Superbill Templates for Audiologists and Speech-Language Pathologists

A superbill is a standard form a private practice or clinic can use to collect key information required to submit health care claims to payers, including patient information, billing codes, and associated fees. A superbill can also serve as an itemized record of services to give directly to the patient. The patient may use this form to file for reimbursement from the health plan when they have paid for audiology or speech-language pathology services out-of-pocket.

ASHA developed the following superbill templates as a tool for audiology and speech-language pathology practices. Each superbill provides a list of the most common billing codes used by audiologists and speech-language pathologists (SLPs), including

  • Current Procedural Terminology (CPT ® American Medical Association) codes that describe audiology and speech-language pathology procedures and services (diagnostic testing or therapy, for example), and
  • Healthcare Common Procedure Coding System (HCPCS) Level II codes that describe prosthetic and durable medical equipment and some procedures used by audiologists and SLPs (hearing aids and related services, or speech-generating devices, for example).

The templates also include space to report International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes that describe the patient’s diagnoses or presenting complaint and symptoms. Comprehensive lists of diagnosis codes developed specifically for audiologists and SLPs are available on ASHA’s ICD-10 webpage.

Each template is customizable to fit the needs of your practice. For example, a practice may choose to add space for additional information, such as secondary insurance, or eliminate certain CPT codes for services they do not provide. ASHA also included space for information most health plans require (NPI numbers and provider address, for example). The templates can be filled out electronically or by hand.

Downloadable Templates

Note: ASHA’s superbill templates do not dictate which services should or should not be listed on the bill and do not imply coverage by payers. Some procedures, codes, or other pertinent information required by a payer may not be included in the templates. Practices and clinicians are responsible for understanding individual payer policies and coverage guidelines to ensure complete and accurate claims submissions. Documentation by the audiologist or SLP should support the selection of diagnosis and procedure codes and justify the medical necessity of services submitted to payers for reimbursement.

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