- Choose Alma if you already have clients or your own referral sources and want higher insurance rates. Therapists report a median of $110 for a 60-minute psychotherapy session (CPT 90837) on Alma, compared with $88 on Grow Therapy. Alma takes no cut of cash-pay sessions.
- Choose Grow Therapy if you need referrals, want no membership fee, plan to see Medicare or Medicaid clients, or want your full insurance payout even when a client never pays their copay.
- Alma costs $125 a month or $1,140 a year, with the first year offered at $600 under its September 2026 promotion. Grow has no membership fee but keeps 5% of cash-pay sessions. At the reported $22 median rate difference, Alma’s $1,500 yearly cost on monthly billing is covered after about 68 sessions.
Alma and Grow Therapy help licensed private-practice therapists accept insurance without contracting with each insurer individually. Both offer weekly payments, but their fees and payment protections differ.
Alma charges a membership fee and credentials you under its tax ID. Grow is free to join and enrolls you in its group contracts as an independent 1099 contractor. Therapists report higher rates on Alma, while Grow guarantees the full insurance payout even if a client never pays their share.
ChoosingTherapy.com may earn a commission from the companies whose services are linked on this page.
Easy Insurance Acceptance and Client Referrals
Grow Therapy gets you paneled for free with the major payors in your state so you can start seeing insurance clients, and any insurance claims you submit are guaranteed. Schedule a call to learn more
How do Alma and Grow Therapy compare?
The rates below are self-reported by therapists on therapistrates.org. Neither company confirms these figures, and your rate may differ.
| Feature | Alma | Grow Therapy |
|---|---|---|
| Membership cost | $125 a month or $1,140 a year; first year: $600 on promotion | Free |
| Cut of cash-pay sessions | None | 5% processing fee |
| Share kept from insurance claims | Not published | Not published |
| Reported CPT 90837 median | $110 across 39 reports | $88 across 33 reports |
| How rates are set | Payer contract, degree tier, and CPT code; Alma treats rates as confidential | Payer, state, CPT code, license type, and credentialing date |
| Payout schedule | Weekly or every other week, within two weeks of the claim | Every Friday; 14 to 21 days after an insurance invoice |
| Unpaid client balances | Deducted from your payout after 60 days | Grow pays your full insurance rate |
| Credentialing | Under Alma’s tax ID; about 45 days | Through Grow’s group contracts; average of 5 to 7 days to the first payer |
| Insurers | Aetna, Cigna, the Optum family, Carelon, and Anthem BCBS in 12 states | 125+ insurance partners |
| Medicare and Medicaid | Not accepted, according to the cited help-center guidance | Available through opt-in enrollment |
| Who can join | Fully licensed clinicians | Independently licensed clinicians; accepted licenses listed by state |
| Appointment types | Telehealth and in-person | Telehealth and in-person |
| Malpractice insurance | Your own policy, with $1 million per claim and $3 million aggregate coverage | Your own policy, usually with $1 million per claim and $3 million aggregate coverage; lower limits for some prescribers |
| Provider referral bonus | $500 per eligible referral | $200 Amazon gift card |
Company terms and community-reported rates reflect information collected from company websites, help centers, and therapistrates.org on September 25, 2026.
When should you choose Alma?
Alma may suit therapists who bring their own clients and bill Aetna, Cigna, or Optum. Its reported rates for those insurers are higher than Grow’s, and it keeps no percentage of private-pay income.
- Alma handles clients who find you through your own referral sources. It sets no caseload requirements, and the membership fee stays the same whether you see five clients or 30.
- Reported CPT 90837 rates are higher for the three main insurers. Therapists report medians of $121 on Alma versus $95 on Grow for Aetna, $117 versus $93 for Optum/UnitedHealthcare, and $102 versus $73 for Cigna. [9, 10]
- Cash-pay sessions have no platform percentage fee. Alma allows sliding-scale rates and lets you use its tools for private-pay clients while credentialing is pending.
