What to Ask a Recruiter Before Signing a Therapy Platform Contract
A Checklist for Therapists Navigating Interviews with Tava, Headway, Grow, Rula, Betterhelp, Talkspace, and Other VC-Backed Companies
You, The Therapist, Are the Product
When recruiters reach out from therapy platforms, they often sound helpful, friendly, and full of opportunity. They promise referrals, ease, and income. But underneath the polished pitch can be misleading terms, exploitative contracts, or deeply flawed systems that leave therapists underpaid, legally vulnerable, or burned out.
This article outlines a comprehensive list of questions every therapist should ask before signing any agreement with a platform. These are real concerns, drawn from real therapist experiences, gathered from public online discussions and years of observing the mental health tech space evolve.
If you are here reading this article, we want you to know, you are not paranoid. You are protecting your livelihood. It’s important to know what you are stepping into, so, let's dig in.
You get a text from a recruiter as a therapist.
It often begins with a brief text or email from the recruiter stating that they have an amazing opportunity for you.
Here is one text Kelly received recently;
“Hello! I hope you’re having a great day. I’m (name), a recruiter with BetterHelp! Are you interested in a remote thearpist opportunity? I have a flexible opportunity for independently licensed therapists, to work 100% remote! I am excited to share all of the details about this poisition, including hte limited time sign on bonus of up to $3,000! If you would like to learn more, please schedule a time to speak with me! Free now? Just give me a call!”
Aside from the enthusiastic explanation marks, the $3,000 bonus (note the clarification of “up to”) is meant to pique interest and to get you excited too. But before you respond or hop on a call, let’s talk about what you want to prepare, so you get the answers you need to make a good decision for yourself and your future.
Let’s start with what to ask a recruiter.
Interview Question 1: What’s The Actual Pay Rate (Not Just the Marketing Rate)
Recruiters often lead with high-sounding rates—"$119 per session" or "$90 an hour"—without providing any real breakdown. But what do these numbers actually mean?
Here’s what to clarify immediately:
Are they quoting the evaluation rate (90791) or the ongoing therapy rate (90834, 90837)?
Evaluation rates are billed once per client; ongoing rates are your actual income.Are the rates based on CPT codes or time blocks?
CPT-code-specific payment is clearer and more standardized. Hourly rates can be easily manipulated.Do they schedule you for 45-minute sessions but pay based on a 60-minute rate?
If you're booked for “45-minute hours,” but they pay you like you’re seeing clients for 60 minutes without acknowledging unpaid documentation time, you could be underpaid or at the very least signing on for one thing while expecting another.Is documentation time built into the rate, or are you expected to complete it off the clock?
And what about contacting clients between sessions? Are there daily check-ins, checking homework, QA reviews, meetings or other activities that are expected that are not reimbursed (there likely are).
Is your pay tied to any particular deliverables like number of clients? For example, BetterHelps pay increase exponentially when you are seeing 30+ clients a week but for many therapists that can mean working 50-60 hours per week.
🟢 Example: Talkspace advertises "$90 per 60-minute session," ($1.50 a minute) but sessions are only 45 minutes long. If you spend 10–30 minutes weekly writing notes, responding to clients outside of sessions, or dealing with platform tech, your actual rate may be closer to $67.50/hour or less. At the very least, you may want to plan for collaborative documentation during sessions or creating a plan to minimize out of session contact.
Interview Question #2: Credentialing: What’s Realistic?
What is the actual timeline for credentialing?
(Some companies promise 30–45 days but take months, or never complete it.)Will they credential you with every insurance they advertise?
What happens if credentialing stalls?
Are you expected to start seeing clients before credentialing is complete?
What if you do NOT want to be credentialed with certain companies- can you opt-out?
Will they require direct access to your CAQH account including your username and password?
🟢 Example: A therapist contracted with Tava in January 2025 and was still not credentialed with any BCBS plans months later.
We deeply like the Fit Check for Therapists Facebook group where therapist are sharing their real-time experiences with online tech companies across the United States (and internationally) and giving details that you will NOT get from recruiters. The person who runs the group does consult with online tech companies and some people are not comfortable with that.
Interview Question #3: Contractor or Employer Position?
