Payments and billing

Telehealth

Support activities can be delivered online, including group support activities. These should be delivered using the relevant line item from the NDIS Pricing Arrangements and Price Limits.

Telehealth services can be offered to participants who are not, or cannot be, in the same physical location as the provider. Providers must ensure the standard of care delivered through telehealth is equal to face-to-face care.

A new ‘Telehealth’ claim field has been added to the myplace provider portal for supports delivered via telehealth.

From 1 July 2020 the price limit should be based on the location of the person delivering the support at the time of service delivery.

However, participants in remote or very remote locations can agree that price limits for remote and very remote locations can apply, if those activities are part of delivering a specific disability support item to that participant, the provider explains why they represent the best use of the participant’s funds, and the provider has the agreement of the participant in advance.

When providing a service using telehealth, with agreement from the participant, providers can use the support line items that they would normally use to provide face-to-face services.

A new ‘Telehealth’ claim field has been added to the myplace provider portal for supports delivered via telehealth.

From 1 July 2020 the price limit should be based on the location of the person delivering the support at the time of service delivery. However, participants in remote or very remote locations can agree that price limits for remote and very remote locations can apply, if those activities are part of delivering a specific disability support item to that participant, the provider explains why they represent the best use of the participant’s funds, and the provider has the agreement of the participant in advance.

The costs of training and upskilling staff are included in the base price limits for supports and are not considered billable non-face-to-face supports. More information is available in the NDIS Pricing Arrangements and Price Limits.

Registered providers must not add any other charge to the cost of the supports they provide.

Where price limits apply, prices charged to participants must not exceed the price limit prescribed for that support in the NDIS Pricing Arrangements and Price Limits.

Personal protective equipment (PPE)

Yes, this is currently available Australia-wide from 28 June 2021.

Providers can claim for support worker PPE from the participant’s plan, if delivering Assistance with Daily Life supports in any of these 3 registration groups:

0104 High Intensity Daily Personal Activities
0107 Daily Personal Activities
0115 Assistance with Daily Life Tasks in a Group or Shared Living Arrangement.

Participants must have agreed to being charged. Providers can only claim the costs that are actually incurred.

The PPE price limit is $27 per participant, per worker, per day.

In order to claim, providers must:

incur the expense and have provided the participant and support workers with PPE
have agreement from the participant to claim expenses from their plan

All provider claims are subject to the NDIA payment assurance process.

The NDIS COVID Addendum has a list of temporary supports by area/state and date.

Providers Australia-wide can claim PPE for support workers from 28 June 2021. This can be claimed from NDIS participant plans, with agreement from the participant.

This support is also available for providers to claim directly from the NDIA in the following states and territories:

New South Wales, from 26 June 2021
Victoria only, from 28 May 2021 to 30 June 2021.

The NDIA will continue to monitor current arrangements and advise any future changes.

Certain participants can use the Low Cost Disability-Related Health Consumables line item in their core supports budget to purchase their own PPE for use when receiving NDIS supports. See participant FAQs.

Direct claiming to the NDIA by providers for PPE for disability support workers is currently available in

New South Wales, from 26 June 2021
Victoria, from 28 May 2021 to 30 June 2021.

Providers have up to one month to bill the NDIA for costs incurred once this support is removed.

The NDIS COVID Addendum has a list of temporary supports by area/state and date.

Eligible registered providers must lodge invoices via the myplace provider portal:

Log in to the myplace provider portal
Select the ‘payment enquiry’ tile
Complete the details of the organisation representative
Select ‘single payment issue’
Submission on behalf of a participant – select ’no’
Drop down box – Request details – select subject ‘Payment Request Enquiry’
Do you have a service booking? No
Do you have a payment request number? No
Is there an amount involved in the enquiry? – select ’no’
In the ‘Feedback’ text box, put 'NSW/Vic PPE Invoice'
Associated documents – you must upload an invoice, not a CSV file
Select what you would like to do with this payment issue. Choose ‘Submit’.

To avoid a delay in payment, providers must:

put 'Vic NSW/PPE Invoice' in the ‘Feedback’ text box
lodge invoices either fortnightly or monthly
include the following information in the invoice:
- participant/s name and NDIS number/s
- supports start and end date
- one of the three support line items
- total number of ‘assistance with daily life’ support hours per participant

The NDIA will accept one invoice with multiple participant numbers.

All provider claims are subject to the NDIA payment assurance process.

For enquiries, please contact [email protected] or phone 1800 800 110.

Direct claiming to the NDIA by providers for PPE for disability support workers is currently available in:

New South Wales, from 26 June 2021
Victoria, from 28 May 2021 to 30 June 2021.

The NDIS COVID Addendum has a list of temporary supports by area/state and date.

