Annual Price Review

The NDIA sets price controls for certain NDIS supports to ensure a balance between NDIS participants obtaining reasonable value for money and enabling providers to operate within a market of adequate size, quality and return.

The Annual Price Review cycle to determine 2019‒20 prices is complete and the NDIA has released an updated NDIS Price Guide and Support Catalogue 2019–20, effective 1 July 2019. 
Key updates effective 1 July 2019 include:

  • general price increases and specific increases for therapists and attendant care and community participation
  • the introduction of a Temporary Transformation Payment (TTP)
  • increases to remote and very remote loadings
  • updates to travel, non face-to-face services and cancellation billing policies
  • updates to Assistive Technology and Home Modifications
  • outcomes from the WA Market and Therapy Reviews

Therapy and therapy assistants

The price limit for most therapy supports, including Early Childhood Early Intervention (ECEI), will increase from 1 July 2019.

Psychologists and physiotherapists will also see additional increases to price limits based on the location in which these supports are delivered.

Two support levels of therapy assistants are included in the NDIS Price Guide 2019–20, effective 1 July 2019. 

Providers can also claim for travel, cancellations and non-face-to-face time for therapy assistant activities.

For further information, visit the Therapy Review page.

Attendant care

Increases to base attendant care and community participation supports across standard and levels one, two and three of high intensity price limits are effective from 1 July 2019.

Funding in participant plans will be automatically adjusted to reflect the changes in the price limits for attendant care and community participation, effective from 1 July 2019, as part of the annual indexation of plans. Participants will not need to seek a plan review to access the additional funds.

For more information, refer to the NDIS Price Guide and Support Catalogue 2019–20, effective 1 July 2019.

Temporary Transformation Payment for Attendant Care and Community Participation supports

From 1 July 2019, providers of attendant care and community and centre based activities have access to a higher support price limit through a Temporary Transformation Payment (TTP). The TTP is a conditional loading to assist providers with any costs associated in transitioning to the NDIS.

In 2019–20, the TTP is set at 7.5 per cent on the relevant level 1 support item and will reduce by 1.5 per cent each year thereafter.

The TTP support item number is the support base number with the addition of the letter T. These support item numbers are outlined in the NDIS Support Catalogue 2019–20, effective 1 July 2019.

Providers will need to comply with the following requirements if they wish to claim the higher TTP price limits:

  • publish their service prices
  • list and keep up-to-date their business contact details in the Provider Finder
  • participate annually in an Agency-approved market benchmarking survey.

The TTP is similar to the previously introduced Temporary Support of Overheads but is of a higher value and is in place for a longer period. 

The TSO will be obsolete as of 1 July 2019 and providers are encouraged to adopt the higher valued TTP and conditions for claiming.

Providers choosing to take up the TTP should familiarise themselves with the full requirements of the TTP as outlined in the NDIS Price Guide 2019–20, effective 1 July 2019.

Clarity around billing arrangements

Non-face-to-face

From 1 July 2019, providers can claim for non-face-to-face direct care-related activities as hours of support against the relevant support item. 

Non-face–to-face activities are billable if:

  • the activities are part of delivering a disability support item to a participant such as writing a report about the client’s progress (rather than a general activity such as staff rostering)
  • the provider explains the activities to be billed to the participant
  • the proposed charges for the activities comply with the conditions set out in the NDIS Price Guide.

Billable non-face-to-face activities must relate specifically to the non-face-to-face services delivered to a particular participant, and do not include general administrative tasks.
The amount charged is based on the time spent delivering the non-face-to-face support each time.

  • For example: providers cannot simply adopt and apply a standard non face-to-face fee to all support items and/or a participant’s ongoing appointments. The charge needs to be reflective of what is delivered each time a support is provided.

Providers must negotiate and seek agreement with their participants before charging for non-face-to-face activities. Once an agreement is reached, providers will need to update the appropriate service bookings to reflect the changes agreed. Refer to the NDIS Price Guide and Support Catalogue 2019–20, effective 1 July 2019, for more information.

Cancellations

There are updated cancellation rules, effective 1 July 2019.

A short notice cancellation (or no show) is now defined as when there is a failure to provide:

  • Two clear business days’ notice for a support or service which is eight hours or less in duration and less than $1,000
  • Five clear business days’ notice, in all other cases.

Providers are able to recover 90 per cent of the fee associated with the cancellation of a support activity, when these cancellation timelines are not met by the participant and subject to the terms of the service agreement with the participant.

When claiming a cancellation, providers should request a claim of 100 per cent of the negotiated price. The NDIS payment system will automatically calculate 90 per cent of the claimed amount.
There is no limit on the number of short notice cancellations (or no shows) that a provider can claim; however, providers do have a responsibility to the participant. If a participant has an unusual number of cancellations then the provider should seek to understand why these are occurring.

