Understanding the Price Guide 

The NDIA released an NDIS Price Guide and Support Catalogue 2020‒21 that is in effect from 1 July 2020.

We will index participant plans from 1 July 2020, and this will show up in your plan budget from 11 July 2020.

This information explains some of the pricing changes that will happen from July 2020  and how those changes might affect you, your family and your carers.

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.

Pricing updates from 1 July 2020

Cancellation rules

What is the change?

From 1 July 2020, you will be charged 100 per cent of the agreed support price if you do not attend your service or cancel a service at short notice.

The NDIA temporarily increased the cancellation rate from 90 per cent to 100 per cent in response to the COVID-19 pandemic. This change will be permanent from 1 July 2020.

From 1 July 2020, the definition of short notice cancellations returns to two business days for most supports.

How does it affect me?

Cancellation charges of 100 per cent will apply if you do not attend your service or support booking, or if you cancel at short notice.

Short notice cancellations are up to 10 business days due to the COVID-19 pandemic until 30 June 2020. From 1 July 2020, two business days' notice is required.

You should read the service agreement you have with your provider as it may have more information about cancellations.

Provider travel

What is the change?

Effective 1 July 2020, providers can charge for travel costs when delivering services and supports to participants.

How does it affect me?

This improvement encourages providers to increase their service reach to support more participants. 

Your provider should speak with you before charging for non-labour travel costs.

Plan management

What is the change?

Plan managers can now charge you for travel and non-face-to-face supports for a support item. The NDIS Price Guide 2020‒21 has details about line items.

How does it affect me?

Your provider can charge you for delivering non-face-to-face supports. Examples of some non-face-to-face activities include personalised resources, explaining budgets over the phone and creating training videos specific to your needs.

Your provider should speak with you before charging for travel and non-face-to-face supports.

Establishment fees

What is the change?

Establishment fees will change, and more providers will be able to claim establishment fees. 

From 1 July 2020, establishment fees will now be calculated at up to ten times the hourly weekday daytime price limit for a standard/level 1 disability support worker. Previously, an establishment fee was based on a flat fee structure of between $250-500.

Providers in the following registration groups will be able to start charging the establishment fee:

  • 0104 High Intensity Daily Personal Activities
  • 0125 Participation in community, social and civic activities
  • 0136 Group and Centre Based Activities.

In addition to the above registration groups, 0107 Daily Personal Activities will continue to be able to charge establishment fees. 

How does it affect me?

If you begin a new agreement with a new provider, the provider can charge an establishment fee. The fee is to assist with one-time costs such as assessing your needs and setting up service bookings. 

A provider cannot charge you an establishment fee more than once across each of your plans.

You may be charged more than once for the establishment fee if you have more than one provider who is eligible to charge the fee.

Group-based supports

What is the change?

From 1 July 2020, some providers will charge differently for group-based supports and claim for your share of the time you spend with a group and with individuals of that group. 

From 1 July, providers will have the opportunity to use either the new streamlined pricing arrangements for group-based supports or continue to use the 2019‒20 arrangements.

Providers and participants have until 30 June 2021 to transition to the new pricing arrangements for group-based supports.

The new arrangements introduced for 2020‒21 remove the worker to participant ratio and instead allow providers to claim against the appropriate 1:1 support line item. This means providers will be able to accurately record the time spent with a group and among the members of that group. Providers can also claim for non-face-to-face supports rather than having an allowance for non-face-to-face supports built into the price limit.

How does it affect me?

This means you may be charged a slightly different way for your share of supports in a group. Some claims may still be made on a worker to participant ratio.

Talk to your provider about group rates and their approach to use either the new streamlined pricing arrangements for group-based supports or continue to use the 2019‒20 arrangements.

Capital centre costs

What is the change?

From 1 July 2020, some providers delivering group-based supports in a centre may be able to claim an allowance for each participant in addition to the cost of the support worker. This is not an extra charge, as it used to be built into the price limit for centre-based supports.

Providers have until 30 June 2021 to use this new cost model for group-based supports, so some providers may charge this and some may not.

How does it affect me?

This means when you join in activities in a centre, you may be charged for your fair share of costs to help maintain the building. 

Programs of supports

What is the change?

  • The NDIA is introducing safeguards in the programs of support arrangements to help improve access to a variety of programs.
  • Providers can enter into service agreements with you for group supports for up to 12 weeks.
  • Participants can exit from the program of support with two weeks’ notice without cost 

How does it affect me?

You can now enter into a service agreement for group based supports to guarantee a longer program.

You can also leave the program of support at no cost, if you give two weeks’ notice, or less if you and the provider agree.