You want to know what is in the contract that you are going to sign as a contractor or what is provider if you are being hired as an employee. Remember, if you are being hired as a contractor, you are still going to be paying self employment tax and handling taxes on your own.
Contractor or Employee? You Might Be Misclassified
If a platform classifies you as a 1099 contractor but:
Sets your hours,
Requires use of their platform or software,
Trains you on a particular model of therapy,
Controls who you see as clients,
Controls how and when you see clients, or
Prevents you from working elsewhere...
...they might be treating you like an employee while avoiding the responsibilities of being an employer.
In California, this is especially risky. Under AB5, the burden is on the company to prove you're truly a contractor under the ABC test:
A: You’re free from control and direction in performing your work
B: You perform work outside the usual course of the company’s business
C: You are engaged in an independently established business
Most therapists working for tech platforms do not meet all three. And importantly:
💡 Only psychologists are exempt from AB5.
LMFTs, LCSWs, LPCCs, and other licenses are not exempt.
If you're an LMFT or LCSW in California, and a company is classifying you as a 1099 but controlling your schedule, dictating your fees, and limiting client decisions—you may be misclassified. That puts you at legal and financial risk, especially in the event of audits, lawsuits, or disputes with clients.
Not in California? This does NOT mean you are necessarily safe. From the IRS website here is what they say about 1099 vs w-2:
“Facts that provide evidence of the degree of control and independence fall into three categories:
Behavioral: Does the company control or have the right to control what the worker does and how the worker does his or her job?
Financial: Are the business aspects of the worker’s job controlled by the payer? (these include things like how worker is paid, whether expenses are reimbursed, who provides tools/supplies, etc.)
Type of relationship: Are there written contracts or employee type benefits (that is, pension plan, insurance, vacation pay, etc.)? Will the relationship continue and is the work performed a key aspect of the business?”
Sound familiar? They go on to say:
“Remote worker An individual working remotely, for example, performing services for you from a location other than an office operated by you, is your employee under the common-law rules, if you can control what will be done and how it will be done. This is so even if the worker can choose to work remotely. What matters is that you have the right to control the details of how the services are performed.”
🟢 Platforms avoid offering W-2 positions because it costs more. But if they're treating you like an employee without offering benefits, unemployment, or proper protections, it's not just unfair, it may be illegal.
Questions to Ask Yourself:
Am I truly independent in how I practice, or am I functioning like an employee?
Am I thinking of myself as an employee when I am really not?
What happens if I challenge my classification?
Does the company have liability coverage for misclassification issues?
Do they provide guidance or leave me on my own to figure out taxes, malpractice, and compliance?
Why does it matter if you are classified as a w-2 employee or a contractor?
W-2 employees have, in the United States certain legal protections federally and in each state. And, there are often benefits that can be a part of a w-2 position. 1099 contractors can’t receive training, are NOT protected legally, and are considered their own independent business. That can mean you hold additional legal liabilities as a business owner that you may or may not have planned for.
We HIGHLY recommend you read this article before determining what your lowest hourly reimbursement can be as a 1099 therapist. We break it down in a way that so many therapists finally see why $90/hr as a 1099 is NOWHERE near the same as $90/hr as a w-2 employee.
Here is a little excerpt:
“So in our example above:
Gross Income $150,000
Net Income After Business Expenses $93,000
Self-employment taxes of 15.3% payed another 14k
Worked 50 weeks per year
Averaged 37 hours a week
Average hourly take-home pay is $42/hr
And, that hourly income is BEFORE paying the regular federal and state income tax. Wow!” Read the full breakdown here.
Interview Question #4: May I see the contract or employee agreement?
Whether you are a contractor with a contract or an employee with an agreement, you want to read the FINE PRINT! Check for:
Exclusivity clauses: Can you still work independently, or with other platforms?
Non-competes or non-solicits: Can you take clients with you if you leave?
Private pay implications: If the platform markets you as in-network, will your private pay clients still pay out of pocket?
Your image, your photos, your voice, etc. Some terms of services include legal language that implies an ability to essentially clone your likeness, which didn’t mean as much before AI- but in this current space? We can create a deep fake of your face, voice, and so much more with a few samples. (In fact, we at zynnyme have tested that for podcasts or doing an audio version of our Therapist Burnout Book and it is WILD what is possible!
