Alma vs Headway for Therapists: Fees and Pay

• Alma fits practices that combine cash-pay or out-of-network clients with insurance, have a Cigna-heavy caseload, or want each claim paid within two weeks.
• Headway fits therapists who want no fixed membership cost, bill mostly Aetna or Optum, see Medicare Advantage or Medicaid clients, or want protection when a client never pays their share.
• Headway has no membership fee. Alma costs $125 a month or $1,140 a year, with the first annual year offered at $600 under its September 2026 promotion. The self-reported CPT 90837 median is $119 on Headway and $110 on Alma. Among the larger payer samples, Alma’s median is higher only for Cigna.

Alma and Headway help independent therapists accept insurance. Both credential you under their group contracts, bill insurers, and pay you before they receive the insurer’s payment.

Alma, owned by Spring Health since May 2026, charges a membership fee. Headway does not. Therapists report higher rates on Headway for Aetna and Optum, and on Alma for Cigna. Alma pays sooner and takes no cut of cash-pay sessions.

Learn more about Alma

How do Alma and Headway compare?

The final column highlights the advantage for a typical solo therapist. Rate medians are self-reported on therapistrates.org and have not been confirmed by either company. Both platforms include telehealth, AI notes, and continuing education courses at no extra charge.

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 practices with cash-pay, out-of-network, or Cigna clients. Its payout schedule also provides payment within two weeks of each claim.

• Cash-pay sessions have no platform percentage fee. Alma lists cash-pay providers in its directory and produces superbills for out-of-network claims. Headway charges 2.95% for card-paid private sessions and matches new clients through insurance only.
• Cigna rates are higher in the community-reported sample. Alma’s CPT 90837 median is $102, compared with $95 on Headway. At 960 sessions a year, that difference would total about $6,720 before Alma’s membership fee. [9, 10]
• Weekly payouts reduce the wait for payment. Alma pays within two weeks of each claim. On Headway, a session confirmed on the first of the month is paid on the last day, about 30 days later.
• Private-pay appointments can begin while credentialing is pending. Alma lets you use its tools for these clients before your insurance effective date.

Look into Alma’s membership

When should you choose Headway?

Headway has no membership fee and higher reported rates for Aetna and Optum. It also accepts some government insurance plans and protects payments when clients do not pay their share.

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Membership costs and reported rates

• Reported CPT 90837 medians are $130 for Aetna and $120 for Optum/UnitedHealthcare, compared with $121 and $117 on Alma. [9, 10]
• Membership, credentialing, and re-credentialing carry no fees.

Payment protection and practice eligibility

• Select Medicare Advantage and Medicaid managed care plans are accepted in some states. Headway requires about 90 minutes of annual training for this work. ¹ Alma’s cited help-center guidance says it does not accept Medicare or Medicaid plans. ²
• Insurance sessions are paid even if the claim is denied or the client never pays. Headway says it will not claw back those payments. ³
• Supervisory billing is available through a group-practice pilot in New York and Texas. Participating practices can bill some sessions by LMSWs, LPC-As, and other associates. Alma accepts fully licensed clinicians only.

Headway is not a Choosing Therapy partner. Our Headway for therapists review covers its provider services in more detail.

How much do Alma and Headway cost and pay?

Membership and insurance fees

Alma’s $600 first annual year renews automatically at $1,140. Sales tax is extra, and canceling mid-term does not qualify for a refund for the unused time. Headway charges no membership, credentialing, or re-credentialing fee.

Both platforms retain an unpublished share of insurance payments. Headway says it sets your rate first, then keeps a share that varies by plan and billing code. It sometimes keeps nothing on low-paying plans.

Alma treats its rates as confidential and says members who share them may lose membership eligibility. ⁴ Published rate comparisons therefore rely on clinicians’ own reports rather than company-confirmed figures.

Self-reported rates

On therapistrates.org, Headway’s CPT 90837 median is $119 across 107 reports, about 95% of the 2026 Medicare reference rate for a master’s-level clinician. Alma’s median is $110 across 39 reports, about 88% of that reference. [9, 10]

At the reported $9 difference, a therapist billing 20 sessions a week for 48 weeks would receive about $8,640 more a year on Headway. Including Alma’s standard membership fee brings the difference to about $9,780 with annual billing or $10,140 with monthly billing.

These are illustrations based on small, self-reported samples, not guaranteed earnings. Your state, license, and payer mix can reverse the comparison.

Alma’s 2026 Aetna rate changes

On May 20, 2026, Alma told members that Aetna planned two changes starting July 15. Doctoral-level evaluation and management (E/M) rates would fall to the master’s level, and sessions lasting 53 minutes or more would pay the same as sessions lasting 37 to 52 minutes. Alma said it disagreed with the changes. Aetna said its policies on license levels had not changed. ⁵

Clinicians reported a revised notice that preserved the differences between codes and degree levels but introduced lower rates on August 15. Alma has not published that notice. On the rate tracker, reported Alma Aetna CPT 90837 rates fell from $129 in July to $112 in August 2026 in California, and from $146 to $126 in Massachusetts. ⁶

How do payouts and payment guarantees work?