The NDIA will produce guidance material for participants and providers for programs of support.

Geographic classification

What is the change?

From 1 October 2020, the NDIA is moving from the 2015 Modified Monash Model (MMM) to the 2019 MMM for how it classifies remote and very remote locations.

The Price Guide has the full list of locations and how they are classified.

How does it affect me?

If you receive services in a location that has increased in classification, your plan budget will automatically increase to account for the additional charge.

If you receive services in a location that has decreased in classification, your plan budget will receive less funding in your next plan review due to the decreased costs of receiving supports.

Your provider should speak with you before making any changes to service bookings.

High intensity supports

What is the change?

The definitions the high intensity support levels 1, 2 and 3 in the NDIS Price Guide will change.

The definitions will clearly link the different price limits to skills and experience of the support worker, as set out in the Social, Community, Home Care and Disability Industry Award 2010 (SCHADS Award).

How does it affect me?

Your provider will find it easier to identify which level of support you require, and accurately charge you for the right price limit.

Time of day and day of week

What is the change?

The NDIA is making the time of day and day of the week definitions clearer.

How does it affect me?

By making the definition clearer, it will ensure you are charged for the correct time when a support is provided to you, and not on the shift of the worker.

Temporary Transformation Payment (TTP)

What is the change?

From 1 July 2020, the percentage of the TTP will decrease from 7.5 per cent to 6 per cent.

How does it affect me?

If you receive support for attendant care and community and centre based activities, your provider may charge you the TTP. 

If you are charged TTP, the rate will decrease to 6 per cent.

Before making any change to an existing service booking, providers and participants need to discuss and agree to any proposed changes to service bookings.

Psychosocial recovery coach

What is the change?

From 1 July 2020, a new support item called the psychosocial recovery coach will be available.

Psychosocial recovery coaches will provide support to people with psychosocial disability to live a full life. People will be supported to take more control of their lives and to manage the complex challenges of day to day living.

How does it affect me?

This is a new support so it may take some time for the support to be widely available.

If you are a participant with a psychosocial disability, you should speak with your LAC or Planner about if a psychosocial recovery coach is the right support for you.

Supported Independent Living

What is the change?

The current quoting and negotiation process will be replaced by a set of price limits for SIL supports.

The price limits for assistance with daily living supports has been updated in the 2020-21 NDIS Price Guide.

Providers should develop a roster of care to help the NDIA decide the type of supports to be included in your plan.

How does it affect me?

If you have an existing SIL quote, your existing plans will continue until the end of their 12 month term. After this, the new SIL price limit will apply.

You (or your nominee) will be directly asked by the NDIA to confirm if you have had the opportunity to see and provide input to the roster of care. 

If you need changes to your roster of care, a provider will need to give detailed information to support the changes.

Pricing updates in response to coronavirus (COVID-19)

What has changed?

The NDIA has made some temporary changes to ensure supports can continue to be delivered to participants during this time, including:

  • low cost assistive technology (AT) arrangements because many face to face services are being suspended, and capacity building supports and interpreting services are now being delivered online
  • assistive technology (AT) rental ability to meet your immediate needs when leaving hospital
  • supported independent living (SIL) arrangements if you are diagnosed with coronavirus (COVID-19)
  • introducing three new support coordination items under Core Supports to support plan flexibility

The following changes ended 30 June 2020:

  • a temporary 10 per cent increase to the price limit of some Core and Capacity Building supports
  • changes to the cancellation rules.

How does it affect me?

Low cost assistive technology (AT)

You can use existing NDIS funds to buy low cost AT such as fitness equipment and smart devices, when:

  • you have discussed with your provider the most appropriate low cost AT to meet your needs;
  • the item will be used as part of your funded NDIS supports like a program, therapy or requirement (for example physiotherapy or Auslan interpreting provided via video conferencing);
  • the provider has confirmed in writing that the item is necessary for your supports and services during current physical distancing requirements;
  • you provide documents to the NDIS confirming items are necessary;
  • it is the lowest specification that will maintain funded supports;
  • you do not already have the item, another suitable item or access to the item;
  • the item has not been funded by another service system (such as education or employment); and
  • the item or circumstance is not excluded (such as devices for entertainment).

Participants should not spend more than $750 on a smart device. 

Assistive technology rental when leaving hospital

If you are leaving hospital, you can immediately access the assistive technology you need to be safe at home or your first destination.

This applies for up to six months until your short, medium and long term assistive technology and home modification needs can be assessed and you have an updated plan in place.

