Invoice for Doctors and Private Clinics

Doctors and private clinics that bill patients directly (or issue superbills for out-of-network reimbursement) need invoices that satisfy insurers. This guide shows what belongs on a medical invoice and includes a superbill-ready template.

What to include on the invoice

1. Practice / clinic name, NPI and address
2. Patient name and date of service
3. CPT (procedure) codes and ICD-10 (diagnosis) codes
4. Rendering provider and NPI
5. Charges per line item
6. Subtotal, adjustments, patient responsibility
7. Payment methods

Sample invoice / superbill

Item	Qty	Rate	Amount
Office visit, established patient (CPT 99213)	1	$150	$150
Rapid strep test (CPT 87880)	1	$45	$45
Injection admin (CPT 96372)	1	$35	$35
Dx: J06.9 acute upper resp. infection	—	—	—

Pricing structures that work

Structure	When to use	Example
Cash-pay per visit	DPC, aesthetics, cash-pay	$150 office visit
Superbill	Out-of-network reimbursement
Membership	Direct primary care	$79/mo
Package	Aesthetics / dermatology	6-treatment package

Payment terms

• Payment due at visit for cash-pay clinics.
• Superbill issued monthly for insurance submission.
• Late fee 1.5%/month after 30 days.
• HIPAA: limit PHI to what the invoice actually requires.

Get paid faster with Invoxa

Invoxa supports superbill-ready invoices with CPT/ICD line items and card-on-file. Try the free invoice generator.

Frequently asked questions

What is a superbill?

An itemized receipt with CPT (procedure) and ICD-10 (diagnosis) codes patients submit to their insurance for out-of-network reimbursement.

Can I put diagnosis codes on an invoice?

Yes — patients need them to file with insurance. Keep the invoice minimal on other PHI to stay HIPAA-safe.

Do I charge sales tax?

Most medical services are exempt. Aesthetic and cosmetic services are often taxable — check your state.