You're allowed to leave
If you're reading this, you've probably been circling the idea of getting off an insurance panel (or two, or all of them) for a while, but part of you just doesn't know how to make it happen. Maybe you've done the math and the amount you're working doesn't match your bank account. Your body is telling you it's all too much, and you crash at the end of the week from exhaustion. You carry a tension in your gut, a mix of fear and desire. You worry about your practice falling apart without insurance referrals, and you also worry about your clients and their access to care. And yet the math isn't mathing anymore, and you can't afford to keep going the way you are.
We've been helping therapists leave insurance panels for a long time, and we want you to know that getting off panels is not greedy, and it isn't abandoning the field. A therapist who can actually pay their bills, save for retirement, and show up fully for clients is a therapist who stays in the profession. That's good for clients, too. (We wrote more about that in Stop Shaming Therapists: Why Therapists Who Leave Insurance Panels Are the Opposite of Greedy.)
This guide walks through how to get off insurance panels, including the credentialing platforms like Alma, Headway, Grow Therapy, and Rula that put you in network with insurers. We'll start where every good exit starts, which is with your numbers. Then we'll help you choose the kind of exit that fits your practice, read your contracts, plan the transition, and talk with your clients in a way that keeps the relationship intact.
Start with your numbers, not your fears
The right exit is the one your numbers support. We know this decision can feel very emotional, and we also need data. Before you decide which panel to drop or when, you need an honest picture of what your practice costs, what you need to earn to support your life, and what you simply can't afford to keep doing.
For some therapists, taking low insurance rates is a privilege. If you have a partner's income, a pension, a salaried job, or a practice that doesn't need to fully support you, you may be able to accept a rate that doesn't cover your real costs or pay you at a sustainable level. That's a legitimate choice. It's also not the situation most therapists are in, and many discover, once they run the numbers, that they can't afford to stay on panels at all.
So the first question isn't "Which panel should I drop?" It's "What fee does my practice actually need?" We mean a fee that does three things at once:
Not "enough to scrape by," but enough to cover your life, save, and plan for a future that includes time off and eventually retirement. Could you get sick today and not panic?
That includes rent, insurance, software, continuing education, consultation, marketing, taxes, and the admin time you put into the practice.
You should be able to show up as a great therapist on Monday morning and still be that therapist on Thursday afternoon. If you can't stay attuned with the caseload you have now, then the caseload needs to shift, and so does your fee. This is where you can see how your fee shapes the therapeutic relationship.
Once you know that number, compare it to what each contract actually pays after the time you spend on billing, authorizations, and denials. Many therapists find that their real hourly rate on a panel is far lower than the reimbursement suggests. That comparison becomes the backbone of every decision that follows.
If you want help building this number, our free training Ditching Insurance & Platforms walks through how to calculate your fee floor based on your income needs, the weeks you actually work, and a session count you can sustain.
Decide which exit you're making
"Getting off insurance" can mean several different things, and the right one really depends on what your numbers told you. Most therapists land in one of these four:
You leave every panel and platform and move to a fully private-pay practice. This makes sense when no contract comes close to your fee floor, or when the admin burden costs you more than the income is worth.
You drop contracts one at a time over months, replacing insurance clients with private-pay clients as you go. This is the most common path, and it lets your income and your nervous system adjust together.
You keep one or two contracts that pay reasonably and treat you well, and drop the rest. Some therapists keep a single panel for a population they're committed to serving.
You leave a platform like Alma or Headway but still want to be in network, so you credential directly with the insurers you want to keep.
The goal is to choose the exit that gets you to a sustainable practice on a timeline you can actually live with.
Why leaving a credentialing platform is different
If you joined Alma, Headway, Grow Therapy, Rula, or a similar platform, you're on insurance panels too. You just got there through someone else's contract. That changes how leaving works in a few important ways.