When should you choose Grow Therapy?
Grow has no membership fee and reports a shorter average wait to begin billing a first insurer. Its referrals and payment guarantee may also help a new or part-time practice.
Referrals and practice costs
- Grow lists you in its directory and shows your profile to clients coming through insurers and employers. Referral volume is the reason clinicians most often give for joining.
- There is no fixed monthly membership cost. An April 2026 job posting also stated that Grow had no minimum visit requirement.
Insurance access and payment protection
- Medicare and Medicaid enrollment is available through an opt-in form. Alma’s cited help-center guidance says it does not accept Medicaid, and Alma told us it accepts Medicare through UnitedHealthcare Medicare plans (confirmed September 16, 2026). 1
- Your full insurance rate is paid even if a client never pays their copay or deductible. 2
- Credentialing averages 5 to 7 days to the first payer, compared with about 45 days on Alma.
How much do Alma and Grow Therapy cost and pay?
Membership and cash-pay fees
Alma costs $125 a month, or $1,500 over a year, on monthly billing. The annual plan costs $1,140. Its September 2026 promotion offers the first year for $600, followed by renewal at $1,140.
Grow charges no fee to join or remain on the platform. Its only published fee is the 5% it keeps from cash-pay sessions. Neither platform discloses how much it keeps from insurance claims.
How insurance rates are set
Alma’s rates depend on the payer, degree tier (MA, MD, NP, or PhD/PsyD), and CPT code. Alma treats rates as confidential and warns that sharing them may affect membership eligibility. 3
Grow shows a rate sheet in its portal for each state where you are licensed or applying for a license. Rates depend on the payer, state, CPT code, license type, and credentialing date. Grow’s own Indeed job postings advertise $70 to $93 an hour for licensed therapists in Rhode Island, Washington, and Oregon.
What therapists report earning
On therapistrates.org, Alma’s median for CPT 90837 is $110 across 39 reports, with a range of $75 to $139. Grow’s median is $88 across 33 reports, ranging from $64 to $117. Those medians are about 88% and 70%, respectively, of the 2026 Medicare rate for a master’s-level clinician. [9, 10]
At that $22 difference, the additional income would cover Alma’s $1,500 cost on monthly billing after about 68 sessions, or its $1,140 annual plan after about 52. Billing 20 sessions a week for 48 weeks at the same difference would produce about $21,120 more on Alma before the membership fee.
These examples use the reported medians, not guaranteed rates. The reported difference also varies by payer: $29 for Cigna, $26 for Aetna, and $24 for Optum.
Alma’s 2026 Aetna rate changes
On May 20, 2026, Alma told members that Aetna planned two changes starting July 15. Sessions lasting 53 minutes or more would pay the same as sessions lasting 37 to 52 minutes, and doctoral-level evaluation and management (E/M) rates would fall to the master’s level. Alma said it disagreed with the changes. Aetna said its reimbursement policies had not changed. 4
Community reports describe a revised notice that preserved the differences between codes and degree levels but reduced rates starting August 15. Alma has not published a statement on the final terms. In August 2026, the rate tracker showed an Aetna CPT 90837 rate of $112 in California, down from $129, and $126 in Massachusetts, down from $146. 5
How do payouts and payment guarantees work?
When payments arrive
Both platforms pay before the insurer finishes processing the claim. Alma pays weekly, or every other week by request, within two weeks of submission. Insurers typically take 45 to 60 days to process the claim.
Grow pays every Friday through Stripe. Insurance payments arrive 14 to 21 days after the invoice, while cash-pay sessions are paid after about seven days. Grow does not issue pay stubs.
