Alma Partially Reversed Aetna's 90837 Cut
By Dax Earl • August 24, 2026
Last updated: August 23, 2026.
The short answer: Alma and Aetna partially reversed the original plan. CPT 90837 and 90834 will not be paid at one consolidated rate, and reimbursement will still differ by degree and training. But Alma says the final schedule still lowers overall Aetna reimbursement through Alma.
For dates of service on or after August 15, 2026, 90837 remains higher-paid than 90834—but below its previous rate. The outcome is better than the proposal, not a full restoration.
What this means for therapists: keep coding the session you provided, then compare post-August 15 claims and payouts with a clean baseline. Do not rely on a portal display or another provider’s rate.
In May, Bomi covered the original proposed Alma/Aetna 90837 change. Here is what happened next.
Sections
What Did Alma and Aetna Do After the Original Announcement?
The American Psychiatric Association and American Psychological Association Services asked Aetna to pause the proposal. Their June 4 letter raised access, clinical, transparency, and parity concerns. Read the APA and APASI letter to Aetna.
Alma told providers on July 9 that negotiations had concluded with a partial reversal: the 90837/90834, 99215/99214, and degree-and-training differentials would remain. Read the reproduced Alma provider update.
Alma credited provider feedback and professional-organization outreach with strengthening its case. That does not prove any one campaign caused the result.
Original proposal versus final outcome
90837 and 90834: the single-rate proposal was reversed. 90837 remains higher-paid than 90834, but below its old rate.
99215 and 99214: the proposed consolidation was reversed.
Degree and training: the proposed flat rate was reversed; distinctions remain.
Overall reimbursement: still falls, including for some less frequently billed codes.
Effective date: moved from July 15 to August 15, 2026.
What Actually Changed on August 15?
The dividing line is the date of service, not claim submission. An August 14 session uses the prior schedule even if submitted later; an August 15 session uses the update.
Alma told affected clinicians to review their exact rates in their accounts. Another provider’s dollar amount or percentage is not a safe forecast for your practice.
Do not change clinically appropriate coding because of the cut. The negotiation changed reimbursement, not coding. CMS still distinguishes 90834 as 38–52 minutes and 90837 as 53 minutes or more. Review the CMS psychotherapy coding guidance.
What Therapists Should Audit Now
Review Aetna services billed through Alma on and after August 15 against comparable earlier claims.
Confirm the service date and CPT code. Separate claims before and after August 15, then group them by code.
Record the old and updated Alma rate. Use the clinician-specific rate, including degree or training level.
Keep payment fields separate. Capture the Aetna allowed amount if visible, Alma payout, and patient responsibility.
Track later changes. Record adjustments, reversals, recoupments, and offsets.
Document portal discrepancies. Save the display, claim, payout detail, and written support response.
Compare by clinician, degree, code, and service date. Finalized claims matter more than one screenshot or an unprocessed claim.
What Is Confirmed—and What Is Not
Confirmed from the reproduced Alma communication: the consolidations were partially reversed, the old 90837 rate was not restored, and the update began with August 15 service dates. A second reproduction of the July 9 Alma letter corroborates those points.
Anecdotal after launch: one provider reported seeing an old portal rate, then said Alma called the display incorrect and confirmed the update applied. Read the provider report. One report does not establish platform-wide payment behavior.
Operational inference: a portal rate can lag, so use the final claim and payout trail plus written support confirmation.
Not established as an Aetna-wide policy: this evidence concerns Alma’s contract. Our review of Aetna’s public provider-news archive through August found no universal 90837/90834 announcement, but that does not prove every other contract’s terms. Review the Aetna OfficeLink archive.
What This Means for Therapists Going Forward
Alma credited provider pressure with strengthening its case, but the outcome shows its limit: the consolidations disappeared while the overall cut survived.
The business lesson is the same one covered in our guide to therapy platforms and insurance reimbursement cuts: a platform can simplify operations, but the clinician usually does not control the payer contract. Know how much revenue depends on each platform-payer relationship.
Where Bomi Fits
Shameless Bomi plug: if comparing rates, claims, and payouts is not how you want to spend your week, Bomi can run the insurance-side audit and follow-up. We can organize the evidence, flag adjustments, and chase potential underpayments without guaranteeing a payer’s rate or claim outcome.
Frequently Asked Questions
Did Alma fully reverse the proposed Aetna 90837 cut?
No. Alma said it achieved a partial reversal. 90837 and 90834 kept separate rates, but the previous 90837 rate and the prior overall Aetna reimbursement schedule were not restored.
Is 90837 still paid differently from 90834 through Alma?
Yes. Alma told providers that the two codes would remain distinct and that 90837 would continue to pay more than 90834. The exact updated rate is provider-specific and should be checked in the clinician’s Alma account and against actual payouts.
Which Alma/Aetna claims use the updated rates?
The updated schedule applies to dates of service on or after August 15, 2026. The service date—not the date the claim was submitted—determines which schedule applies.
Does this change apply to every therapist contracted with Aetna?
No evidence reviewed for this article establishes an Aetna-wide change. The confirmed provider communication concerns Aetna services billed through Alma’s contract.
What if the Alma portal still shows an old rate?
Save the display, but do not treat it as final proof of payment. Confirm the current rate with Alma in writing and reconcile the adjudicated claim, payout, and any later adjustment.
Bottom Line
Alma and Aetna abandoned the one-rate approach without restoring the old schedule. 90837 remains higher than 90834, but the updated 90837 rate and overall reimbursement are still lower.
Use August 15 as the service-date dividing line and verify the change against finalized claims and payouts.
Sources
This article provides general educational and billing-operations information, not legal, clinical, or coding advice. Confirm your current Alma rate, payer instructions, and actual claim outcome for each clinician and service.
Want Bomi to handle insurance billing?
Bomi helps therapy practices with benefit checks, claims, denials, balances, CAQH, attestations, and revenue management.
Talk to Bomi about billing