Pricing updates – announced 22 June 2022

From 1 July 2022 we are increasing price limits for services delivered by disability support workers by 9% to address known cost pressures on providers, including:

• changes to the Social, Community, Home Care and Disability Services (SCHADS) Industry Award conditions that will come into effect on 1 July 2022
• costs associated with managing the COVID-19 pandemic 
• NDIS quality and safeguards regulatory requirements 
• Fair Work Commission’s recent wage decision 
• superannuation guarantee charge increase. 

The Annual Pricing Review showed the cost of delivering core supports was higher than anticipated during 2021-22, as a result of the impact of COVID-19 and quality and safeguarding requirements.

The NDIA will also make up to an extra $514 million available to providers to recognise costs of keeping participants safe, particularly during the COVID-19 pandemic, and the significant overhead costs incurred by registered providers of activities of daily living and community participation supports not previously taken into account. 

NDIS Disability Support Worker Cost Model

We have updated the NDIS Disability Support Worker Cost Model to better reflect the cost structures of efficient providers in the sector.  

From 1 July 2022 we are increasing price limits for supports delivered by disability support workers by 9%. This includes:  

• 1.7% increase to base prices
• 2% temporary loading, reviewed annually 
• 4.6% increase in award minimum wages 
• 0.5% increase to superannuation guarantee charge

The NDIS Disability Support Worker Cost Model determines the price limits of assistance with activities of daily living and social, community and economic participation supports (and of some capacity building supports).

Simplify NDIS price control framework

We have updated the NDIS Pricing Arrangements and Price Limits to clarify a High Intensity support as a support provided to a person:  

• who needs frequent (at least one instance per shift) assistance to manage challenging behaviours that require intensive positive behaviour support, and/or
• who has support needs that require the skills described by the NDIS Commission as “High Intensity Daily Personal Activities”.  

We have introduced a single price limit for High Intensity supports (varying by time of day and day of week), set at the previous Level 2 price.   

Provider travel

We have updated the NDIS Pricing Arrangements and Price Limits so the pricing arrangements for provider travel is the same for providers of core supports to participants in remote and very remote areas as for providers of capacity building supports.

Providers of core supports will also be able to claim for return travel in certain circumstances.

Group based community participation supports

As we previously announced in April 2022, we are extending the transitional pricing arrangements for group based core supports until 30 June 2023 to allow providers more time to adjust to the pricing arrangements introduced on 1 July 2020.  

Temporary Transformation Payment arrangements

As planned, the Temporary Transformation Payment (TPP) loading will reduce to 3.0% from 1 July 2022 and then to 1.5% on 1 July 2023 and then 0% from 1 July 2024.  

Therapy Supports 

The price limits for therapy supports will be maintained at the 2021 price limits. Further work will be conducted to review therapy price limits.

Specific line items for other therapists: ‘other therapists’ is defined as a person who is not one of the types of therapists specifically listed but who the provider considers to be an appropriate professional to deliver therapeutic supports in line with the NDIS Quality and Safeguarding Commission’s requirements for the Therapeutic Supports Registration Group.

Early Childhood Intervention Supports 

Specific line items for other professionals: ‘other professionals’ is defined as a person who is not one of the types of professionals specifically listed but who the provider considers to be an appropriate professional to deliver supports in line with the NDIS Quality and Safeguarding Commission’s requirements for the Early Intervention Supports for Early Childhood Registration Group.

There have also been minor support item name changes to Early Childhood Intervention Supports. 
 

Nursing Supports

The price limits for nursing supports will be indexed on 1 July 2022 in line with the Wage Price Index and Consumer Price Index.  

Support Coordination

Support coordination price limits will be maintained at 2021 levels for the following supports at this time:  

• Level 2: Coordination of Supports  
• Level 3: Specialist Support Coordination.  

The price limits for support coordination will be maintained at the 2021 price limits while further in-depth reviews are completed. Further information on this will be released shortly.

Level 1 support coordination supports will be indexed in line with other supports whose price limits are determined by the DSW Cost Model.

Plan Management

The price limits for plan management will be maintained at the 2021 price limits while further in-depth reviews are completed. Further information on this will be released shortly.

Specialist Disability Accommodation

We are introducing a new SDA line item from 1 July 2022 to ensure providers have an easier way to claim for services delivered to participants. 

