Payments and billing

Direct claiming information

The following information should also be used for each support to successfully claim through the bulk payment request template:

Supported Independent Living (SIL) – Deep cleaning and additional support for SIL Participants who are required to self-isolate or quarantine

NDIS number – 430000011 (providers must use the same number for each direct payment claim)
Dates support delivered – from 7 February 2022 (see the bulk payment requests guide for accepted date formatting, including YYYY-MM-DD or DD-MM-YYYY).
Support number (see examples – all relevant support numbers are in the Addendum)
- support for self-isolating participants – i.e. ADD_SERVICES_SIL_NOT_REMOTE
- deep cleaning for participants – i.e. DEEP_CLEAN_SIL_NOT_REMOTE
- deep cleaning for support worker related COVID-19 diagnosis – i.e. DEEP_CLEAN_OTHER_NOT_REMOTE
Quantity
- support for self-isolating participants – 1 per day
- deep cleaning for participants – 1 per participant
- deep cleaning for support worker related COVID-19 diagnosis – 1 per participant
Unit price
- support for self-isolating participants – $1,200
- deep cleaning for participants – $300
- deep cleaning for support worker related COVID-19 diagnosis – $300
Claim reference number – Participant’s NDIS number number and date of service (YYYYMMDD format only) (for example: 12345678-20220228).

Enabling COVID Vaccination for participants – on or before 31 March 2022

NDIS number – 430000011 (providers must use the same number for each direct payment claim)
Dates support delivered – must be between the specified dates in COVID Addendum (see the bulk payment requests guide for accepted date formatting, including YYYY-MM-DD or DD-MM-YYYY).
Support number – use i.e. ‘PARTICIPANT_VACCINE’
Quantity – use 1 for each participant vaccine
Unit price – up to $150
Claim reference number – Participant’s NDIS number.

Enabling COVID Vaccination for participants – from 1 April 2022 to 31 August 2022

NDIS number – 430000011 (providers must use the same number for each direct payment claim)
Dates support delivered – from 1 April to 31 August 2022 (YYYY-MM-DD or DD-MM-YYYY);
Support number – use i.e. ‘PARTICIPANT_VACCINATIONS’;
Quantity – use 1 per participant, per dose;
Unit price – $75
Claim reference number – Participant’s NDIS number and date of eligible doses administered between 1 April and 31 August 2022 (YYYYMMDD format only) (for example, for vaccinations administered on 1 April 2022 and 16 May 2022, the claim reference number would be 12345678_20220401-20220516.)

Rapid Antigen Testing for SIL Support Workers

NDIS number – 430000011 (providers must use the same number for each direct payment claim)
Dates support delivered
- rapid antigen test - must be between 23 December and 31 August 2022 (see the bulk payment requests guide for accepted date formatting, including YYYY-MM-DD or DD-MM-YYYY).
Support number
- rapid antigen test - use ‘RAPID_ANTIGEN_TEST_SIL’
Quantity – 1 per worker
Unit price
- rapid antigen test – $12.50
Claim reference number – Provider’s invoice number, the support worker’s initials and date of rapid antigen testing (up to 50 characters), for example: Inv123456_JB_01-04-2022.

Enabling Vaccination Boosters for Workers

NDIS number – 430000011 (providers must use the same number for each direct payment claim);
Dates support delivered – must be between 1 January 2022 and 30 June 2022 (see the bulk payment requests guide for accepted date formatting, including YYYY-MM-DD or DD-MM-YYYY).
Support number – use ‘BOOSTER_VACCINE_DSW’;
Quantity – 1 per worker;
Unit price – $100;
Claim reference number – Provider’s invoice number, the support worker’s initials and date of rapid antigen testing (up to 50 characters), for example: Inv123456_JB_01-04-2022.

Personal protective equipment (PPE)

From 1 January 2022:

the price limits for community participation supports and supports with activities of daily living, other than group core supports and Supported independent living (SIL), will increase by 0.25%
the price limits for group core supports and SIL will increase by 0.4%.

We have published an updated COVID Addendum that outlines the dates of these changes.

We have provided a higher increase for group core supports and SIL supports to account for the greater need for PPE when delivering these supports.

The increased price limits are a temporary measure. We continuously monitor public health orders and the need for this support.

We will make a decision on ongoing pricing arrangements for PPE costs as part of the Annual Pricing Review 2021–22.

From 1 January 2022, providers can no longer claim separately from participant plans for the cost of support worker PPE.

