Headway is introducing a baseline assessment requirement (PHQ-9 or GAD-7) for every new client before their first session. This requirement currently applies to talk therapist providers and will be rolled out to prescribers and groups in the coming months.
You will see prompts to send a baseline assessment directly in Headway when you add a new client. If you do not see these prompts, no action is needed at this time.
Why we are asking for this
Health plans are increasingly expecting more baseline assessments from Headway to understand clients' starting point for care across their network. These scores help us show plans that care on Headway works, which is how we protect and strengthen rates and agreements. Patient Reported Outcome Measures (PROMs), such as PHQ-9 or GAD-7, give them a standardized, network-wide picture of how their members are doing, which is what lets us keep advocating for strong rates on your behalf — especially in markets where outcomes data is already tied to the rates we are able to deliver.
Health plans view this type of requirement as one of the most effective ways to improve care in their network. For example, measurement-based care is recommended in major depression guidelines (CANMAT) and is linked to higher treatment completion and greater symptom reduction.
For more information, visit our Measurement Informed Care course to learn more about best practices for incorporating measurement-informed care into your practice standards. In this course, you'll learn how to transform brief patient check-ins into actionable clinical data. We'll cover how to select the right tools, integrate them into your workflow, and use the results to power collaborative breakthroughs with your patients over the course of their treatment.
What is required
Who: Every new adult client added to your Headway caseload
What: One initial PHQ-9 or GAD-7. Only one is needed but you can send others as well. After that, we ask for at least one completed follow-up assessment per client each year. We encourage you to collect follow-ups at the recommended clinical frequency of the assessment(s) you choose to align with measurement-informed care standards.
When: Completed before the end of the client's first session with you on Headway.
If a client does not complete one: If a client hasn't completed one by the time you confirm your session, you will be prompted to enter a reason that they didn't in order to confirm the session. If you feel a baseline assessment would be inappropriate for this particular client, you have the option to exclude them going forward. Your individual answer stays with Headway and helps us improve our reminders.
If you collect assessments elsewhere and are able to provide them on request within 3 business days, you can select that as an exception reason.
What counts as a completed baseline
Any of the following satisfies the requirement:
- The client filled out the assessment themselves prior to the session (sent by Headway via email, SMS, or in the telehealth waiting room)
- You and the client completed it together in session
- The client completed a PHQ-9 or GAD-7 outside Headway and you entered the results on their behalf
Note: Clients do not need to log in to complete the assessment — they can fill it out directly from the link in their email or SMS.
How to complete a baseline
Option 1: Complete ahead of session
When you add a client through the "Add client" flow, Headway will prompt you to send a PHQ-9 or GAD-7 to your client. They will receive the assessments via email and SMS before your appointment. You will also be able to select and send any additional assessments from our library at this time.
- Add the client from your Clients tab.
- The PHQ-9 and GAD-7 is pre-checked. Select at least one of them to send (plus any other assessments you would like to send)
- Confirm completion: the assessment status updates on the client's profile and in your appointment view.
Option 2: Complete in session
If the client has not filled out the assessment ahead of time, you can complete it together at the start of the session. Headway will flag any missing assessments in your calendar.
- Open the client's profile from your Clients tab, or go to your Calendar and click Prepare on the session to open the Session Prep Sidebar (available for talk therapists only).
- Select the Assessments tab (or, in the sidebar, click Fill out together on the assessment directly).
- Start the assessment and walk through the questions with your client.
- The completed assessment logs immediately in the client's profile.
Note: If you are using Headway's Telehealth platform, clients complete their assessment in the telehealth waiting room.
Ongoing assessments after baseline
Every adult client completes a baseline PROMs assessment (like the PHQ-9 or GAD-7) when they start care on Headway, and after that intake baseline — the only required assessment right now — the sole ongoing requirement is at least one follow-up assessment per year, with the option to add recurring sends or other clinically appropriate assessments beyond that. Visit our Measurement Informed Care (MIC) course to learn more about best practices for incorporating measurement-informed care into your practice
Other assessments available in Headway's library to send to clients:
- PCL-5 (PTSD)
- IES-R (traumatic stress)
- ASRS v1.1 (adult ADHD)
- DOCS (OCD-spectrum)
- AUDIT-C (alcohol use)
- BAM (substance use, repeatable)
- WHO-5 (well-being)
- WHODAS 2.0 (functional impairment)
- PROMIS GPH (general health)
- EDE-Q (eating disorder)
- AHC HRSN (social needs)
- PMQ-9 (mania)
- ADNM8 (adjustment disorder)
Turn recurring sends on or off from the Manage Assessments page in the client's profile.
Your clients' data
Your information and your clients' information stay protected. Health plans are HIPAA-covered entities held to the same 'minimum necessary' standard Headway follows, which requires them to use only the smallest amount of information needed for a permitted purpose. They must also follow their established prior authorization processes and policies when authorizing or determining whether to cover care.
FAQ
Does this apply to existing clients, or only new ones?
Only new clients added on or after October 12, 2026. Existing clients on your caseload do not need a backfilled baseline under this requirement. However, we ask for at least one completed follow-up assessment per client each year. When you need to collect this, or have an outdated assessment, you will see reminders embedded throughout your experience - like on your homepage or in your calendar.
What happens if I miss a baseline?
The claim associated with the appointment is not automatically denied. If a client hasn't completed one by the time you confirm your session, you will be prompted to enter a reason that they didn't in order to confirm the session. If you feel a baseline assessment would be inappropriate for this particular client, you have the option to exclude them going forward. Your individual answer stays with Headway and helps us improve our reminders.
If you collect assessments elsewhere and are able to provide them on request within 3 business days, you can select that as an exception reason.
If you are routinely skipping completing baseline assessments, you may receive outreach from Headway for non-compliance with the provider agreement
Can I use a different assessment besides PHQ-9 or GAD-7?
For the baseline requirement, PHQ-9 and GAD-7 are the two options as it is commonly recommended to screen for depression and anxiety in adults and they map to health plan reporting standards (see the USPTF guidelines for depression and anxiety screening). You can always add additional assessments to be sent along with these. After baseline, you can add other assessments from the library based on what is clinically appropriate. We are continually working with our health plan partners to better accommodate other assessments that may better capture specific patient symptoms.
Will this affect my rates?
Higher PROMs adherence strengthens our position with health plans, which is how we continue to advocate for strong rates on your behalf. We will continue to share updates as rate negotiations evolve.
Does the client need to log in to complete it?
No. We removed the login requirement earlier this year — clients can complete the assessment from the link in their email or SMS without creating an account.
What if my client does not want to fill it out?
You can still confirm the session by selecting a reason at session confirmation- for example, "client declined" or other clinically inappropriate reasons. Your answer stays with Headway and helps us improve our reminders.
How does Headway handle high-risk assessment results?
When a client's response indicates a risk of harm to self, Headway provides crisis resources directly to the client and sends you a notification.
When a client's response indicates risk, the client automatically receives:
- Headway Crisis hotline information and national crisis resources (988)
- Guidance to seek help from 911 or the emergency room, if needed
- Crisis Text Line
- National Domestic Violence Hotline
- Childhelp National Child Abuse Hotline
- The Trevor Project (LGBTQ+) line
- A note that assessment results are not monitored in real-time, and that they should use the resources provided for any urgent help
What the provider notification means:
The email you receive lets you know about the result so you can factor it into your clinical approach; it is recommended standard of care to follow up as clinically indicated. Headway has already routed crisis resources to the client directly.
If a client completes a baseline assessment before your first appointment, you are sent a notification so you're aware before your first session.
When you see a client following a high-risk result, best practices include:
- As for all clinical encounters, documenting a risk assessment in your clinical note, including explicit documentation of suicidal ideation (SI) and homicidal ideation (HI) — see Quality documentation standards for 90791 for guidance
- Consider using the Columbia Suicide Severity Rating Scale (C-SSRS) to structure your assessment
- Consider whether a safety plan is appropriate, based on your clinical assessment
Questions
Get in touch via the contact form, or chat with Headway's virtual assistant.