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NDIS Pricing and Finances

The maximum prices you pay as an NDIS client are specified by the NDIA register of fees, which is updated regularly. Like other government funded schemes like transport accident and worker's health insurance, the NDIS price guide is there to ensure that professionals, supports and other workers are appropriately reimbursed for their time and effort in helping NDIS clients achieve their goals. However, there are a few important things to know about billing against an NDIS plan. The first and most important thing is that someone providing help for an NDIS client cannot charge above the price limit specified by the NDIA. While individual providers can charge their own prices, and the NDIA cannot tell a provider to charge a specific price for a specific client, a provider cannot charge more than the NDIA will allow for a given service. This is an important distinction - while patients on Medicare referrals may have gap payments, and so too may patients on worker's or transport insurance, providers of services to NDIS patients cannot charge additional costs like gaps, surcharges and exit fees. 


Another important thing about NDIS funding is how those funds are divided. An NDIS plan splits funds between different categories, which are called Supports. These supports are defined and allocated depending on the resources and services you may need to access to achieve your goals. Funding allocated to Core Supports is there to help with every day activities, transport, and disability related needs, and can even be used flexibly to compensate for a lack of funds in another support category. Capacity Building Supports are there to help build independence and reduce the need for the same level of support into the future. Funding for Capital Supports is allocated for high-cost pieces of assistive technology like equipment, home and vehicle modifications. Like all services provided by the NDIS, NDIS funding is in place for clients to access reasonable and necessary services and supports to help them pursue their goals. Things like transport, consumables like exercise equipment, home modification, and assistance supports are all things that can be funded. 


When accessing physiotherapy services on an NDIS entitlement, it's important to know where your funding will go and how it will be used. NDIS funding is versatile because it can be applied towards many potential expenses as part of engaging in treatments. This is so that you as a participant can access what you need quickly, rather than waiting. It also means that you get the final say on what and how much of anything is paid for. It's important to remember that funding from the NDIS is meant to be used on things that are reasonable and necessary to achieve your goals, and so the therapy you receive as well as anything around that can only be funded from the NDIS as long as it's helping you achieve your goals. You always have the opportunity to discuss your funding and how it can be used with your therapist, with an advocate, or with your plan manager, to make sure you're getting the most out of the resources provided to you by the NDIA.

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