Headway Is Not Your Friend, Your Employer, or Your Business Partner

Oct 2, 2026 · @Miranda

On October 1, 2026, Headway told therapists it will start taking $9.99 out of every session with a new client who finds them through the Headway marketplace. For therapists in Virginia, Washington, Georgia, Ohio, and Illinois, it starts October 8. That is seven days of notice for a change to how much money lands in your bank account.

Every other state follows by the end of 2026. Headway's promise to those therapists is a banner in their account at least seven days before the fee begins. (Headway's help article is here.)

If you are on Headway and your stomach dropped when you read the email, we want to say this as colleagues who have been in this field for twenty years: your reaction makes sense. And the fee itself is not the whole story. The story is what the fee tells you about the relationship you are actually in.

Headway is not your friend. Headway is not your employer. Headway is not your business partner. Headway is a venture-backed company with a last confirmed valuation of $2.38 billion, and an estimated current valuation of $2.65 billion based on secondary market trading (StockAnalysis.com, as of September 30, 2026). Here is their 2025 annual report if you want to see how they describe their own year.

Let's sit with that number for a second, because "billion" is a word our brains skim right past. $2.38 billion is 2,380 million dollars. A million seconds is about eleven and a half days; a billion seconds is almost 32 years. A therapist grossing $120,000 a year would have to work for more than 19,800 years to bring in $2.38 billion. And spread across the 65,000-plus providers Headway says are on its platform, that valuation works out to roughly $36,600 per therapist.

That value was built on your sessions, and it tells you who the company is for. Headway is a private, venture-backed company. Venture capital firms do not put hundreds of millions of dollars into a business as a gift to the therapy field; they invest to get back many times what they put in. The company's first obligation is to the people who own it. Not to you as a therapist, and not to your clients. Being helpful to therapists was the growth strategy. It was never the purpose.

"Earning more doesn't have a catch"

That is a headline on Headway's page for providers. The pitch underneath it goes like this: as the nation's largest mental health provider network, Headway works directly with insurers to negotiate better rates on your behalf, and then a small amount goes toward keeping "Headway free for everyone."

So the deal, as advertised, was simple. You never pay Headway. Headway keeps a slice of what the insurance company pays, before it ever gets to you, and that slice is the whole cost of doing business.

Now there is a second slice. This one comes out of your payout, per session, as a line item. Headway is careful to say that this "isn't a change to your contracted rate." That is technically true and practically meaningless. If your rate is $93 and $9.99 comes out before the deposit hits, you were paid $83.01.

There was a catch. It just arrived later, with a week's warning.

How the fee works (and how you end up competing with yourself)

Here is the short version of Headway's own explanation.

The fee applies to any client who books with you for the first time, on or after your state's start date, by searching on Headway and booking from your Headway profile. Once a client is tagged as a marketplace client, they stay tagged. The $9.99 comes out of every session you ever have with that person, insurance or private pay, for as long as you work together. Turning off your marketplace listing later does not undo it.

The fee does not apply to clients you were already seeing before the change, clients you add yourself in your provider portal, clients who book through your personal direct link, or referrals from health systems. Sessions that do not happen (cancellations, no-shows) are not charged either.

On paper, that sounds reasonable. Headway finds you a client; Headway takes a finder's fee. In practice, it is a finder's fee with no end date, and the question of who actually found the client is decided by Headway, based on which link the client happened to click the very first time.

Here is what we are hearing from therapists we coach. A potential client lands on your website. They read your about page, your specialties page, maybe three blog posts. You did that marketing. Then they Google your name to look for reviews, see your Headway or Alma profile in the results, notice that it takes their insurance, and book there instead.

You did the work. The platform gets the credit. And as of this month, on Headway, that credit is worth $9.99 a session for the life of the client.

This is especially painful for therapists who are actively trying to get out. You build your own website and your own referral sources so you can leave an unsustainable contract, and your own platform profile outranks you for your own name. You are competing against yourself, and now you are paying for the privilege.

A little math on what a flat fee really means

$9.99 sounds small. It is designed to sound small. But a flat fee is the same number no matter what you are paid, which means it takes the biggest bite from the therapists who are paid the least.

If your reimbursement for a session is $68, the fee is 14.7% of your pay. If it is $110, the fee is 9.1%. And remember, this is on top of whatever Headway already keeps from the insurer before your rate is ever set.

