top of page
  • Writer's pictureAaron Norrish

Understanding the NDIS Price Guide and Price Limits

Looking for clarity on the NDIS pricing guide? Our article breaks down the essential aspects of the NDIS Price List, including the latest NDIS price limits and how they impact participants and providers. Expect a straightforward exploration of key components, usage tips, and essential updates effective from January 2024.


NDIS logo on a building

Key Takeaways

  • The NDIS Pricing Arrangements and Price Limits document (formerly known as the Price Guide) sets the price ceiling for services to ensure fairness for participants and providers, specifying support item numbers, names, and hourly rates for services like therapy and support coordination.

  • The NDIS Pricing Guide also details support categories, including core and capacity-building supports, and has separate provisions for Specialist Disability Accommodation (SDA), aiding participants in identifying claimable items and providers in billing accurately.

  • Recent pricing updates effective January 2024 reflect economic changes, with a 5.3% increase for disability support worker costs and a stable pricing for therapy and support coordination services, while provider considerations now include adjusted travel claims and the conclusion of the Temporary Transformation Payment (TTP) by July 2024.



NDIS Price Guide Logo

Understanding the NDIS Price Guide

At the heart of the National Disability Insurance Scheme (NDIS) is the NDIS Price List, also known as the Pricing Arrangements and Price Limits document, a beacon that illuminates the path for participants and providers navigating the financial aspects of disability support services. Once known as the NDIS Price Guide, this pivotal document delineates the price controls within the NDIS ecosystem, ensuring participants are charged relatively and providers offer value for money.

The guide’s price limits serve as the capstone for service costs, protecting the interests of NDIS participants by setting a ceiling on how much-registered providers can bill for various supports.


Key Components of the Price Guide

The Price Guide is not just a list of numbers; it’s a framework that ensures every dollar spent is an investment in quality support. With price limits as its core, the guide specifies the highest amount providers can charge for each service, promoting transparency and consistency across the board.

The NDIS Support Catalogue complements the guide, detailing current price limits for each support item and serving as a reference for providers. The guide also includes a breakdown of services, complete with support item numbers, names, and hourly rates, particularly for therapy and support coordination.


How to use the Price Guide

Navigating the financial waters of the NDIS can be effortless with the right compass. The NDIS Support Catalogue is that compass, a comprehensive list that details supports covered by the NDIS along with their current price limits. It also includes notes on claimable items such as provider travel and non-face-to-face services, making it a vital tool for participants to plan their budgets and for providers to prepare their invoices accurately.



Navigating Support Categories and Line Items

Diving deeper into the NDIS Price Guide reveals a well-organized trove of support categories and line items, each with unique codes and descriptions. While the catalogue’s breadth can seem daunting, its meticulous structure helps locate the exact line item to use for specific services, including therapeutic support, support coordination, and accommodation.

The guide is designed to assist in identifying claimable items by providing price limits, support categories, descriptions, and line item numbers for various supports. The NDIS Support Catalogue specifies all available support items and includes current and previous price limits, as well as applicable claim types for each item.


Core Supports

Core supports are the bedrock of the NDIS, providing participants with the fundamental services required for their daily lives, including supported independent living. These supports are tailored to cover day-to-day activities and are flexible to align with the participant’s long-term goals and aspirations.


Capacity Building Supports

Capacity-building supports are the scaffolding that helps NDIS participants reach their personal summits. Support coordination is a distinct pillar within this category, steering participants toward the effective use of their NDIS plans and connecting them with essential services.

The funding for support coordination is versatile, allowing for the amount and intensity to be customised to the participant’s unique needs, as outlined in their plan.


Specialist Disability Accommodation (SDA)

Specialist Disability Accommodation (SDA) is a specialised category within the NDIS that focuses on housing solutions with unique features for those with extreme functional impairment or very high support needs. The pricing arrangements for SDA are laid out in a separate document, ensuring a fair return on investment for such properties and catering to the specific needs of eligible participants.



Key Pricing Changes and Updates

Keeping up with the ever-evolving pricing landscape is vital for both NDIS participants and providers. The NDIA’s latest pricing arrangements and price limits came into effect in January 2024, marking an important milestone for the NDIS community.

These updates, which include price limit increases and adjustments due to factors like the COVID-19 pandemic, ensure that NDIS plans remain up-to-date and reflective of the current economic climate.


Price Limit Increases

The recent adjustments to price limits are a response to economic shifts, with disability support worker price limits increasing by 5.3% and other supports seeing a 4.36% rise. These changes are influenced by various factors, such as wage decisions and superannuation charges, and play a critical role in maintaining fair and sustainable pricing for NDIS services, following the dsw cost model.


Therapy, Support Coordination, and Plan Management Pricing

In contrast, therapy, support coordination, and Plan Management services have not seen price increases. The decision to maintain current prices for these services is founded on market analysis and the belief that existing prices are competitive and sufficient to ensure access to services.

This stable pricing may influence provider operations and participant choices, as it affects the allocation of unaltered budgets for these services.



