Annual price review 2020-21

Recommendations from the Annual Price Review to determine 2020‒21 price controls and market settings are reflected in changes to the NDIS Price Guide 2020–21, effective from 1 July 2020.

Visit Annual Price Review - consultation for information on the Review process and to download a copy of the Annual Price Review Report May 2020.

Key updates effective 1 July 2020 include:

  • geographic classification changes from 25 October 2020
  • changes to the Disability Support Worker Cost Model
  • Temporary Transformation Payment updates
  • clarifying definitions for high intensity support levels 1 to 3 and time of day and day of week
  • retaining the cancellation rule to claim 100 per cent
  • more providers eligible to charge establishment fees
  • group-based support changes including capital costs
  • plan managers are now eligible to claim provider travel and non-face-to-face supports
  • safeguards for programs of support
  • provider travel rule updates with new line items to claim non-labour costs

More information on each of these updates is outlined below with more detail within the NDIS Price Guide 2020‒21.

The NDIA will automatically index participant plans from 1 July.

Geographic classifications

From 25 October 2020, the NDIA is moving from the Modified Monash Model (MMM) 2015 to the MMM 2019 for classifying regional, remote and very remote locations.

This has an impact on pricing arrangements in some locations including whether providers can access the loadings for services delivered in remote and very remote areas. A 40% loading is available for a number of services in remote locations and a 50% loading in very remote locations.

The MMM 2019 reflects the growth and changing demographics of locations across Australia. For more information on MMM classifications, visit the Australian Government’s ‘Health Workforce Locator’ .

From 25 October 2020, the geographic classification of the following locations will change.

Fourteen locations will change from regional (MMM5) to remote (MMM6). These locations are eligible for a 40% loading:

  • NSW: Dangar Island, Ravenswood and Warren 
  • Vic: French Island
  • Qld: Bluff, Coochiemudlo Island, Dunwich, North and South Stradbroke Island, Glenden, Karragarra Island and Lamb Island
  • Tas: Adventure Bay, Simpsons Bay, South Bruny

Nine locations will change from remote (MMM6) to very remote (MMM7). These locations are eligible for a 50% loading:

  • Qld: Kooringal and Moreton Island
  • WA: Brockman, Carnarvon, Greys Plain, Kununurra, Morgantown, South Plantations
  • SA: Penneshaw 

Four locations will change from very remote (MMM7) to remote (MMM6). These locations are eligible for a 40% loading:

  • NSW: Bourke
  • Qld: Injune, Beilba, Mount Hutton

The following 26 locations will change from remote (MMM6) to regional (MMM5). These locations are no longer eligible for a remote loading:

  • NSW: Baradine
  • Vic: Beulah, Deddick Valley, Goongerah, Hopetoun, Yaapeet
  • Qld: Bogandilla, Boolburra, Braemeadows, Burra Burri, Cardwell, Hideaway Bay – Dingo Beach, Duaringa, Euramo, Goowarra, Macknade, Nebo
  • WA: Boorara Brook, Green Head, Horrocks, Leeman, Northcliffe, Watheroo 
  • SA: Mundulla West, Padthaway, Willalooka

One location will change from very remote (MMM7) to regional (MMM5). This location will no longer be eligible for the very remote loading:

  • Qld: Magnetic Island

Isolated towns modification

The NDIA modifies the MMM classification of some locations. Where a location is surrounded by remote or very remote areas then the NDIA classifies that location as a remote area for planning and pricing purposes. Refer to the ‘Regional, Remote and Very Remote Areas’ page of the Price Guide for a list of isolated town modifications. 

After the Annual Price Review announcement in June, the NDIA undertook additional modelling and adjusted some MMM classifications due to changes in coordinates and the volume of participants located in reclassified areas. Final classifications differs in some locations to those previously announced. 

Geographic classification impact on participant plans

Participants receiving services in a location that has increased in classification to remote (MMM6) or very remote (MMM7) will require an increase in their NDIS funding. The NDIA will contact participants directly to inform them if their NDIS funding is being increased.

Participants can request an early plan review if they are concerned about funds.

Participants who live in a location where remote or very remote loadings no longer apply may have their funds adjusted at their next plan review. Any adjustment to funding will align with the decrease in remote loading.

Changes to the Disability Support Worker Cost Model

Base price limits for core supports are determined by the application of the NDIS Disability Support Worker Cost Model, published in June 2019.

The model estimates the cost of delivering a billable hour of support through a variety of inputs and range of factors.

Informed by the Financial Benchmarking Survey, the Disability Support Worker Cost Model is being amended to better reflect the cost structures of efficient providers.

Interested stakeholders are encouraged to read the Annual Price Review Report May 2020 available on the Annual Price Review consultation page.