If Headway pays you	$9.99 is this much of your pay	You take home
$55	18.2%	$45.01
$61	16.4%	$51.01
$68	14.7%	$58.01
$75	13.3%	$65.01
$93	10.7%	$83.01
$110	9.1%	$100.01
$126	7.9%	$116.01
$185	5.4%	$175.01

Those are not made-up numbers. They come from TherapistRates.org, a site where clinicians anonymously submit what platforms pay them. It is crowdsourced and self-reported, so we cannot verify every entry, and some states have only a handful of reports. With that caveat, here is what therapists have reported for Headway in the five states where the fee starts first (60-minute sessions, 90837, unless noted):

State	Reported median	Reported range	Reports	Fee as share of median
Georgia (all codes)	$93	$55 to $196.24	35	10.7%
Ohio	$110	$89 to $121	5	9.1%
Virginia	$126	$126	1	7.9%
Illinois	$129	$129	1	7.7%
Washington	$146.13	$120.55 to $185	4	6.8%

Source: self-reported submissions to TherapistRates.org. 60-minute sessions (90837) unless noted.

Georgia has the most data, and it shows who gets hit hardest. Master's-level clinicians there report 45-minute sessions (90834) paying $61 to $77 and EAP sessions paying as little as $55. A psychologist reporting $196.24 from Aetna loses about 5% to the fee. A counselor doing a $55 EAP session loses 18%. Same fee, very different consequences.

One Virginia clinician added a note to their submission saying Headway received a rate increase from Anthem in July 2026 and did not pass it along to providers. That is a single anonymous report and we have not confirmed it. We mention it because it is exactly the kind of thing you have no way to check when someone else holds the contract.

If you are on Headway, go add your rates. The only reason any of us can see this data is that therapists decided to share it.

Now multiply it

One weekly marketplace client, seen 45 times in a year, costs you $449.55.

Ten marketplace sessions a week, over 48 working weeks, is $4,795.20 a year. Twenty a week is $9,590.40.

For comparison, Alma, Headway's closest competitor, currently charges a flat $125 a month for membership. That is $1,500 a year. At $9.99 a session, you pass Alma's entire monthly fee at your 13th marketplace session of the month. We are not telling you to switch to Alma (more on that below). We are telling you that "free" was never free, and the new fee is not small.

You signed a contract written by Headway, to protect Headway

We say this with love, because we know how these platforms market themselves. The language is warm. The onboarding is friendly. They call you a partner. It feels like being on a team.

You are not on a team. You are a 1099 independent contractor who signed an agreement drafted by Headway's lawyers, and that agreement is built to protect Headway. This week is what that looks like in real life: the terms you work under changed, and you found out seven days ahead.

It is worth remembering how this has gone before. In October 2024, Headway and Alma both cut what they paid therapists for Optum clients after renegotiating their Optum contracts. Headway described that kind of change as extremely rare and said it had given providers several months of notice so they could adjust (ClearHealthCosts covered it here).

Two years later, the notice period for a brand new per-session fee is one week.

An employer would owe you certain protections. A business partner would owe you a seat at the table. A friend would at least call first. A platform owes you whatever the contract says, and you did not write the contract.

Who is invested in Headway?

This is the part most therapists never hear during onboarding.

According to DNP Consulting's breakdown of who funds these platforms, Headway raised $125 million in 2023, with strategic investment from HCSC, the parent company of several Blue Cross Blue Shield plans. Headway has also announced partnerships with Cigna Healthcare and Evernorth. Alma's $130 million Series D included both Optum Ventures (UnitedHealth Group) and Cigna Ventures. Rula has backing from the Blue Venture Fund, which is supported by multiple Blue Cross Blue Shield organizations.

Read that again slowly. The companies that set your reimbursement rates are investors in, or partners of, the companies that promise to negotiate better reimbursement rates for you.

Here is how it looks to us. Imagine the neighborhood burglar starts a home security company. He shows up at your door, sympathetic about the break-ins, and offers to install a system. You feel safer. You pay him every month. And he was always going to rob you again, because that is his actual business. Now he just gets paid for the feeling of protection in between.

To be fair and precise about it: we are not saying anyone is breaking the law. Insurance companies cutting rates is legal. Platforms adding fees is legal. That is rather the point. Insurers are built to pay out less. Investors are built to get a return. A platform funded by insurers and venture capital is not going to be the thing that finally makes insurance pay therapists well, because nobody who owns it wants that outcome.

So even if the perfect platform launched tomorrow, with a beautiful interface and a heartfelt mission statement, the first question to ask would be: who owns it? If the answer includes the insurance industry, we already know how the story goes. Can we learn the lesson this time?

"Can't we just push back? We need a union."

Every time one of these announcements lands, the chats and comment threads fill up with the same questions. Can't everyone just refuse? Can't we organize? Can't we make the insurance companies fix the real problem?

We love the instinct. Here is the frustrating reality.

Therapists who are W-2 employees can unionize. Independent practice owners, which is what you are when you contract with a platform or a panel, are treated under antitrust law as competing businesses. When competing businesses agree together on what rates they will accept, the law does not call that a union. It calls it price-fixing. We go deeper on this in our post about Anthem dropping rates by $47 a session.

