Headway and Alma alternatives: the four ways to take insurance

Already decided to leave and want the dollar figure and the move steps? Our page on leaving Headway or Alma has a take-home calculator. This page is the step before: comparing the options fairly.

The four models, side by side

Model	What it costs you	Who holds the payer contract	Best when
Free network (Headway, Grow Therapy)	No fee to join; the network keeps part of what the insurer pays, and doesn't publish how much	The network	You want to start taking insurance fast, with the network handling claims and guaranteeing your pay
Membership network (Alma)	A monthly or yearly membership; insurance sessions paid at Alma's payout rates	Alma, with its payer partners	You want a network's insurance access plus practice tools, and a fixed fee suits you
Your own contracts	An EHR and claims fees; credentialing work (yours, or paid help)	You	You plan to stay in practice, may hire, and want your full contracted rate and portable client relationships
Hybrid	Both, for a while	The network for some plans, you for others	You're moving to your own contracts without a gap in income

Headway, Alma and Grow, from their own pages

Item	Headway	Alma	Grow Therapy
Cost to join	Free, no membership or subscription	Membership: $125 a month, or $1,140 a year ($95 a month); sales tax applies	No cost; no subscription fees
How it earns	Negotiates rates with plans and keeps a portion of session payments; the share isn't published	The membership; insurance payout rates set by payer, degree and CPT code	Paid by the insurers it contracts with; your rate sheet shows what you're paid per session
When you're paid	Every two weeks, before the insurer pays Headway	Weekly payouts, per its provider pages	Weekly, Fridays; usually 1 to 3 business days to arrive
If a claim isn't paid	Headway says it absorbs claims that are never paid	Not stated on the pages we read	Guarantees insurance payouts even if it can't collect
Requirements	Credentialing through Headway, using CAQH ProView	New members must join its insurance program and credential with at least one of Aetna, Cigna or Optum	Independent contractor agreement; 1099
Cash-pay clients	Not covered on the pages we read	Alma says cash-pay income stays with you	Paid once the client pays, minus a 5% processing fee
EHR tools	A free EHR inside its platform: notes (AI drafts for 1:1 progress notes), scheduling, video	Not compared here; ask Alma what membership includes	Not compared here; ask Grow what its platform includes

Sources: Headway, Where Headway's earnings come from and Why we made our EHR free; Alma, FAQ and insurance program; Grow Therapy, for providers and payout and earnings FAQ. All read October 24, 2026. Promotions change; Alma has advertised introductory offers, so check the live page.

What a network gives you, and what you give up

What you get

• Speed to your first insured session. The network already holds the payer contracts. On your own, expect 60 to 120 days per commercial payer; our guide to how long credentialing takes has payer-by-payer detail.
• Predictable pay. Headway and Grow both say they pay you on a schedule even when the insurer is slow or doesn't pay. On your own, denials and slow payers are your problem; that's real work.
• Billing done for you. No clearinghouse, ERAs or claim follow-up to learn.
• Referrals. Networks list you in their directories.

What you give up

• Part of the rate, or a fixed fee. Free networks keep a share they don't publish; Alma charges a membership. With your own contract you're paid the full allowed amount, which can be higher or lower than a network's rate depending on the payer and your market. Compare real numbers before deciding.
• The contract itself. If you leave, the payer relationship stays with the network, and you credential again on your own. Your CAQH ProView profile and your NPI stay yours.
• Some say over the client relationship. Network agreements can have rules about notice and about clients you met through the network. Read yours before you plan a move; we can't summarize terms that differ by contract.
• Room to grow. Hiring an associate, opening a group or adding an IOP all run on contracts you hold. Our guide on starting a group practice in Texas covers group contracts.

A decision guide

Your situation	Usually the best fit
Newly licensed, few clients, no billing experience	A network. Get experience and a caseload; start your CAQH profile now so it's ready later.
Full caseload, mostly one or two insurers	Hybrid: apply directly to those insurers first, and move clients as each contract starts.
Mostly cash-pay with a few insured clients	Compare Alma's fixed membership with a network that charges per session, or your own EHR with superbills for out-of-network clients.
Planning to hire associates or open a group	Your own contracts, under a group NPI. A network seat doesn't carry over to your hires.
Medicare clients (LPCs and LMFTs)	Your own Medicare enrollment is possible since 2024, when CMS began paying MFTs and mental health counselors. Our Medicare enrollment guide walks through PECOS.
You hate billing and always will	Stay on a network, or go direct and hire a biller. Both are fine; know what each costs.

