Allowed amount
Reported allowed amounts and therapist payouts
6 reports include both an allowed amount and a clinician payout. Each is listed below as an unverified report. These amounts alone cannot establish a platform’s revenue or profit.
The reports
- Aetna, 90837, Direct contract in Minnesota. Reported allowed amount: $202.88. Reported clinician payout: $157.52. Allowed minus payout: $45.36. Effective month: 2026-09. Claim status: not supplied.
- BCBS, 90837, Direct contract in Massachusetts. Reported allowed amount: $140.12. Reported clinician payout: $140.12. Allowed minus payout: $0. Effective month: 2026-09. Claim status: not supplied. This is for an independently licensed clinician as a sole proprietor in private practice (LICSW)
- Medicaid, 90837, Direct contract in Tennessee. Reported allowed amount: $60. Reported clinician payout: $60. Allowed minus payout: $0. Effective month: 2026-09. Claim status: not supplied.
- Carelon, 90837, Direct contract in California. Reported allowed amount: $120. Reported clinician payout: $120. Allowed minus payout: $0. Effective month: 2024-10. Claim status: not supplied.
- Carelon, 90834, Direct contract in California. Reported allowed amount: $95. Reported clinician payout: $95. Allowed minus payout: $0. Effective month: 2024-10. Claim status: not supplied.
- Carelon, 90837, Direct contract in California. Reported allowed amount: $210. Reported clinician payout: $210. Allowed minus payout: $0. Effective month: 2026-03. Claim status: not supplied. Took significant negotiation and advocacy
What the amounts mean
- Billed charge
- The amount requested on the claim.
- Allowed amount
- The amount recognized for the covered service under the plan; patient cost sharing can be part of it.
- Plan payment
- The insurer’s portion of payment.
- Patient responsibility
- The portion assigned to the patient after processing. The EOB alone does not establish that it was collected.
- Clinician payout
- The amount the therapist reports receiving.
- Claim status
- Whether the claim is pending, rejected, denied, or processed. The status and any later adjustment matter when interpreting an amount.
The CMS EOB guide distinguishes charges, allowed charges, insurer payment, and patient balance. The CMS glossary explains allowed amounts and cost sharing. Sources checked September 9, 2026.
Adding an allowed amount
Use the line labeled allowed amount on the EOB or remittance for the same session as your payout. Leave it blank if you can see only a billed charge, plan payment, or platform deposit. Keep patient names, claim numbers, and other patient information out of the form.
Correction: September 9, 2026
An earlier version labeled a reported $220 Headway/BCBS billed charge as an allowed amount and inferred a $110 platform share from a $110 clinician payout. The stored source note described a later denial. The allowed amount is now marked unknown, and that report is excluded here. The $110 reported payout and the original source note remain in the rate table. The report does not establish how much the platform collected.
Every report is self-reported and unverified. Reports with a stated pending, rejected, or denied status are excluded from this comparison. Missing status, collection details, or later adjustments limit what the remaining figures can tell us. The form began collecting allowed amounts on August 29, 2026.