Barbara Griswold, LMFT, of Navigating the Insurance Maze, lays this out clearly in Let's Go On Strike (Oh Wait, We Can't). The short version: the Sherman Antitrust Act of 1890 was written to stop large corporations from conspiring on prices, and it treats a solo therapist as a business, not a worker. Two employees agreeing to ask their boss for a raise is protected collective bargaining. Two private practice therapists agreeing to ask an insurance company for a raise is price-fixing, and the penalties are real. A law meant to break up monopolies now keeps the smallest players in health care from negotiating together.

And even for W-2 therapists, a union is not one big national thing. Unions are typically organized employer by employer, which in practice means one hospital system, one agency, one state, or even one county at a time. Griswold's article points to the ten-week strike by 2,000 Kaiser Permanente mental health workers in 2022: real power, and limited to people who share one employer. There is no legal path right now to a nationwide union of private practice therapists.

(We are therapists and business coaches, not attorneys, so please treat this as education and not legal advice.)

Meanwhile, the insurance companies and the platforms they fund are free to act at scale. That imbalance is the real issue. And remember who is on the other side of it: the biggest insurers, including UnitedHealth Group, Elevance Health, Cigna, and CVS Health (which owns Aetna), are by and large publicly traded companies. You guessed it; they answer to their stockholders before their patients, and before the people who hold contracts with them. That includes you.

So what can we actually do about the system itself? Vote. What changes this is federal: elected officials who are willing to rebuild the insurance system from the ground up. Otherwise we are all stuck trying to close every loophole one at a time, state by state, and for-profit insurance company by for-profit insurance company. Keep showing up with your professional associations, your state insurance commissioner, and your legislators, because those fights matter. They are just slow, and the other side has more lawyers.

But there is one form of pushback that requires no permission and no organizing committee. Each practice owner gets to decide, on their own, which contracts they sign and which ones they leave. One therapist walking away from an unsustainable contract is a business decision. Thousands of therapists each making that decision for their own practice is pressure that no platform can ignore.

You do not need a union to stop working for a rate that does not work.

Steps you can take this week

1. Decide whether you want to be on the marketplace at all. In your Headway provider portal, go to Settings, then New Clients Settings. You can turn your marketplace appearance off. If most of your clients come from your own website, Psychology Today, and word of mouth, the marketplace may be costing you more than it brings in. Do this before your state's start date if you can, because anyone tagged as a marketplace client stays tagged.

2. Audit every place a Headway link lives. Your website, your Psychology Today profile, your email signature, your Google Business Profile, your social bios. A generic Headway profile link sends the client you earned into Headway's marketplace. If you are leaving, take the links down. If you are staying for now, replace each one with the personal direct link in your Profile settings, since Headway says clients who book through that link are not charged the fee.

3. Google yourself. Search your name the way a client would. If your Headway or Alma profile shows up above your own website, that is the leak. Your own site, your own reviews, and your own booking link need to be the easiest path.

4. Check how each new client gets tagged. Headway says each client's page shows how they found you and that fees appear in your Payments tab. Look. If someone you referred yourself is tagged as a marketplace client, raise it right away and keep a record.

5. Run your own numbers. Take your actual rate for each payer and code, subtract $9.99, and look at what is left after taxes and expenses. Then ask the honest question: is this sustainable for the practice and the life you want?

6. Read your contract. The whole thing. Look for how and when terms can change, what notice you are owed, how you terminate, and what happens to your clients and your in-network status if you leave.

7. Build an alternative or an exit plan. Not a panic exit; a plan. That might mean a private pay practice, a mix, or a slow and deliberate transition. What it should not mean is hopping from one investor-backed platform to the next and hoping this one is different.

8. Share your rates. Add what you are paid to TherapistRates.org. Transparency is one of the few tools we all have.

If your state is not on the first list, do not wait for the banner. You have a head start that therapists in Virginia, Washington, Georgia, Ohio, and Illinois did not get. Use it.

What is possible instead

We are not mad at therapists for joining Headway. These platforms solved a real problem: credentialing is miserable, billing is miserable, and you wanted to see clients who could not afford to pay out of pocket. Those are good reasons, and wanting care to be accessible is one of the best things about this field.

We are mad on your behalf. You were told there was no catch. You built part of your livelihood on that promise, and it changed with a week of notice.

The good news is that the skills that make a practice independent are learnable, and you probably have more of them than you think. A practice where you set the fee, you own the client relationships, and nobody can take $9.99 out of your session with a banner notification is not a fantasy. Therapists build them every day, including in areas where everyone swears it cannot be done.

If you want help thinking it through, we have two free trainings:

• How to build a private pay practice, for seeing what a practice without panels or platforms can look like.

• Ditching insurance, for making a sustainable plan to leave insurance and platforms without blowing up your income or abandoning your clients.

Headway is not your friend, your employer, or your business partner. You, on the other hand, are a business owner. It is okay to start acting like one.