How Much Does Alma Pay Therapists? Rates and Fees for 2026

• Alma publishes no rate card and keeps its rates confidential. Therapists self-report a median of $110 for a 90837 through Alma, with a range of $75 to $139 across 39 reports on therapistrates.org (updated 25 September 2026).
• Membership costs $125 a month or $1,140 a year. On Alma’s current offer the first annual year is $600, or $50 a month (checked 25 September 2026).
• Alma pays per insurance claim, within two weeks of the claim, on a weekly schedule. The amount depends on your license degree, the CPT code, the insurer and your state.

Alma is a membership network for licensed therapists in private practice. Therapists can see eligible insured clients through Alma’s group contracts with most health insurance companies. Alma handles the claims and pays therapists within two weeks. Each insurer sets the payout rate based on your degree and the CPT code, and Alma keeps the specific rates confidential. Aetna lowered rates for many Alma therapists in summer 2026, so what you earn can vary quite a bit depending on which insurers you work with.

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How much does Alma pay therapists per session?

Alma doesn’t publish what it pays therapists per session. Its help center describes the rates as highly confidential under its agreements with insurers and says members who share them may become ineligible to join.¹ Members can view their own rates in the Membership Agreement and the Alma portal. The rates below come from therapists self-reporting their own pay to therapistrates.org. Alma hasn’t confirmed their accuracy.

Self-reported on therapistrates.org, updated 25 September 2026. Half of the reported rates fall between $103 and $120.

There are also a few reports for 45-minute 90834 sessions and 90791 intakes.

Self-reported on therapistrates.org, checked 25 September 2026.

During onboarding, Alma asks you to choose a payout level based on your license. Telehealth and in-person sessions pay the same rate and are subject to state rules. Employee assistance program (EAP) visits are open only to master’s-level and doctoral clinicians. Optum EAP visits pay the regular insurance rate, and other EAP programs set their own rates.

The 2026 Aetna cuts

In May 2026, Behavioral Health Business reported that Aetna planned to pay Alma-contracted therapists the same rate for 90837 and 90834 sessions starting July 15. Alma claimed to oppose the change.² A revised notice later shared by therapists said rates would still vary by CPT code and degree, with the cuts starting August 15, though Alma has not confirmed that publicly. By August, one Massachusetts LCSW reported their 90837 rate dropping from $146 to $126, while a New York psychologist reported a drop from $201 to $138.1

Alma membership fees

You can pay for your Alma membership either monthly or annually.

These prices come directly from Alma’s provider page and membership form and are current as of September, 2026. Sales tax is extra.

Your membership fee covers credentialing and billing, along with eligibility checks and weekly payouts. You also get Alma’s EHR, which includes telehealth and AI-assisted notes. A directory listing and access to CEU courses are also included.

Alma offers free onboarding months, or a comparable discount if you pay annually, but doesn’t say how many. After any promotional pricing ends, you’ll pay Alma’s current rate. Plans renew automatically, and fees are non-refundable.³ Changes or cancellations need to be made by the 20th of the month before your renewal.

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How much does Alma pay therapists per hour?

Alma doesn’t pay therapists an hourly wage because you aren’t their employee. You’re paid per insurance claim as an independent practitioner.

A 90837 covers a session of 53 minutes or more, so the $110 median works out to roughly $110 per clinical hour before the membership fee. The middle half of reported rates comes out to $103 to $120.1

Administrative work and no-shows are unpaid, so your actual hourly earnings will be lower once you account for that time. Alma’s ROI calculator starts from an assumed $120 payout per one-hour session.

To put it simply, if you see twenty clients per week billing 90837 at the median, you’d gross $105,000. At 15 per week, that compensation drops to $79,200. These figures don’t account for fees, taxes, and other business operating expenses.

What Alma keeps and deducts

Alma takes no cut of cash-pay sessions and reports the membership fee is its charge.⁴ Card payments through Alma have a processing fee of 2.4% plus 30 cents per invoice. Alma doesn’t disclose how much it keeps from what the insurer pays before paying the therapist. Its terms say it settles to the provider less fees and other amounts owed.³ Because of these vague terms, some therapists have questioned how much Alma keeps, particularly since the Aetna cuts.

