Billing

Groups

Supervisee Claims in SimplePractice and TherapyNotes

By George Ruan • October 3, 2026

Last reviewed: October 8, 2026.

To bill a pre-licensed clinician’s sessions in SimplePractice or TherapyNotes, first find out what each payer wants on the claim. Then set the EHR to produce exactly that, for that clinician and that payer. The EHR setting only carries out the payer’s rule. It does not make the arrangement allowed.

The short answer: some payers want the supervisor as the rendering provider in box 24J. Some also want the supervisor in box 17 with the DQ qualifier and a modifier. Others want the supervisee in 24J under their own NPI, and some do not pay for supervised services at all. In SimplePractice, use the clinician’s Clinical info, claim rules, and the client’s additional claim fields. In TherapyNotes, use the supervisee’s Supervision settings and the per-payer Supervisor Billing column.

Group owners adding associates often assume the EHR will “handle supervision billing.” Both systems let you choose whose name and NPI go on the claim, and both say it is your job to confirm the payer’s format first. If the setting is wrong, the claim goes out wrong.

Sections

Which provider goes where on the claim
Before you change any setting
SimplePractice setup
TherapyNotes setup
Check the first claim before you send more
Mistakes we see
Related supervised-billing guides
Frequently Asked Questions
Sources

Which provider goes where on the claim

On the CMS-1500, the NUCC instruction manual puts the individual who rendered the service in box 24J. Box 17 can report a supervising provider with qualifier DQ, with the NPI in 17b. On the electronic 837P, the NUCC crosswalk maps 24J to the rendering provider (loop 2310B) and the box 17 supervising provider to loop 2310D. Box 33 is the billing provider, usually your group.

Payer rules usually fall into one of these patterns:

Supervisor as rendering provider. The supervisor’s NPI goes in 24J. Aetna (in-network commercial behavioral health) and Cigna/Evernorth list the credentialed supervisor as rendering. BCBS of Illinois bills pre-licensed interns’ services under the supervising clinician’s NPI. Priority Health puts the supervising LMSW in 24J for an LLMSW’s session and adds the AJ modifier.
Supervisor as rendering, plus box 17 and a modifier. Optum’s commercial supervision policy and billing guide call for the supervisor’s name, credentials, and NPI at claim level with qualifier DQ, plus modifier U5 on each supervised service. Optum pays supervised services broadly only in a few states. Everywhere else, the group needs Optum’s prior approval.
Supervisee as rendering, supervisor reported separately. Some Medicaid plans want the clinician who actually did the session in 24J. The supervisor goes in the supervising-provider field when it is required. AmeriHealth Caritas Ohio’s claims manual separates the rendering field (24J) from the supervisor (box 17 with DQ, loop 2310D). BCBS of Illinois also lets groups add LSWs and LPCs, who bill under their own rendering NPIs.
Not allowed. Some payers and products do not pay for one clinician’s session under another clinician’s NPI. In those cases no EHR setting will fix it. The clinician needs their own participation, or the client sees a clinician who has it.

These are examples, not a complete list, and rules change. Check the payer’s current policy for the member’s exact product, your state, and the date of service. For who can serve as the supervisor at all, see who you can bill under as a supervisor.

Before you change any setting

For each payer, confirm these first:

The supervisor in the EHR is the associate’s actual clinical supervisor. Bomi requires the billed supervisor and the supervisor of record to be the same person.
The supervisor is credentialed and in-network with that payer under your group’s tax ID and NPI, not just somewhere in the network.
The payer allows supervised services for this license level, state, and product. Get the policy page or a written answer, and keep it.
You know the filing format: whose NPI goes in 24J, whether box 17 is needed, and which modifier, if any.

Leave the associate as the clinician on the appointment and the author of the note. Changing the appointment to the supervisor to make a claim go out misstates who saw the client. Control the claim fields with the settings below.

SimplePractice setup

1. Link the supervisee to the supervisor

Per SimplePractice’s supervisor and supervisee guide, the Account Owner or a practice manager gives the supervisor the Supervisor role. Then go to Settings > Team > Team members, select the supervisee, click Edit next to Clinical info, turn on Under supervision, and pick the supervisor. A supervisee can have only one supervisor in SimplePractice.

2. Have the supervisor sign notes

In SimplePractice’s supervision signing flow, the supervisee uses Sign and share. The supervisor reviews it on the Supervision tab under Notes to sign, then can Request Edits or Sign and lock. The signed note shows both signatures. Whether the payer needs a co-signature, and how fast, is a payer rule. Priority Health, for example, wants the supervisor to review the LLMSW’s notes within one week of each visit.

3. Set what goes in box 24J

SimplePractice’s billing under supervision article sets this in the supervisee’s Settings > Profile > Clinical info (Clinician details). Choose Pre-Licensed as the Licensure type, confirm the supervisor, and enter the supervisor’s taxonomy code. Then:

Enter the supervisor’s NPI to bill with the supervisee’s name and the supervisor’s credentials.
Leave the NPI empty to bill with the supervisor’s name and credentials.

This profile setting applies to that clinician’s claims going forward, whichever payer they go to. If e-Prescribe is on, the NPI field is locked, and SimplePractice suggests downloading claims and entering the supervisor’s details outside the system.

4. Use claim rules when payers differ

If one payer wants the supervisor in 24J and another wants the associate, use claim rules. Go to Settings > Client billing and insurance > Insurance billing > Claim rule automation. Under IF, choose the supervisee and the payer. Under THEN, click Add field > Rendering provider info and pick an Existing clinician or enter a Custom clinician (name, NPI, and taxonomy). Rules cannot be edited once saved. To change one, duplicate it and turn off the original. Claims show a “Claim rules” count at the top, so you can confirm which rules applied. SimplePractice does not spell out how a rule interacts with the Clinical info setting from step 3, so open the first claim for each payer and check 24J.