Supported independent living (SIL) items if you are diagnosed with coronavirus (COVID-19)

If you are funded for supported independent living (SIL) and have been diagnosed with coronavirus (COVID-19), providers can claim additional costs to manage your care and support when you:

  • continue to reside in the your normal SIL accommodation
  • are admitted to hospital
  • are relocated to alternative housing for isolation purposes or while transitioning into or out of hospital.

This covers:

  • $300 for a one-off professional deep clean of your SIL residence
  • additional support of $1,200 a day, from the date your infection is confirmed until you are no longer infectious (usually up to 14 days). This is on top of the cost of your usual SIL supports and includes increased costs for staffing, equipment, laundering and more.

Three new support coordination items to support plan flexibility

Three new support coordination items were introduced under Core Supports, Assistance with Daily Life. The new item numbers allow you to use your funds more flexibly to access these supports from either your Core or Capacity Building budgets.

Temporary increase to price limits

The NDIA temporarily increased price limits by 10 per cent for some critical supports in recognition of additional costs to providers at this time. This temporary price increase applied to some supports delivered between 25 March and 30 June 2020. Participant plans are being automatically extended to ensure you continue to have access to funding.

Cancellations

Between 25 March and 30 June 2020, participants were required to give 10 business days’ notice (up from two days) for a cancellation if they want to avoid paying the full fee for a cancelled service.

Impact on your plan

The NDIA has made changes to make sure you have the funding you need to meet essential needs during the coronavirus (COVID-19) pandemic. 

This includes taking a flexible approach to amending plans and, where necessary, shifting capacity building funding to core supports funding. 

If we have been unable to undertake a plan review, on the day your current plan ends, it will be automatically extended by 365 days to make sure you have the funding you need.

For supports not included in a plan, special teams of planners are available to help make urgent changes to plans. Participants can phone 1800 800 110 for urgent assistance. 

For more information on any of the above items, refer to the coronavirus (COVID-19) FAQs for participants.

Participant transport

What has changed?

From March 2020, you can use your plan’s support funding to pay registered providers transport costs when they are transporting you to and from a number of community activities funded in your NDIS plan including employment and higher education.

While these are not price controlled, the NDIS Price Guide outlines reasonable levels of costs that providers can claim for. These include: 

  • up to $0.85 a kilometre for a vehicle that is not modified for accessibility
  • up to $2.40 a kilometre for a vehicle that is modified for accessibility or a bus
  • other forms of transport or associated costs up to the full amount, such as road tolls, parking, public transport fares

This does not allow for payment of fines or other similar costs.

How does it affect me?

You can now use your budget flexibly to pay registered providers for their transport costs when they are transporting you to and from a number of community activities, and selected capacity building activities where they are funded in your plan.

Providers can claim these costs through the myplace provider portal.

This means you can continue to access your community-based supports, employment supports and higher education supports because registered providers can claim transport costs.

Your provider should discuss with you and explain any transport costs such as reasonable vehicle running costs or other associated costs before you are charged and before service bookings are updated.

If you have chosen to receive a periodic payment for transport, then that payment continues.

If you are concerned that you don’t have enough funds in your plan to cover transport costs, you may request a plan review. 

What exactly are (and are not) “NDIS funded community activities”? 

The Activity-based transport items listed in the NDIS Price Guide and Support Catalogue include the following community-based activities :

  • Assistance with social and community participation
  • Improved living arrangements
  • Increased social and community participation
  • Finding and keeping a job
  • Improved relationships
  • Improved learning.

Can I use the funds for transport to go to doctor appointments?

Generally the answer is no, as medical appointments are usually personal activities, rather than a funded support within an NDIS plan.

Can I use the funds to go and see my friends?

No, this change is for selected capacity building supports and activity-based transports. 

Is this only for people who have service providers? What if we don’t have a service provider but want to use some of our core funding for transport?

This enables registered providers to submit payment requests to cover the transport costs they incur as part of transporting participants to and from community-based activities and selected capacity building supports. Participants funded for transport as a Core support can use their funding flexibly to book a transport provider.

Can I use my core funding to pay the difference between the taxi fare and my vouchers? Is that allowed?

Participants funded for transport as a Core support can use their funding flexibly to book a transport provider. Participants receiving transport funding as a periodic payment can also use those funds to pay the difference. 

What happens if my provider charges more than 85 cents a kilometre? 

While these items are not price-controlled, the Price Guide outlines the reasonable level of these non-labour costs which participants and providers can use to discuss and agree on charges. Providers cannot charge more than participants have agreed to pay. Participants have choice and control over how they spend their NDIS funds and which providers they choose to deliver their services.

Who should I contact to discuss these changes?

If you have any questions about the pricing changes 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
1 July 2020