Temporary Transformation Payment updates 

From 1 July 2020, the Temporary Transformation Payment (TTP) reduced by 1.5 per cent, 7.5 per cent to 6 per cent, as previously announced.

Providers eligible to claim TTP are sent an email asking them to ‘opt in’ or ‘opt out’ of claiming TTP during the current financial year. Providers have to inform the NDIA of their intent to claim TTP.

From 1 July 2020, plan managers are required to inform the NDIA, when requested, which registered providers have claimed for a TTP support item.

Note: unregistered providers are not eligible to claim the TTP rates.

The TTP is available to providers of attendant care and community participation supports. To claim the TTP in the 2020–21 financial year, providers must comply with the following conditions: 

  • publish their service prices;
  • list their business contact details in the Provider Finder and ensure those details are kept up-to-date; and
  • participate annually in an NDIA-approved financial benchmarking survey.

A report with the results of the financial benchmarking survey conducted with providers claiming TTP in 2019‒2020 is available on the Annual Price Review consultation page.

Clarifying definitions

We have clarified a number of definitions in the NDIS Price Guide 2020–21.

Level 1 to 3 high intensity supports 

We are amending the definition of the high intensity support levels 1, 2 and 3 in the NDIS Price Guide 2020‒21. 

The definitions 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).

This makes it easier for providers and participants to identify which level of support is being provided and reduces confusion about which price limit applies.

Time of day, day of week

To make it easier for providers to accurately claim for the delivery of services, we are clarifying time of day and day of week definitions.

Providers will be able to claim based on when the support is provided to the participant, and not necessarily the shift of the worker used to deliver that support.

Cancellation rules

From 1 July 2020, the NDIA will retain the cancellation rule regarding claiming 100 per cent rather than 90 per cent, introduced in response to the COVID-19 pandemic.

This means providers can claim 100 per cent of the agreed support price for a cancellation at short notice.

This change has been made to cover the costs incurred by a provider if a participant has cancelled at short notice, or does not show up.

Establishment fees

More providers will be eligible to charge an establishment fee from 1 July 2020, to assist with one-off costs such as assessing a participant's needs, creating a service agreement with the participant and setting up service bookings within the NDIA system.

Before 1 July 2020 only providers registered for 0107 Daily Personal Activities could claim establishment fees and the fee was based on a flat fee structure.

Each provider can only claim an establishment fee once per participant across all plans.

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 will be able to accurately apportion 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.

The current 2019‒20 arrangements are retained in the Price Guide 2020‒21 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.

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

Capital centre costs 

From 1 July 2020 a number of new line items are available to claim capital centre costs. 

This is for providers delivering group-based supports in a centre under the new pricing arrangements for 2020‒21. Providers can claim a capital allowance for each participant, where appropriate, in addition to the cost of the support worker. This acknowledges capital costs such as asset maintenance and purpose built refurbishments to centres. A capital allowance was formerly within the price limit and will now be a separate line item.

Providers delivering Core Group-Based supports in the following registration categories, will be eligible:

  • High Intensity Daily Personal Activities (0104) when occurring for group activities
  • Specialised Supported Employment (0133)
  • Group and Centre Based Activities (0136).

Plan management 

Plan management providers will be able to claim for travel and non-face-to-face supports for some support items.

From 1 July 2020, plan managers are required to inform the NDIA, when requested, which registered providers have made a claim for a TTP support item.

Programs of support 

To help improve participant access to a variety of programs and give participants greater certainty that the program will operate fully throughout its term, the NDIA is introducing safeguards in the programs of support arrangements.

Providers will be allowed to enter into service agreements for providing programs of support, specifically group supports, as long as:

  • they are not longer than 12 weeks; and 
  • participants can exit from an agreed program of support without cost, subject to an agreed notice period that can be no longer than two weeks.

The NDIA will be establishing an evaluation of the effectiveness of programs of support and will produce guidance material for participants and providers before programs of support are introduced.

Provider travel 

Changes to the provider travel rules improves the way providers can recover their travel costs and encourages providers to increase their service reach to support participants.

Providers will be able to claim non-labour costs associated with provider travel when eligible, in line with activity-based transport arrangements.

Guidance on reasonable costs is provided in the Price Guide 2020–21 along with line items so that providers can select the most appropriate item to claim costs related to:

  • Non-labour costs associated with provider travel where the rules allow for a provider travel claim to be made
  • Activity-Based Transport to claim non-labour costs when transporting one or more participants to/from a community based support as part of the support.

While these items are not price-controlled, the NDIS Price Guide 2020–21 effective 1 July 2020 outlines the reasonable level of these non-labour costs that participants and providers can use to discuss and agree on charges. These include:

  • up to $0.85 a kilometre for a vehicle that is not modified for accessibility; and
  • other forms of transport or associated costs up to the full amount, such as road tolls or parking.
This page current as of
24 March 2021
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