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.

A small number of changes have been made to the NDIS Price Guide and Support Catalogue 2019-20 which are effective 1 December 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.

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

Remote locations

What has changed?

To help increase the services available in remote and very remote locations, providers can charge a higher rate when delivering services in certain locations.

  • The remote location rate loading increased from 20 to 40 per cent.
  • The very remote location rate loading increased from 25 to 50 per cent.
  • Before providers can apply the remote and very remote loading to prices they charge, they must inform you and confirm your acceptance of the new price.
  • Some towns have been added to the list of locations that can charge the remote price limit.

How does it affect me?

  • Your provider will contact you if they propose to claim the additional remote loading.
  • Some plans for participants living in the new list of remote locations have not yet had their funds increased to include the remote loadings.
  • If your plan is affected, the NDIA will contact you to arrange a plan review, including booking an appointment. This will ensure you have the correct amount of funding to pay for the supports you need. 
  • If you live in a remote location, make sure your address details are correct in the myplace participant portal so that your plan funding includes the remote loading.

Introduction of Medium Term Accommodation

What has changed?

The NDIA has introduced a new support item Medium Term Accommodation (MTA). MTA is for NDIS participants who need transitional accommodation while they wait to move into their confirmed permanent home (for example at hospital discharge).

MTA consists of the accommodation component of care only which is then supported by the participant’s existing living costs and disability support arrangements.

Providing NDIS participants with access to medium term transitional housing aims to reduce the number of young people in aged care, minimise delays in hospital discharges and support participants transitioning from custodial settings into the community.

Providing NDIS participants with access to medium term transitional housing aims to reduce the number of young people in aged care, minimise delays in hospital discharges and support participants transitioning from custodial settings into the community.

How does it affect me?

If you are an NDIS participant and are waiting to move into your permanent home, you may be able to access MTA.

For more information about your housing options, please talk with your Local Area Coordinator or planner. Alternatively you can call 1800 800 110.

Participants in MTA continue to have access to their existing daily living and capacity building supports with them (e.g., assistance with self-care, disability support worker to assist with social participation). Alternatively, they may choose to purchase these kinds of supports from their medium term accommodation provider.

Price limit increases and name change to Short Term Accommodation and Assistance

What has changed?

The NDIA has increased price limits for Short Term Accommodation and Assistance across weekdays, weekends and public holidays and from 1:1 through to 1:4 support ratios, effective 1 December 2019. 

The changes better reflect sustainable cost levels for these supports. Any impact from the price limit increases is expected to be minimal as respite is an occasional care need only. Participant plans therefore will not be indexed as a result of the change. 

The NDIA has introduced the word ‘respite’ into the title and description of all Short Term Accommodation and Assistance line items. This has been abbreviated to ‘STA and Assistance (incl. respite)’ in the Support Catalogue and Provider Portal.  

How does it affect me?

Participants can purchase respite services as a short-term accommodation support to give family and/or carers a break from their caring responsibilities.

The NDIA recognises that it is important for family and carers to take time off to manage their own health and wellbeing. This change aims to ensure they are able to achieve this. 
 

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 arrange 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. 

Disability-related health 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
  • 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
20 January 2020