There are some situations where Alma can deduct money from your payouts:

• Client invoices unpaid after 60 days are deducted, since Alma advanced that amount. You must collect from the client directly.
• A claim denied for inadequate documentation is deducted from your next payout.
• Claims tied to unanswered billing questions can be canceled or reversed.
• An unanswered records request freezes payouts after 30 days, and after 60 days Alma ends the membership and deducts the affected claims.

Outside those cases, Alma’s Payout Confidence policy keeps your payout unchanged when an insurer denies a claim or changes the client’s share. This is true as long as the client pays on time. Alma also reviews CPT code use that is above network averages and can adjust claims or freeze payouts.⁵

Payout timing

Alma therapists are paid weekly by direct deposit and within two weeks of each submitted claim.⁶ Insurers can take 45 to 60 days to process claims, so Alma usually pays you before it gets paid by the insurer. You must submit claims within 30 days of the session.

How does Alma work for therapists?

Alma credentials licensed therapists with insurers and handles billing in return for a membership fee. To join, you start with a call with Alma’s team and sign a Membership Agreement. Then you’ll complete your profile and credentialing forms. You need a Type 1 NPI, a CAQH login and malpractice coverage of $1 million per claim and $3 million aggregate.

Alma credentials you under its tax ID with Aetna, Cigna, Optum, Carelon and Anthem BCBS plans in 12 states. Credentialing can take up to about 45 days.

Before your credentialing date, you can see private-pay clients with Alma’s tools. You set your own cash rate and cancellation fee. Afterwards, Alma checks eligibility, files claims, and invoices clients for copays and deductibles.

Alma lists you in its client directory, and any referrals from Alma stay in its network. There’s no exclusivity clause in the public terms, so you can continue seeing clients outside Alma. But leaving Alma means contracting directly with each insurer if you want to keep those clients in network. Our review of Alma for therapists covers the EHR and daily tools, and the Alma review covers the client side.

Alma vs Headway vs Grow Therapy for providers

Headway and Grow Therapy also credential therapists and pay per session. Headway keeps an unpublished share of each insurance payment that varies by plan and code.⁷ The medians are self-reported on therapistrates.org from 39 Alma, 107 Headway and 33 Grow reports.⁸

Checked 25 September 2026.

Based on those reports, Headway has the highest median and doesn’t charge therapists to join. Grow Therapy is also free to join and guarantees the insurance payout when a client never pays their share.⁹

Alma’s reported pay is higher than Grow’s, and Alma pays each claim within two weeks. Alma also doesn’t take a percentage of your cash-pay income, which may matter if your practice includes both cash-pay and insured clients.

How Alma therapist pay compares with Medicare and salaried jobs

The numbers can get complicated. The 2026 Medicare fee schedule pays a psychologist $167.00 for a 90837 nationally.¹⁰ Medicare pays marriage and family therapists and mental health counselors 75% of that, or $125.25.7 The $110 Alma median is about 88% of the master’s-level figure.

It can be helpful to look at the overarching compensation trends for the therapist profession. For example, the Bureau of Labor Statistics puts May 2025 median pay at $32.18 an hour for marriage and family therapists, $28.53 for mental health counselors and $29.70 for social workers.¹¹

But all things considered, these statistics aren’t a direct comparison to Alma’s per-session rates. Salaried clinicians are generally paid for all work, including hours that aren’t direct therapy, and they may receive benefits.

Is Alma worth it for therapists?

If you want to outsource your credentialing and billing, Alma may be worth it. The membership fee is relatively minor, averaging to about just 63 cents a session if you hold 20 sessions a week for 48 weeks.

Therapists report an Optum 90837 median of $117 through Alma (14 reports) and $116 under direct contracts (45 reports), though the samples come from different states.⁸ That’s a pretty small difference, but going direct means handling credentialing and billing yourself. Alma also pays a $500 bonus two months after a therapist you refer starts, once their profile is live and they have submitted a first claim.

Therapists report an Optum 90837 median of $117 through Alma (14 reports) and $116 under direct contracts (45 reports), though the samples come from different states.⁸ Going direct means doing your own credentialing and billing, which Alma handles for the fee. Alma also pays a $500 bonus two months after a therapist you refer starts, once their profile is live and they have submitted a first claim.

Therapists who endorse Alma often praise its reliable payouts and CE library. The complaints we found were mostly about referrals slowing down after the first few months and bot-first support. The Aetna cuts may also speak to a trend about upcoming rate issues.

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