Pricing and payment
The National Disability Insurance Scheme Act 2013 states that a funded support must represent “value for money” in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support”. Prices on the list of possible support options are structured to reflect this requirement.
Prices for supports included in participant plans are developed and published by the National Disability Insurance Agency (NDIA). Prices are based on a value-for-money principle and reflect prices in comparable schemes in trial site areas and work jointly undertaken by NDS and NDIA to establish an efficient price for personal care and community access.
NDIA will update prices on at least an annual basis, effective 1 July each year, taking account of market trends, changes in costs and wage rates. Changes to prices will be published on this website. Each updated price list will include the date it was published to help providers ensure that they are using the most up-to-date version.
NDIS Price Reviews - Personal Care and Community Participation
The NDIA is currently reviewing a number of supports and services across personal care and community participation. This is a targeted set of reviews, rather than a complete review of NDIS prices for personal care and community participation. The reviews will involve stakeholder consultation and include opportunities for feedback from any interested parties. Learn more about the NDIS Price Reviews.
NDIA Price Guide 1 August 2015
Please direct any queries to your local trial site Engagement personnel or the NDIA provider support team: email@example.com
For plans approved from 1 August 2015
The NDIA Price Guide accompanies the release of a revised participant plan format. The new NDIA plan format aligns funded supports to participant goals and outcomes.
All assistive technology has been separated into a separate Price Guide, NDIA Price Guide for Assistive Technology.
The NDIA Price Guide is significantly different from the Catalogue of Supports (Support Clusters and Pricing document) that preceded it. The range of services that can be delivered to participants, as a minimum, remains the same, provided they are related to the participant’s disability, achievement of outcomes and ultimately their goals. The new Price Guide reinforces the concept that these services are not constrained by rigid definitions of a support item as listed in a “catalogue”.
The NDIA Price Guide applies to the delivery of supports to participants whose plans were finalised from 1 August 2015.
Participants with plans approved before 1 August will continue to have the cost of their supports claimed as described in the NDIA “Support Clusters and Associated Pricing” document.
- For supports delivered from 1 August, 2015, (against a plan approved before 1 August, 2015) the support clusters and pricing document (effective 1 August, 2015) should be used
- For supports delivered before 1 August, 2015, (against a plan approved before 1 August, 2015) the relevant supports clusters and pricing document (corresponding to the date of service delivery) should be used.
Latest price increase
Under the arrangements that come in place from 1 August 2015, the NDIA is increasing the transition period for personal support and community participation by increasing the current pricing by 1.9% for all states bringing forward the December Equal Remuneration Order (ERO) increase.
On top of this 1.9% increase, the NDIA will apply the annual indexation of 2.3% to prices in New South Wales, Tasmania and Victoria for personal support and community participation to help bring the current transition prices in line with those already established in Western Australia, South Australia and Northern Territory.
All other services subject to indexation, outside of personal support and community participation, will be indexed by 2.3%.
Find out more on the Pricing and catalogue changes from 1 August 2015 page.
Principles in relation to pricing
The National Disability Insurance Scheme Act 2013 states that a funded support must represent “value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support” (Section 34 (c)).
All supports funded by the NDIS are expected to assist the participant to attain their goals. When a participant’s plan is reviewed, the planner will consider whether there is evidence that a support has helped the participant to achieve measurable outcomes. Additional funding for continued supports will not be provided by the NDIS if there is no evidence that the support is helping to achieve these outcomes.
The NDIA sets the value for funded supports in participant packages. At present it also limits the price a provider may charge to that value. The NDIA will continue striving to increase flexibility for participants by encouraging vibrant and responsive markets for disability supports. The more the market for disability supports matures, the more choice participants will have over how they spend their individualised budget, consistent with the vision of the Productivity Commission.
The NDIA has set these support item prices believing they are similar to prices of equivalent supports in comparable schemes existing in trial site markets. This ensures that the NDIA does not compete with other purchasers, avoiding inadvertent market disruption. However, concerns have been raised by the NDS over hourly rates for two of the highest-volume supports – assistance with self-care activities and assistance to access the community. NDS is concerned that pricing support below the real cost of delivery will reduce choice of the available providers for participants and lower service quality.
The NDIA and NDS agreed to a six-week joint project to examine these concerns and recommend solutions, forming the Pricing Joint Working Group.
The Final Report of the Pricing Working Group is now available.
The NDIA has also released the methodology for developing the efficient price of two of the highest volume supports – assistance with self-care and community participation.
NDIA held a webinar about the 2014 price changes and you can view 13 video segments of questions and answers.
Most items are GST exempt, as per Australian Tax Office information about GST and NDIS and the application of section 38-38 of the GST Act. For a small number of items, where GST is applicable (for example delivery fees and taxi fares) the price is inclusive of GST.
Provider travel funding information
As part of the changes introduced with the new prices for assistance with self-care activities and assistance to access the community released at the end of June 2014, provider travel to deliver these services has been simplified and clarified. This is the result of the joint working group between NDIA and National Disability Services (NDS), the peak body for not-for-profit providers. Read about provider travel funding.