What happens when a client does not pay
Alma’s Payout Confidence policy preserves your payout after a denial or a change in the client’s cost share, provided the client pays their Alma invoice. If the invoice remains unpaid after 60 days, Alma deducts it from your next insurance payout. 6
Grow guarantees your full insurance rate even if it cannot collect from the insurer or the client never pays their copay or deductible. The guarantee does not cover no-show fees or cash-pay sessions. 2
Audit-related deductions
Alma also deducts claims denied in an audit because of inadequate documentation. Requested records are due within 30 days. After that, payouts are frozen. After 60 days, membership ends and the claims are deducted from the final payout. 6
Alma’s provider terms allow it to recover money owed by debiting your account or offsetting the amount against pending payouts. 7
Who can join, and how does credentialing work?
Alma’s insurance program
Alma has been part of Spring Health since May 2026. Every new member must join its insurance program and credential under Alma’s tax ID with at least one of Aetna, Cigna, or Optum, regardless of existing individual contracts.
Alma also credentials with Carelon and Anthem BCBS plans in 12 states. Its cited help-center guidance excludes Humana, state or community plans such as NYSHIP, and Medicare and Medicaid. Confirm Medicare Advantage participation with Alma before joining. 1
Credentialing takes about 45 days, and you can apply in any state where you are already licensed.
Grow’s group contracts
Grow enrolls you with every contracted payer available to you, with the option to turn individual payers off. Enrollment averages 5 to 7 days to the first payer. Some take two months or more, and a few take longer than six months.
Medicare and Medicaid enrollment is optional and starts with an interest form. Grow cannot work with clinicians on the Medicare opt-out list. Enrollment does not transfer if you leave because it is tied to Grow’s group contracts. 8
Licensing and prescribing requirements
Both platforms require a full, independent license. Associates and pre-licensed clinicians cannot join either.
Grow publishes accepted license types for every state, including psychologists, counselors, LCSW variants, LMFTs, PMHNPs, and MDs or DOs. Grow does not provide an e-prescribing tool but reimburses prescribers up to $55 a month for an outside service.
What should you know about referrals and contracts?
Grow’s referrals and provider feedback
Grow sends unmatched inquiries to other providers on its platform and covers Zocdoc profiles and opt-in Psychology Today profiles. It may hide a profile from search while investigating a quality concern or a pattern of provider no-shows.
Clinicians rated Grow 4.8 out of 5 across 1,577 Indeed reviews in August 2026. The most common complaints were lower pay than Alma and Headway, and support that relies heavily on bots.
Alma’s referrals and provider feedback
Alma advertises access to clients who average three or more visits but does not publish referral-volume figures. In 2026, therapists commonly reported receiving referrals in their first months, followed by a slowdown. Some said referrals stopped after a change to Alma’s matching process.
Many members value Alma mainly for handling claims and denials. Others report slow support replies, and some describe leaving at renewal after the Aetna rate changes.
Renewal, cancellation, and contract restrictions
Alma renews automatically at its current price and offers no prorated refund for canceling mid-term. Its terms allow pricing changes at any time. 7 Unpaid dues end membership after 60 days. 3
Alma may suspend or end access at any time for any reason. Disputes go to individual arbitration unless you opt out within 30 days. Its public provider terms contain no non-compete clause. However, the group-practice section of its membership overview asks that referrals and consultation requests received through Alma remain within its network.
Grow’s provider agreement is not public. Some clinicians report being warned that moving clients off the platform could cost them referrals. Review the agreement before signing rather than relying on those reports as a statement of its terms.
How does Headway compare with Alma and Grow Therapy?
Headway is not a Choosing Therapy partner. Like Grow, it charges no membership fee. It has the highest community-reported CPT 90837 median of the three at $119 across 107 reports, with Aetna at $130. These figures are self-reported rather than guaranteed rates. 9
Headway pays twice a month, on the 15th and the last day. It says it protects clinicians from clawbacks even when clients do not pay. Credentialing can take as little as 30 days across more than 70 insurance partners, and providers can end their agreement at any time.
Grow reports the shortest time to a first payer among the three. Our Headway for therapists review covers its terms in detail. For more on the other platforms, read our Alma for therapists review and Grow Therapy employee review.
