Price guides and pricing

NDIS Price Guide 2020-21

The NDIS Price Guide and Support Catalogue 2020‒21 reflects the Annual Price Review and indexed prices as a result of the Fair Work Commission Annual Wage Review 2019‒20.

Price Guide and Support Catalogue COVID normal update - 1 March 2021

The following ‘COVID normal’ changes to the Price Guide are effective from Monday 1 March 2021.

Please refer to the Coronavirus (COVID-19) Response section of the NDIS Price Guide 2020-21 and Price Guide Addendum for details.

Low cost assistive technology (AT) – available nationally ongoing

COVID-19 has changed the way a number of NDIS supports are delivered. The flexible approach to low cost AT currently remains in place.

Find out more on the Low cost AT for support continuity page.

Support coordination temporary line items – ends 31 March 2021

The temporary support measure which gave participants access to support coordination through a flexible line item in their Core supports budget will end on 31 March 2021.

Support coordination in Capacity Building supports budget will still be available for all participants who have a reasonable and necessary need for it.

The following temporary duplicated Support Catalogue line items will not be available after 31 March 2021:

01_790_0106_8_3 - Level 1: Support Connection
01_791_0106_8_3 - Level 2: Coordination Of Supports
01_794_0132_8_3 - Level 3: Specialist Support Coordination.

Personal protective equipment (PPE) for providers in restricted areas – price limit reduced

Providers in restricted areas who deliver essential services in certain Assistance with Daily Life support categories can claim PPE against a participant’s plan for:

up to $27 per worker, per participant, per day, for supports delivered in person
participants must agree to be charged
providers can only claim for costs that they have actually incurred.

A list of restricted areas and the dates they apply are in the NDIS Price Guide Addendum.

Personal protective equipment (PPE) for participants in restricted areas

Participants in restricted areas who receive 1 hour a day or more of face-to-face daily living support, can claim up to $50 per week from their Core budget, against the Disability-Related Health Consumables – Low Cost support item.

A list of restricted areas and the dates they apply are in the NDIS Price Guide Addendum.

Supported independent living (SIL) providers – extended nationally until 30 June 2021

Two support items - cleaning services and additional supports - are available for participants living in SIL arrangements who:

have been diagnosed with COVID-19
are required to self-isolate or quarantine
are in isolation or quarantine while waiting for the results of a COVID-19 test or because of measures taken by government or medical authorities in response to the COVID-19 pandemic.

Deep cleaning – extended nationally until 30 June 2021

Participants can access a one-time deep clean cost when a support worker who has visited their home has received a positive COVID-19 diagnosis.

Deactivated support line items

A number of legacy support line items have been deactivated to simplify the Support Catalogue. Replacement line items are listed in the Support Catalogue so that participants can continue to claims for these supports.

How pricing works

The NDIA sets price limits for some supports to ensure they provide value for money for participants.

Changes to prices are updated to respond to market trends and changes in costs and are generally identified through an Annual Price Review, with any new prices outlined in an updated price guide, effective 1 July each year.

The Pricing Reference Group helps guide NDIS price regulation activities and decisions.

Refer to the Annual price review page for the latest updates.

Providers can also read the NDIA's Market position statements and recently released quarterly data on the performance of the NDIS.

Understanding the Price Guide - for participants

Understanding the Price Guide explains the key changes in the Price Guide and Support Catalogue and how they might affect participants, their families and carers.

It’s important for participants to understand all of the prices they might be charged, so they can be confident of receiving value for money from their plan budget.

Other information

Please direct queries to your local NDIA Provider Engagement team or email the NDIA.

The Price Guide and Support Catalogue 2020‒21 published 29 June 2020 also reflect the end of some of the temporary arrangements introduced in response to the coronavirus (COVID-19) pandemic.

Other clarifications include:

Group-based supports

In response to feedback, providers have until 30 June 2021 to transition to the new pricing arrangements for group-based supports.

From 1 July 2020, 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.

