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Guide · updated August 2026 · figures from 301 reports
What Headway, Alma, and Grow Therapy each pay for the same session
For an Aetna 90837, therapists reported a median of $122 through Headway across 13 reports, $121 through Alma across 5, and $95 through Grow Therapy on a single report. Under Optum the medians were $119, $117, and $88. Under Cigna they were $95, $100, and $71. Direct contracts with the same payers reported $113, $116, and $98.
Those are the comparisons that matter, because a platform's rate is a share of what the payer pays the platform. Comparing Headway's overall median to Alma's mixes in every payer and state each platform happens to operate in. Comparing them on the same payer removes most of that.
On the two largest payers, Headway and Alma pay within a few dollars
| Payer, 90837 | Headway | Alma | Grow Therapy | Direct contract |
|---|---|---|---|---|
| Aetna | $122 (13) | $121 (5) | $95 (1) | $113 (14) |
| Optum / UHC | $119 (6) | $117 (7) | $88 (1) | $116 (17) |
| Cigna | $95 (3) | $100 (4) | $71 (2) | $98 (13) |
| BCBS | $112 (16) | — (0) | $72 (3) | $150 (27) |
Three things stand out. First, on Aetna and Optum, Headway and Alma report within $2 of each other, and both sit at or slightly above the direct-contract median. Second, Cigna is the low payer on every route, which is consistent with the code-level data. Third, BCBS is the one payer where direct contracts report far above the platforms, at $150 against Headway's $112. The BCBS direct-contract sample is heavy with Oregon, Wyoming, and Illinois psychologists, so the $38 gap likely overstates what a typical therapist would see; even so, it is the largest spread in the data and the one worth checking against your own state's rows.
Grow Therapy's reports run lower, and the sample is small
Grow's overall 90837 median is $88 across 15 reports, against $119 for Headway and $114 for Alma. Ten of those fifteen reports come from licensed counselors in Georgia, which is the lowest-paid state and the lowest-paid license in the dataset. Grow's Kaiser reports, from California, had a median of $101 across three. With one report each on Aetna and Optum, the data cannot yet say whether Grow pays less for the same session or simply operates where rates are lower. Fifteen more Grow reports from outside Georgia would settle it.
Shorter sessions and intakes
The same pattern holds on the codes with fewer reports. For an Aetna 90834, Headway reported $103 across three, Alma $101 across two, and Grow $61 on one. For an Aetna intake (90791), Headway reported $124 across three and direct contracts $144 across two. Intake reports under direct contracts run consistently above the platforms: BCBS $174 against Headway's $114, Optum $134 against Alma's $132. The 90791 page has every row.
What each platform holds back
The rate is one term in the contract. The company pages track the rest with sources; the short version follows.
- Headway pays weekly and absorbs most clawbacks, which is why many clinicians join. Credentialing is delegated: it belongs to Headway's group contract and does not follow you when you leave. The November 2024 Optum cut and the 2026 identity-verification hold on payment are on its timeline.
- Alma charges a membership fee on top of the per-session rate, so the effective rate depends on caseload. Its July 2026 Aetna change reached members with weeks of notice. Details and sources on the Alma page.
- Grow Therapy charges no membership fee and pays per session. Its reported rates are the lowest of the three, and its Kaiser contract in California is the exception. Sources on the Grow page.
Questions to ask a platform recruiter
Each of these has a number for an answer, and the table tells you whether the number you hear is in line with what others report.
- What does the platform pay for a 90837, a 90834, and a 90791 under each of my payers, in my state, at my license level?
- How much notice does the platform give before a rate changes, and has it changed rates in the past two years?
- Who holds the payer credentialing, and what happens to my panel status if I leave?
- Who absorbs a clawback when a payer reverses a paid claim?
- When is payment made relative to the session date?
Limitations
These comparisons have three limitations. First, every rate is self-reported and unverified. Second, the cells are small: Grow's Aetna and Optum figures rest on one report each, and Alma has no BCBS reports at all. Third, the platforms and the direct-contract group draw from different states, and state moves the number more than platform does. Nevertheless, holding the payer constant is the closest public approximation to the comparison a therapist actually faces, and the cells fill in with every submission.
Every figure above is a community report unless a primary source is linked. The full table · the CSV · add your rate.