Superbills & Reimbursement

Superbills: Frequently Asked Questions

‍As a direct pay clinic, we understand that navigating insurance reimbursement is an important part of your healthcare journey with us. We strive to be transparent about our costs to help you make informed decisions about your care.

What is a Superbill?

A superbill is a detailed, itemized document that contains all the information insurance companies need to process your reimbursement claim. It includes visit dates, service descriptions, procedure codes (CPT), diagnosis codes (ICD-10), provider information, and associated charges. To support you in this process, we provide a comprehensive superbill after your appointment that you can submit directly to your insurance company for potential reimbursement.

Requesting a Superbill From Our Clinic

Your insurance plan may offer out-of-network reimbursement options depending on your specific policy details. Payment is due before your appointment, and you can request the superbill immediately after your appointment concludes by sending a message through the portal. Please allow 3-5 business days for your request to be processed. Your completed superbill will be sent in your patient portal once ready. If you experience any difficulties accessing or understanding your superbill, please send a patient portal message, and we'll be happy to assist you.

Submitting Your Superbill to Insurance

While some insurance companies allow up to a year for submission, many have a 90-day deadline for superbill submission and reimbursement claims. For faster processing, we recommend submitting your superbill to your insurance company promptly. Typical reimbursement processing time is 2-4 weeks.

Preparing for Insurance Reimbursement

If you want to reach out to your insurance company ahead of time to inquire about potential reimbursement, you can ask the agent about about the following CPT codes:

First visit: 99205, 99417, modifier 95
Follow-up visits: 99215, 99417, modifier 95
Some insurance companies may require telehealth specific codes.

First visit: 98003, 99417
Follow-up visit: 99007, 99417

If your insurance company asks for ICD codes, please know that these codes will vary greatly based on your appointment and what is discussed. However, common codes may include:

Condition (ICD-10)

• Ehlers-Danlos syndromes (Q79.6)
• Ehlers-Danlos syndromes, unspecified (Q79.60)
• Hypermobile Ehlers-Danlos Syndrome (Q79.62)
• Postural Orthostatic Tachycardia Syndrome (G90.A)
• Orthostatic Hypotension (I95.1)
• Mast Cell Activation (D89.40)
• Chronic Fatigue (G93.32)
• Chronic Pain (G89.29)
• Gastrointestinal Dysmotility (K59.89)

We recommend contacting your insurance provider before scheduling an appointment to understand your coverage options. This call can help you determine potential reimbursement amounts and any requirements from your insurer. However, this step is not necessary to obtain an appointment with our clinic.

Medicare, Medicaid, and Tricare

Medicare and Medicaid programs do not provide reimbursement via superbill. We are not able to see patients enrolled in Medicare or Medicaid programs due to federal and state restrictions.

Patients enrolled in Tricare are eligible to be seen by the EDS Clinic but are unlikely to be reimbursed by their insurance via superbill without a Prior Authorization. It is the patient’s responsibility to reach out to their Tricare medical team ahead of time to obtain prior authorization before scheduling with our clinic.

What is The EDS Clinic?

The EDS Clinic is a telehealth medical practice focused on serving people with Ehlers-Danlos syndromes (EDS), hypermobility-related conditions, autonomic disorders, mast cell disorders, and other complex chronic illnesses. Our mission is to address unmet diagnostic and care needs for patients who often struggle to find knowledgeable providers.

Updated: March, 2026