A second SDA line item has been created in the SDA Pricing Arrangements.

The new SDA line item means providers can complete service bookings for participants living in SDA enrolled dwellings.

This removes the need for the NDIA to complete the service bookings on the participant’s behalf.
    
The existing SDA (quote required) line item will continue to be used for participants not yet living in SDA dwellings.

Regional, remote and very remote area supports

From 1 July 2022, locations that are not classified as remote or very remote under the Modified Monash Model (MMM) will be classified as remote for planning and pricing purposes if it is not possible to travel from the identified location to a major city, or other city of more than 50,000 people, without crossing a remote area.

For example, Geraldton in Western Australia, and its surrounding areas, will be treated as remote.

• We will maintain the current remote and very remote loadings for pricing and planning purposes.
• We will continue to use the MMM of geographical classification for planning and pricing purposes.

New NDIS Bereavement Addendum 

The new NDIS Bereavement Addendum lists support items that providers can claim after an NDIS participant has died.

The NDIS Bereavement Addendum is not a standalone document and must be read in conjunction with NDIS Pricing Arrangements and Price Limits. 

There are two items in the current Addendum, one for plan managers and the other for supported independent living (SIL) providers to use in the event of a participant’s death.

Extension of COVID-19 booster payment for disability support workers

COVID-19 booster payment for disability support workers has been extended to 31 August 2022.

Registered providers in the following registration groups can claim $100 per worker for a booster vaccination:

• 0104 High Intensity Daily Personal Activities
• 0107 Daily Personal Activities
• 0115 Assistance with Daily Life Tasks in a Group or Shared Living Arrangement
• 0125 Participation in Community, Social and Civic Activities

The COVID-19 Addendum has been updated to reflect this change.
 
Learn more about COVID-19 booster payment for disability support workers.

Pricing updates – announced 26 May 2022

Minor update to COVID Addendum

On 26 May 2022, the NDIA updated the COVID Addendum to remove the terms ‘up to’ for Supported independent living (SIL) supports and ‘up to a fixed price of’ for vaccines and Rapid antigen tests (RATs):

• Supported Independent Living (SIL) – Additional Support for SIL Participants who are required to self-isolate or quarantine – Direct Billing Arrangement
• Supported Independent Living (SIL) – Deep Cleaning when a SIL Participant is required to self-isolate or quarantine – Direct Billing Arrangement
• Deep Cleaning for Support Worker-Related COVID Diagnosis – Direct Billing Arrangement
• Enabling COVID Vaccinations for participants
• Rapid antigen testing for SIL support workers
• Enabling vaccination boosters for workers.

This administrative update aims to clarify the process in claiming direct billing items.

Pricing updates – announced 1 April 2022

Changes and extensions to the participant COVID-19 vaccination enablement payments for providers

From 1 April 2022, providers in the following registration groups can claim $75 per participant per COVID-19 dose when they support a participant to receive their vaccinations:

• 0104 High Intensity Daily Personal Activities
• 0106 Assistance in Coordinating or Managing Life Stages, Transitions And Supports
• 0107 Daily Personal Activities
• 0115 Assistance with Daily Life Tasks in a Group or Shared Living Arrangement
• 0125 Participation in Community, Social and Civic Activities
• 0127 Management of Funding for Supports in Participants’ Plans
• 0133 Specialised Supported Employment
• 0136 Group and Centre Based Activities

COVID-19 vaccinations eligible for this support include the primary vaccination dose, as well as any booster vaccination dosages.

Providers can claim the $75 payment per participant per vaccination dosage delivered between 1 April and 31 August 2022.

Providers have 28 calendar days after 31 August 2022 to claim for this support.

This support replaces the following previous temporary supports:

• $150 to assist a participant to receive their primary doses of the COVID-19 vaccination
• $75 to assist a participant to receive their booster doses.

Rapid antigen test (RAT) expansion for support workers

RAT claims for support workers have been extended until 31 August 2022.

This support was originally scheduled to end on 30 April 2022.

Learn more about these temporary COVID-19 supports:

• For participants: Your health and safety
• For providers - coronavirus (COVID-19)

Pricing updates – announced 30 March 2022

The NDIA has published an updated Pricing Arrangements for SDA 2021-22 and SDA Price Calculator 2021-22. 

