Medical Invoice Template

Free invoice templates for medical professionals built for services and procedures, lab tests, and copays and deductibles. Download and edit in PDF, Word, Excel, Google Docs, or Google Sheets.

Also called: medical invoice, medical bill, or doctor visit invoice.

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Download Free Medical Invoice Templates

Download a template, then edit in PDF, Word, Excel, Google Docs or Google Sheets. Print or email when ready.

Sheets, Excel, Word and Doc Templates Coming November 21, 2025.

Editable Medical Invoice Template

Best for:

Edit codes, units, modifiers, visit dates, notes.

Custom Medical Invoice Template

Best for:

Logo, NPI and claim fields, payment plan.

Printable Medical Invoice Template

Best for:

Copay, insurance, claim ref, signatures.

Free Medical Invoice Template

Best for:

CPT codes, units, diagnosis, date, balance.

How to Invoice as a Medical Professional

Turn your clinical notes into a clear, patient-friendly bill that gets paid without back-and-forth.

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In 5 Steps:

Capture what you did, including date, time, place, and a short summary from your notes.
Turn the work into clear lines with any required codes and the units or minutes for each line.
Add supplies used and travel distance, and record any referral or authorization numbers.
Apply your rates, subtract any deposit already paid, and add tax only where rules require it.
Set terms and due date, choose payment methods, then send the invoice with a brief summary.

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What to Include in a Medical Invoice

These fields keep your invoices clear, professional, and compliant.

Provider or clinic name, address, email, and phone
Patient full name, address, and contact
Invoice number and issue date
Service date and time
Location of care (clinic, telehealth, home)
Provider license number and provider ID where required (check local rules)
Diagnosis code(s) with brief description where required (check local rules)
Procedure or treatment code(s) with description where required (check local rules)
Units or minutes and rate type for each service
Supplies or disposables with quantities
Deposits received, payments applied, and balance due
Taxes on eligible items only and tax ID if required (check local rules)

Billing Scenarios for Medical Professionals

How to label charges so every invoice makes sense the moment your clients see it.

Urgent call-out; After-hours surcharge

After-hours urgent visit

You left normal hours to treat a time sensitive issue.

Telehealth consult (15 min); Follow-up summary note

Short telehealth consult

Remote care took less time and included a written summary.

Home visit; Travel/mileage

Home visit with travel

You delivered care at the patient’s location and covered the trip.

Late cancellation; Reserved slot

No-show or late cancellation

State the due date, payment window, and late fee in the footer. Use the same terms on every invoice.

Procedure name; Sterile supplies

In-office procedure using disposables

The treatment and the one time supplies are separate costs.

Treatment package (5 sessions); Deposit applied

The deposit secures the plan and lowers the balance due.

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Standard charges and patient fees for medical offices

Itemize services and procedures, lab tests, copays, and deductibles with professional invoice line items.

Charge or Service

Unit

Taxable

When to use

How to show it

Office Visit - Established

Item

Established patient, routine problem

Item × rate. Attach diagnosis and procedure codes to support medical necessity.

New Patient Exam

Item

First visit or long gap

Item × rate. Document history, exam, and plan to justify level of service.

Telehealth Visit

Time

Virtual visit with patient

Minutes × hourly rate. Note start and stop times plus platform used.

In-Office Lab Draw

Item

Blood draw performed in clinic

Qty × rate. Link ordered tests and maintain specimen labeling and chain-of-custody as required.

Point-of-Care Test

Item

Rapid strep, flu, glucose, etc.

Each test × rate. Record test type, lot number, expiration, and final result in the chart.

Vaccine Administration

Item

Immunization given in clinic

Dose × rate. Capture manufacturer, lot, site, consent, and any observation notes.

Laceration Repair Procedure

Item

Clean, anesthetize, and close a cut

Item × rate. Document length, location, technique, and aftercare provided.

After-Hours Surcharge

Item

Care delivered outside standard hours

Qty × rate. Apply only when appointment time meets your after-hours policy; reference visit or procedure.

Medical Form Completion

Time

School, work, disability or clearance forms

Minutes × hourly rate. Note form type and delivery method; store a copy in the record.

Wrist Brace (DME)

Item

Taxable

Take-home brace fitted in clinic

Cost × (1 + markup%). Provide sizing, fit check, and home-use instructions; record serial or SKU if available.

Save and reuse your medical services and fees

Create a free account and save procedure fees, lab charges, and copays once, so nothing gets retyped.

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Common Medical Invoicing Mistakes

Billing can get messy fast, which slows cash flow and hurts trust. Use these fixes to keep invoices clear and dispute proof.

Mistake

How to fix it

Using only medical jargon or codes confuses patients and slows payment.

Pair every code with plain words and a short reason for the charge. Keep descriptions simple and outcome focused.

Bundling all work into one line hides time, materials, and travel, which sparks disputes.

Split services, time, and materials into separate lines with units for each. Show the math so totals are easy to verify.

Add your license or provider ID and any required diagnosis or procedure codes. Keep identifiers current and check local rules.

State the due date, payment window, and late fee in the footer. Use the same terms on every invoice.

Charging tax on exempt services or missing tax on taxable items leads to refunds or penalties.

Apply tax only to eligible items and include your tax ID when needed. Confirm what is taxable and check local rules.

Using mixed time units or rounding in your favor breaks trust and invites pushback.

Pick one unit system and stick with it. Show exact minutes or units and calculate totals from those figures.

Medical Invoice FAQs

Billing for office visits, telehealth, labs, vaccines, surgery, and therapy. Copays, modifiers, implants, and records fees, plus HIPAA basics. Get clear answers.

How do I list CPT and ICD-10 on the patient invoice?

Show the service with its CPT and the diagnosis with ICD-10 so patients and payers see the medical necessity. Example: “99213 Office visit: CPT 99213: ICD-10 J06.9: $145.”

What’s the clean way to show copay, deductible, and coinsurance?

Break them out so the patient sees what is owed today versus later. Example: “Copay $30,” “Applied to deductible $75,” “Estimated coinsurance 20% of $100 = $20,” “Amount due today $50.”

How should telehealth charges appear?

Note it as a virtual visit, include the modifier used by your payer mix, and list the place of service. Example: “Telehealth evaluation: CPT 99212-95: POS 02: $95.”

How do I bill a vaccine with its administration?

List the vaccine product and the admin fee as separate lines, plus the diagnosis code. Example: “Influenza vaccine: CPT 90686: $28” and “Vaccine admin: CPT 90471: $25: ICD-10 Z23.”

What about post-op visits in the global period?

Mark post-op visits as no charge when bundled to the surgery so patients are not double billed. Example: “Post-op visit day 10: global to CPT 29881: $0.00.”

Can I itemize implants, contrast, or injectables?

Yes, if your payer allows pass-throughs. Show the supply with its HCPCS and your acquisition cost or fee. Example: “Intraocular lens: HCPCS V2632: $350.”

How should a no-show or late cancel fee be written?

Use a clear line with your policy reference and flat amount. Example: “Missed appointment fee per office policy: $40.”

How do I separate in-house labs from send-outs?

List each test and add a specimen collection or handling fee when allowed. Example: “CBC in-house: CPT 85025: $22” and “Specimen handling: CPT 99000: $8.”