Payments and billing

personal protective equipment (PPE) for workers and participants in NSW and Victoria—including masks
cleaning services in Victoria
supporting participants in Victoria required to self-isolate or quarantine
extending eligibility of additional Supported Independent Living (SIL) supports for participants living in SIL in Victoria who are required to quarantine or self-isolate.

These arrangements are in place from 29 July 2020 until 30 September 2020. We will continue to monitor the situation and may implement further measures.

Providers and participants should discuss and agree on any pricing changes before they are applied.

In April 2020, two new support items were introduced for cleaning services and higher intensity support to support participants with Supported Independent Living arrangements during the coronavirus (COVID-19) pandemic.

In June 2020, the Minister for the NDIS, Stuart Robert, announced the outcome following a review of temporary measures introduced to support participants and disability providers during the pandemic.

As community restrictions ease in much of Australia, a number of the temporary measures ceased at 30 June 2020.

The following applies from 1 July 2020:

removal of temporary 10 per cent price loading on certain core and capacity building supports;
definition of cancellation returns to the previous policy levels; and
Medium Term Accommodation period returns to the original policy of 90 days (rolled back from 180 days).

From 1 October 2020, recovery of the coronavirus (COVID-19) advance payment to eligible registered providers will commence.

The Price Guide 2020-21 reflects these temporary arrangements.

The Government has announced a range of financial support measures for eligible businesses and sole traders affected by the Coronavirus (COVID-19) pandemic. More information is available at Services Australia .

The agency will be continuing to monitor spending to ensure funds are used appropriately. If you believe a participant or their representative are trying to take advantage of the current crisis, you can make a report to the fraud reporting hotline on 1800 650 717 or email fraudreporting@ndis.gov.au

The NDIA have a dedicated team to assist with compliance issues. It’s important to engage with us early; the agency will work with you to rectify the issue. Contact us on 1800 650 717 and we can help fix the mistake.

If a specific item is required to maintain supports, providers will need to supply written confirmation that the AT item is necessary and appropriate to support this purchase.

This written advice needs to be provided to the NDIA.

Self-managed participants or plan managers can upload the written advice from their provider direct to the participant record.

Providers can email it to enquiries@ndis.gov.au with the subject line ‘Low cost AT flexibility evidence’.

Providers and plan managers should also keep a copy of this written advice in case the Agency requests it at a later date.

The written advice (which can include an email) should include:

the participant’s name and NDIS number;
confirmation that delivery of current supports in the participant’s plan have been significantly hindered due to physical distancing restrictions (or other consequences of coronavirus (COVID-19)) and that alternative solutions to maintain delivery/outcome have been considered, but do not fully address the limitations;
how the device is necessary to maintain supports and services while maintaining physical distancing requirements;
the specific technologies and associated accessories required, and that these represent the lowest specification capable of delivering the benefit; and
that the participant is able to use the device/s to access the support.

Before the participant (or nominee) or provider makes a claim for the selected item, the participant should be sure that:

the participant does not already have the item, another suitable item or access to the item, and
a similar or suitable item has not been funded by another service system (such as education), and
the item or circumstances are not specifically excluded under this policy.

The criteria for participants to purchase an AT item with their existing NDIS funding is listed on the Assistive technology explained page.

Supported Independent Living (SIL)

We know participants living in SIL arrangements are at higher health risk during the coronavirus (COVID-19) pandemic, due to the SIL environment and other existing health conditions.

We are also aware that you may require additional funding to manage the care and support of residents who are diagnosed with coronavirus (COVID-19).

Two support items are available for participants residing in SIL properties and diagnosed with coronavirus (COVID-19).

Eligibility to access these items has been extended to participants living in SIL in Victoria who are required to quarantine or self-isolate. The arrangements for Victoria are in place from 29 July 2020 until 30 September 2020. We will continue to monitor the situation and may implement further measures.

The two 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 new line items are available in the NDIS Price Guide and Support Catalogue.

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 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 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 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.

