shapes coverage generally.

How do you actually submit one?

Pay your therapist directly and request a superbill for the session, or ask if they issue these monthly by default.
Find your insurer’s out-of-network claim form, usually in your member portal under something like “submit a claim” or “reimbursement request.”
Attach the superbill and submit it, by upload or mail, along with the claim form.
Keep a copy of everything you send.

Processing typically takes a few weeks. Most plans also set a filing deadline, often somewhere between 90 days and a year from the date of service, so check yours and don’t sit on a stack of superbills too long.

What if your plan won’t reimburse out-of-network care at all?

Then a superbill has nothing to submit to. Two things are worth knowing here. First, HSA and FSA funds run on a separate system entirely: they aren’t tied to your insurer’s network, so they often still work for therapy even when out-of-network reimbursement doesn’t. Can you use HSA or FSA for therapy and wellness apps? covers the rules.

Second, if you’re paying entirely out of pocket, the No Surprises Act requires your provider to give you a written Good Faith Estimate of expected charges before you start, separate from any superbill. It won’t get you money back, but it tells you what to expect, and gives you a way to dispute a bill that comes in far above what you were quoted.

Why many EMDR therapists don’t take insurance and EMDR therapy cost without insurance cover more of the bigger picture if reimbursement alone doesn’t close the gap. For the full price range either way, see how much does EMDR therapy cost?

None of this applies if what you’re looking for is a way to practice the technique behind EMDR for everyday stress rather than deep trauma. Bilateral stimulation, EMDR’s core left-right rhythm, is something you can do on your own. EmEase, a self-guided EMDR app, guides it at app.emease.com for $14.99/month or $69.99/year, after a 7-day free trial, roughly 90% cheaper than a typical self-pay course of therapist-led EMDR, a difference in access cost, not outcome.

There’s no superbill involved, because it isn’t therapy or an insurance-billed treatment. For the heavier material a superbill might be helping you afford, a licensed therapist is still the right tool.