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 can accurately apportion time spent with a group and among 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.

The current 2019‒20 arrangements will be retained in the NDIS Price Guide 2020‒21 until 30 June 2021 and allow for the support items covering the range of ratios to allow for one support worker to different numbers of participants and have allowances built into the price limits for non-face-to-face supports.

Evening support times and shift boundaries

The Price Guide 2020‒21 clarifies evening support times as any support to an individual participant that starts after 8.00pm and finishes at or before midnight on a single weekday, unless that support is a public holiday support or a night-time sleepover support.

The Price Guide also clarifies arrangements when a support crosses a shift boundary and the same worker delivers the entire support. The higher of the relevant price limits applies to the entire support and providers can claim against the relevant support item.

Establishment fees

From 1 July 2020, the changes to establishment fee rules mean that a provider can only claim an establishment fee once per participant across all plans.

Line item updates

The Price Guide and Support Catalogue 2020‒21 have been amended to include the following support items:

Self-Management Capacity Building (01_134_0117_8_1)
Skills Development and Training (09_009_0117_6_3)
Innovative Community Participation (09_008_0116_6_3).

The new look Price Guide aims to be clear and transparent about pricing arrangements and make it easier to find information for specific supports by including applicable line items and claiming rules within the one document.

In addition to the Price Guide updates outlined as part of the Annual Price Review, the Price Guide 2020‒21 also incorporates pricing details to support other significant initiatives from 1 July including:

Psychosocial recovery coaches—to offer added support to participants with a psychosocial disability.
- Six new line items introduced to support participants to achieve outcomes.
- For more information visit the mental health page
Individualised Living Options—two new line items, to give people with disability access to alternative living arrangements within the Assistance with Daily Living Support Category:
- Individualised Living Option – Exploration and Design
- Individualised Living Option – Support Model
  - More information will be provided in July including the funding bands that will used when making this determination.
  - Providers interested in further information about ILO can email the NDIA ILO Project Team at ILO@ndis.gov.au.
Supported Independent Living (SIL)—set price limits for SIL supports will replace the current quoting and negotiation process.
- The NDIA is conducting a review of SIL price controls and endorsed recommendations will be included in a Price Guide released later in 2020. Until this review is complete the price limits for assistance with daily living will apply to SIL supports.
- Existing plans containing agreed SIL quotes will continue until the end of their 12 month term, at which point the new SIL price limit will apply.
- A new Provider SIL Pack was published 30 June 2020.
Supports in Employment—to support increased employment opportunities for participants:
- Five new line items introduced so eligible providers can claim for different times of day and days of week to deliver supports in employment.
- Two new line items introduced to allow eligible providers to transport one or more participants to / from a community-based support and claim non-labour costs associated with provider travel
- Amending the unit of measurement for ‘Employment related assessment and counselling’ support item from ‘each’ to ‘per hour’
- Introducing new establishment fee rules for Supports in Employment
- For more information visit the Supports in Employment page.

The NDIS Price Guide was updated on 17 November with the following:

A final adjustment of the Equal Remuneration Order (ERO)

Effective 1 December 2020, price limits of 369 support items will increase due to the final ERO adjustment. Price limits for impacted support items will increase by between 1.5% and 2.7%.

For a list of impacted support items, please refer to ‘Price limits determined by the Cost Model’, located in the Disability Support Worker Cost Model 2020-21.

Clarifying programs of support for Early Childhood Intervention (ECI) supports.

Providers of capacity building ECI supports can enter into an agreement with a participant for programs of support. Programs of support for ECI can include group and one-to-one supports for participants.

Clarifying claiming for telehealth

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.

Increased price limits and new columns in the Support Catalogue

The Support Catalogue has been updated to reflect increased price limits of 369 support items as a result of the final ERO adjustment. There are also 5 new columns in the Support Catalogue to help providers identify if a support item is eligible for:

non-face-to-face support provision
provider travel
short notice cancellation
NDIA requested reports
irregular Supported Independent Living (SIL) options.