The existing measures for SIL providers, announced on 27 April 2020, which apply where an NDIS participant in SIL is diagnosed with COVID-19, have now been extended to apply when a SIL participant in Victoria is required to self-isolate or quarantine.

This means SIL participants in Victoria can access a one-off professional deep clean and additional support as needed.

Currently this is limited to SIL providers delivering services in Victoria—to support them to meet public health guidelines.

We will continue to monitor the situation and may implement further measures.

The table is correct as this pricing applies nationally to eligible participants in SIL, currently:

diagnosed as coronavirus (COVID-19) positive
living in Victoria and required to quarantine or self-isolate.

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

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

When informed of a confirmed participant diagnosis, the NDIA will update the participants 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 Commission will inform the NDIA, and we will update the participants plan as quickly as possible to include additional funding against these new items as stated supports.

We have a dedicated team to manage coronavirus (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 coronavirus (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 from 30 April 2020.

For example, if a participant was diagnosed with coronavirus (COVID-19) on 20 April, the $300 one-off cleaning charge and $1,200 day rate can be claimed from 30 April until the participant tests negative.

Funding alternative SIL arrangements would depend on the individual situation.

Please contact your support coordinator, LAC or planner.

Advance payments

On 21 March 2020, the Minister for the NDIS announced a number of new measures to support participants and providers during the coronavirus (COVID-19) pandemic.

Included in these temporary measures was an advance payment to eligible registered providers to increase their immediate availability of funds.

Eligible registered NDIS providers received a one-off advance payment in the week commencing 30 March 2020. The advance payment represented approximately one-third of a provider’s payment claims processed via the NDIS myplace portal between December 2019 and February 2020.

This financial assistance has enabled NDIS providers to continue delivering supports during this time.

To cover the additional costs of service delivery for existing supports, a temporary 10 per cent coronavirus (COVID-19) loading was added to price limits for some Core and Capacity Building supports delivered between 25 March and 30 June 2020.

The cancellation rules also temporarily changed and three new support coordination items were added to the NDIS Price Guide under Core Supports to support plan flexibility.

From 1 July, many of the temporary coronavirus (COVID-19) measures ceased.

The advance payment is part of the NDIA’s plan to ensure providers can continue to deliver support to NDIS participants.

The one-off advance payment:

has been made to eligible NDIS providers by electronic funds transfer
is part of a proportionate and coordinated strategy in line with the whole of government response
represents a pre-payment for disability services which must be provided to NDIS participants to deliver reasonable and necessary supports approved in their plans.

Treasury and the Australian Taxation Office have confirmed that the advance payment made to providers are not included in the JobKeeper turnover test for NDIS providers.

The advance payment has been calculated as approximately one-third of a provider’s cumulative payment claims processed via the NDIS myplace portal between December 2019 and February 2020.

The advance payment does not include:

Plan managers
Unregistered providers
Providers who would have received an advance payment of less than $50.

The NDIA advised providers of their advance payment amount through a direct email sent 25 March 2020.

Please note: the amount received is specific to each provider and different from the amount other providers may receive.

NDIS registered providers were eligible if they received a payment paid through the myplace provider portal in February 2020 and at least one other payment in December 2019 or January 2020.

The advance payment will be recovered through an offset method, starting 1 October 2020.

Over six months, from October 2020 to March 2021, the NDIA will apply offsets against a provider’s monthly payment requests until 16.67 per cent of that provider’s total advance payment has been recovered each month.

For example, if a provider received an advance payment of $10,000, the NDIA will offset against all claims by that provider until a total of $1,666.70 (16.67% of $10,000) is reached per month. Any payment requests above $1,666.70 in the month will be processed and paid to the provider as per normal.

By offsetting the advance payment recovery over six months, repayment is smoothed over a longer period.

Existing claims and remittance processes continue without change.

Yes, if you did not opt out of receiving the advance payment, it will need to be repaid (in accordance with section 182 of the NDIS Act).

Recovery of the advance payment to providers via the offset recovery method will commence on 1 October 2020.

