A Guide to NDIS Pricing

Since the beginning of its operation, the National Disability Insurance Scheme (NDIS) has supported thousands of disabled people all over Australia. Through the supports and services provided by the NDIS, these disabled citizens have gained control and fulfillment from their lives.

But the question is, how exactly does NDIS pricing work in terms of allocating proper funds for each patient? What guidelines are followed by the NDIS pricing to ensure that their patients get the value for their money? In this article, we’ll be giving you a guide to NDIS pricing and the primary things you need to know about it.

Supports funded through NDIS Pricing

Participants who are eligible to receive funding from NDIS can create a plan based on their individual needs and life goals. One of the outstanding features of this scheme is that each patient has full control over what kind of assistance they get and the provider of their choice. There are also cases wherein the NDIA will take over the management of the patient’s plan if the situation requires. After which, NDIS will allocate funds for matters such as:

• Household tasks and personal activities
• Vehicular modifications and/or transportation services
• Workplace assistance
• Mobility equipment and devices, including assistance in setup and training
• Modifications such as construction and design in the home
• Behavioural and therapeutic supports

How NDIS Pricing Works

In terms of setting the price limits for the services and supports, the National Disability Insurance Agency (NDIA) is responsible for ensuring that the participants get most of their NDIS plan. When the NDIS makes decisions on determining prices for regulation activities and other services, they refer to the Pricing Reference Group (PRG). Through the help of the PRG and the CEO, the NDIA board receives advice on matters regarding the price control arrangements. The PRG is important because it makes sure that the allocated funding is set to achieve the best outcome for the patients of NDIS, especially when transitioning to a competitive market.

NDIS Pricing Updates for 2019-2020

A few changes have been put into effect last December 1, 2019, in the NDIS Price Guide and Support Catalogue. These changes are related to the provider’s charges, which may affect the patient’s plan budget. The NDIS participants must be aware of these changes, as well as their rights so that they can be confident about their partnership with NDIS. Here’s a look at the aspects wherein the changes were applied:

Remote Locations

In specific locations, providers charge higher rates for their delivering services. There is an increase of 20-40% in remote location rate and an increase of 25-50% in very remote location rate. Before any additional charges, participants will be informed by the providers. However, those living in remote locations have not had an increase in funds yet. In the meantime, participants from remote locations should double-check the details of their address for their plan to include remote loading.

Temporary Transformation Payment (TTP)

The TTP is an additional charge apart from the base rate price limit for matters relating to attendant care and community activities. Participants will be informed beforehand and will have to confirm that they are willing to pay the charge. Providers who will charge TTP should put their service prices on their websites and keep a list of their business contact details. They should also participate in the Agency-approved market benchmarking survey that is done annually.

Short Term Accommodation and Assistance

There have been increased price limits, as per NDIA, in the Short Term Accommodation and Assistance. This applies across weekends, weekdays, and public holidays from support ratios of 1:1 to 1:4. Since respite is considered an occasional need, the impact of the price limit increase is only minimal. Patients can still purchase respite services to give their caretakers a break from their responsibilities. These services are recognized as short-term accommodation support.

Medium Term Accommodation (MTA)

The MTA has been introduced to provide participants with transitional homes before moving into their permanent residences. The MTA is designed to assist the participant’s transition to a community setting, diminish the number of youth in aged care, and lessen the delays in hospital discharges. Those who wish to avail MTA can continue to access their capacity building and daily living supports such as self-care assistance and social participation assistance. On the other hand, participants can also purchase the supports mentioned above from medium-term accommodation providers in their area.

Cancellation Bill Policy

Cancellation will need five business days to accomplish. The participant has 48 hours to cancel a booking that is less than $1000 or a booking that is not more than 8 hours. Support and services bookings that are not attended will be charged accordingly. In other cases, canceling outside the designated timeframes will also incur a charge, despite the participant receiving the support/service.

Non-face-to-face Services

Non-face-to-face activities include delivering support or service items to the participants but does not cover general business matters. The charge is depending on the time it will take for the delivery to accomplish. These activities will be charged on the participant; but before any transaction, the providers must discuss the terms and ask the participant’s confirmation.

Provider Travel

Residents from regional areas will be charged 60 minutes per booking and residents of the city area will be charged 30 minutes per booking. The travel of therapy assistants may also be charged by the providers. A fee can only be charged per booking if the capacity building support providers need a return trip.

Support Coordinators

Travel, report writing, and cancellations will now be charged by support coordinators. Participants will be informed that they will be charged when their supports or services are being delivered.

Disability-related Health Supports

Any additional support that is disability-related can be purchased through NDIS funding. The need for these supports must be related to the participant’s significant and permanent disability. The conditions which can be funded include, but not limited to: epilepsy, diabetes, podiatry, dysphagia, respiratory, nutrition, and wound care. If the participants have an existing NDIS plan, they can now use their plan budget to purchase disability-related health supports or they can continue receiving support from Territory or State health services.