Free Physical Therapist Invoice Template

What is a Physical Therapist invoice?

A physical therapist invoice is a clinical billing document used to charge patients or insurance companies for physical therapy services. It records the evaluation, treatment sessions, therapeutic modalities, and any home exercise programs provided. When used for insurance billing, it must include standardized codes (CPT and ICD-10) and provider information. For cash-pay or direct-access clients, a simplified itemized invoice is sufficient.

What to include on a Physical Therapist invoice

• Your full name, PT license number, and NPI number
• Practice or clinic name and address
• Patient name and date of birth
• Invoice or claim number and date of service
• CPT procedure codes and descriptions for each service
• ICD-10 diagnosis codes linked to each service
• Units billed per CPT code (e.g. 4 units of therapeutic exercise)
• Charge per unit and total charges
• Insurance information and authorization number if applicable
• Payment due date and patient balance after insurance

Common physical therapist invoice line items

How to invoice as a physical therapist

For insurance-based practices, invoices are submitted as CMS-1500 claims to the payer, and a patient statement is generated for the remaining balance (copay, deductible, coinsurance). For cash-pay or direct-access practices, issue a detailed invoice to the patient after each session or weekly. Always include CPT codes even on patient-facing invoices, as patients often need them for HSA/FSA reimbursement or out-of-network claims. Keep your fee schedule current and document the time spent on each timed code accurately, as this affects units billed. Issue superbills on request for patients seeking out-of-network reimbursement.