therapistrates.org

Platform rate page

Direct contracts therapist rates

A direct contract is your own agreement with a payer, with no platform in the middle. Solo credentialing takes 3-9 months and the base rates can run below what platforms pass through (a 2024 report put Optum's solo 90837 at $110.30 while Alma paid $120-130 from a $151 payment). The contract is yours: no membership fee, no platform spread, no delegated credentialing that evaporates when you leave, and the client relationship stays with you. Therapists who left the platforms report the all-in difference often runs under $5-10 per session.

Reported rates: median $116.62, range $39–$220 (34 reports, all CPTs pooled — filter by CPT)

PayerStLicenseCPTRateEffectiveNote / source
Optum/UHC——90837$110.30October 2024Solo-contract rate cited for comparison against platform rates. Same commenter reported Optum pays Alma ~$151 for the identical session. source
MedicaidSC—90837$117.43November 2025SC Medicaid published rate per poster source
Optum/UHC—LCSW—$121.33November 2025United; solo practice licensed in DC/MD/VA source
BCBS—LCSW—$101.91November 2025solo practice, DC/MD/VA source
Aetna—LCSW—$101.35November 2025solo practice, DC/MD/VA source
Cigna—LCSW—$108November 2025solo practice, DC/MD/VA source
Tricare—LCSW—$81.90November 2025solo practice, DC/MD/VA source
MedicaidCA—90837$131.97October 2025Medi-Cal, most payors source
MedicaidCA—90834$90October 2025Medi-Cal source
MedicaidCA—90837$171October 2025one CA county's Medi-Cal rate source
MedicaidCA—90837$175November 2025Alameda County Medi-Cal, 53-minute session source
MedicaidCA——$65November 2025Santa Cruz County Medi-Cal, secondhand report source
MedicaidCA—90837$99.98October 2025Medi-Cal via Health Net source
BCBSTX—90837$93.88August 2025BCBS PPO and HMO, masters level; Medicare Advantage $124.99 source
BCBSRILCSW90837$128August 2025LICSW source
BCBSIA—90837$172.90August 2025masters level; 90791 $187.10, 90834 $116.70 source
Optum/UHCIA—90837$89.25August 2025UHC, masters level source
BCBSDCLCSW90837$109.97August 2025CareFirst; increased to $113.40 in December 2025 source
CignaDCLCSW90837$128August 2025LICSW; group and individual contracts pay the same source
AetnaOR—90837$151.74August 2025group contract, masters level; 90791 $164.15 source
KaiserOR—90837$167.09August 2025group contract; 90791 $171.98 source
MedicareOR—90837$154.29August 2025group contract; 90791 $166.91 source
MedicaidOR—90837$184.66August 2025OHP open-card base rate; CareOregon Tier 2 $203 source
MedicaidNM—90837$220September 2025LMSW, group practice source
MedicaidMI—90837$81.28January 2026Meridian Medicaid, group; below state Medicaid minimum per poster source
CignaNC—90837$103September 2025Evernorth first offer; poster reports negotiable to $115, then $130 before signing source
AetnaAZPhD/PsyD90837$137.75October 2025decreased $2 on 2025-10-15; BCBS AZ $122.03 source
BCBSVA—90837$150December 2025Anthem, independent contract, masters level, rounded source
TricareVA—90837$74December 2025independent contract, masters level, rounded source
Optum/UHCWALCSW90837$159December 2025United/Optum, group practice, western WA; group Cigna $117 source
AetnaCALMFT90837$112.96August 2025Southern CA, direct credentialing; Cigna offered $80, declined source
Optum/UHCMDPhD/PsyD90837$115.82September 2025United Behavioral Health/Optum, Baltimore area source
CignaAZ—90837$39May 2026lowest Cigna rate reported in the thread source
MedicaidCO—90837$130May 2026source

Recent changes and reports: Clawbacks, audits, and 14-35 day payment cycles are yours to manage — a clearinghouse (~$50/month) and disciplined eligibility checks cover most of it. The going-direct guide covers the transition.

Add your Direct contracts rate See these rows in the full table

All figures are community reports with sources linked; self-reported and unverified. Updated as new reports clear moderation.