Leaving Headway, Alma or Grow: How to Keep Your Clients and Your Income

Why your in-network status does not come with you

Each platform says in its own help center that you are credentialed through its agreements with insurers. Grow is the most direct. Asked "If I leave Grow, do I keep my enrollment status?", its help center answers: "No, your enrollment status won't transfer outside of Grow."

Headway says it "credentials providers directly through its own payer agreements, which are separate from any carrier relationships you may have independently." Alma says its credentialing puts members in network "under Alma's tax ID."

In practice, that means leaving a platform without contracts of your own leaves you out of network with every insurer at once. Your clients' insurance still works, but not with you, until your own credentialing is done.

Why therapists are leaving

The most common reason we hear is pay. Platform rates are set through the platform's agreements, and they can change. In May 2026, Behavioral Health Business reported that Aetna would lower what it pays therapists through Alma from July 15, 2026, including paying the same for 90837 as for 90834.

After pushback from Alma and professional associations, Aetna partially reversed the flattening it announced in May: the 90837/90834 rate differential stayed, and degree-based differentials stayed. But Aetna's final rates still came down overall. The cut happened, just shaped differently than first announced.

We see it in our own work. One therapist we work with is leaving Headway because the rates kept dropping. We are building her practice website and getting her credentialed under her own contracts, and she is handling her exit from the platform herself.

Headway's $9.99 marketplace fee

Headway is adding a $9.99 fee to every session with a new client who finds you through its marketplace, for as long as you see that client. It rolls out state by state starting November 2026 and reaches every state by the end of 2026. Headway says it is not a change to your contracted rate, and clients pay the same.

Clients you bring yourself, clients who book through your direct link and clients who found you before your state's start date are not charged. One weekly marketplace client at 40 sessions a year comes to $399.60 in fees. Our Headway fee calculator shows your own number, and who is exempt.

The fee does not have to mean leaving. You can keep your current clients on Headway, send every client you find yourself through your direct link, and start your own credentialing now so your own contracts are ready when you want them.

What Headway keeps

Headway negotiates your rate with the insurer, takes its portion off the top, and pays you what's left. Headway doesn't publish how much it keeps, so nobody outside Headway knows the size of that spread.

Therapists have started comparing notes. Crowdsourced reports collected by SingleAim put Headway's average pay around $107 for a 60-minute session, roughly the same as contracting directly ($106).

But it swings by payer. In SingleAim's data, Headway pays more than direct contracts with Aetna and Cigna, and less with Blue Cross and Optum; the 589 reports on TherapistRates.org agree on Aetna and Blue Cross but show the opposite for Cigna and Optum. These are self-reported numbers, so treat them as directional, not exact.

The $9.99 marketplace fee sits on top of that unpublished cut. That's why therapists are calling it double dipping, and they're right.

A flat fee also hits hardest where pay is lowest. The therapists paid the least lose the most.

The portability trap

Here's the trap most therapists don't see until they're in it. Your claims go out under Headway's group NPI and tax ID, not yours. That means you never build your own relationship with the payer.

The contract is theirs. The payment history is theirs. So when you leave, you take nothing with you.

• New credentialing with every insurer
• New contracts, on whatever rate each insurer offers you
• 60 to 90 days per payer before you can bill under your own name

The way out isn't complicated, it's just slow: get credentialed on your own NPI while you're still on the platform. Then the contracts are yours no matter where you see clients.

That's what the 90-day plan below does. It starts the clock now, so you're not starting from zero later.

Will you make more on your own contracts?

Often, but not always. A platform's negotiated rate can be higher than what an insurer first offers a new solo practice, so compare real numbers before you decide.

1. Write down what the platform pays you

   For your three or four most common insurers, note what you are paid per session type today.

2. Find what each insurer pays you directly

   Ask each insurer for its fee schedule for your license type in your state before you sign a contract, so you are comparing real numbers.

3. Subtract what doing it yourself costs

   Billing (for example, 4-8% of collections if you outsource it), credentialing ($150 per application, per provider with Medtransic), and practice software.

4. Compare the totals

   If your own contracts still pay more after those costs, leaving makes financial sense. If not, staying may be the better choice for now.

A 90-day plan for leaving

1. Pick your insurers (week 1)

   Start with the insurers most of your current clients use. You do not have to join every panel on day one.

2. Set up your practice basics (week 1)

   Your own individual NPI, which is free, and a tax ID for your practice. If your practice is a corporation, LLC or group, it usually needs its own organization NPI too; a sole proprietor uses only the individual one. Update your CAQH profile (now the CAQH Provider Data Portal) so it shows your own practice.

3. Submit your applications (weeks 1 to 2)

   File with each insurer at the same time, not one after another. Every week of delay is a week later you can bill.

4. Set up billing and software (weeks 2 to 8)

   Choose practice software such as SimplePractice or TherapyNotes, set up claims submission, and decide who handles billing.

5. Follow up until you have effective dates (days 30 to 90)

   Insurers set their own timelines. Evernorth, for example, says joining its behavioral health network can take up to 90 calendar days, and applications stall on missing details. Weekly follow-up is what keeps applications moving.

6. Move clients as each contract goes live

   Once an insurer confirms your effective date, clients with that insurance can move to your practice. Read your platform agreement for notice and client terms before you give notice.

What changes when you bill on your own

On a platform, claims are handled for you. On your own contracts, someone has to do that work, whether that is you or a billing service.

• Checking each client's coverage before sessions
• Sending claims and fixing rejected ones
• Working denials and appealing underpayments
• Posting payments and following up on unpaid claims
• Collecting copays and patient balances

How Medtransic helps

We credential you with your chosen insurers before you leave, at $150 per application, per provider, and track every application to an effective date in your client portal. Once your contracts are live, we can bill for you at 4-8% of collections, inside SimplePractice, TherapyNotes or the software you choose, with no long-term contract.

For a new practice, our practice launch package also covers your website and getting set up with insurance. Leaving the platform itself stays your decision and your process.