🟢 Example: One therapist said, “I would never bring private pay clients to Tava,” yet many don’t realize platforms often create online profiles that make you look in-network to anyone searching.
Interview Question #5: Who is Responsible for What?
Who handles billing, documentation, and insurance appeals?
Do they have access to your documentation?
Do they provide reviews of your documentation?
Is there any notice when reviewing documentation?
Do they track your outcomes?
Can they publish your outcomes?
Can they share their outcomes with you?
Can they aggregate the data that you are collecting and share it with employers, or the public?
🟢 Example: A therapist realized later that Tava or Headway listed them as in-network, confusing private pay clients and creating reimbursement headaches.
Interview Question #6: What About Payouts, Platforms, and Tech Policies?
Many platforms require you to use their EHR or video software, but what they don’t always tell you upfront is how those tools might come with strings attached, like:
AI note-taking tools that record sessions by default
While recordings may be recorded- transcripts may not be.
Video platforms that embed session tracking or recording without client clarity
Consent to recording buried in Terms of Service, not clearly disclosed to clients
What happens if a client asks to transfer to your private practice? Are there any fees or prohibitions?
What happens if a client wants to see you off-platform?
If the platform sends a client, do you have to stay in-network forever?
🟢 Some therapists have shared that platforms like Tava or others offer AI support “as an option”—but it’s not always optional in practice. The client may be automatically opted in without fully understanding what they’ve agreed to.
Ask:
Can I opt out of using your video platform?
Can I opt out of AI session recording for myself and for clients?
Do you obtain explicit, informed consent for any session monitoring?
Where is that consent documented?
Who owns the AI-generated notes or session data?
What happens to video, audio, and transcripts?
Interview Question #6: Referral Flow – Is It Worth It?
One of the biggest selling points recruiters push is the promise of “steady referrals.” But what does that actually look like in practice?
Before signing on, ask:
How many actual referrals are therapists receiving with your license in your state?
Is there seasonal inconsistency in referrals (e.g., boom in January, crickets in July)?
Are you responsible for retaining clients, or can the platform reassign them at will?
Does your location, modality, or niche impact whether clients are routed to you?
What happens if you specialize in something the platform doesn’t prioritize? Will you ever be matched?
🟢 Example: Some therapists report that platforms like Talkspace, Lyra, or MDLive fill their schedule quickly—but others, particularly in less populated states or with less “mainstream” modalities, sit empty for weeks.
Therapist Checklist – Print This Before Any Recruiter Call
Before you sign anything, ask your recruiter (and yourself):
☐ What are the CPT codes you pay for, and what is the rate for each?
☐ Are the rates the same whether the client is referred by me or the platform?
☐ Are there any credit card processing fees or platform fees taken out?
☐ What happens if I say no to a referral or want to refer someone out?
☐ Do I have complete control over my schedule?
☐ Will you credential me with all insurance plans listed, and how long will it take?
☐ What happens if I am not credentialed within that period?
☐ Can I continue to work with other platforms or private clients?
☐ How would my private pay clients feel if they found out they could be seeing me for just a copay through this other service?
☐ What happens if I leave? Can clients follow me?
☐ Am I listed online as in-network or accepting insurance through your platform?
☐ What online profiles do you create for me and with which services?
☐ Do I have control over how I am portrayed through that profile?
☐ How quickly are those profiles taken down when/if I end a contract?
☐ Are no-shows and late cancellations paid?
☐ Do I use your EHR, or can I use my own?
☐ Do you require specific telehealth or AI tools?
☐ Am I classified as a 1099 or W-2 contractor?
☐ Who is liable if a tech failure impacts care?
☐ Who is liable for any HIPAA violations or the protection of PHI in this case?
☐ What are your payment cycles and minimum thresholds?
☐ Can I opt out of Medicare or Medicaid while on your platform?
☐ What if I am already opted out of Medicare?
☐ What is the average referral rate in my state and license?
☐ Will you provide a copy of the full contract to review before signing?
☐ Sit down and explore – what are 5 more questions that this brought up for you? Share them in the comments!
Let’s Look at The Bigger Picture: Why Referrals Are “Drying Up”
A phrase echoing through therapist communities lately is:
“Referrals are drying up.”