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

Vaccination supports

Providers in the following registration groups are eligible to claim for the COVID-19 participant vaccine enablement payment:

0115 Assistance with Daily Life Tasks in a Group or Shared Living Arrangement - from 26 May 2021
0104 High Intensity Daily Personal Activities – from 1 September 2021
0106 Assistance in Coordinating or Managing Life Stages, Transitions and Supports – from 1 September 2021
0107 Daily Personal Activities – from 1 September 2021
0125 Participation in Community, Social and Civic Activities – from 1 September 2021
0127 Management of Funding for Supports in Participants’ Plans – from 4 October 2021
0133 Specialised Supported Employment – from 17 January 2022
0136 Group and Centre Based Activities – from 17 January 2022.

Check the COVID Addendum for all COVID-19 support claiming conditions including dates and locations.

Providers in registration group 0132 Specialised Support Coordination are not eligible.

Participants with this support item in their plans are very likely to have received support for vaccination through other temporary supports.

Eligible providers must claim for COVID-19 booster vaccination support using the bulk payment request template in the myplace provider portal.

Providers need to include some specific information in the bulk payment request template to claim for this support:

NDIS number – 430000011 (providers must use the same number for each direct payment claim);
Dates support delivered – must be between 1 January 2022 and 30 June 2022 (YYYY-MM-DD or DD-MM-YYYY);
Support number – use ‘BOOSTER_VACCINE_DSW’;
Quantity – 1 per worker;
Unit price – $100;
Claim reference number – Provider’s invoice number, the support worker’s initials and date of booster vaccine (up to 50 characters), for example: Inv123456_JB_01-04-2022.

Refer to the COVID Addendum for full claiming conditions and eligibility.

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

No. There is no need for participant plan budgets to be adjusted as the temporary COVID-19 vaccination support payments don’t come from participant plan funds.

This support has been introduced to help providers cover the administrative costs of supporting disability support workers to receive a booster vaccination dose offsite, such as replacement staff and rostering.

Providers should only claim this payment if they actually incurred costs to support a disability support worker to attend a booster vaccination appointment. The NDIA expects that only one provider would incur a cost per disability support worker vaccination dose.

All provider claims are subject to the NDIS financial obligations and provider payment assurance processes.

We may ask providers to supply evidence to support their claims. Please keep records of booster vaccination dates, evidence of vaccinations, vaccination-related sick leave/paid leave, staff rosters etc.

All provider claims are subject to the NDIS financial obligations and provider payment assurance processes.

Currently, providers in the following registration groups are eligible to claim for the COVID-19 participant vaccine enablement payment:

0115 Assistance with Daily Life Tasks in a Group or Shared Living Arrangement - from 26 May 2021
0104 High Intensity Daily Personal Activities – from 1 September 2021
0106 Assistance in Coordinating or Managing Life Stages, Transitions and Supports – from 1 September 2021
0107 Daily Personal Activities – from 1 September 2021
0125 Participation in Community, Social and Civic Activities – from 1 September 2021
0127 Management of Funding for Supports in Participants’ Plans – from 4 October 2021
0133 Specialised Supported Employment – from 17 January 2022
0136 Group and Centre Based Activities – from 17 January 2022.

Check the COVID Addendum for all COVID-19 support claiming conditions including dates and locations.

Providers in registration group 0132 Specialised Support Coordination are not eligible.

Participants with this support item in their plans are very likely to have received support for vaccination through other temporary supports.

We have combined our COVID-19 vaccine and booster arrangements into a single participant vaccination support measure.

From 1 April 2022, eligible providers can claim $75 per participant per COVID-19 dosage when they support a participant to receive any COVID-19 vaccination (including primary vaccinations and any additional booster vaccinations).

Providers can claim for this support through the bulk payment request template.

Details about what to include in the direct claiming information are:

NDIS number – 430000011 (providers must use the same number for each direct payment claim)
Dates support delivered – from 1 April to 31 August 2022 (YYYY-MM-DD or DD-MM-YYYY);
Support number – use i.e. ‘PARTICIPANT_VACCINATIONS’;
Quantity – use 1 per participant, per dose;
Unit price – $75
Claim reference number – Participant’s NDIS number and date of eligible doses administered between 1 April and 31 August 2022 (YYYYMMDD format only) (for example, for vaccinations administered on 1 April 2022 and 16 May 2022, the claim reference number would be 12345678_20220401-20220516.)

The new participant vaccination support arrangement replaces the previous arrangement where eligible providers could claim:

$150 when supporting a participant to receive their first two COVID-19 vaccinations
$75 when supporting a participant to receive their COVID-19 booster.

If a provider helps a participant receive their first COVID-19 vaccination on or before 31 March 2022, and their second vaccination after 31 March 2022, the provider can claim $75 per participant per COVID-19 dose using the new claim code, ‘PARTICIPANT_VACCINATIONS’.

