Pricing updates – announced 17 January 2022

Expansion of COVID-19 vaccination and booster enablement payments for providers

From 17 January 2022, providers in the following registration groups can claim the COVID vaccine and booster enablement payments if they support a participant to receive their vaccinations:

  • 0133 Specialised Supported Employment
  • 0136 Group and Centre Based Activities

Providers must claim for the payments within the following dates:

  • $150 COVID-19 vaccination payment by 31 March 2022
  • $75 COVID-19 booster vaccination payment by 30 June 2022.

Learn more about this temporary COVID-19 support:

Pricing updates – announced 13 January 2022

Expansion of temporary COVID-19 arrangements for meal preparation and delivery supports

From 12 January 2022 to 28 February 2022, NDIS participants with Core funding for support worker hours to help with meal preparation or shopping can now flexibly use their Core supports budget to pay an external provider for meal preparation and delivery, instead of paying a support worker to assist them with these tasks at home.

This arrangement is available across all states and territories.

Check the COVID Addendum for all COVID-19 support claiming conditions including the dates that this temporary supports are claimable.

Learn more about this temporary COVID-19 support:

Direct claiming for SIL cleaning services and additional SIL supports

From 7 February 2022, providers can directly claim for cleaning services and additional SIL supports for participants with additional needs because they are directed to self-isolate or quarantine from the relevant state/territory government or Australian Government due to COVID-19.

The 2 support items are:

  • up to $300 for one-off deep-cleaning services when they are required as a result of COVID-19
  • up to $1200 per participant, per day for additional supports if you are required to self-isolate as a result of COVID-19.

Information about how to directly claim for these supports through the bulk payment request template will be emailed directly to SIL providers.

Learn more about this temporary COVID-19 support:

Direct claiming for support worker-related COVID diagnosis

From 7 February 2022, if a support worker attends a participant’s home who later tests positive to COVID-19, providers can claim up to $300 per professional deep clean directly from the NDIA.

Any professional deep cleans that happen before 7 February 2022, can be paid for from the participant’s plan.

Instructions about how to claim this support will be emailed directly to providers and published on the NDIS website by 7 February 2022. Please continue to check the payments and billing page for updated advice.
 

Pricing updates – announced 23 December 2021

COVID-19 rapid antigen test eligibility and claiming for SIL participants and providers

Between 23 December 2021 and 31 January 2022, eligible participants and providers can directly claim up to $12.50 per rapid antigen test (RAT) from the NDIS.

RAT support can be claimed by:

  • SIL providers when a support worker is required to undergo COVID-19 testing to safely deliver supports to a participant, based on state and territory public health advice 
  • Participants in SIL when it is needed in order to safely live in their dwelling.

These temporary measures are available nationally from 23 December 2021 until 31 January 2021, subject to state and territory public health recommendations or requirements about testing.

Check the COVID Addendum for all COVID-19 support claiming conditions including dates and locations.

Learn more about this temporary COVID-19 support:

Pricing updates – announced 17 December 2021

Extending temporary COVID-19 pricing arrangements for COVID-19 vaccination enablement payment and booster

From 8 November 2021 to 30 June 2022 an additional $75 payment is available to eligible providers for each participant they support to get their COVID-19 vaccine booster.

Providers have until 31 March 2022 to support participants to get their primary course of COVID-19 vaccination. These arrangements originally ended 31 December 2021.

Check the COVID Addendum for all COVID-19 support claiming conditions including dates and locations.

Learn more about this temporary COVID-19 support on the Latest advice from the NDIS page.

Pricing updates – effective 1 January 2022

Temporary price limit increases and COVID-19 pricing arrangements for PPE

From 1 January 2022, the NDIA will apply:

  • a temporary increase of 0.25% to the price limits for community participation supports and supports with activities of daily living, other than group core supports and Supported independent living (SIL) 
  • a temporary increase of 0.4% to the price limits for group core supports and SIL.

We have provided a higher increase for group core supports and SIL supports to account for the greater need for PPE when delivering these supports. 

Providers will no longer claim separately from participant plans for the cost of support worker PPE.

Providers in New South Wales, Victoria and the Australian Capital Territory will no longer directly claim reimbursement from the NDIA for the cost of PPE.

The increased price limits are a temporary measure. We continuously monitor public health orders and the need for this support.

Pricing updates – effective 7 December 2021

Subscription services

From 7 December 2021, a new subscription services clause was added to the:

Providers can now claim for a supports using a subscription model of payment. 

Participants can purchase supports in advance through subscriptions. They can then use the support for the agreed subscription period. Subscriptions can be cancelled at any time.

Providers who enter subscription arrangements for services must meet the conditions outlined in the pricing arrangements.  

Subscription service example

An Auslan provider agrees to set up a subscription service with a participant.

The provider claims a prepayment of $240 per month as an all-inclusive cost for up to 2 hours of translation over the month.

The participant then has access to the provider’s online, on-demand service whenever they need during the month.

Unless the participant cancels the subscription, it will continue (and another payment claimed) for the following months.

For this arrangement to meet NDIA subscription service conditions, the provider must have a plain English service agreement with the participant.

The agreement must outline all of the terms and conditions for the subscription service. The provider cannot charge penalties or exit fees.