But here’s what’s really happening:
Referrals aren’t drying up. They’re being redirected.
VC-backed therapy platforms pour millions into advertising, SEO, podcast sponsorships, and referral pipelines—diverting clients away from independent therapists and toward platforms that underpay the very providers doing the clinical work.
And in response, therapists—desperate to fill their caseloads—start accepting unsustainable contracts that reinforce the system. It becomes a vicious cycle:
Clients are pushed toward platforms.
Therapists join those platforms because “referrals are slow.”
The platforms grow stronger, further reducing direct-to-therapist referrals.
The more therapists sign on to low-paying platforms, the more power those companies have to dominate search results, referral networks, and eventually insurance contracts.
Follow the Money: Who Gets Paid?
Want to see how these companies really value your labor?
Look up salaries for:
A marketing manager or referral coordinator at one of these companies.
A VP of growth, brand strategist, or SEO manager.
Then compare that to what they pay you—the person actually providing the clinical care and carrying the ethical, emotional, and legal risk.
🟢 In many cases, therapists are paid $60–$90 per session while marketing staff earn six figures to make sure more therapists keep signing on at those same low rates.
That’s not just about numbers. It’s about who holds the power in shaping mental health access—and whose work is being exploited to build scalable business models.
Red Flags to Watch For
They won’t give you rates in writing
They avoid naming specific CPT codes when quoting fees
They push urgency: “We just need your signature today”
They speak vaguely about how you’re marketed or who will see your profile
They offer a referral bonus for getting others to sign up without fully vetting the terms
Misrepresenting your fees (e.g., quoting evaluation rate instead of session rate)
Listing you online as in-network without your knowledge
Not allowing you to ensure you are advertised accurately
Preventing you from declining or referring out inappropriate clients
Limiting your ability to opt out of tech tools, video platforms, or AI tools
Using broad Terms of Service that allow client data to be used for “product development”
🟢 If someone pushes you to sign a contract faster than you can read it, walk away.
A Word About VC-Backed Therapy Platforms
Companies like Headway, Alma, Grow, Lyra, and Talkspace are not built by therapists for therapists. They're built for investors. That doesn’t mean they’re evil—but it does mean their first loyalty is to profitability.
When these companies lose investor funding, they may:
Slash therapist pay
Cut support services
Change contract terms with little notice
Collapse entirely, leaving clients stranded and therapists unpaid
This happened with VC backed companies for decades. We actually just saw Joanne’s Fabric go out of business- why? Because a VC backed company came in, sold off the assets for big profits, and then ran it into bankruptcy. In this case, the employees had a nice window. But, not all companies have notice when they close, doors can close overnight.
The Hourly Pay Trap: “$90/hour” Means Nothing Without Context
One of the most common—and misleading—phrases recruiters use is:
“We pay $X per hour.”
Here’s why that should always prompt follow-up questions:
Is that clinical hour, clock hour, or billable hour?
Do they book clients for 45-minute sessions and claim it’s an hour?
What happens if a client has a crisis? Is suicidal, etc.- is there a way to be reimbursed for that time?
Are you expected to complete notes, messages, or follow-ups on your own time?
If you're paid per session but expected to remain available between clients, that time is unpaid labor.
When companies quote “hourly” pay without referencing CPT codes, you’re missing the data you need to make an informed financial decision.
🟢 Example: A platform might say they pay "$78/hour"—but they’re referring to a 90834 code (38–52 minutes), with 5–10 minutes of unpaid admin time. In reality, you're earning far less.
Therapist Recruiter Translation Table: What They Say vs. What It Means
| What They Say | What It Probably Means |
|---|---|
| “We pay $90/hour” | They’re quoting a 60-minute rate—but scheduling you for 45-minute sessions. No pay for documentation time. |
| “You keep 100% of your fee!” | After we take our cut. Or we’re quoting the rate before deductions and processing fees. |
| “You’ll get consistent referrals.” | You might get flooded in January and then nothing in July. No guarantees. |
| “You’ll be listed on Psychology Today!” | We’ll build a duplicate profile and redirect clients—without disclosing we’re taking a cut. |
| “We use AI to streamline documentation.” | We record or transcribe your sessions and may use that data to build proprietary tools. |
| “Clients must sign our terms before starting.” | We bury AI consent deep in the fine print, and you might not know either. |
| “You're an independent contractor, so you control your schedule.” | You're 1099, liable for everything, with none of the benefits—and often less actual control than promised. |
| “We only need a few clients to get started.” | We hope you won’t ask hard questions because it sounds low-risk. But the terms still apply to every client. |
AI Therapists, Consent, and the Future of Your License
With the first AI therapist clinical trials now underway, the stakes are higher than ever. We have websites claiming 100% AI Therapy 24/7 like Abby.
