The Price Guide
When does the new Price Guide take effect?
The NDIA updates its Price Guide annually, effective from 1 July each year.
Why does the NDIA conduct annual price control reviews?
An important part of the NDIA’s role as market steward is ensuring the right balance between providers operating in a viable, competitive market and value for participants.
This is in line with the NDIA’s aim to facilitate improved economic and social outcomes for participants in a way that remains consistent with its aim to foster the development of a vibrant and innovative market for disability supports.
Where can I find the new prices for the 2018/19 financial year?
How do price changes affect participant plans?
Participant plans have been adjusted automatically in the CRM to reflect changes to price limits effective from 1 July.
Do providers have to wait until service agreements expire before charging the new prices?
Providers may not have to wait until service agreements with participants have expired before charging the new prices, if their agreement allows for this.
In all cases, providers and participants must agree on any changes to services, including prices, before the support is delivered.
Why doesn't the Price Guide list all support items?
The NDIA Price Guide is not a comprehensive list of all available supports, nor does it prescribe the only supports funded by the NDIS. The Price Guide only lists supports that are subject to price controls.
A comprehensive listing of support ‘line items’ is available under 'Support Catalogue - CSV Files' on the Pricing and Payments page on the NDIS website.
How many separate Price Guides are there?
There are four Price Guides, one for each of the following areas:
Very remote areas
The only differences between the Guides are price limits for some supports and services.
The prices for the services I provide are higher than those in the Price Guide. Can I still offer my services to NDIS participants?
Prices noted in the Price Guide are the maximum that can be claimed against NDIS participants’ budgets.
The rate you offer must be agreed with the participant prior to the support being provided.
These price limits are in place to ensure that participants receive value for money in the supports and services they receive. This is an important measure for many participants, especially in disability support markets that are immature or where there are few options for participants to choose from.
Do price limits in the Price Guide apply to self-managing participants?
No. As per the NDIS Terms of Business, self-managing participants can negotiate the prices they pay for services.
Can I upload new prices and support reference numbers in bulk to my ICT system?
Yes. CSV files containing all support line item codes, and where relevant price limits, can be found on the Pricing and Payments page on the NDIS website.
Will the NDIS pay me the same as I was getting under state or territory funding?
The NDIS is a participant led scheme, meaning participants have greater control over the support mix they choose to purchase.
For agency-managed participants, the Agency will make payments to a provider based on a participant’s assessed needs and according to the NDIS price guide. This means that there may be a difference in what a support is called and the amount of funding previously received from states and territories. As a result, providers will need to understand the Price Guide and manage the cost of their services under the NDIS.
Why is there a price difference between the funding I was previously receiving from the state government and the NDIS accepted quote?
This could be for three reasons:
1. Some services previously provided may have been split-out from the NDIS support item and may or may not still be provided by the same (single) provider (e.g. therapy, transport, SDA, etc.)
2. Some services or costs may have been funded by the State that are not funded by the NDIS
3. Some services may have been funded at different prices (e,g, repayment for overheads)
Allied Health Practitioner Students and Provisional Psychologists
How can Allied Health Practitioner (AHP) students/provisional psychologists work with AHP providers and the NDIS?
The NDIA encourages innovation from providers when delivering supports to achieve participant's goals. The NDIA also seeks to develop the capacity of participants as consumers to exercise choice and negotiate with providers. Providers should talk with participants about the ways Allied Health Practitioners (AHP), students/provisional psychologists, or Allied Health Assistants (AHA) can contribute to achieving participant outcomes. It is also beneficial for the student/provisional psychologist to work with people with disability as they are more likely to choose to work in the area if they have a positive experience as a student.
Are AHP students/provisional psychologists on clinical/practice placement able to provider services to NDIS participants?
Yes, provided they are under the supervision of a qualified AHP when delivering the services, and the participant has agreed that the student may deliver specific aspects of the support. The NDIS expects that the specifics of this consent is documented in the service agreement between the provider and the participant and the arrangement results in added flexibility (e.g. lower hourly rate or additional hours of service) for the participant.
Can a registered provider charge a supplemental fee for services provided to NDIS participants by AHP students/provisional psychologists on placement?
No. The Department of Social Services Market and Workforce Development Team and the NDIA have agreed that students/provisional psychologists on professional placement under supervision (usually an unpaid role) are NOT payable separately to their professional supervisor. The supervisor can claim the relevant professional rate from the NDIS and, if agreeable with the participant, the student can provide the services under the professional's supervision. They cannot charge for the student/provisional psychologist as an AHA (or other role) in addition to the professional rate.
Would AHP students/provisional psychologists on placement be able to deliver a service (supervised by the professional provider) that was not billed?
