In 2019, the NDIA introduced higher price limits for psychologists and physiotherapists in some states as a short-term measure to support market development
These premiums were not intended to be permanent and were to be reviewed once better data became available.
This year’s APR uses the most comprehensive set of external data to date by significantly expanding its data sources to include more than 10.5 million therapy transactions.
The NDIA used data gathered from four main sources – Medicare Benefits Schedule data (showing the full fee charged to patients, inclusive of both the government rebate and the patient’s co-payment), Private Health Insurance Claims Data from a major private health insurer, website listing data, and data from comparable government schemes.
Additionally, data shows the current NDIS price limits for physiotherapists, dieticians and podiatrists are higher than market rates for non-NDIS participants.
For example, the NDIS hourly price limit of $193.99 for Physiotherapy (or $224.62 in WA, SA, NT and TAS) is 22-29% above MBS and PHI benchmarks in eastern states, and up to 55-68% higher in WA, SA, NT, and TAS.
These comparative benchmarks are based on new, comprehensive billing datasets.
Aligning with broader market rates supports long-term sustainability and fairness for all participants. It ensures pricing decisions reflect actual market conditions.
