Acupuncturist Invoice Template — Free Download (2026)
Licensed acupuncturists in private practice need invoices that support insurance superbill submissions, FSA/HSA reimbursement, herbal medicine pass-throughs, and self-pay package tracking. A professional, clinically complete invoice protects your practice and helps patients get reimbursed faster.
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Generate invoice →What to include on an acupuncturist invoice
Your credentials, license number, and NPI
Your full name, LAc (Licensed Acupuncturist) credential, state license number, and NPI (National Provider Identifier). These are required on superbills. Even for self-pay invoices, including your license number establishes professional legitimacy and is expected by most patients in a licensed healthcare field.
Patient name and date of service
Patient's full name and the exact date of treatment. For monthly superbills covering multiple sessions, list each date of service individually — insurance requires individual dates, not date ranges, to process out-of-network claims.
CPT codes for superbill patients
Primary acupuncture CPT codes: 97810 (acupuncture, first 15 min without electrical stimulation), 97811 (each additional 15 min, no e-stim), 97813 (first 15 min with electrical stimulation), 97814 (each additional 15 min, e-stim). Cupping: 97039 (unlisted physical medicine procedure). Pair with ICD-10 codes: M54.5 (low back pain), G43 (migraine), M25.5 (joint pain), F41.1 (anxiety), G47.0 (insomnia). Without CPT + ICD codes, insurance will not process the claim.
Treatment description
A brief note: 'Acupuncture treatment — low back pain / sciatica, 60 min, 12 needles, electrical stimulation L4-L5 region' or 'Initial intake + treatment — anxiety, 90 min.' This helps patients understand what was performed and supports insurance claims if documentation is requested.
Herbal medicine as a separate line
Herbal medicine formulas, supplements, and teas sold through your practice should be invoiced as separate line items from treatment. Note the formula name (e.g., 'Gui Zhi Fu Ling Wan — 200 tablets') and price. Herbal medicine is typically not covered by insurance and is not FSA/HSA eligible unless prescribed for a specific condition by an MD — invoice it clearly to avoid patient confusion.
Package session tracking
For patients on a 10-treatment package, note the running balance on every invoice: 'Package: 10 treatments prepaid. Used: 4. Remaining: 6.' Even when nothing is due, this documentation prevents 'I thought I had more sessions left' disputes.
FSA/HSA eligibility note
Acupuncture is FSA/HSA eligible in most circumstances (IRS now recognizes acupuncture as a qualified medical expense). Adding a line: 'Acupuncture treatment is FSA/HSA eligible — receipt available for reimbursement filing' saves patients the step of asking.
Payment terms
Most acupuncture patients pay at time of service. For package patients, many practitioners collect full payment at session 1. If you invoice after service, Net 7 is appropriate. List accepted methods: credit card, HSA card, check, Venmo, Zelle.
Acupuncturist invoice examples
Individual treatment — superbill format
SUPERBILL #AC-0031
Dr. Wei Chen, LAc, DACM | License: CA-AC-14892 | NPI: 1234509876 | Patient: Monica Reyes | DOS: June 5, 2026
| CPT / Description | Units | Fee |
|---|---|---|
| 97813 — Acupuncture w/ e-stim, first 15 min | 1 | $85.00 |
| 97814 — Acupuncture w/ e-stim, each add'l 15 min | 2 | $100.00 |
| 97039 — Cupping therapy (unlisted PM&R) | 1 | $40.00 |
| Herbal formula — Tian Ma Gou Teng Yin (7-day supply) | — | $32.00 |
| Diagnosis: G43.909 (Migraine, unspecified) + M54.2 (Cervicalgia) | Place of Service: 11 (Office) | Amount paid: $257.00 | ||
| Total / Paid | $257.00 | |
10-treatment package — session tracking
INVOICE #AC-0038
Dr. Wei Chen, LAc | Patient: James O'Sullivan | Fertility support — 10-treatment package
| 10-treatment fertility support package (prepaid May 1) | $1,200.00 |
| Session 1 (May 5) — Initial intake + treatment, 90 min | Applied |
| Session 2 (May 9) — Treatment + moxibustion, 60 min | Applied |
| Session 3 (May 13) — Treatment, 60 min | Applied |
| Session 4 (May 19) — Treatment + cupping, 60 min | Applied |
| Sessions 5–10 remaining | 6 sessions |
| Package balance (6 sessions remaining) | $0 due |
5 invoicing rules for acupuncturists
Always use CPT codes on superbills — not just treatment descriptions
A superbill that says 'acupuncture treatment — 60 min: $150' is not processable by insurance. You need CPT codes (97810, 97811, 97813, 97814) paired with ICD-10 diagnosis codes. Patients who want out-of-network reimbursement need CPT-coded superbills. Build a superbill template and use it consistently for every patient who might submit to insurance.