Yes. For example, the provider might bill for a fixed number of appointments/services as agreed with the participant, but then offer extra sessions delivered by the student/provisional psychologist under supervision to effectively extend the value of the service purchased. In this scenario, the participant would essentially receive more hours of service for the same cost (as the student/provisional psychologist hours are not billed). Alternatively, the provider and participant may agree a lower hourly rate when supports are provided by a student, enabling the funding of additional hours of service.
Can an AHP student/provisional psychologist, not on placement, but employed by a provider in an appropriate capacity under the NDIS Terms of Business and Guide to Suitability, be paid for services delivered to an NDIS participant with the participant's agreement and note in a service agreement?
Yes. If a person (whether student or otherwise) is employed at the provider's practice, for example, as an AHA and appropriately supervised, they can provide that support (and it can be claimed at the appropriate AHA rate). The AHA cannot claim the AHP rate and the AHA rate for the same service.
Why is the approach for provisional psychologists the same as for AHP students?
The Psychology Board of Australia/AHPRA does not register students. Students enrolled in an approved program of study that leads to registration with the Psychology Board of Australia apply for provisional registration.
Provisional registration is the registration type that enables the individual to complete a period of unsupervised practice that is required to be eligible for general registration as a psychologist
Use of participant funding
Am I able to provide supports to a participant for items they are not funded for within their NDIS plan?
Participants have a significant degree of flexibility and control in their NDIS plans. Providers are able to provide supports to participants as long as participants are able to use their funds in that category. The providers should claim against the line item of the support provided.
Participants are generally able to use core budget funds flexibly for other supports unless funds have been set aside for a specific purpose such as periodic payments for transport, or core budget line types.
specialist disability accommodation
in-kind supports e.g. government prepaid supports such as school transport of some therapy supports
stated items (including quotes for certain items)
Capacity-building funding is allocated across eight support sub-categories. Participants are able to use their capacity-building funding as they choose within these categories. However, they are unable to use funds from one category for supports in another category. The capacity-building support categories include:
- Choice and control e.g. training in planning and plan management
- Daily activity e.g. therapy aimed at building capacity to participate
- Employment e.g. employment related assessment and counselling
- Health and well being e.g. exercise advice required due to impact of disability
- Home living e.g. support to obtain/retain appropriate accommodation
- Lifelong learning e.g. assistance moving from school to further education
- Relationships e.g. positive behavioural support strategies to reduce behaviours of concern
- Social and community participation e.g. individual life skills development and training including public transport training and support, developing skills for community, social and recreational participation.
The Capital Support Budget relates to supports such as assistive technology or modifications to a participant's home and as such depends on quotes from suppliers. Funds within this budget can only be used for their specific purpose (e.g. a rail in the bathroom or a wheelchair) and cannot be used to fund other items.
Transport for participants
If I am providing transport to participants as part of Community Access Supports, what line item do I charge under?
Providing community access supports may also involve a worker accompanying a participant on a community outing or transporting a participant from their home to the community. In these situations, the worker's time can be claimed at the hourly rate for the relevant support item for the total time the worker provides support to a participant, including time spent accompanying or transporting the participant. Where a provider is transporting two or more participants on the same trip, the worker's time should be claimed at the appropriate group rate.
If a provider incurs costs in addition to the cost of a worker's time, for example, when accompanying or transporting participants in the community, they may negotiate with the participant for them to make a reasonable contribution towards these costs. A plan may include funding for transport supports that are paid directly to the participant. This funding can be used to meet these types of contributions, which should be clearly specified in the Service Agreement.
However, if a participant does not have transport included in their NDIS plan, or is receiving the entirety of their transport funding as period payments, they cannot be required to contribute towards transport in service agreements.
If transport is not included in a participant's plan, providers should not claim the costs under another support item. Instead, it is the participant's responsibility to pay the cost of transport. If the participant believes that transport should be included in their plan, they may request a plan review.
Adjustment of plan values due to Annual Price Review - January 2018
Why am I seeing new service bookings?
Service bookings have been automatically updated to increase plan values to reflect the 2017-2018 price caps. Service bookings relating to an accepted quote item or in kind item have not been changed.
You will also note that service bookings made at a category level have a general percentage increase, while service bookings for stated items have received a specific increase to reflect the new price cap in the 2017-18 price.
Will indexed stated item service bookings now have two of the same line items at different prices?
No. System limitations prevent a service booking from having two of the same line items. Instead the service booking will be end dated either at 30 June 2017 or on the latest payment request service end date. A new service booking with a start date of the following day will be created and the line item in the new booking will be indexed. You will now have two service bookings. The original service booking price will not be indexed but the new service booking will.
Are providers automatically entitled to claim at the new 2017-18 prices now the service bookings are indexed?
