Briefing · October 8, 2026
What changed in Aetna’s 2026 rate cut for Alma therapists
Therapists paid through Alma for Aetna members reported a median of $111 for a 60-minute session (90837) after August 2026, down from $129.37 in earlier reports. The reduction followed a May notice in which Aetna's new terms would have paid 90837 at the 45-minute rate and paid psychologists the same as master's-level clinicians. Alma says it negotiated both of those terms away, and a smaller cut took effect August 15.
The May notice
On May 20, 2026, Alma notified its clinicians of new Aetna rates starting July 15. Clinicians reproduced the notice on a public forum the next day: "Starting July 15, 2026, CPT code 90837 (53+-minute sessions) will be reimbursed at the same rate as code 90834," and "Psychologists will be reimbursed at the same rate as midlevel providers." Alma told clinicians, as quoted by Behavioral Health Business, "We disagree with these changes."
Aetna told the same outlet that "our overarching reimbursement policies related to behavioral health providers and license levels have not changed" and declined to comment on any specific provider. Aetna's provider newsletters from April through October 2026 do not mention the change. The terms therefore appear to be specific to Aetna's contract with Alma, which bills Aetna on behalf of the clinicians it pays.
The American Psychiatric Association and APA Services wrote to Aetna jointly on June 4, citing "notices received by clinicians," and asked it to reverse the reduction.
What Alma says changed in July
In a July 9 email to clinicians, reproduced by billing consultant Barbara Griswold, Alma founder and CEO Harry Ritter wrote that the two largest terms had been dropped:
- "CPT codes 90837 and 90834 reimbursement rates will not be consolidated into a single rate."
- "Reimbursement will continue to reflect degree type and training, rather than being paid at one flat rate."
The same email stated that "Aetna's final rates still reduce overall reimbursement," that Alma was "not able to restore 90837 to our previous level," and that "other less frequently billed codes will see reductions." The new rates took effect for dates of service on or after August 15, 2026. Alma directed clinicians to the rates in their own accounts and did not publish a schedule or list affected states. ClearHealthCosts reported the same partial reversal.
What therapists report being paid
Reports on this site are consistent with Alma's account. After the change, 90837 still paid more than 90834, and psychologists still reported more than master's-level clinicians, though both were lower than before.
| Alma · Aetna | Before July 2026 | August 2026 onward |
|---|---|---|
| 90837, master's-level | $129.37 (n=4, all licenses) | $111 (n=8) |
| 90837, PhD/PsyD | none reported | $138 (n=2) |
| 90834, all licenses | none reported | $101 (n=4) |
Several reports describe the drop directly. Two psychologists, in New York and Wisconsin, reported 90837 falling from $201 and $180.31 to $138. A Massachusetts clinical social worker reported $146 falling to $126, and a California clinical social worker reported $129 falling to $112. These are individual, unverified reports. The Alma rate page updates as more arrive.
For comparison, Headway reports for Aetna 90837 have a median of $129.74 (n=39), mostly from before August. No source reviewed for this briefing shows a similar Aetna change on Headway.
The surrounding context
The notice arrived 19 days after Spring Health completed its acquisition of Alma on May 1, 2026. Alma's own page on the acquisition told clinicians there would be "no changes to Alma provider pricing or contracts" as a result of the deal. The Aetna terms came through Alma's payer contract, a separate process.
On May 28, Aetna announced Aetna Mental Health On Demand, its own clinician service for members 13 and older starting January 1, 2027, according to ClearHealthCosts. The insurer that set Alma's lower rates will also run a competing service for the same members. The insurer-on-both-sides briefing covers that pattern across payers.
This is the second payer cut to reach Alma clinicians in two years. In late 2024, Alma and Headway both reduced therapist pay on Optum contracts after renegotiations, reported by ClearHealthCosts.
What to check in your own account
- Compare your Aetna rates for each code in your Alma account with your last payout before August 15.
- Check claims with dates of service before August 15 were paid at the earlier rate, as Alma stated they would be.
- Ask Alma in writing which Aetna plans and states the schedule covers.
- If you also hold a direct Aetna contract, compare the two. The Aetna rate page shows direct-contract reports.
How to read this briefing
This briefing has several limitations. First, the May and July notices are quoted from clinician and consultant reproductions, since Alma did not post either publicly. Second, Aetna has not described the terms on the record. Third, the rate reports are few, unverified and drawn from different states and plans. Nevertheless, the notices, the reversal and the reported payments line up, and therapists can confirm their own rates directly in their accounts.
Company statements are quoted from press or verbatim reproductions with links. Rate figures are community reports. Corrections via the form.