Therapists with an existing caseload who mainly bill Aetna, Cigna, or Optum can compare Alma’s rates and membership costs. Those seeking referrals, Medicare or Medicaid enrollment, or protection against unpaid client balances can explore Grow Therapy.
Frequently Asked Questions
Is Alma or Grow Therapy better for therapists?
Alma may suit therapists with their own clients who want higher insurance rates. Its reported CPT 90837 median is $110, compared with $88 on Grow. Grow may suit therapists who need referrals, want no membership fee, or see Medicare and Medicaid clients. Actual rates depend on the clinician and payer.
Does Grow Therapy charge therapists a fee?
Grow charges no membership or joining fee. It keeps 5% of cash-pay sessions as a processing fee and does not publish how much it retains from insurance payments.
How much does Alma cost for therapists?
Alma costs $125 a month or $1,140 a year on annual billing. Its September 2026 promotion offers the first year for $600, followed by renewal at the standard price. Sales tax is extra, and canceling mid-term does not qualify for a prorated refund.
Which pays more per session, Alma or Grow Therapy?
Alma has the higher community-reported median: $110 for CPT 90837, compared with $88 on Grow at therapistrates.org. Alma treats rates as confidential, and Grow shows your rates in its provider portal. Neither company confirms the reported medians, so compare your own rate offers.
How quickly do Alma and Grow Therapy pay?
Alma pays weekly, or every other week by request, within two weeks of claim submission. Grow pays every Friday, with insurance payments arriving 14 to 21 days after the invoice and cash-pay sessions after about seven days.
Can I join both Alma and Grow Therapy?
Neither publishes an exclusivity rule. Alma handles clients who find you elsewhere, and its public provider terms contain no non-compete clause. Grow works with independent 1099 contractors, and an April 2026 job posting listed no minimum visit requirement. Its provider agreement is not public, so review it before signing.
Does Alma accept Medicare?
Alma’s cited help-center guidance, updated in September 2026, says it does not accept Medicaid, and Alma told us it accepts Medicare through UnitedHealthcare Medicare plans (confirmed September 16, 2026). Its Medicare Advantage participation needs confirmation with Alma before joining. Grow enrolls clinicians with Medicare and Medicaid plans on an opt-in basis, with availability varying by state.
Can associates or pre-licensed therapists join Alma or Grow Therapy?
No. Alma requires fully licensed clinicians, and Grow accepts independently licensed providers.
How long does credentialing take on Alma and Grow Therapy?
Alma says credentialing takes about 45 days from submission. Grow averages 5 to 7 days to the first payer, although some take two months or more. Alma allows you to see private-pay clients while credentialing is pending.
Do Alma or Grow Therapy provide malpractice insurance?
Neither provides a policy. Both require your own coverage, generally with limits of $1 million per claim and $3 million aggregate. Grow sets lower minimums for some prescribers, including nurse practitioners in California and Florida.
What happens to my credentialing if I leave?
Grow says enrollment does not transfer because it is tied to its group contracts. Alma credentials members under its own tax ID, but its public pages do not explain what happens to that credentialing when you leave.
ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
- Alma. (2026, September). Alma’s Participating Insurance Plans.
- Grow Therapy. (2026, September). Payout and earnings FAQ.
- Alma. (2026, September). Membership Overview.
- Behavioral Health Business. (2026, May). Aetna cuts rates with Alma-contracted therapists.
- Therapist Rates. (2026, September). Alma rates.
- Alma. (2026, June). Billing Practices Overview.
- Alma. (2026, September). Provider Terms of Use.
- Grow Therapy. (2026, September). Enrollment and credentialing FAQ.
- Therapist Rates. (2026, September). Headway rates.
- Alma. (2026, September). Alma for providers.
- Grow Therapy. (2026, September). Grow Therapy for providers.
- Therapist Rates. (2026, September). Grow Therapy rates.
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: Luke Prest, MD
Reviewer: MD review pending
