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Filtered field notes — therapist pay.

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All therapist pay posts.

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insurance downcoding

The Invisible Pay Cut: How Insurers Downcode a Therapy Session Without Denying It

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.

Jul 20, 2026 Matthew Sexton, LCSW
insurance reimbursement

Insurance Reimbursement Gap: 30% Less Than Private Pay

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.

Jul 06, 2026 Matthew Sexton, LCSW
therapist pay

Headway and Alma Therapist Pay Cuts of Up to 30%

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.

Jul 06, 2026 Matthew Sexton, LCSW
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