Pricing and payment

The National Disability Insurance Scheme Act 2013 states that a funded support must represent “value for money” in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support”.

Prices

Prices for supports included in participant plans are developed and published by the National Disability Insurance Agency (NDIA).

NDIA will update prices on at least an annual basis, effective 1 July each year, taking account of market trends, changes in costs and wage rates. Changes to prices will be published on this website. Each updated price list will include the date it was published to help providers ensure that they are using the most up-to-date version.

2016/2017 Price Guide for NDIS service providers – Beginning July 1 2016

NOTE: The Guide has been updated to include Specialist Disability Accommodation (SDA) supports, which will be part of the NDIS for the first time in 2016/17. SDA supports are in the ‘Home’ Support Category (previously ‘Home Modifications).

All Support Item Reference Numbers have been updated to include a formatting change. The change has replaced a 2-digit component of the Support Item Reference Numbers, which refers to Provider Registration Groups, with a 4 digit code. This change has been made for technical reasons, to support payment system functionality, and does not alter the prices, rules or other arrangements for any Support Line Items.

Both of these updates are reflected in new csv format files below that map old support codes with new support codes that are recognised in the NDIS payment system.

Summary and context documents:

The NDIA has published its 2016/17 Price Guide, which will take effect on 1 July 2016.

The decisions in the 2016/17 Price Guide have been informed by significant input from market stakeholders through regional forums, targeted workshops, individual discussions and responses to discussion papers. The NDIA would like to thank all those who have engaged in these consultations.

We recognise that the sector is undergoing significant change and appreciate the time taken to constructively contribute to our reviews and consultations. The new Price Guide incorporates a series of changes and additions designed to ensure that NDIS pricing is sustainable, to balance the need for participants to maximise choice and the value of their supports with allowing service providers to adapt and grow in the NDIS, and to provide for stability through Scheme transition. Consistent with the NDIA’s commitment to engagement and evidence-based decision making, the approach taken for this 2016/17 pricing is underpinned by stakeholder feedback, emerging insights from the recent price reviews and learnings from NDIS trial experience.

The 2016/17 Price Guide will include several updates and additions to NDIS pricing arrangements and claiming processes:

  • Incorporating a 3.9 % increase in prices applied for Personal Care and Community Participation supports in NSW, Victoria, Tasmania and Queensland. To support the move towards nationally consistent pricing, the prices for these supports will increase by 1.9% in WA, SA, the Northern Territory and the ACT. This means the base rate for these supports, delivered between Monday to Friday, increases from $41.18 to $42.79, with higher rates available for supports delivered out of hours and on the weekends, and higher rates also applicable for participants requiring high intensity supports.
  • A 2% increase in price levels for all other supports that are subject to growth in wage costs, to be applied nationally.
  • Service bookings are a new enhancement designed to provide greater clarity between participants and their chosen provider on service requirements, payment arrangements and timing of service delivery. Details of service booking arrangements are set out in the Price Guide.
  • New support options and pricing arrangements to incentivise participants to self-manage their plans or use an intermediary to manage and maximise the value of their plans.
  • Clarification of provisions for early childhood intervention services.
  • Inclusion of School Leaver Employment supports, which are part of the NDIA’s efforts to foster new and innovative employment support options for people with disability.
  • Increased price loadings to apply for the delivery of supports to participants in remote and very remote parts of Australia (18% in remote areas and 23% in very remote areas), and;
  • The introduction of Specialist Disability Accommodation (SDA) supports, incentivising developers to invest in new, innovative housing options for eligible

Improvements have also been made to the presentation of information in the Price Guide, to provide more clarity for participants and providers on the disability supports that the NDIA funds in plans, how they are funded, and to continue to promote the proactive service design and flexible use of these funds by participants.

This approach to pricing and associated arrangements is designed to help providers to transition to the new, open market environment of the NDIS, maximising choice for participants and providing incentives for participants and providers to co-develop new, innovative services and products.

Providers are also encouraged to familiarise themselves with the emerging NDIS market by viewing recently released Market Position Statements for VIC, NSW and QLD as well as recently released Quarterly data on the performance of the NDIS.

Material for Service Providers

Other information

 

Fact Sheets and Publications

Check the fact sheets about arrangements in each state and territory.

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