Lean AI

Payer Contracting

Contract status, fee schedules, and margin analysis for behavioral health payers

2025
Q1 '25
Q2 '25
Q3 '25
Q4 '25
2026
Q1 '26
Q2 '26
Q3 '26
Q4 '26
2027
Q1 '27
Q2 '27
Cigna / Evernorth
Live since Jan 2025
Aetna
Live since Apr 15, 2025
Anthem
Target go-live Dec 2026
Blue Shield
Target go-live Dec 2026
Standalone Cigna
Repaper to Lean PC — Q1 2027
Standalone Aetna
Repaper to Lean PC — Q1 2027
Blue Cross
Target go-live Mar 2027
Kaiser
Target go-live Jun 2027
Live Target Milestone

Cigna / Evernorth

Live

Live (via Helyx contract, pending repaper to Lean PC)

Contract Entity

Redwood Phoenix Medical Inc DBA Helyx Health

Effective

January 2025

Renewal

Needs research

Notes

Lean NPI being added to Helyx’s existing Evernorth contract. Goal: repaper to standalone Lean contract once volume established.

Aetna

Live

Live (via Helyx contract)

Contract Entity

Redwood Phoenix Medical Inc DBA Helyx Health

Effective

April 15, 2025

Renewal

Needs research

Rate Basis

165% of Aetna Market Fee Schedule (Northern California market)

Notes

Core psych/therapy CPT codes at 165%. All other services at 115% (masters), 117% (psychologists), 118% (NPs/psychiatrists).

Anthem

Target

Target go-live Dec 2026

Renewal

Notes

New payer contract targeted for Q4 2026.

Blue Shield

Target

Target go-live Dec 2026

Renewal

Notes

New payer contract targeted for Q4 2026.

Blue Cross

Target

Target go-live Mar 2027

Renewal

Notes

New payer contract targeted for Q1 2027.

Kaiser

Target

Target go-live Jun 2027

Renewal

Notes

New payer contract targeted for Q2 2027.

CPTDescriptionProviderCigna RateAetna RateAetna Base × Mult.
9083760-min psychotherapyPsychologist$337.00$239.50$145.15 × 1.65
9083760-min psychotherapyMasters$200.00$179.62$108.86 × 1.65
9083760-min psychotherapyPsychiatrist$275.00$239.50$145.15 × 1.65
9083445-min psychotherapyPsychologist$306.00$181.50$110.00 × 1.65
9083445-min psychotherapyMasters$136.00$136.13$82.50 × 1.65
90791Intake evaluationAll$491.00$272.25$165.00 × 1.65
Provider TypePayerContracted RateClinician PayoutLean MarginTake %Margin Bar
PsychologistCigna$337.00$175.00$162.0048.1%
$162.00
PsychologistAetna$239.50$160.00$79.5033.2%
$79.50
MastersCigna$200.00$120.00$80.0040.0%
$80.00
MastersAetna$179.62$107.77$71.8540.0%
$71.85

Blended Economics (50/50 Cigna/Aetna)

ProviderBlended RevPayoutGross MarginTake %EHR (4%)Coll. Loss (3.5%)Net Margin
Psychologist$288.25$167.50$120.7541.9%$11.53$10.09$99.13
Masters$189.81$113.88$75.9340.0%$7.59$6.64$61.69
Cigna: 50%Aetna: 50%
100% Cigna50/50100% Aetna

Psychologist

Blended Revenue

$288.25

Blended Payout

$167.50

Gross Margin

$120.75

Take Rate

41.9%

Net Margin (after EHR + coll. loss)

$99.13

Masters

Blended Revenue

$189.81

Blended Payout

$113.89

Gross Margin

$75.93

Take Rate

40.0%

Net Margin (after EHR + coll. loss)

$61.69

critical

Single payer concentration risk

Cigna is primary revenue driver

monitor

Aetna margin compression

33.2% psychologist take vs 48.1% on Cigna

critical

Contract dependency

Both contracts currently held via Helyx Health entity, not Lean PC

monitor

Renewal dates unknown

Needs research for both Cigna and Aetna