Providers of plan or self-managed NDIS participants must lodge invoices by email to pro[email protected]

Invoices must include:

participant/s name and NDIS number/s
supports start and end date
value and details of claim (i.e. number of participants x number of hours x number of days)
any GST included
the category of assistance with daily life support delivered:
- 0104 High Intensity Daily Personal Activities
- 0107 Daily Personal Activities
- 0115 Assistance with Daily Life Tasks in a Group or Shared Living Arrangement
provider ABN, legal name and bank account details.

Note: bank accounts must be a business name. Personal bank accounts will not be accepted. Invoices without a valid ABN will not be processed.

Providers can invoice the NDIA for these supports on a fortnightly or monthly basis.

All provider claims are subject to the NDIA payment assurance process.

For enquiries, please contact [email protected] or phone 1800 800 110.

Supported Independent Living (SIL)

We have added a new temporary support for providers helping NDIS participants in SIL to access the COVID-19 vaccination. This support is effective from 26 May 2021.

SIL providers can claim up to $150 for each NDIS participant in SIL to attend an offsite location to receive their series of COVID-19 vaccinations.

The $150 pays for the SIL provider’s administration costs to arrange the offsite COVID-19 vaccination.

SIL providers can also claim the actual costs of delivering this support from participant plans, such as transport and support workers.

SIL providers can claim the $150 by invoicing the NDIA. The $150 is not claimed from the participant’s NDIS funds.

In order to claim this payment, SIL providers must ensure the participant is fully vaccinated (correct number of doses have been administered).

Two other support items are available nationally for participants residing in SIL properties and diagnosed with COVID-19.

Participants with SIL who are required to quarantine or self-isolate can also access these supports.

The 2 support items are:

Cleaning services: a one-off professional deep cleaning service of a residence of an eligible participant.
Additional supports: to allow for higher intensity support including staffing increase, personal protective equipment (PPE), professional laundering, and any ancillary expenses required by eligible participants.

The NDIS will not cover additional administrative costs, staff sick leave, medical costs associated with a hospital stay or everyday expenses.

Providers can continue to claim usual SIL costs for eligible participants in hospital or isolated in alternative accommodation. Alternative accommodation will also be claimable through the short term accommodation support item.

The temporary line items are available in the NDIS Pricing Arrangements and Price Limits.

From 25 October 2020, providers can use a new ‘irregular SIL supports’ claim field in the myplace provider portal when a SIL support is delivered in unexpected or unplanned circumstances. For example, when a participant cannot attend their day program due to illness or if a family stay has been cancelled. Details are in the NDIS Pricing Arrangements and Price Limits and the Provider SIL Pack.

If you have a participant residing in SIL who is diagnosed with COVID-19 you must immediately notify the NDIS Quality and Safeguards Commission .

The NDIS Commission will inform the NDIA, and we will update the participant’s plan as quickly as possible to include additional funding against these new items as stated supports.

When a SIL provider is required to organise alternative support due to the suspension of day programs or local government restrictions, providers can use the ‘irregular SIL supports’ claim field in the myplace provider portal when a SIL support is delivered in unexpected or unplanned circumstances.

Details are in the NDIS Pricing Arrangements and Price Limits and the Provider SIL Pack.

NDIA planners and local area coordinators monitor plan utilisation through our business system reporting process.

Where funding is being used at a higher rate than anticipated for the time the plan has been in place, NDIA planners and LACs will check in with participants to discuss their NDIS supports.

If participants have concerns about their plan funds because of the NSW Health advice or if their circumstances have changed, they can contact us.

SIL providers can submit a claim once the NDIS participant has received all required doses to become fully vaccinated against COVID-19.

Unless for reasons outside of the SIL provider’s control the participant can’t receive all required doses.

Registered providers supporting participants in SIL to access the COVID-19 vaccination offsite must submit invoices using the myplace provider portal.
All provider claims are subject to the NDIS financial obligations and NDIA payment assurance processes.

Log in to the myplace provider portal
Select the ‘payment enquiry’ tile
Complete the details of the organisation representative
Select ‘single payment issue’
Submission on behalf of a participant – select ’no’
Drop down box – Request details – select subject ‘payment request enquiry’
Do you have a service booking? – select ’no’
Do you have a payment request number? – select ’no’
Is there an amount involved in the enquiry? – select ’no’
In the ‘Feedback’ text box, type ‘Covid19 Vaccination Support Invoice’
Associated documents – you must upload an invoice, not a CSV file
Select what you would like to do with this payment issue – select ‘Submit’.

To avoid a delay in payment, providers must:

type ‘Covid19 Vaccination Support Invoice’ in the ‘Feedback’ text box
submit invoices within 28 days of the final vaccination appointment
include the following information in the invoice:
- participant/s name, NDIS number/s and date/s of birth
- this statement confirming the COVID-19 vaccination support has been delivered to the participant – ‘I confirm this claim for payment is correct and NDIS participants included have completed their series of COVID-19 vaccinations including all required doses’.

The NDIA will accept one invoice with multiple participant claims.