To ensure this claim is successful in the bulk payment request template, please use the following details:

NDIS number – 430000011 (providers must use the same number for each direct payment claim)
Dates support delivered – from 1 April to 31 August 2022 (YYYY-MM-DD or DD-MM-YYYY);
Support number – use i.e. ‘PARTICIPANT_VACCINATIONS’;
Quantity – use 1 per participant, per dose;
Unit price – $75
Claim reference number – Participant’s NDIS number and date of eliglble doses administered before 31 August 2022 (YYYYMMDD format only) (for example, for vaccinations administered on 31 March 2022 and 30 April 2022, the claim reference number would be 12345678_20220331-20220430.)

All provider claims are subject to the NDIS financial obligations and the Provider Payment Assurance Program.

Eligible NDIS providers must claim for COVID-19 vaccination supports using the bulk payment request template in the myplace provider portal.

Providers need to include some specific information in the bulk payment request template to claim for COVID-19 vaccination supports.

Specific details you will need to include are:

Dates support delivered – must be between the specified dates in the Addendum (YYYY-MM-DD or DD-MM-YYYY);

Eligible dates for participant COVID-19 vaccinations
- 26 May 2021 – 31 March 2022 for providers in registration groups 0115
- 1 September 2021 – 31 March 2022 for providers in registration groups 0104, 0106, 0107 and 0125
- 4 October 2021 – 31 March 2022 for providers in registration group 0127
- 17 January 2022 – 31 March 2022 for providers in registration groups 0133 and 0136
Eligible dates for participant COVID-19 booster shots:
- 8 November 2021 – 31 March 2022 for providers in registration groups 0115, 0104, 0106, 0107, 0125 and 0127
- 17 January – 31 March 2022 for providers in registration groups 0133 and 0136:

Support number – use i.e. ‘PARTICIPANT_VACCINE’ or BOOSTER_VACCINE_PARTICIPANT

Quantity – use 1 for each participant vaccine or booster dose;

Unit price – up to $150 for primary vaccinations or up to $75 for a booster vaccine;

Claim reference number – Participant’s NDIS number.

COVID-19 vaccination payments can be included with other NDIS payment requests lodged using the bulk payment request template.

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.

Advice regarding participant consent is available through the Australian Department of Health website .

Vaccinations are voluntary. All Australians must give informed consent before having the COVID-19 vaccine.

When a person has a substitute decision maker, then the provider will need to arrange for consent as required in the jurisdiction the person lives in. This can vary across states and territories. This would be similar to what a provider would do with a flu vaccination or other health care arrangements. The vaccination team needs to know the person (or their authorised substitute decision maker) has consented to having the vaccination.

Some vaccination clinics have asked for a copy of consent for their records.

More information including a consent form is available through the Australian Department of Health website .

Supported Independent Living (SIL)

The following support measures are available to SIL providers:

a $75 participant vaccination enablement payment
Direct claiming for cleaning services: a one-off professional deep cleaning service
Direct claiming for higher intensity supports: including staffing increase, personal protective equipment, professional laundering and any ancillary expenses required by eligible participants.
National clinical first response service and participant contingent care panel for SIL providers - until 30 June 2022
Rapid antigen test (RAT) supports: Between 23 December 2021 and 31 August 2022, eligible SIL providers can claim for a RAT when a support worker is required to undergo COVID-19 testing to deliver supports, based on state or territory public health recommendations or requirements.

Between 23 December 2021 and 31 August 2022, eligible SIL providers can claim $12.50 for a rapid antigen test (RAT) when a support worker is required to undergo COVID-19 testing to deliver supports, based on state or territory public health authority recommendations or requirements.

Providers have 28 calendar days after 31 August 2022 to claim for supports that were delivered between 23 December 2021 and 31 August 2022.

Providers need to include some specific information in the bulk payment request template to claim for this support:

NDIS number – 430000011 (providers must use the same number for each direct payment claim);
Dates support delivered – must be between 23 December 2021 and 31 August 2022 (YYYY-MM-DD or DD-MM-YYYY);
Support number – use ‘RAPID_ANTIGEN_TEST_SIL;
Quantity – 1 per worker;
Unit price – $12.50;
Claim reference number – Provider’s invoice number, the support worker’s initials and date of rapid antigen testing (up to 50 characters), for example: Inv123456_JB_01-04-2022.

Providers should use the details of one participant in the household to claim the RAT supports.

Providers can claim $12.50 per RAT directly from the NDIS – it does not affect funding in participant plans.

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.

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 due to the impact of public health orders or if their circumstances have changed, they can contact us.

From 7 February 2022, providers can claim for the following supports directly from the NDIA if a participant is required to isolate or quarantine under federal or state/territory government COVID-19 policies.

The 2 supports are:

one-off cleaning services
additional supports if a participant is required to self-isolate.

Additional SIL supports delivered between 11 January and before 7 February can be claimed through the direct claiming process using the bulk payment request template.

Providers should use a claim date of 7 February to ensure a successful claim.

Direct claiming for additional SIL supports that include a date before 7 February will not be processed.

