We, the undersigned licensed mental health providers, clients, and advocates, submit this petition in strong opposition to Aetna's announced reimbursement changes, effective July 15, 2026, through the Alma platform. These changes include reimbursing CPT code 90837 at the same rate as 90834 and reducing reimbursement for doctoral-level providers to master's-level rates. These actions represent a serious and unjustifiable deterioration of mental health reimbursement standards that will cause direct harm to providers, clients, and communities across the United States.

CPT codes are the national standard for documenting and reimbursing healthcare services. CPT 90837 covers individual psychotherapy lasting 53 minutes or more, a clinically distinct service that is not interchangeable with a shorter session. Flattening its reimbursement rate is not a cost-saving measure. It is a unilateral redefinition imposed without clinical justification, one that will make longer, evidence-based therapy economically unviable for in-network providers and directly reduce insured clients' access to care.

The reported elimination of differential reimbursement for doctoral-level providers is equally indefensible. Psychologists at the PhD and PsyD level bring years of advanced training, supervised clinical experience, and specialized expertise. Reimbursing their services at master's-level rates ignores clinical reality and sets a dangerous precedent that could erase credential-based care differentiation across the entire healthcare system.

Qualified Mental Health Professionals already receive reimbursement rates that fall short of the equity standards required under the Mental Health Parity and Addiction Equity Act. These providers are the backbone of their communities, serving some of the most vulnerable populations in the country. Further reductions, whether direct or structural, push us farther from parity. This is a step backward that we will not accept in silence.

We call on Alma and its parent company, Spring Health, to publicly disclose whether and how artificial intelligence is used to review, score, audit, or aggregate behavioral health claims and mental health records, and to obtain meaningful informed consent from both providers and clients before any such practices are implemented. Mental health data carries the highest expectation of privacy and trust. Transparency is not optional. We demand regulatory scrutiny and enforceable accountability.

We demand a system that reflects the true value of mental health care, respects providers' training and expertise, protects client privacy and autonomy, and operates with transparency.

Alma and Spring Health must be transparent with clients and providers about any use of AI in the review or processing of mental health records. A mental health record is not a data asset. It is a sacred trust.

Aetna must reverse its decision to circumvent national CPT standards. Downcoding degrades the mental health system, ignores client and provider autonomy, and disregards clinical judgment. These changes create real barriers to care for real people.

The behavioral health community is watching, organized, and prepared to respond. We will advocate for meaningful change and increased regulatory oversight to ensure ethical accountability and protect the integrity of the therapeutic relationship. We are not only fighting to stop the dismantling. We are building something better, and we will not stop until every person in this country can access the care they deserve.