The hybrid plan: your own contracts, one payer at a time

1. Count your clients by insurer. The two or three plans covering most of your caseload are the ones to apply to first.
2. Get your NPI and CAQH profile current. Add your own practice location and tax ID. If you're forming a group, get a Type 2 NPI; our NPI Type 1 vs Type 2 guide explains when.
3. Apply to each payer directly. The steps, follow-up and effective dates are in how to get credentialed with insurance. Keep seeing everyone through the network meanwhile.
4. Set up your own EHR in parallel. Start with cash-pay and out-of-network clients (superbills), so the system is proven before insured clients move.
5. Move clients as each contract becomes effective, never before. Check their coverage, send new paperwork, book them on your calendar. Respect your network agreement's notice rules.
6. Stay on the network for plans you don't contract with yourself, as long as that's allowed and it's worth it.

Cima Consulting can do the credentialing for you: CAQH, each payer application and follow-up every two weeks, priced per plan. See credentialing help.

What you need once you go direct

On your own contracts you need what the network did for you: scheduling and reminders, notes, claims, ERAs and payment posting, eligibility checks and a BAA. Here's what that looks like on Cima EHR, for comparison with any EHR you're considering:

• Price: Solo $59 a month; $39 per added clinician; claims 30¢, ERAs 20¢, eligibility 30¢ at the clearinghouse's standard rate. No percentage of collections, ever. A solo clinician sending 80 claims a month pays $99.00.
• Billing: signing the note creates the charge; each claim is checked for NPIs, taxonomy, member ID and your filing limit; ERAs post payments from payers you've enrolled with. Insurance is checked the evening before each insured visit.
• Clients: booking page, text and email reminders, paperwork signed on their phone, superbills for out-of-network clients.
• Notes: templates with AI drafting included, PIN signing, late-entry marking.
• Not included: built-in video (add your own HIPAA-ready link), card processing (record payments from your own processor), and live e-prescribing (coming soon).

Weighing EHRs too? See our SimplePractice and TherapyNotes comparisons, or what free EHRs include. Headway's own EHR is free only inside its network.

Questions

What's the best alternative to Headway?

It depends on why you're leaving. For a different network, Grow Therapy is also free to join and Alma charges a membership. To keep your full contracted rate, credential directly with your main insurers and run your own EHR, keeping Headway for other plans until your contracts start.

How much does Alma cost?

Alma's FAQ lists $125 a month, or $1,140 a year ($95 a month), plus sales tax where it applies. New members must join its insurance program and credential with at least one of Aetna, Cigna or Optum. Alma has advertised introductory offers, so check its current page.

How much does Headway take from each session?

Headway doesn't publish it. It says it negotiates rates with plans and keeps a portion of session payments, and that rates vary by license and plan. Our Headway and Alma page cites one research firm's estimate and has a calculator for your own guess.

Can I keep my clients if I leave a network?

Check your agreement first: network contracts can set notice periods and rules about clients you met through them. Clients can choose their own clinician, but their insurance only pays you directly once your own contract with their plan is effective.

Do I need a new CAQH profile or NPI when I leave?

No. Both are yours. Update your CAQH practice location, tax ID and billing details for your own practice, and re-attest. Our CAQH ProView guide covers each section.

Is Headway's EHR really free?

Headway says its EHR is free and built into its platform for providers in its network. It's not a standalone EHR you use with your own insurance contracts.

Sources

1. Headway: Where Headway's earnings come from (and where they go); Why we made our EHR free for therapists; Using CAQH ProView for credentialing with Headway. Read October 24, 2026.
2. Alma: Frequently Asked Questions; Insurance Program for Therapists. Read October 24, 2026.
3. Grow Therapy: Providers; Payout & Earnings; Payment policy for cash-pay appointments. Read October 24, 2026.
4. CMS, Marriage and family therapists and mental health counselors; NPPES; CAQH ProView.
5. Cima EHR prices and features: cimaehr.com/pricing and the app (alturaops server/solo).

Headway, Alma and Grow Therapy are trademarks of their owners, named here only to compare published facts. Not legal or financial advice: read your own network agreement. If something here is out of date, tell us and we'll fix it.