Providers should keep accurate records to support this claim, in accordance with the provider payment assurance process.

Cleaning services (delivered before 7 February) and additional SIL supports (delivered before 11 January) can only be claimed from a participant’s plan.

Claims for all supports delivered from 7 February 2022 onwards can only be claimed directly from the NDIA using the bulk payment request template and will not come from a participant’s plan.

Providers need to include some specific information in the bulk payment request template to claim for this support directly from the NDIA:

NDIS number – 430000011 (providers must use the same number for each direct payment claim);
Dates support delivered – from 7 February 2022 (YYYY-MM-DD or DD-MM-YYYY);
Support number – use i.e. ‘DEEP_CLEAN_SIL_NOT_REMOTE’ or ‘ADD_SERVICES_SIL_NOT_REMOTE;
Quantity – 1 per day;
Unit price – the price limit detailed in the COVID Addendum
Claim reference number – Participant’s NDIS number and date of service (YYYYMMDD format only) (for example: 12345678-20220228).

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

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.

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

Payment claims for all cleaning services and additional SIL supports must contain a claim reference of:

the participant’s NDIS number (please do not use the NDIS number 430000011) and
the date of service (in YYYYMMDD format only).

For example, the claim reference number for a support delivered on 28 February 2022 would be ‘12345678-20220228’.

Claims submitted without this claim reference may be in breach of invoicing requirements as part of Provider Payment Assurance Program obligations.

Correct payments details for deep cleaning and additional SIL supports include:

NDIS number – 430000011 (providers must use the same number for each direct payment claim)
Dates support delivered – from 7 February 2022 (see the bulk payment requests guide for accepted date formatting, including YYYY-MM-DD or DD-MM-YYYY).
Support number:
- support for self-isolating participants – i.e. ADD_SERVICES_SIL_NOT_REMOTE
- deep cleaning for participants – i.e. DEEP_CLEAN_SIL_NOT_REMOTE
- deep cleaning for support worker related COVID-19 diagnosis – i.e. DEEP_CLEAN_OTHER_NOT_REMOTE
Quantity
- support for self-isolating participants – 1 per day
- deep cleaning for participants – 1 per participant
- deep cleaning for support worker related COVID-19 diagnosis – 1 per participant
Unit price
- support for self-isolating participants – $1,200
- deep cleaning for participants – $300
- deep cleaning for support worker related COVID-19 diagnosis – $300
Claim reference number – Participant’s NDIS number and date of service (YYYYMMDD format only) (for example: 12345678-20220228).

Providers should ensure all details of the payment claim to ensure details are correct.

Yes, providers can claim cleaning services and additional supports for participants in SIL who are required to self-isolate or quarantine.

The two 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.

Additional SIL supports delivered between 11 January and before 7 February can be claimed through direct claiming from the NDIA.

To ensure a successful claim, providers need to use a date of 7 February 2022 in the bulk payment request template for additional SIL supports delivered between 11 January and before 7 February.

Additional SIL supports delivered before 11 January can only be claimed from a participant’s plan.

From 7 February 2022, additional SIL supports can be claimed directly from the NDIA through the bulk payment request template.

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.

From 7 February 2022, providers can directly claim for cleaning and additional SIL supports from the NDIA through the bulk payment request template.

Participant plans will not receive additional funds after this date for this temporary support.

If you are claiming for cleaning and additional SIL supports before 7 February 2022, you must receive the participant’s consent before claiming the temporary line item.

All claims for cleaning and additional SIL supports made after 7 February 2022 can be claimed directly from the NDIA through the bulk payment request template.

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.

Meal preparation and delivery

We made this support more flexible to help participants during COVID-19. Some flexibility will now continue so participants can change arrangements for a short time, without the need for a plan review.

We recently updated our guidelines on meal preparation .

This replaces the temporary arrangements for meal preparation and delivery which ended on 28 February 2022.

It means participants can change their arrangements for a limited time, without the need for a plan review.

Our guidelines make it clear about when funding for support for meal preparation is reasonable and necessary.

NDIS participants who usually have a support worker help them prepare meals at home or help with grocery shopping, can use these funds to pay for meal preparation and delivery support for a limited time.

This support can be claimed, with agreement from the participant, using the support item 01_023_0120_1_1: Assistance with the cost of preparation and delivery of meals.

NDIS funds cannot be used to buy food. The NDIS can cover the cost of preparing a meal and having it delivered to eligible participants.

If the meal provider does not separate labour costs from food costs in the invoice, you can pay for 70% of the total invoice from the participant’s plan.

You will need to let the participant know that the other 30% needs to be paid from their personal funds as it is for food which is a daily living expense. You can speak to the provider and ask them to separate their invoices in future.

More information is in our updated guidelines on meal preparation .

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.

Payments and billing

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