Provider Considerations: Billing, Invoicing, and Travel Costs

For providers within the NDIS framework, understanding billing, invoicing, and travel cost claims is as crucial as the services they deliver. Providers must carefully navigate the flexible billing allowed under the NDIS, ensuring invoices are properly managed and travel costs are transparently communicated to participants.


Temporary Transformation Payment (TTP)

The Temporary Transformation Payment (TTP) has been guiding providers through the NDIS transition, with a phased reduction in the loading set to conclude by July 2024. This gradual approach allows providers to adjust to the changing landscape, ensuring they remain sustainable post-TTP.


Provider Travel Claims

Provider travel claims have been adjusted to ensure compensation reflects the true costs of delivering services, particularly in remote areas. These changes allow providers to claim for both the time spent travelling and the non-labour costs associated with it, such as vehicle expenses and parking fees.



Assistive Technology and Home Modifications Pricing

Within the NDIS, assistive technology and home modifications represent crucial investments in participant independence and quality of life. Different cost categories exist for assistive technology, each with distinct funding provisions, while home modifications are classified based on the extent and complexity of the work required. For more intricate or potentially hazardous items, professional assessments are mandated to ensure participant safety and appropriate use of funds.


Code Guide and Changes

The NDIS Code Guide, updated as of July 2023, serves as a directory for commonly used assistive technology, home modifications, and consumables. While the guide is comprehensive, it is not exhaustive, which means participants and providers need to stay informed and proactive when it comes to planning and claim submissions.


Mid-Cost Assistive Technology (AT)

For mid-cost assistive technology items, the NDIS has streamlined the funding process to require evidence such as a cost estimate, but formal quotes are not mandatory. This simplification aids participants in accessing the necessary technology with less administrative burden.



Support Coordination and Plan Management Pricing

The pricing arrangement for support coordination and Plan Management plays a significant role in shaping the delivery of NDIS services. Providers can choose to price these services below the price limits set by the NDIS, offering flexibility in the arrangements between providers and participants.


Levels of Support Coordination

Support coordination is offered at three different levels, catering to the varying complexities of participants’ needs. While Level 1 support coordination will see a price increase, Levels 2 and 3 will maintain their current price limits, enabling providers to continue offering tailored support to participants.


Plan Management Fees

Plan Management fees are subject to the price controls stipulated in the NDIS Pricing Arrangements and Price Limits document. When you first engage a Plan Manager, they receive a one-time set-up fee added to your initial plan funding. Additionally, they are paid a monthly fee (also added to your plan funding) to oversee the financial aspects of your NDIS plan. Importantly, none of these fees are borne by the participant and do not affect the funding within a participant's NDIS plan. 



Regional, Remote, and Very Remote Area Supports

Participants in regional, remote, and very remote areas face unique challenges, and the NDIS has crafted strategies to ensure they receive the necessary supports. With higher NDIS price limits and government measures like thin market trials, the NDIS aims to make services more accessible and sustainable in these areas.


Classification Changes

The classification criteria for remote areas have been refined, with a focus on delivering culturally relevant plans and improving service coordination. The NDIA’s ongoing strategy includes detailed actions to enhance engagement and support for Aboriginal and Torres Strait Islander communities.


Adjustments to Provider Travel Claims

Provider travel claims have been adjusted to more accurately reflect the costs and time associated with delivering services in remote areas. These changes, such as allowing for longer travel time claims and higher kilometre rates, incentivise providers to extend their reach to remote communities.



Summary

In the dynamic world of NDIS pricing, understanding the latest updates and strategies is key to maximising the scheme's benefits. From mastering the details of the Price Guide to navigating the implications of pricing changes, this guide has provided insight into every facet of NDIS financial management. Embrace these insights to ensure that every NDIS dollar spent is an investment in a brighter, more empowered future.



 

Frequently Asked Questions


What are the price limits in the NDIS Price Guide?

The NDIS Price Guide sets price limits for the maximum prices that NDIS registered providers can charge participants for specific supports, ensuring value for the services received.


How often are pricing arrangements and price limits updated?

The NDIS periodically updates pricing arrangements and price limits to reflect changes in the market and economy. The latest update took effect in January 2024. Prices are adjusted to keep up with market and economic changes.


Can providers charge less than the price limits set by the NDIS?

Yes, providers and participants can negotiate prices below the NDIS set price limits, allowing for billing flexibility. This allows for more flexibility in pricing arrangements and fosters collaboration in finding the best solution for both parties.


What are the three levels of Support Coordination, and how are they priced?

The NDIS offers three levels of support coordination: Support Connection, Support Coordination, and Specialist Support Coordination. While the price for Level 1 will increase, Levels 2 and 3 will maintain their current price limits.


How does the NDIS ensure services are accessible in remote areas?

The NDIS ensures services are accessible in remote areas by implementing higher price limits and specific government measures such as thin market trials. This helps make necessary supports more accessible to remote and very remote participants.


 

If you want to learn more about plan management and how it can benefit you, contact Simplified Plan Management. Our expert team is here to assist you with managing your NDIS plan, ensuring you can focus on achieving your goals while we handle the administrative tasks. Reach us at 0491 090 757 or email us at info@simplifiedpm.com.au.

 

48 views0 comments

Comments


bottom of page