Payment schedules

Insurers typically take 45 to 60 days to pay a claim. Alma pays weekly, or every other week by request, within two weeks of each claim.

Headway pays on the 15th for sessions confirmed from the 16th through the end of the previous month. Sessions confirmed from the first through the 15th are paid on the last day of that month. Only sessions confirmed within 30 days are paid.

Unpaid balances and denied claims

Alma’s Payout Confidence policy protects your payout from denials and changes in the client’s cost share, provided the client pays their Alma invoice. An invoice left unpaid for 60 days is deducted from your next insurance payout. ⁷

Headway says it pays for insurance sessions whether or not it receives payment. It also says it protects clinicians from clawbacks when a claim is denied or a client does not pay after a session. ³ Cancellation fees and private-pay sessions are paid only after the money is collected.

Documentation and audits

Alma deducts claims denied in an audit because of inadequate notes. It also freezes payouts if requested records are not returned within 30 days. ⁷

Headway’s documentation protection is tied to its own templates and AI notes. Clinicians also report payer audits of Headway providers, including Anthem BCBS reviews that began in late 2025.

How does credentialing work on Alma and Headway?

Alma’s insurance program

Every Alma member must join its insurance program and credential under Alma’s tax ID with at least one of Aetna, Cigna, or Optum. This applies even if you already have individual contracts. Alma also offers Carelon and Anthem BCBS in 12 states.

Credentialing takes about 45 days after submission, according to Alma. Previous credentialing with the same insurers does not shorten the process. ⁸

Headway’s payers and timelines

Headway’s payers include Aetna, Anthem, Cigna, Oscar, UnitedHealthcare, Oxford, Carelon, Kaiser in Hawaii and Northern California, and Florida Blue.

Its published timelines differ. The provider page says as few as 30 days, the help center gives a range of 3 weeks to 4 months, and the group FAQ lists 90 to 120 days for some carriers. No timeline is guaranteed. ⁹ Insurers can take up to eight weeks after approval to begin paying.

The portal identifies waitlisted plans. Clinicians reported Optum/UnitedHealthcare waitlists on both platforms in August 2026. Anthem BCBS in Virginia, Missouri, and California also requires you to live in the state.

What happens to credentialing when you leave?

Both platforms bill under their group identity: Alma’s tax ID and Headway’s Type 2 NPI. Neither explains on its public pages whether that enrollment follows you when you leave.

Who can join, and what malpractice coverage is required?

Licenses and supervisory billing

Alma accepts fully licensed clinicians only and sets rates by degree tier: MA, MD, NP, or PhD/PsyD. Headway accepts independently licensed master’s-level clinicians and above, with accepted license types listed by state.

Headway’s supervisory billing pilot covers group practices in New York for Aetna and Cigna, and in Texas for Aetna, Cigna, and BCBS TX. Headway does not bill psychological testing codes such as 96130 to 96139.

Malpractice insurance

Both platforms require your own policy. Alma’s minimum is $1 million per claim and $3 million aggregate. Headway’s minimum for non-prescribing therapists in most states is $1 million per occurrence and $1 million aggregate.

Headway requires $1 million/$3 million in Alabama, Arizona, New Jersey, and North Carolina, as well as for prescribers in most states.

Can you expect client referrals?

Clinician reports from 2026 describe limited or inconsistent referrals from both platforms. Alma referrals tend to arrive in the first few months and then decline. Clinicians mostly describe Headway as a billing service rather than a source of clients.

Headway says it offers one-to-one marketing support and a $90 Psychology Today stipend.

Can you use Alma and Headway at the same time?

Joining both platforms

Many therapists report being credentialed with both, and neither platform’s public terms prohibit it. Headway says its credentialing does not affect your existing insurance contracts. Alma’s cancellation form also lists Headway as another service a member might use.

Headway’s provider agreement is not public, so review it before signing. Before enrolling with the same insurer through both platforms, ask the insurer whether you can do so.

Client referrals and billing

Alma’s terms say consultation requests and referrals received through Alma should remain in its network. ⁴ Headway says clients you bring are yours to take with you, while clients who find you through Headway should continue being seen there. ¹⁰

Keep referred clients on the platform they came through. Use your own EHR to bill clients covered by your direct insurance contracts.

Renewal and cancellation

Alma renews automatically. Requests for changes must be made by the 20th of the month before your renewal date.

Headway allows you to end its agreement at any time but processes deactivations monthly. Confirm every outstanding session before submitting the deactivation form.

How does Grow Therapy compare?

Grow Therapy may suit therapists who need referrals or want to see clients with Original Medicare, which neither Alma nor Headway lists. Grow is free to join and has more than 125 insurance partners, with Medicare and Medicaid enrollment available on an opt-in basis. ¹¹

Grow features providers in its directory and markets them through Zocdoc. Its average time to a first payer is 5 to 7 days. Its self-reported CPT 90837 median is lower at $88, and it keeps 5% of cash-pay sessions. See Grow Therapy.

Alma may be worth its membership fee for practices that mix insurance and cash-pay clients, bill mostly Cigna, or prioritize faster payouts. Explore Alma’s membership. Our Alma for therapists review covers the membership in more detail.