When you credential through a platform, you're typically billing under the platform's agreements with insurers rather than your own. That means leaving the platform usually means leaving every insurer you accessed through it, all at once. If you want to keep seeing some clients in network, you'll need to apply for your own contract with those insurers first, and credentialing can take months. Plan for that gap before you give notice.
Platforms also tend to hold more of your practice than a direct contract does. Depending on the platform, your scheduling, notes, client contact information, and billing history may live in their system. Before you leave, find out:
- How much notice your agreement requires, and how notice has to be given
- What happens to your clinical records and how you can access or export them
- Whether your agreement says anything about continuing to see clients privately after you leave
- When claims for sessions before your exit will be paid
Every platform agreement is different, and they change. Read the current version of yours, not the one you remember signing. If something is unclear, ask in writing so you have the answer on record.
If you're still deciding whether to leave a platform at all, we've written about that question in depth in Alma, Headway, and the Big Question and Are Third-Party Credentialing Platforms a Lifeline or a Trap?
How to get off insurance panels in six steps
Get clear on why you're leaving
Write down your reasons for leaving and keep the list somewhere you'll see it. When the doubt shows up (and it will), you'll want your own words in front of you rather than a vague sense that "it just wasn't working."
Then write down your fears, and look at each one honestly. Is there evidence for it, or is it the voice that told you to join the panel in the first place? Many therapists joined panels out of fear rather than as a deliberate business decision, and that same fear tends to show up again on the way out.
We once worked with a therapist who was convinced she would lose every client when she left her panels. She lost one, and that client had already been planning to end treatment. Your fears deserve attention, but they don't get to make the plan.
Evaluate every contract
Make a simple spreadsheet with a row for every panel and platform you're on. For each one, track:
- The average reimbursement per session, and your real hourly rate once billing and admin time are included
- How many current clients use that contract
- How difficult the insurer or platform is to work with (denials, audits, clawbacks, slow payment, hours on hold)
- The termination terms, including the notice period and how notice must be given
- For platforms, which insurers you'd lose access to by leaving
Put your fee floor at the top of the sheet. Seeing every contract next to the number your practice needs tends to make the next decision a lot clearer.
Read your termination clause
Every insurer and every platform handles termination differently, so the only reliable source is your own contract. Look for:
- The notice period. How far in advance you have to notify them, and whether it's tied to a contract anniversary date.
- How notice must be sent. Some contracts require certified mail or a specific provider portal. An email to a rep may not count.
- Continuity-of-care requirements. Some contracts require you to keep seeing certain clients for a period after termination, or to help them transition.
- Claims and recoupment. When claims for pre-termination sessions will be paid, and how long the insurer can audit or take money back after you leave.
If you can't find your contract, request a copy from provider relations before you do anything else.
Build a transition plan that fits your nervous system
There's no single right order for dropping contracts. You might start with the lowest-paying contract, the most difficult one to work with, or the one with the fewest clients on your caseload. Starting small can help your nervous system learn that you can survive this, while starting with the worst offender gives you the fastest relief. Choose the order that lets you move forward steadily.
That said, we see the opposite problem just as often. It's possible to be so careful that you stay in a relationship with a contract that doesn't work for you for years. A plan to "leave eventually" isn't a plan. Be honest about your timeline and about what your life and your business need from you, and give yourself real deadlines. Put the date you'll send each termination notice on your calendar.
Your transition plan should include:
- The order you'll drop contracts, and the date for each notice
- A client letter for each contract you're leaving
- A referral list for clients who need to stay in network
- Client contact information stored somewhere you control and that's HIPAA-compliant, especially if it currently lives in a platform's system
- Updates to your website, directory profiles, and intake paperwork
Give notice and follow through
Send your termination notice exactly the way your contract requires, and keep a copy. Ask for written confirmation of your termination date, and follow up if you don't receive one.
New referrals may still come in during your notice period. You can refer them elsewhere, or you can accept them while being clear about how long insurance will cover their sessions and what payment will look like after that date. Either way, they get to make an informed choice.