Pricing updates – effective 20 September 2021

Pricing Arrangements for Specialist Disability Accommodation 2021-22 have been updated in line with Disability Support Pension indexation:

  • fortnightly maximum reasonable rent contribution has increased by $5.69 for singles and $3.70 for members of a couple
  • fortnightly maximum board has increased by $6.95 for singles and $5.25 for members of a couple.

The 2021-22 SDA price calculator has been improved to calculate SDA amounts for shared living arrangements, making it easier for providers and SDA developers to estimate the likely revenue from an SDA property.

Corrections were made to the Pricing Arrangements for Specialist Disability Accommodation 2021-22 regarding the annual base price for legacy stock with and without on-site overnight assistance.

Pricing updates – effective 1 September 2021

Updated pricing documents can be downloaded from the Pricing arrangements page.

COVID-19 vaccination enablement payments 

From 1 September 2021 this payment was extended to support coordinators and providers who deliver supports in these registration groups:

  • High Intensity Daily Personal Activities
  • Assistance in Coordinating or Managing Life Stages, Transitions and Supports 
  • Daily Personal Activities
  • Participation in Community, Social and Civic Activities
  • Assistance with Daily Life Tasks in a Group or Shared Living Arrangement – effective 26 May 2021.

Learn more about this temporary COVID-19 support on the coronavirus latest advice page.
 

Pricing updates – effective 17 August 2021

COVID-19 supported independent living additional supports

From 17 August 2021, providers are entitled to claim up to $1200 per participant, per day for each participant living in the supported independent living (SIL) dwelling that meets the conditions set out in the COVID Addendum.

A participant living in a SIL arrangement is eligible for COVID-19 SIL additional support if they:

  • have been diagnosed with COVID-19 or are an identified COVID-19 close contact and 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 medial authorities in response to the COVID-19 pandemic.

Pricing updates – effective 1 July 2021

NDIS Pricing Arrangements and Price Limits 2021-22 - new price limits

Disability Support Worker Cost Model – effective 1 July 2021

The 2021-22 price limits for supports delivered by disability support workers in line with the NDIS Disability Support Worker Cost Model have been updated to allow for:

  • the increase in the super guarantee percentage from 9.5% to 10% 
  • the Fair Work Commission 2.5% increase in the minimum wage.

SDA indexation of price limits - effective 1 July 2021

The price limits for specialist disability accommodation (SDA) have been increased by 1.1%.

The refurbishment thresholds, which determine if an existing SDA dwelling can be treated as a new dwelling, have also been increased by 1.1%. 

SDA price limits have been updated to reflect movement in the Consumer Price Index

Temporary transformation payments - effective 1 July 2021

The Temporary Transformation Payment (TTP) loading has been reduced by 1.5%, from 6% to 4.5%, as planned.

Group-based supports – effective 1 July 2021

In response to sector feedback and the impact of COVID-19, the transitional pricing arrangements for group-based supports have been extended until 30 June 2022.

Extending the transition for a further 12 months allows providers more time to adopt a program of supports approach and agree the new arrangements with participants. This helps reduce the administrative burden of the new pricing arrangements. 

NDIS Pricing Arrangements and Price Limits 2021-22 - clarifications

We have clarified the following in the NDIS Pricing Arrangements and Price Limits (previously the NDIS Price Guide):

  • claiming for more than one worker or therapist
  • provider prepayments
  • Australian Business Numbers (ABN) a requirement for all plan-managed payment requests
  • calculating claims for support items with a ‘notional’ price limit.

Providers should not tell participants that their prices are set by the NDIA. Prices are negotiated and agreed by providers and participants. Registered providers cannot set prices higher than the price limits in the NDIS Pricing Arrangements and Price Limits

Claiming for more than one worker or therapist

If a participant needs assistance from more than 1 worker or therapist at the same time, providers can claim for everyone’s time. For example:

  • ‘Shadow shifts’ to allow new workers to be introduced to a participant who has complex individual support needs.
  • Supervision of, or specific training for, therapy assistants by the supervising therapist as part of the handover of the support delivery. 
  • A case conference between therapists about the specific support needs of a participant.

Provider prepayments

Providers can now claim prepayments for some supports without written approval from the NDIA. Prepayments are subject to the conditions listed in NDIS Pricing Arrangements and Price Limits.

Australian Business Numbers (ABN) and plan-managed payment requests

Plan managers must include the ABN of service providers when making payment requests for plan-managed services and supports.

Claiming for support items with no price limit

Where a support item does not have a price limit, providers can calculate claims using the ‘notional’ unit price listed in the NDIS Support Catalogue and the NDIS Assistive Technology, Home Modifications and Consumables Code Guide (Code Guide). 

To enable consistent claiming across a number of supports, where a support has a notional unit price, it is now set at $1. 

The Support Catalogue and the Code Guide now include the notional $1 unit price for the following supports:

  • Provider travel – non-labour costs
  • Activity based transport
  • AT repairs and maintenance
  • AT rental (including deactivated supports)
  • Low cost AT
  • AT delivery (including deactivated supports)
  • Assistance with daily life tasks in residential aged care
  • Incontinence alarms.

Examples of how to calculate a claim using the notional unit price are included in the NDIS Pricing Arrangements and Price Limits.

Understanding pricing updates - for participants

Understanding pricing updates explains the key changes in the NDIS Pricing Arrangements and Price Limits 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.

This page current as of
18 January 2022
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