Invoice herbal medicine separately from treatments
Herbal formulas sold through your practice have different FSA/HSA eligibility rules than acupuncture treatments. Keep them on separate lines. Some patients want a treatment-only receipt for insurance or FSA/HSA and a separate receipt for herbs. Making these separate on your invoice from the start prevents having to issue corrected invoices later.
Collect for packages upfront — don't offer payment plans for packages
Packages are a cash flow advantage only if you collect upfront. A patient who pays for a 10-treatment package and then comes in once a month has paid you for a year of appointments at session 1. If you allow installment payments on packages, you've eliminated the cash flow benefit and added collection work. Collect the full package price before session 1.
Issue monthly superbills for ongoing patients
Patients who plan to submit to insurance need superbills promptly — most insurers have 90-day to 12-month filing windows. Instead of waiting for patients to ask, send a superbill at the start of each new month covering the previous month's visits. This is a small service that builds enormous loyalty and reduces the 'can you resend my superbill from April?' email volume.
Document treatment focus on every invoice, not just the CPT code
A superbill entry of '97813 — $85' tells the patient nothing they can explain to their insurance company. A superbill that says '97813 — Acupuncture w/ e-stim, first 15 min — low back pain, L3-S1 region' gives the patient context they can articulate in an insurance call. Brief clinical notes on the invoice build patient trust and reduce support questions.
Frequently asked questions
Is acupuncture FSA/HSA eligible?↓
Yes. The IRS updated its guidance in 2020 to explicitly include acupuncture as a qualified medical expense eligible for FSA/HSA reimbursement. Patients can pay for acupuncture with their HSA or FSA card, or pay out-of-pocket and submit a receipt (your invoice) for reimbursement. Herbal medicine is generally not FSA/HSA eligible unless prescribed by an MD as part of a treatment plan.
What CPT codes do acupuncturists use?↓
The primary acupuncture CPT codes are 97810 (acupuncture, first 15 min, no e-stim), 97811 (each additional 15 min, no e-stim), 97813 (first 15 min with e-stim), and 97814 (each additional 15 min with e-stim). For cupping: 97039 (unlisted physical medicine procedure). For moxibustion: 97039 or 97799 (unlisted PM&R service). Always pair CPT codes with ICD-10 diagnosis codes on superbills.
Can acupuncturists accept insurance directly?↓
Some acupuncturists are in-network with insurance plans, but many operate on a self-pay model and provide superbills for patients to submit for out-of-network reimbursement. Becoming an in-network provider requires credentialing with each insurance company — a time-intensive process. Many acupuncturists find that a self-pay model with superbill support is simpler to manage and often more profitable per visit than accepting insurance directly.
How do I handle a patient who wants a refund for unused package sessions?↓
State your policy clearly before patients purchase a package. Common approaches: 'Unused sessions are non-refundable but transferable within 12 months' or 'Unused sessions refunded at 80% of the per-session price.' Whatever your policy, note it on the invoice and your intake paperwork. If a refund is due, create a final invoice showing sessions used, sessions refunded, and the net credit issued. Keep documentation of when the refund was processed.
Do I need to include a diagnosis code if I'm not billing insurance?↓
Not for self-pay patients who won't submit to insurance. A simple service description is sufficient. But for any patient who might submit a superbill, you need ICD-10 diagnosis codes — they're required for insurance processing. A good practice: always include a brief treatment description (e.g., 'chronic low back pain, sciatica') on your invoice. Even without a formal ICD-10 code, it gives patients context for reimbursement conversations with their insurer.
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