Future-Proof Your Practice

Aetna reimbursement changes are affecting Alma providers. If you missed our recent workshop - here’s everything you need to know!

Update — August 2026: Since this article was originally published, Aetna and Alma have partially revised the proposed reimbursement changes following negotiations and provider advocacy. CPT codes 90837 and 90834 will continue to be reimbursed at separate rates, rather than being consolidated into a single rate, and reimbursement will continue to reflect provider degree and training. However, the revised Aetna fee schedule still represents an overall reduction in reimbursement for mental health services through Alma, with the updated rates taking effect for dates of service on or after August 15, 2026.

Following a recent acquisition by Spring Health, a B2B-focused mental health provider, Aetna is now reducing the rates that it pays therapists via the digital therapy platform Alma. Coming into effect on July 15th, here’s what you can expect:

Extended sessions will no longer be reimbursed at a higher rate. CPT code 90837 (53+ minute sessions) will be reimbursed at the same rate as CPT code 90834 (used for a 37-52 minutes session). An approximate $20 per session decrease.
Reimbursement for psychotherapy (90834 / 90837) will also no longer vary by degree type. A single rate of pay is being applied to all provider credentials. This means that doctoral level psychologists, whose rates are typically 25% higher, will be reimbursed at the same rate as masters-level providers.
Sessions billed at CPT code 99215 will also no longer be reimbursed at a higher rate. 99215 currently considered to be a ‘highly complex’ visit will be reimbursed the same rate as 99214 which is currently considered a ‘complex visit’.

Melissa Norris, CEO & Founder of TherAssist Practice Concierge and a credentialing expert with more than two decades of experience in behavioral health administration, compliance, and practice operations came and talked us through these changes:

More recently, insurance companies have pitched ‘value based care’ (VBC) as a way of reducing health care costs. This approach pays providers for outcomes rather than procedures which is supposed to be a means of motivating providers to be more outcome focused and ensure efficiency in providing ‘seamless’ and effective treatment. But can you really apply this model to mental health and talk therapies?

Learn more about Value-Based Care in Behavioral Health by reading Melissa’s blog on What Therapists Need to Know (And Why It’s Starting to Feel Like a Hostile Takeover).

Something to note: These platforms are credentialing providers under their own payer contracts, which means you are accepting insurance through the platform’s relationship with insurers, not your own. Just like a practice, the platform makes money by keeping a share of the insurance reimbursement on top of the platform subscription fees charged.

But it’s not all bad… This means you are still able to look at independently contracting with your own agreed rates or alternatively you also have the option to resign from the network all together.

Melissa emphasizes the importance of taking the time to understand your credentialing, contracting CAQH/DataSpring, liability insurance, tax IDs, NPIs, and ongoing payer compliance. Now more than ever would be the time to consider your options and look at whether staying with a platform, contracting independently, or joining a group practice is the best fit for you.

But what can you do right now? What are your options?

Check out the workshop recording here

Fill out this short Therapist Needs Assessment to help us understand your needs around insurance and billing
Speak up! Log into your Alma portal and speak to customer service. Be vocal about the impact it is having on you and your practice.
Engage with the Mental Health Insurance Reform Task Force
Sign the petition demanding a system that reflects the true value of mental health care
Add your name to the change.org petition directly demanding that Aetna reverse the 90837 rate decision.

Did you find the above helpful?

By becoming a member at Chicago Minds you will have access to workshops and advocacy conversation around topics such as these that help to inform and protect independent therapy practices. Get in touch with us today to find out more info@chicagominds.co

Not in Chicago? Find your community through the Hivemind Collective. The Hivemind Collective, consisting Be Well in Philadelphia, Mates in Mind in Washington D.C., Practisage in Houston, Blue House Collective in Atlanta, and Chicago Minds, is an informal, grassroots collective of five therapist-owned co-working spaces across five cities. We are not a corporation. We are not backed by venture capital or private equity. We are clinicians who believe that the future of this field depends on us taking care of each other — and that the best way to fight back against the forces threatening independent practice is to share, collaborate, and build together.