Free Physiotherapy Invoice Template

This template is for physiotherapists and physical therapists who bill clients directly for sessions: clients paying privately, or the family member or other person responsible for their bill. It suits clinics, solo practitioners and mobile or home-visit practices.

Physiotherapy and physical therapy are two names for the same profession. World Physiotherapy's policy statement on protection of title says the title used depends largely on the profession's history in each country, and its list of recognized titles gives "physical therapist" and "Doctor of Physical Therapy (DPT)" for the United States. The invoice works the same under either name.

It is an invoice, not an insurance claim form. If you bill Medicare or a health insurer, use their claim process instead (see "Insurance, claims, HSAs and FSAs" below).

The physiotherapy session invoice has:

• Practice: practice name, address, phone or email, and the treating therapist.
• Invoice details: invoice number, invoice date, payment terms, due date and the client account number.
• Bill to (client or responsible party): the name, address and contact details of whoever pays.
• Client and sessions: the client's name, the dates of the sessions on this invoice, and the payment type (private pay in the sample).
• Sessions: one line per session with the date, session type, hours, rate per hour and amount.
• Session packages: the date, package, quantity, price and amount for any package of sessions you're selling.
• Totals: a sessions subtotal and a packages subtotal, then the subtotal, total, "Less: payment received at first visit" and the amount due.
• How to pay: accepted methods, placeholders for your account name and bank details, and the payment reference to quote.
• About this invoice: notes explaining how sessions are charged, the package terms and any payment already received.
• A footnote saying the invoice shows charges only, is not an insurance claim form and contains no clinical information.

There is no tax line and no license number field. If you need to show a license number, add it to the practice details.

It comes as three files:

• PDF: a blank form to print and fill in by hand.
• Word (.docx) and Excel (.xlsx): the same layout filled with sample values. Overwrite them with your own. In the Excel file, each line amount is hours × rate per hour (or quantity × price for packages), the subtotals and total are formulas, and the amount due is the total less the payment received that you type in. If no payment has been received yet, set that line to 0.00 rather than deleting the row, because the totals refer to it. In the Word file you can simply delete lines you don't need.

The sample rates, package price and payment only show how the form works. They are not typical market rates or recommended fees.

Give each session its own line:

• Date of the session.
• Session type in plain words, with its length, for example "Initial assessment, 60 min" or "Follow-up session, 45 min". Home visits or other session types you price differently go on their own lines.
• Hours of the session, in decimal hours: 60 minutes is 1, 45 minutes is 0.75 and 30 minutes is 0.5.
• Rate per hour for that session type. The sample charges a different hourly rate for an initial assessment than for follow-up sessions.

The "About this invoice" note in the sample tells the client how the hours work, so a 45-minute session billed at 0.75 hours doesn't look like an error.

If you charge a flat fee per session rather than by the hour, enter 1 in Hours and the session fee as the rate, and change the column headings (for example to "Qty" and "Fee") so the invoice reads correctly.

Describe the session, not the client's health. Write "Follow-up session, 45 min", not a diagnosis, injury, test results or treatment notes. Clinical details belong in the client's record. An invoice may be emailed, forwarded to a family member or filed with household papers, so keep it to what is needed to bill. The template has no fields for diagnoses or billing codes.

A late cancellation or missed-appointment fee is a clinic policy you set, not a standard charge. If you charge one, tell clients before they book, then bill it in the sessions section as its own line, dated the day of the missed appointment, for example "Late cancellation fee" with 1 in Hours and the fee as the rate. Put the policy in the "About this invoice" notes. For package clients, say in the package terms whether a missed appointment uses up a session.

This is an invoice for clients who pay you directly. It is not an insurance claim form, and it doesn't include the codes or other details that insurers require. Medicare and health insurers have their own claim process, such as the CMS-1500 professional paper claim form or an electronic claim.

Clients claiming reimbursement themselves. If a client plans to pay you and then claim from their insurer, ask what the insurer needs from you. This template isn't designed to meet any payer's requirements.

HSAs and FSAs. Whether a client can pay with a health savings account (HSA) or flexible spending arrangement (FSA) is between the client and their plan administrator, so don't print "HSA/FSA eligible" on your invoice. In the US, IRS Publication 502 defines medical expenses as the costs of diagnosis, cure, mitigation, treatment or prevention of disease, and says amounts paid for therapy received as medical treatment can be included. It also says expenses that are merely beneficial to general health don't count.

Clients not using insurance. In the US, CMS's No Surprises FAQ for providers says uninsured and self-pay individuals are entitled to a good faith estimate "upon request or scheduling of an item or service". It also says the rules "apply broadly to any physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable state law", judged by how a provider practices "rather than the provider's specialty type". So a licensed physical therapy practice should expect to give uninsured and self-pay clients a good faith estimate when they schedule sessions or ask for one. CMS's page on medical bill rights explains these rights from the client's side.

• Invoice: asks for payment for sessions already given or a package being bought, with a due date and the amount due. This template.
• Receipt: confirms that a payment was received. If a client pays at the end of each session, give them a receipt instead. The service receipt templates cover that.

If you'd rather not keep spreadsheets, Billed lets you create invoices and send them by email with an option to pay online, and recurring invoices can bill a regular client on a schedule. For other professions, browse all invoice templates.