5. Add box 17 and modifiers when required

For a payer that wants the supervisor in box 17, open the client’s Overview > Edit client > Billing and Insurance and check Show additional claim fields. Choose DQ - Supervising Provider Claim Level from the Referring provider dropdown and enter the supervisor’s name and NPI. This is set per client, so do it for each affected client. For a required modifier such as Optum’s U5, add it under Client Default Services. Claims already created but not submitted will not update. Edit them, or delete and recreate them.

TherapyNotes setup

1. Assign the supervisor and the level of supervision

TherapyNotes’ Set Up Supervision article has a Practice Administrator check the Supervisor role under Staff > Staff name > Roles. Then, in the supervisee’s User Information, set the Supervision dropdown. Only “Must review and co-sign all notes” makes the supervisor co-sign every note, and TherapyNotes says that co-signature is required to bill under the supervisor’s credentials. Then choose the Billing option and the Supervisors. If a supervisee has more than one supervisor, they pick the right one in each note’s header.

2. Choose the billing method for each payer

Under Staff > Staff name > Billing tab, the Payers box has a Supervisor Billing column. Only a Practice Administrator who also has the Practice Biller role can change it. The options are:

Bill as Clinician: only the rendering clinician’s information goes on the claim.
Include Clinician and Supervisor: both the clinician’s and the supervisor’s information.
Bill as Supervisor (Incident-To): only the supervisor’s information.

For Optum commercial plans, TherapyNotes’ Optum article says it puts the supervisor in both the rendering and the supervising provider fields when the supervisee bills as supervisor for Optum’s payer IDs. You add U5 yourself, on the appointment or through a service code with U5 as a default modifier.

3. Fix notes completed before the change

Changing supervision settings does not update notes that are already finished. Open the note, click Edit in the header, choose the right supervisor, and set Signature Required to Billing as Supervisor if needed. Click Update Note Header, then re-sign. The supervisor gets a to-do to co-sign, and the claim is ready once they sign.

TherapyNotes’ claim warnings catch some of these mistakes: “Item Not Billed as Supervisor” (the clinician bills as supervisor but the note does not), “Supervisor Not In-Network” (the chosen supervisor is not in-network with that payer), and a missing clinician or supervisor NPI, which blocks the claim.

Check the first claim before you send more

Open the claim and read 24J, 17/17b, the modifiers in 24D, and box 33. Compare them with the payer’s rule, not with your last claim.
Make sure the taxonomy in 24J belongs to the NPI in 24J. A supervisor’s NPI with the associate’s taxonomy is a common cause of taxonomy rejections.
If the claim comes back with a missing or invalid rendering NPI rejection, fix the setting that built it before you resubmit, or every later claim will repeat the error.
Once the first payment arrives, confirm the payer paid it as a supervised service at the rate you expected.

Mistakes we see

One setting for every payer. A supervisor-as-rendering profile setting will also send the supervisor’s NPI to payers that want the associate, or that do not allow it.
The owner as default supervisor. The billed supervisor should be the person who actually supervises the associate. Ownership alone does not qualify someone.
A supervisor who is not in-network for the group. The supervisor has to be in-network with that payer under the billing group.
Expecting old notes to update. In TherapyNotes, notes finished before a settings change keep their old header until you edit and re-sign them.

Bomi bills supervised sessions for group practices on SimplePractice and TherapyNotes. Before any claim goes out, we check the payer’s rule, the supervisor’s participation, and the claim format for each clinician and payer. Billing is 4% of net collections; see pricing or talk to us.

Frequently Asked Questions

Should the supervisor be the rendering provider or the supervising provider on the claim?

It depends on the payer. Aetna and Cigna/Evernorth list the credentialed supervisor as rendering in box 24J. Optum also wants the supervisor at claim level with qualifier DQ and modifier U5 where it allows supervised services. Some Medicaid plans want the associate as rendering, with the supervisor in box 17 (loop 2310D). Follow the payer’s written rule for the member’s product and state.

Can SimplePractice use a different rendering provider for different payers?

Yes. A claim rule with IF set to the supervisee and the payer, and THEN set to Rendering provider info, controls box 24J for that combination. The supervisee’s Clinical info also affects 24J, so check the first claim for each payer. Box 17 is set per client under Show additional claim fields.

Does TherapyNotes require the supervisor to co-sign notes?

To bill under the supervisor’s credentials, yes. The supervisee needs the “Must review and co-sign all notes” setting, and the claim is ready once the supervisor co-signs. Whether the payer itself needs a co-signature is a separate payer rule.

If I change the supervision settings, do existing claims update?

No. In SimplePractice, edit or recreate unsubmitted claims. In TherapyNotes, edit the note header, re-sign, and have the supervisor co-sign. Claims already submitted need a corrected claim.

Does turning on these settings mean the payer allows it?

No. The EHR only formats the claim. Whether the payer pays for a supervised session depends on its policy, your state, the associate’s license level, and whether the supervisor is in-network under your group.

Sources

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Founded by George Ruan, Dax Earl, and Andrey Goder, Bomi helps independent therapists and group practices with insurance billing, credentialing, and payer follow-up. Bomi grew out of Dax’s experience helping his mother with her therapy practice, with a clear purpose: reduce the administrative burden of insurance while keeping practice owners in control.

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