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:

  • 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
  • geographic classification changes from 1 October 2020.

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. This requires a system update is expected to occur from 11 July 2020.

Providers and participants must discuss and agree to any proposed changes. 

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) will reduce by 1.5 per cent, 7.5 per cent to 6 per cent, as previously announced.

Providers will have to inform the NDIA of their intent to claim TTP in 2020‒2021 before 1 July 2020 by responding to a direct email.

Providers eligible to claim TTP will be sent an email in early June 2020 and before 30 June, must select ‘opt in’ or ‘opt out’ of claiming TTP during the 2020–21 financial year.

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 participant supports. To be eligible to claim the TTP in the 2020–21 financial year, providers need to comply with the following requirements: 

  • 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 Agency-approved market 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.

Geographic classification—effective 1 October 2020

From 1 October 2020, the NDIA will be moving from the 2015 Modified Monash Model (MMM) to the 2019 MMM for classifying remote and very remote classifications.

The NDIA uses the MMM to determine a participant’s remoteness status, in particular for remote and very remote areas. This has an impact on whether providers can claim the higher price limits available for services delivered in remote and very remote areas. 

The MMM 2019 reflects the growth and changing demographics of locations across Australia. To determine the MMM classification of an area, visit the Australian Government’s ‘Health Workforce Locator’ .

From 1 October 2020, some locations will change in classification as part of the MMM 2019.

Six locations are changing from regional (MMM5) to remote (MMM6)

  • NSW: Dangar Island 
  • Qld: Coochiemudlo Island, Dunwich, Glenden, Karragarra Island and Lamb Island.

Three locations are changing from remote (MMM6) to very remote (MMM7)

  • SA: Penneshaw 
  • WA: Carnarvon and Kununurra. 

Five locations are changing from very remote (MMM7) to remote (MMM6)

  • NSW: Bourke, Cobar 
  • Qld: Injune 
  • WA: Broome
  • NT: Gunbalanya (Oenpelli).

Seven locations are changing from remote (MMM6) to regional (MMM5)

  • Vic: Hopetoun 
  • Qld: Cardwell, Duaringa, Hideaway Bay – Dingo Beach, Nebo 
  • WA: Green Head, Leeman 

Four locations are changing from very remote (MMM7) to regional (MMM5)

  • Qld: Magnetic Island (Arcadia Bay, Horseshoe Bay, Nelly Bay and Picnic Bay).

The following locations will no longer be classified as remote (MMM6) and, from 1 October 2020, will no longer be eligible for higher location-based loadings:

  • Vic: Hopetoun
  • Qld: Cardwell, Duaringa, Hideaway Bay – Dingo Beach, Nebo
  • WA: Green Head, Leeman.

Also from 1 October 2020, the NDIA will reclassify two additional areas as remote, which will be eligible for a 40 per cent loading on price limits:

  • NSW: Ravenswood and Warren.

To allow participants and providers time to understand these changes, these geographical changes will not apply until 1 October 2020.

This page current as of
26 June 2020
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