For enquiries, please contact [email protected] or phone 1800 800 110.

Providers for plan and self-managed participants with SIL can also invoice the NDIA for vaccination support:

Providers of plan or self-managed NDIS participants must submit invoices by email to [email protected]

Invoices must be submitted within 28 days of the final vaccination appointment and include:

participant/s name, NDIS number/s and date/s of birth
value of claim up to $150 and details of claim and number of participants
this statement confirming the COVID-19 vaccination support has been delivered to the participant – ‘I confirm this claim for payment is correct and NDIS participants included have completed their series of COVID-19 vaccinations including all required doses’
provider ABN, legal name and bank account details.

Note: bank accounts must be a business name. Personal bank accounts will not be accepted. Invoices without a valid ABN will not be processed.

For enquiries, please contact [email protected] or phone 1800 800 110.

Safe Work Australia has information for workplaces on COVID-safe passenger transport for taxi and ride sharing services .

Read the Department of Health’s transcript with advice about using public transport .

States and territories also have their own local travel advice.

You can continue to claim usual SIL costs while an eligible participant is in hospital or isolated in alternative accommodation.

Alternative accommodation will also be claimable through the short term accommodation support item.

If you have a participant residing in SIL who is diagnosed with COVID-19 you must immediately notify the NDIS Quality and Safeguards Commission.

The NDIS Commission will inform the NDIA, and we will update the participant’s plan as quickly as possible to include additional funding against these new items as stated supports.

You can claim from these items following the normal myplace portal processes.

Yes, cleaning services and additional supports for participants in SIL who are required to self-isolate or quarantine have been extended nationally until 30 June 2021.

The 2 support items are:

Cleaning services: a one-off professional deep cleaning of a residence per participant newly diagnosed with COVID-19, with one claim allowable per participant diagnosed with COVID-19.
Additional supports: to allow for higher intensity support including staffing increase, personal protective equipment (PPE), professional laundering, and any ancillary expenses directly related to the participant’s diagnosis.

You can claim $300 (or more in remote areas) to cover the cost of a one-off professional deep cleaning of a residence per participant newly diagnosed with COVID-19, with one claim allowable per participant diagnosed with COVID-19.

The ongoing cost of cleaning is covered in the daily amount.

NDIS participants have choice and control over how they use the funded supports in their plan. Providers should discuss with participants when there is an impact on service delivery, including any new arrangements and the impact on service fees.

The NDIS Pricing Arrangements and Price Limits states that providers can only charge participants for services delivered. It is the responsibility of the provider to ensure that the claim accurately reflects the supports delivered.

When informed of a confirmed participant diagnosis, the NDIA will update the participant's plan as quickly as possible to include additional funding against these new items as stated supports.

If you have a participant residing in SIL who is diagnosed you must immediately notify the NDIS Quality and Safeguards Commission .

The NDIS Commission will inform the NDIA, and we will update the participant's plan as quickly as possible to include additional funding against these new items as stated supports.

We have a dedicated team to manage COVID-19 related participant issues and will monitor these cases and the time it takes to update plans – if there are delays NDIA processes will be adjusted to improve this process.

Yes. However, when a participant has tested positive for COVID-19 and the NDIS Quality and Safeguards Commission has notified the NDIA, additional funding will be added to the participant’s plan to meet these costs.

These items can be claimed within the dates listed in the NDIS COVID Addendum.

Cancellations

Yes, if you have agreed to a cancellation fee in your service agreement.

You can also claim a cancellation fee if the participant has agreed to a cancellation fee as part of the program of support.

Cancellation fees must follow the conditions set out in the Pricing Arrangements and Price Limits:

A short notice cancellation can be claimed if a provider gets fewer than 2 business days’ notice and supports meets the following conditions:
- the support is less than 8 hours continuous in duration
- the agreed total price for the support is less than $1000.
A short notice cancellation requires 5 business days’ notice if:
- the agreed total price for the support is more than $1000
- the support is more than 8 hours duration.

Yes, in general, cancellation rules apply.

Regardless of the reason for cancellation, providers have often incurred costs on the basis of the service agreement prior to the support or service being cancelled.

Support coordination

Participants cannot use their Core budget to access support coordination from 1 April 2021. The 3 temporary support coordination line items in Core – Assistance with Daily Life category were deactivated on 1 April 2021.

Once the 3 line items have been deactivated, providers can only claim through the myplace provider portal using the bulk upload process.

If you provided support coordination to a participant against their Core budget prior to 1 April 2021, you can still claim up to 90 days after you delivered the service.

Providers will be unable to claim for support coordination services from a participant’s Core budget for support coordination delivered from 1 April 2021.

Service bookings will need to be updated to reflect this change. Participants and providers can both make edits to service bookings. There is more information on the Service bookings page.

Payments and billing

On this page:

Eligible registered providers must lodge invoices via the myplace provider portal: