Key takeaways

• An invoice tells a client how much they owe you for treatment you’ve provided.
• An invoice usually isn’t detailed enough for a client to claim out-of-network benefits. For that, clients typically need a superbill.
• However you invoice clients, use a HIPAA-compliant method, including HIPAA-compliant email if you send invoices that way.

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When you run your own therapy practice, good invoicing helps you get paid faster. 

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Thorough, carefully filled-out invoices make it easier for clients to understand what they owe and how they can pay you. Not only that, but clients filing health insurance claims in order to be reimbursed for the cost of therapy rely on detailed invoices to do so.

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The easiest way to invoice clients is with a template. Keep reading for a free invoice template for therapy practices, plus instructions on how to fill it out.

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How to send a HIPAA-compliant invoice

On the surface, emails may seem like a simple, direct way to communicate with your clients. On the technical side, it’s much more complex. 

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The data contained in an email may bounce between a number of different servers before reaching its final destination. Each time it travels from one server to another, it’s vulnerable to theft.

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Hackers may use your patients’ data for the purpose of identity theft, blackmail, or fraud. Not only does that hurt your client, but it could result in steep fines for your practice.  

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Under HIPAA, you can send unencrypted emails containing protected health information (PHI) to clients, provided they agree to it after you’ve warned them of the risks. But taking extra steps to make sure the data is unreadable better protects your clients’ privacy.

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The most direct method is encryption. If you use a business email service like Google Workspace, sign the provider’s business associate agreement (BAA) before emailing client information. Gmail encrypts messages in transit when the recipient’s email provider supports it, but that isn’t guaranteed for every recipient. For guaranteed encryption, send invoices through your EHR’s secure client portal or a dedicated encrypted email service.

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Any electronic health records (EHR) tool that allows you to bill clients should also be HIPAA-compliant. If you’re not sure, check that you’ve signed a BAA with the EHR provider.

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Other invoicing apps or accounting software may or may not be HIPAA-compliant or provide encryption. Make sure you’re using a 100% HIPAA-compliant method before sending any client data over the internet.

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For more information, check out our HIPAA Compliance Checklist for Therapists.

Why you need an invoice template for your therapy practice

If you’ll be invoicing your clients by email, it’s absolutely essential to choose a template that works for your practice.

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While your exact needs may differ somewhat, here’s what any template you use should include:

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• Your practice’s name, your address, and other contact info
• Your client’s name and address
• The invoice number
• A section where you list services being charged for (line items)
• A section showing the costs and total cost of the items you’re charging for
• Details on how clients can pay you by check or ACH
• A section for extra notes
• The date and your signature

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Heard’s free invoice template for therapy practices below includes all of these sections.

How often should you invoice therapy clients?

Most therapists invoice per session, sending an invoice (or charging a card on file) after each appointment. For clients in ongoing treatment, a single monthly invoice covering every session that month is also common and cuts down on paperwork.

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Whichever schedule you choose, explain it in your financial policy at intake, so a therapy bill never catches a client by surprise.

Invoice vs. receipt vs. superbill vs. Good Faith Estimate

Invoices belong to a family of documents that tell clients what therapy costs. Receipts, superbills, and Good Faith Estimates are part of the same family, but each serves a distinct purpose:

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• A psychotherapy invoice tells a client how much they owe you for treatment.
• A receipt (sometimes called a therapy or counseling receipt) confirms the amount a client has already paid you.
• A superbill records what a client has paid, plus the diagnosis and procedure codes and provider details their insurer needs to reimburse them for out-of-network therapy.
• A Good Faith Estimate tells uninsured or self-pay clients what their treatment is expected to cost before it begins.

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Here’s a side-by-side comparison for quick reference:

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Heard’s free invoice template for therapists

Here’s a quick preview of Heard’s free invoice template for therapists:

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Here’s how to access the template and make a copy for yourself:

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1. Log in to your Google account.
2. Sign up to receive the template in the Heard Resource Hub: Invoice Template for Therapists. The email will be sent directly to your inbox.
3. Check your email, then access the template by clicking the “Download template” button.
4. In Google Sheets, go to File > Make a copy.
5. Google Sheets will prompt you to save a copy of the file to your own Google Drive folder
6. Select a folder in Google Drive*, then click “Make a copy.”
7. A new tab will open showing your own, personal copy of the template.

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* If you’re not super familiar with Google Drive and you’re not sure where to save the template, don’t worry. When the dialog opens prompting you to choose a folder, click “All locations” and select My Drive.

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You can now close the tab with the original Heard Invoice Template for Therapists, and begin using your own copy of the template to create invoices.

How to create an invoice in Google Sheets with your copy of the template

The easiest way to create new invoices using the template is to make copies of it, and fill out each copy as a separate invoice.

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Heads up: Before saving any client data in the cloud, make sure to read up on Google and HIPAA compliance.

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But before making any copies, fill out your practice name, address, signature, and contact info. It will save you having to enter the same information each time you create a new invoice.

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Then, go to File > Make a copy to start creating copies.

How to add your signature

If you have a copy of your signature saved on your computer, you can add it to the Google Sheets template so it’s included on every invoice you send.

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First, select the shaded cell next to “Signature:” (cell E38).

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Then, in Google Sheets, go to Insert > Image > Insert an image over the cells.

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Now you can resize your signature and drag it into the right position on the template.

How to email your client an invoice created with the template

Before emailing your client a copy of an invoice, convert it to a PDF.

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The PDF format is easier to share if your client doesn’t have Excel or Google Sheets.

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To export a PDF version, go to File > Download > PDF (.pdf)

How to turn the Google Sheets template into an Excel spreadsheet

You can convert your Google Sheets invoice template into an .xlsx file readable by Microsoft Excel.

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This is a good idea if you already have Excel installed, know how to use it, and want to fill out and store all your invoices natively on your own computer rather than in the cloud.

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To download a copy of the template for Excel, go to File > Download > Microsoft Excel (.xlsx)

Example therapy invoice 

To get a better idea of how the Heard Invoice Template for Therapists works, here’s an example of it in action:

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The template is being used by an imaginary therapy practice in Boise, Idaho. The client being invoiced is imaginary, too.

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At the top, we see names and contact info for the practice and the client.

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To the right of that, there’s the invoice number and the date of issue, as well as the due date.

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You can number your invoices any way that works for you. The numbers are for your use internally, so you can keep track of the invoices you’ve sent; and for communications with clients, bookkeepers, and accountants, so it’s easy to refer to specific invoices.

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Next, the line items. These are the meat of the invoice. There are spaces for:

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• The date the service was rendered
• The CPT code (important if your client is being reimbursed by their insurance provider)
• The type of service provided
• The duration of the service
• Your hourly rate
• The total cost of each line item
• The total cost, at the bottom, of all line items

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Note that the template will automatically multiply the duration in each line item in hours by your hourly rate in dollars to arrive at the total.

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Below, there’s space to fill in account and routing numbers so your client can pay you electronically or by check.

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Then there’s a space for notes, in case you need to provide any extra contextual information about the invoice. 

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Finally, there’s the issuer’s signature and the date.

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Once you’ve saved a copy of the invoice template for yourself, it’s 100% editable. You’re free to add or remove sections as you see fit. The template is just a starting point, and the only limit to what you can do is how much time and energy you’re willing to invest.

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Invoice software for therapists

Heard’s invoice template is free and easy to modify to suit your needs. But for high-volume invoicing and payment processing, you may prefer a software solution.

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Here’s a breakdown of some of the most popular invoicing tools used by therapists. This is an overview to help you compare prices, features, and HIPAA compliance. For a deeper dive, research each option to find the one that’s right for your practice.

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Summary

• Therapy invoices include PHI; using a HIPAA-compliant method to send invoices protects that information.
• An invoice lists the type of treatment provided, relevant dates, total cost owed, and methods for payment.
• Receipts, superbills, and Good Faith Estimates are similar to invoices in some ways, but serve different functions.
• If you use invoicing software, sign a BAA with the provider to comply with HIPAA and protect PHI.
• Therapists typically invoice clients per session or monthly (the latter for ongoing treatment).

Frequently asked questions

What should a therapy invoice include?

A therapy invoice should include your practice's name and contact info, your client's name and address, an invoice number, line items for services, costs and a total, payment details for check or ACH, a notes section, and the date and your signature.

How do therapists send HIPAA-compliant invoices?

Use a HIPAA-compliant method, such as an EHR you've signed a business associate agreement (BAA) with or a business email service whose BAA you've signed. For guaranteed encryption, send invoices through your EHR's secure client portal or a dedicated encrypted email service.

How often should therapists invoice clients?

Most therapists invoice per session, sending an invoice or charging a card on file after each appointment. A single monthly invoice for clients in ongoing treatment is also common, and either way you should explain your schedule in your financial policy at intake.

What is the difference between an invoice, a receipt, and a superbill?

An invoice tells a client how much they owe you, while a receipt confirms what they've already paid. A superbill records what a client paid plus the diagnosis and procedure codes and provider details their insurer needs to reimburse them for out-of-network therapy.

What is a Good Faith Estimate in therapy?

A Good Faith Estimate tells uninsured or self-pay clients what their treatment is expected to cost before it begins.

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Invoicing clients electronically? Learn more about HIPAA-compliant payment methods for therapists.

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This post is to be used for informational purposes only and does not constitute legal, business, or tax advice. Each person should consult their own attorney, business advisor, or tax advisor with respect to matters referenced in this post.

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Bryce Warnes is a West Coast writer specializing in small business finances.

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