There is a moment in therapy that never happens in the first twenty minutes.

It comes later. After the small talk. After “I’m fine.” After the part where you perform being okay, because performing okay is the habit of a lifetime. The real work starts at minute thirty-eight. Minute forty. That late part of the hour is the entire reason a long session exists.

Aetna just decided that part of the hour is worth nothing extra.

Starting July 15, 2026, Aetna will pay a therapist the same for a 53-minute session as for a short one. The billing codes are 90837 and 90834, but forget the codes. Here is what it means. The reason to give you the longer session, the one your therapist fights for when you are coming apart, is being erased.

Right now it is coming through Alma, the platform a lot of therapists use to take Aetna. And here is the part that should stop you cold. Alma, the company that had to deliver this news, said out loud that it disagrees with it. When even the messenger tells you the message is wrong, you know exactly who wrote it.

These things never stay in one lane. Today it is one network. Tomorrow it is every Aetna patient. We are not going to sit here and wait to find out.
Aetna will never call this a cut to your care. It is smarter than that. But the math does not lie. Stop paying for the longer session and you get fewer of them. Therapists shorten visits to keep the lights on, or they walk away from Aetna for good. Either way the patient pays. You wait longer for someone who takes your insurance. You get walked to the door right before the part of the session that actually holds you together.

So answer the question, Aetna. In regular medicine, a longer and harder visit pays more. Why is mental health the exception? There is a federal parity law written to stop insurers from treating therapy like the cheaper kind of medicine. This is exactly the kind of thing it exists to catch.

We want three things:

1. Reverse the July 15 decision. Pay for extended sessions when they are clinically necessary, the way you did before.
2. Show your work. Release the parity analysis that supposedly justifies this. If it is fair, prove it.
3. Put it in writing that you will not push this onto more plans or more patients.

Patients never got a vote in this. Therapists were told, not asked. This is the vote.

If you have ever needed more than thirty minutes to tell someone the truth, sign this. If you love someone who has, sign this. Then send it to everyone you know, because a company like this moves for a headline and ignores a help ticket.
We are not asking for a favor. We are telling you to take the stopwatch off of getting better.