The NDIA will monitor claims for cancellations and may contact providers who have a participant with an unusual number of cancellations.

Provider travel

The length of time providers can claim for travel has changed, effective 1 July 2019.

If agreed by participants, providers can claim for travel up to 30 minutes per participant per day between appointments within city areas (MMM 1–3) and up to 60 minutes per participant per day in regional areas (MMM 4–5). This is an increase from 20 and 45 minutes, respectively. 

Providers delivering capacity-building supports are also able to claim time spent travelling from the last participant to their usual place of work. The maximum amount that can be claimed for return travel is 30 minutes within city areas and 60 minutes in regional areas.

Before providers can charge for travel, they must first discuss and get agreement on any changes with the participant. Once an agreement is reached, providers will need to update the relevant service bookings to reflect the changes agreed. 

The NDIA has made it easy to distinguish when and where travel is claimable by outlining this against each claimable support item number in the NDIS Support Catalogue 2019–20.

Refer to the NDIS Price Guide and Support Catalogue 2019–20, effective 1 July 2019 for details. 

Community and centre based supports

In March 2019, base rate increases were announced for Community Participation supports.

The price limits for Community and centre based supports have been modified to reflect the Temporary Transformation Payment (TTP) from 1 July 2019. 

Community and centre based supports include a non-face-to-face component in the price. Providers can therefore not make any additional or separate claims for non-face-to-face activities linked to this support.

Centre based rates still include a capital component, community based rates do not.

Support Coordination: inclusion for travel, cancellations and report writing 

From 1 July 2019, Support Coordinators will be able to claim for travel, cancellations and report writing.

The NDIA has made this change to ensure Support Coordinators are remunerated appropriately and to clear up any confusion. Until now, support coordinators were claiming these items incorrectly or absorbing the costs.

Before providers can charge a participant for these activities, they must first discuss and get agreement from the participant. Once an agreement is reached, providers will need to update the relevant service bookings to reflect the changes agreed.

Refer to the NDIS Price Guide and Support Catalogue 2019–20 for further details.

Remote and very remote

A key finding of the WA Market Review was the determination that the cost to deliver services to lower density populated areas is discouraging providers from delivering services to participants in these areas, in effect, reducing choice for participants.

This issue affects remote and very remote areas across Australia.

In response, the NDIA has increased the remote and very remote loadings on price limits from 20 per cent to 40 per cent, and from 25 per cent to 50 per cent respectively, effective 1 July 2019.
This increase proposes to support the ongoing delivery of support services right across Australia.

From 1 August 2019, the NDIA will be amending its geographic arrangements so that towns classified as ‘regional’ and completely surrounded by ‘remote’ or ‘very remote’ areas, will be classified as ‘remote’ areas for planning and pricing purposes. This primarily affects Kalgoorlie, WA.

Reclassifying these areas as remote aims to encourage more providers to deliver supports in these locations.

Refer to the NDIS Price Guide and Support Catalogue 2019–20 for details on the remote and very remote loadings and geographic arrangements.

Assistive Technology and Home Modification

The NDIA has introduced a number of changes to support line item numbers for assistive technology (AT), home modifications (HM) and to related benchmark pricing, effective 1 July 2019.

Section two of the Assistive Technology and Consumables Code Guide has been updated to address confusion and how to apply units of measure to low cost AT and repairs and maintenance.

For more information, visit the Pricing and Payments for AT providers page.

School Leaver Employment Supports (SLES)

Providers of school leaver employment supports are now able to claim NDIA report writing. 

Refer to the NDIS Price Guide and Support Catalogue 2019–20 for more information.

Independent Living Options

Three new interim support line items have been added to the NDIS Support Catalogue for “Individual Living Options” (ILOs). 

These line items cover:

  • Individual Living Option—co-residency
  • Individual Living Option—host arrangement
  • Individual Living Option—rostered support

These items have been included in the NDIS Price Guide and Support Catalogue 2019-20, effective 1 July 2019 and are for planning purposes only.

Participant plans and service bookings

NDIS funding in existing participant plans has been adjusted to reflect indexation, the changes in the price limits for therapy, attendant care and community participation and the application of the Temporary Transformation Payment.

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

The NDIA will not be adjusting existing service bookings.

Before any changes can be made to existing service bookings, providers and participants need to discuss and agree on any proposed changes. Once agreed, providers are then required to update service bookings to reflect the agreed changes. 

For more information on how to amend service bookings, visit the Provider Toolkit (External website).
 

This page current as of
2 July 2019