Understanding the Price Guide 

The 2019-20 NDIS Price Guide and Support Catalogue went into effect 1 July. This information explains some of the pricing changes in the new Guide, and how those changes might affect you, your family and your carers.

Information was added to the Price Guide and the Support Catalogue in late September 2019 to support the implementation of disability-related health support changes agreed by the Commonwealth, State and Territory governments from 1 October 2019.

It’s important to understand all of the prices you might be charged by your providers, so you can be confident you are receiving value for money from your plan budget.

You should be aware of your rights and you must have the opportunity to discuss any changes to prices you pay providers.

What has changed?

The updated 2019-20 Price Guide and Support Catalogue makes it easier for you to understand the maximum prices you can be charged when receiving services under the NDIS.

Key changes introduced include:

  • The introduction of a Temporary Transformation Payment (TTP) for attendant care and community and centre-based activities
  • Updates to travel charges
  • Changes to policies for non-face-to-face services and cancellation billing
  • New disability-related health supports.

Below, we have explained what each change means and how it may affect you.

Temporary Transformation Payment

What has changed?

  • The Temporary Transformation Payment (TTP) is an additional cost providers can charge as they continue to transition to working under the NDIS.
  • The TTP is a charge on top of the base rate price limit for attendant care and community and centre-based activities.
  • Before providers can apply the TTP to prices they charge, they must inform you and confirm your acceptance of the new price.
  • You should also check your service agreement with your provider. 
  • If providers want to charge the TTP, they must:
    • publish their service prices on their website;
    • list and keep up-to-date their business contact details in the Provider Finder; and
    • participate annually in an Agency-approved market benchmarking survey.

How does it affect me?

  • All plans are built to support your reasonable and necessary needs.
  • Your provider will contact you if they propose to claim the additional TTP loading. 
  • TTP is set at 7.5 per cent of the support cost and will reduce by 1.5 per cent each year. This means TTP in 2020-21 will reduce to 6 per cent.
  • If you had an NDIS plan in place before 1 July 2019, an extra amount was added to your plan to take into account price changes implemented on 1 July, including TTP. 
  • If you have an NDIS plan put in place after 1 July 2019, your plan does not include funding specifically for TTP but your core budget is flexible and should be able to accommodate TTP.
  • The NDIA has a process that monitors utilisation of NDIS plans.
  • If this process identifies a plan with high utilisation that might run out of funds before the plan end date, the NDIA will contact the participant to initiate an unscheduled plan review so you will continue to receive your supports without disruption.
  • You can discuss your situation with LACs and Support Coordinators. They can help you meet your support needs within your budget. They can also discuss your options to request a plan review if necessary.

Non-face-to-face services  

What has changed?

  • Your provider may charge you for non-face-to-face activities.
  • These activities must be part of delivering a disability support item to you. One example is writing a progress report for your other support providers.
  • These activities do not include general business activities such as scheduling staff. 

How does it affect me?

  • Your provider should discuss and explain the non-face-to-face activities you are charged. 
  • Providers can only charge for non-face-to-face activities each time they deliver a service or support.
  • The charge needs to be reflective of the length of time it takes to deliver a non-face-to-face activity.
  • Non-face-to-face charges should never appear as an ongoing, standardised fee billed from your provider. 

Cancellation billing policy

What has changed?

  • The length of time needed to cancel a booking with providers and support coordinators has changed.
  • You will need to give the following notice for any cancellation:
    • Bookings for less than $1,000 or for eight hours or less should be cancelled 48 hours prior to your booking.
    • In all other cases, cancellations require five business days.

How does it affect me?

  • Cancellation charges will apply if you do not attend your service or support booking.
  • If you cancel outside the timeframes, you may be charged – even if you did not receive the support. 
  • You should understand the service agreement you have with your provider as it may contain information on cancellations.
  • You should discuss your preferred cancellation method with your provider and / or Support Coordinator. This could include notification by phone, SMS, email and/or via the myplace portal
  • If you have a high number of cancellations, your provider may discuss this with you. 

Provider Travel

What has changed?

  • The length of time that providers can charge you for travel has increased.  
  • If you reside within city areas you will now be charged up to 30 minutes per booking. 
  • If you reside within regional areas you will now be charged up to 60 minutes per booking.
  • Providers can also now charge travel for therapy assistants.
  • You can only be charged this fee once per booking unless it is a capacity-building support where providers may also charge for return travel.

How does it affect me?

  • Your provider should make you aware of these travel charges prior to delivering your supports.

Support Coordinators: inclusion for travel, cancellations and report writing

What has changed?

  • From 1 July 2019, Support Coordinators can charge for travel, cancellations and report writing.
  • This change clears up confusion. Until now, Support Coordinators were claiming these items incorrectly or absorbing the costs.

How does it affect me?

  • Your Support Coordinator may have a conversation with you about charging for these services when these services are required as part of delivering your supports. 

What has changed?

  • From 1 October 2019, additional disability-related health supports will be available to purchase using NDIS funding. 
  • The need for these disability-related health supports must directly relate to an NDIS participant’s significant and permanent functional impairment, and the support need is ongoing and best provided by the NDIS.
  • The typical types of support available can be grouped into eight ‘support type’ categories but this is not an exhaustive list. 
  • The NDIS will fund disability-related health supports for participants who need help to manage a range of conditions including continence, respiratory, nutrition, wound and pressure care, dysphagia, diabetes, podiatry and epilepsy.
  • The Commonwealth, State and Territory governments have committed to ensuring NDIS participants continue to receive disability-related health supports while the funding arrangements transfer to the NDIS.
  • Access to disability-related health supports will not stop during the transfer.

How does it affect me?

  • If you already have an NDIS plan, you have two options:
    • You can use your plan budget flexibly to purchase disability-related health supports (with the exception of Assistive Technology valued over $1500, this support can only be purchased once you have a plan review and funds are included in your plan).
    • You can continue to receive support from your State or Territory health service and inform them you are an NDIS participant. Your health service may seek your permission to share information with the NDIA or support you to ask for a plan review. This will help you get supports included in your plan quicker, allowing you to choose the providers you want to deliver these services.
  • The Price Guide includes specific items for Assistive Technology and Consumables associated with disability-related health supports.
  • Two sets of support codes have been developed:
    • One for when you have a specific disability-related health support included in your plan,
    • Another for when you are using your plan flexibly prior to them being included at your plan review.
      • When you are using your funds flexibly, providers will need to make service bookings at category level and then claim for payment for these items.
  • New support codes have been added to the Price Guide, which outlines the price limits for disability-related health supports when delivered by a:
    • Enrolled nurse,
    • Registered nurse, 
    • Clinical nurse, or
    • Nurse practitioner.

Who should I contact to discuss these changes?

  • If you have any questions about the changes to the Price Guide or specific policies you can:
    • talk to your providers, and/or 
    • discuss your situation with LACs and Support Coordinators. They can help you shop for supports, check prices and meet your support needs within your budget.
  • You have choice and control over how you spend your NDIS funds and which providers you choose to deliver their services.
  • It is up to you with the assistance of your family, carer or Support Coordinator to manage your supports within your allocated plan budget.

Remember

  • We want to ensure that quality supports and services are available to you and that those services meet your personal needs. 
  • Before a provider can charge you higher prices, they must first get your agreement before they can make a claim in the myplace portal.
  • If you think you can get a better service from your plan funds, you can discuss this with your provider or Support Coordinator, or you may even choose to find another provider instead.
  • If a provider wants to charge the TTP, they are required to publish their pricing information. This will promote greater transparency about the value for money for all NDIS participants.
This page current as of
21 October 2019