Free Physical Therapy Invoice Template Invoice Template
A free physical therapy invoice template for PTs and rehab clinics, available in Word, Excel, PDF, and Google Docs. Set up as a superbill with CPT treatment codes, units, and the diagnosis and provider fields patients need for insurance reimbursement.
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| Description | Qty | Unit price | Amount |
|---|---|---|---|
| Therapeutic exercise (CPT 97110, per unit) | 3 | $45.00 | $135.00 |
| Manual therapy (CPT 97140, per unit) | 2 | $50.00 | $100.00 |
| PT evaluation, moderate complexity (CPT 97162) | 1 | $175.00 | $175.00 |
| Neuromuscular re-education (CPT 97112, per unit) | 1 | $48.00 | $48.00 |
| Therapeutic activities (CPT 97530, per unit) | 2 | $47.00 | $94.00 |
| Subtotal | $552.00 | ||
| Sales tax (8%) | $44.16 | ||
| Total | $596.16 | ||
Example figures — every field is editable in the download.
Who uses this template
- ✓Licensed physical therapists
- ✓Outpatient PT and rehab clinics
- ✓Sports medicine and ortho practices
- ✓Cash-based/out-of-network PT providers
- ✓Occupational and hand therapists
What to include
- ✓Provider name, license, and NPI
- ✓Patient name and dates of service
- ✓CPT code and units per service (8-minute rule)
- ✓ICD-10 diagnosis code
- ✓Tax ID / EIN for claims
- ✓Amount paid and applied to deductible
- ✓Referring physician and plan-of-care reference
Available in 5 formats
Word (.docx)
Fully editable in Microsoft Word, Google Docs, Apple Pages and LibreOffice — best for quick text edits.
Excel (.xlsx)
Line totals, subtotal and tax calculate automatically — best if you want the math done for you.
A clean, print-ready, fixed layout — best for emailing a finished invoice to a client.
Google Docs / Sheets
Open in your browser, then File → Make a copy to edit and share with your team.
Invoicing tips for physical therapy invoice template
- ✓ Bill timed CPT codes in 15-minute units following Medicare's 8-minute rule so unit counts hold up to insurer review.
- ✓ Format the invoice as a superbill with CPT, ICD-10, NPI, and EIN so cash-pay patients can seek out-of-network reimbursement.
- ✓ List each dated visit and its codes separately — insurers reject statements that combine multiple dates of service.
- ✓ Reference the referring physician and plan of care, which many payers require for PT coverage.
- ✓ Distinguish the evaluation code (one-time) from ongoing treatment codes so the higher eval charge is clearly justified.
Physical Therapy Invoice Template invoice FAQ
What is the 8-minute rule for PT billing?
Medicare's 8-minute rule determines how many 15-minute timed units you can bill based on total treatment time. Apply it so your unit counts on CPT codes like 97110 and 97140 are defensible.
Which CPT codes go on a PT invoice?
Common timed codes include 97110 (therapeutic exercise), 97140 (manual therapy), 97112 (neuromuscular re-ed), and 97530 (therapeutic activities), plus evaluation codes 97161–97163.
Can patients submit a PT superbill to insurance?
Yes. A superbill with CPT codes, units, ICD-10 diagnosis, your NPI and EIN lets cash-pay patients request out-of-network reimbursement. This template includes those fields.
Do physical therapists charge sales tax?
No — physical therapy is a medical service and exempt from sales tax in all states. You do not add sales tax to treatment charges.
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