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A commercial insurer doesn't have to deny a therapy claim to cut the pay. It can pay the claim and quietly reclassify a 53-minute session down to a shorter, cheaper code. In 2026 the longer 90837 session commonly pays 15% to 25% more than the shorter 90834, and Cigna began downcoding certain visits automatically on October 1, 2025. There is no denial, so there is nothing to appeal.
Headway cut therapist pay up to 30% on Jan. 1, 2025 — one 45-minute session fell from $144.27 to $103, per ClearHealthCosts. Aetna cuts Alma rates July 15, 2026.
Insurance pays therapists $111 a session vs. $159 private pay, about 30% less — why therapists leave insurance panels, and why your card may not get an appointment.