Finally, update your marketing. Make sure your website, directory listings, and intake forms reflect your new fees, so your next clients find you as the practice you're becoming. Throughout this whole process, you'll be working on your marketing for private-pay clients, which is something we help therapists do inside Business School for Therapists.
Talk with your clients
Once you've decided, and you have a plan and an exit date, you can share it with your clients. You may want to have it written down to give them after the session as well, since things can be misheard and people sometimes need extra time to process the news. Explain what's changing, when, and what their options are. Those options might include continuing with you as a private-pay client, using out-of-network benefits if their plan has them, or transferring to an in-network provider you've helped them find.
Client reactions to this news are part of the clinical work. Some will feel disappointed or even hurt, and that's material you can work with together. Many clients choose to stay, and therapists are often surprised by how many do.
If you're not sure how to help clients use their out-of-network benefits, our free training What You Must Know About Insurance as an Out-of-Network Therapist covers how to support clients through reimbursement in a way that improves retention.
If you're staying on one panel
Keeping a contract can be a perfectly sound decision, but if you stay, stay on terms you've chosen rather than ones you've drifted into.
That might mean asking for a higher rate, especially if you can show strong outcomes or serve a population the insurer struggles to cover. We walk through how to do that in How to Ask for a Raise When You Are Underpaid (Insurance Edition). It also means understanding what you've actually agreed to, which is where Insurance Contracts 101 can help.
Then revisit the decision once a year. Compare the contract to your fee floor and ask yourself honestly whether it still earns its place in your practice.
Get the full exit plan
If you're ready to stop thinking about leaving and start planning it, our free training Ditching Insurance & Platforms goes deeper than this guide. We walk you through an unbiased assessment of every contract you hold, how to calculate your fee floor, how platform contracts are structured, which contract to drop first, and how to build a termination plan before you ever send a notice. It's free, it's on demand, and it was made for therapists who are tired of contracts that don't pay what their work is worth.
Watch the free trainingFrequently asked questions
How long does it take to get off an insurance panel?
It depends on your contract. Each insurer and platform sets its own notice period, and some tie termination to a contract anniversary date, so read your termination clause before you set a timeline. Add time on top of the notice period to talk with clients, find referrals, and adjust your marketing.
Will I lose all my clients if I leave insurance?
Most therapists keep more clients than they expect. Some clients will choose to pay privately, some will use out-of-network benefits, and some will need to transfer to an in-network provider. Planning ahead, talking with clients in session, and having referrals ready makes the transition smoother for everyone.
Can I keep my clients if I leave Alma, Headway, or another platform?
Possibly, but check your platform agreement first. Some agreements include terms about clients and records after you leave. If you want to keep seeing clients in network, you'll also need your own contract with their insurer, which can take months to get.
Should I drop all my insurance panels at once?
Only if your numbers and your caseload support it. Many therapists drop one contract at a time, starting with the lowest-paying, the most difficult, or the one with the fewest clients. The key is to set real deadlines so a phased exit doesn't turn into staying indefinitely.
Can I stay in network with some insurers and drop others?
Yes. A selective exit is a common and reasonable choice. Keep the contracts that pay close to your fee floor and treat you well, and drop the rest.
What happens to claims after I leave a panel?
Claims for sessions before your termination date are generally still processed, but timelines and audit or recoupment rights vary by contract. Keep thorough records and copies of your termination notice and confirmation.
About the authors
Miranda Palmer, LMFT and Kelly Higdon, LMFT are the co-founders of zynnyme. They both built thriving private-pay practices in California, started during a recession, and have spent the last two decades helping therapists across the country do the same. Through Business School for Therapists and their work as co-authors of Therapist Burnout and Intensive by Design, they've reached more than 100,000 clinicians. They believe you can build a practice that actually works, without burning out or selling your soul to an insurance panel.
