Aetna had the highest reimbursement rates among the commercial insurers analyzed for 60-minute individual psychotherapy sessions.
The insurer’s median reimbursement rate for an hour-long session was $156. Meanwhile, Cigna had the lowest median reimbursement rate for a 60-minute session at $120.
That’s according to a new dashboard compiled by Allia Health using publicly available Transparency in Coverage files, which contain in-network contracted rates.
The data includes median negotiated rates from three major health plans — Aetna, Cigna and UnitedHealthcare — across the eight providers that appeared most frequently in machine-readable files (MRFs).
Across all providers and insurers included in the analysis, the median reimbursement rates were $96 for a 45-minute session and $138 for a 60-minute session.
Therapist enablement platform Alma had some of the highest median reimbursement rates in the analysis. For a 45-minute psychotherapy session, Alma’s median negotiated rates were $150 with UnitedHealthcare, $148 with Aetna and $99 with Cigna.
It’s important to note, however, that Aetna recently announced rate changes affecting therapists on the Alma platform beginning July 15. Under the new policy, Aetna will pay the same rate for sessions longer than 53 minutes as it does for sessions lasting 37 to 52 minutes. The insurer will also reimburse doctoral-level providers at the same rate as master ‘s-level providers.
The planned changes have made waves in the industry, with the American Psychiatric Association and American Psychological Association Service even asking Aetna to reconsider its decision.
Meanwhile, digital behavioral health platform Cerebral had some of the lowest reimbursement rates among the eight providers included in the analysis. A 45-minute psychotherapy session through Cerebral was reimbursed at a median rate of roughly $89 to $92, depending on the insurer.
The other companies included in the analysis were Talkspace, Talkiatry, Grow Therapy, LifeStance Health, Headway and SonderMind. Together, they represent a mix of large behavioral health providers and therapist enablement platforms.
Recently, Behavioral Health Business spoke with several independent providers who said payers had encouraged them to join therapist enablement platforms in exchange for access to higher reimbursement rates.
Payers have also pursued relationships with these platforms through partnerships aimed at addressing ghost-network concerns and through investments made by their venture arms.
For example, Cigna Ventures and UnitedHealth Group’s Optum Ventures have invested in Alma. In addition, Health Care Service Corporation (HCSC), the largest customer-owned health insurer in the U.S. and an independent Blue Cross Blue Shield licensee, has invested in Headway.