Is your license designation and the service you provide being protected by the licensing boards and professional associations?
There is material buried inside of the Big Beautiful Bill as of the writing of this that says states (who are the ones that are in charge of our licensing laws and designations) can’t create laws regarding the use of AI for the next 10 years. There is a LOT at stake here right now. American Psychological Association is working with Federal Trade Commission to try to create regulations, and Utah has posed a bill- but any state bills would be outlawed.
Some platforms claim they’re using AI to “support clinicians” through automated notes or scheduling. But what happens when they stop needing you?
Is the AI being trained on your sessions or notes?
Do you understand what happens with the transcripts, recordings, and/or data collected?
Do clients know what happens with their transcripts, recordings or the data collected?
Is the platform actually worried about documentation—or are they collecting training data to replace you later?
Are they creating their own AI Therapist that could become the primary service provider lowering the need for you and your rates even further?
OR- could this be a time for you to really up your game and know that whoever can’t be helped by the AI Therapist is in need of significant expertise and can you INCREASE your rates?
🟢 Rumors of Kaiser’s investment in Rula are reportedly tied to the development of future AI therapist models. If your sessions are being recorded and transcribed, you may be feeding the very machine designed to take your job.
This isn’t a wild conspiracy—it’s a legitimate business strategy. Venture capital-backed platforms need scale. Therapists don’t scale well. AI does.
Ask yourself:
Who benefits most from mandatory session recordings?
What happens if you object?
Is your client’s data being used to build a product without their true understanding?
This is why therapists must be vigilant not just about how much they are paid, but why the system is being designed this way. Remember, your clients are trusting YOU as the professional to determine what is ok and trustworthy.
What You Can Do – Action Steps to Protect Yourself
You can’t always control what companies do—but you can control how you respond. Here are concrete actions you can take:
🛑 Before Signing Anything:
Ask for the full contract in writing. Don’t settle for verbal promises or slide decks.
Request a CPT code rate sheet. If they refuse, that’s a red flag.
Get a copy of the Terms of Service and Privacy Policy. Look for AI mentions, data use, and session recording policies.
Demand clear consent language for clients. If a platform uses AI tools, where and how are clients informed?
Clarify opt-out rights. Can you decline referrals, opt out of tech tools, or restrict marketing use of your name?
🔎 If You're Already on a Platform:
Review your contract line by line, especially after any updates.
Check how you're listed online. Are you being presented as in-network without your permission?
Search the Terms of Service for keywords like “record,” “AI,” “third party,” “data collection,” and “training purposes.”
Ask your clients if they know they're being recorded—if you’re not sure, that’s a problem.
Track your time and income. Know your actual hourly rate after documentation, no-shows, and unpaid tasks.
📢 Advocate Systemically:
Share your experience anonymously in therapist groups or watchdog projects.
Push for transparency requirements in professional associations and licensing boards.
Encourage clients to ask how their data is used—this builds ethical awareness and puts pressure on platforms to clean up their terms.
Final Thoughts: Be Cautious, Not Fearful
Not every platform is a scam. But every platform is a business, and your labor is part of how they make money. And, if you are being paid as a 1099 contractor- the assumption is that YOU are operating and making decisions as a BUSINESS OWNER.
Before you sign a contract, pause. Reflect. Read. Ask hard questions. And don’t mistake “a handful of clients” for “a harmless experiment”- you’re still handing over control of your professional name, your billing, and your reputation.
You deserve to earn a living wage, protect your license, and build a sustainable practice. Let platforms serve you—not the other way around.
Therapists are being marketed to, through, and against—often without transparency. You have every right to pause, push back, and ask for more.
If a recruiter dodges your questions, take that as your answer.
You deserve clarity, fair compensation, and to have your labor respected, not extracted.