No. The NDIA will offset 16.67 per cent of all claims made by the provider until the total advance payment has been recovered.

Yes. The total amount offset by the NDIA will be equal to the advance payment you received.

Yes. If you would like to repay the advance payment via a lump sum, please email advance.payment1@ndis.gov.au.

The maximum offset in any month will be 16.67 per cent of your total advance payment. The maximum offset per month is capped at 16.67 per cent.

Therefore, if you have a high NDIS claiming month, the NDIA will not offset more than this agreed amount.

The advance payment amount was calculated on an average of payments received over the Dec 2019 – Feb 2020 period, taking into account any seasonal impacts over the holiday period.

Providers will not be required to take any action prior to the advance payment recovery via the offset method, and claiming via the provider portal will continue without change. Offsets will commence and will be applied automatically.

Please claim your full NDIS claims. Offsets will be calculated by the NDIA. Providers will not be required to take any action prior to the advance payment recovery, and claiming via the provider portal will continue without change.

In the event that the total advance payment is unable to be offset against future claims, you will be obliged to repay the balance of any outstanding advance payment to the NDIA within 30 days of the Agency issuing a demand on you.

Treasury and the Australian Taxation Office have confirmed that the advance payment made to providers are not included in the JobKeeper turnover test for NDIS providers.

The advance payment will not be treated as input taxed loans and they should be excluded from Goods and Services Tax (GST) turnover.

The GST turnover test only includes supplies that have or are likely to be made in the test period and the advance payments are for supplies that will be made in a later period.

We encourage you to seek advice from a taxation specialist.

Providers may be eligible to apply for Australian Government support for business in response to COVID-19. For more information, refer to the Department of Treasury website.

Refer to state and territory government websites for their latest response during the pandemic.

Some local government areas are also offering support to businesses at this time and providers can refer to their local government website .

The NDIA continues to closely monitor the situation and has not ruled out additional future measures.

Pricing increase

The temporary increase in price limits was to price controlled support items only. It did not apply to quotable supports.

Support items with price limits listed under the following categories, with some exclusions, had the 10 per cent increase applied to their price limits between 25 March and 30 June 2020:

Assistance with Daily Life (but not including Supported Independent Living)
Assistance with Social and Community Participation
Improved Health and Wellbeing (but not including personal training)
Improved Daily Living Skills.

The price limit increases were applied to the relevant support line items in the NDIS Price Guide 2019-20 from 25 March and 30 April which were effective until 30 June 2020.

Providers can claim up to the price limits under the existing line item numbers, subject to the service agreement with the participant.

Service bookings created at the category level will not need immediate action, however to apply the temporary price increase, the ‘Allocated Dollar’ amount should be updated.

Service bookings created at the line item level will need to be updated.

You can find more information about updating service bookings in response to pricing changes.

Plans should have sufficient funds to cover these costs without needing a plan review.

We proactively monitor participant plans to identify the need for an early plan review.

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 Price Guide and Support Catalogue.

Participant plans will not be indexed. The NDIA automatically extends plans that are due to expire, ensuring participants have the funding they need.

Providers should review and abide by the service agreements they currently have in place with participants, and should inform the participant before implementing any price increases.

At this time, NDIS funds cannot be used to pay family members to provide supports.

This is an unprecedented situation and it is understandable that some systems and processes are delayed. We encourage Plan Mangers to liaise with providers to make suitable arrangements.

These measures require changes to NDIA’s business systems by Services Australia .

Services Australia is progressing requests as fast as possible but unfortunately this does take time and there are many competing priorities due to the coronavirus (COVID-19).

NDIS participants continue to have choice and control over how they use the funded supports in their plan.

Providers and participants need to discuss and agree on any pricing arrangements and the impact on service fees.

The 10 per cent increase to price limits was added to price limits for certain supports delivered from 25 March to 30 June 2020 as part of a financial assistance package to assist registered providers to continue to deliver supports during the initial response to the coronavirus (COVID-19) pandemic.

Payments and billing

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