Maximum reasonable rent contribution (MRRC) and maximum board 

Maximum rent contribution and maximum board amounts have been updated to reflect the increases to the Disability Support Pension.

Effective from 20 March 2022, the fortnightly maximum reasonable rent contribution has increased:

• to $389.18 for a single person (an increase of $8.03)
• to $252.15 for each member of a couple (an increase of $5.17).

Effective from 20 March 2022, the fortnightly maximum board contribution has increased:

• to $464.50 for a single person (an increase of $9.30)
• to $350.10 for each member of a couple (an increase of $7.00).

Providers must honour existing service agreements with participants and ensure they are compliant with Appendix H – SDA Terms of Business from the Pricing Arrangements for SDA 2021-22.

SDA multi-design category dwellings

The Pricing Arrangements for SDA 2021-22 now includes information on SDA multi-design category dwellings, and how they are priced.

The pricing for an SDA dwelling with multiple design categories reflects a maximum price per participant, for each design category.

We price individual bedrooms separately and take into account the total number of residents/bedrooms in the dwelling.

For example, in a group home of 4 residents (each with their own bedrooms), where two bedrooms meet the High Physical Support design category and two bedrooms meet the Improved Liveability design standard:

• the two Improved Liveability bedrooms are each eligible for the per participant, Group Home, 4 resident, Improved Liveability price; and,
• the two High Physical Support bedrooms are each eligible for the per participant, Group Home, 4 resident, High Physical Support price.

If an SDA provider has enrolled a multi-design category dwelling that includes Robust category bedrooms and a breakout room, then the additional price for the breakout room is added to the base price of the per participant price for each bedroom of the Robust design category only.

Please check the Pricing Arrangements for SDA for full pricing conditions for multi-design category dwellings.
 

Pricing updates – announced 1 March 2022

Meal preparation and delivery – ongoing flexibility in our guidelines

Effective 1 March 2022, NDIS participants who usually have a support worker help them prepare meals at home or help with grocery shopping, can flexibly use these funds to pay for prepared meals and delivery support in certain circumstances. 

This was made clear in our guidelines for Nutrition Supports including meal preparation published on 28 February 2022.

A new support item has been added to the pricing arrangements 01_023_0120_1_1: Assistance with the cost of preparation and delivery of meals.

Providers will no longer need to submit quotes for meal preparation and delivery supports included in new plans from 1 March 2022, however a participant must have this support included in their plan for a provider to be able to claim. This does not impact existing plans.

Mid cost assistive technology (AT)

New support items for AT have been included in the support catalogue to support the changes that expand mid cost AT to cover AT valued between $1,500 and $15,000 and changes to quote arrangements. Learn more.

Rapid antigen test (RAT) expansion for support workers

RAT claims for eligible supported independent living (SIL) providers have been extended until 30 April 2022.

This support was originally ending on 28 February 2022.

Pricing updates – announced 8 February 2022

Booster vaccination payments for disability support workers

Effective 1 January to 30 June, providers in the following registration groups can claim $100 per worker to receive a booster vaccination:

• 0104 High Intensity Daily Personal Activities
• 0107 Daily Personal Activities
• 0115 Assistance with Daily Life Tasks in a Group or Shared Living Arrangement
• 0125 Participation in Community, Social and Civic Activities 

Rapid antigen test (RAT) expansion for support workers

RAT claims for support workers have been extended until 28 February 2022. This support was originally ending on 31 January 2022.

Direct claiming for additional SIL supports between 11 January and before 7 February 2022

Additional SIL supports delivered between 11 January and before 7 February can be claimed through the direct claiming process using the bulk payment request template.

Providers should use a claim date of 7 February to ensure a successful claim.

Direct claiming for additional SIL supports that include a date before 7 February will not be processed.

Learn more about these temporary COVID-19 supports:

• For providers - coronavirus (COVID-19)
• For providers – payments and billing.

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:

• For participants: Your health and safety
• For providers - coronavirus (COVID-19)

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 these temporary supports are claimable.

Learn more about this temporary COVID-19 support:

• For participants: Your health and safety
• For providers - coronavirus (COVID-19)

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:

• For providers - coronavirus (COVID-19)

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.

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.