No. Providers still need to negotiate the prices for service with their participants. myplace is now in a better position to fund supports at the new prices.
New Provider Portal - myplace
What is myplace?
myplace is the online portal that allows providers to view and manage their services with a participant. This includes:
making payment requests for services provided to participants
managing and viewing the details of agreements entered into with participants
viewing registration details
instant messaging with participants
How do I access myplace?
Access to myplace is through an authentication process called Provider Digital Access (PRODA) which is managed by the Department of Human Services. All providers need to have a PRODA account before they can use myplace. Once a PRODA account is created, providers can login to myplace using their PRODA username and password.
For more information and support with PRODA, refer to the PRODA step by step guide available in the Provider Toolkit.
Do I automatically get access to myplace?
No. All users of myplace will need to link their PRODA account to myplace before they can access it to manage the products and services provided to participants.
Can I assign myplace access for other staff in my organisation?
Providers will need to nominate a Primary Contact who will be responsible for approving myplace access requests for other users within their organisation.
We recommend that a Primary Contact is nominated before commencing the process for setting up myplace access or registering with NDIS.
If you are the Primary Contact for your organisation, you can approve access for additional users within your organisation. Note that all users of myplace will need to have their own individual PRODA account and any additional users requiring myplace access will need to be successfully authenticated in PRODA.
If you are the Primary Contact within your organisation, you will receive a request to approve the additional user’s access once their PRODA account has been successfully created and authenticated, and they have linked their PRODA account to myplace. When you have approved the request, the additional user will be able to access myplace.
How do I change system access levels for staff in my organisation?
Different levels of access are not available in myplace. All users that have been granted access to myplace will have the ability to add and update information.
How can I get an update on my registration status?
You will be able to monitor the status of your registration in myplace.
Please ensure you have read the ‘Guide to Suitability’ in the Provider Toolkit, and have commenced any applications for quality and safeguard checks that are required for you to be registered.
You can prepare for your access to myplace by ensuring that you have created a PRODA account.
I received my certificate of approval from the NDIS, but I still have some supports listed as ‘Pending State Approval’. What does this mean?
If you receive a certificate that shows some of your supports as ‘pending state approval’, it is because you have applied for a specialist disability support that is required to meet the quality and safeguard standards as set out in your state/territory.
The NDIA requires evidence that you have met your state/territory quality and safeguard requirements before you can be registered. Further information is available on the NDIS website.
Authentication (PRODA) and Access to myplace
I’m an allied health professional and already have a PRODA account. Do I need another one?
No, you will be able to use your existing PRODA account to link to myplace.
Information on how to login to myplace for the first time is available in the Key Resources section of the Provider Toolkit.
How many users can register for PRODA?
There is no limit on the number of users that can register for PRODA.
You are required to nominate a Primary Contact in your organisation, and have them create a PRODA account and link to myplace first.
Once your Primary Contact is set up, they can then grant permission for other PRODA account holders to connect to myplace.
If you experience any issues with your PRODA account or have questions about setting up a PRODA account, you can call 1800 800 110.
Who should the myplace Primary Contact be?
It is up to the provider to determine who within their organisation establishes a PRODA account first for the purposes of accessing myplace.
The first person to login to myplace will automatically be identified as the Primary Contact.
The Primary Contact will be responsible for granting other people within your organisation access to your details and make Payment Requests.
When can other users have access to myplace?
After your Primary Contact has successfully connected to myplace and has approved your myplace access request.
Additional contacts can apply for their PRODA account now, but the first person to log into myplace on behalf of your organisation should be your nominated Primary Contact.
What if I need to change my Primary Contact?
Every provider is able to update their Primary Contact. Please refer to the 'Using myplace Provider Portal Step By Step Guide' in the Provider Toolkit for instructions on how to do this.
Registering for Supports / Registration groups
Which supports/registration groups should I register for?
Descriptions of each registration group, along with required professional qualifications and experience to deliver services under those registration groups, can be found in the 'Guide to Suitability' which is available in the Provider Toolkit.
When reading the Guide to Suitability, please consider whether your state/territory requires you to undergo a quality and safeguards assurance process before you can be registered with the NDIS.
Terms of Business
When can a pre-payment be authorised by the provider for supports as outlined in the Terms of Business?
The Terms of Business have been updated to make it clear that providers can only be paid in arrears.
Can I use the NDIS logo to identify as a NDIS registered provider?
No. The Registered Provider Terms of Business outlines how providers can promote their association with the Scheme. Providers may identify their NDIS registration by stating ‘Registered NDIS Provider’.
The NDIS logo and colour scheme must not be used by a registered provider in any publicity material, including use on vehicles, buildings, emails, stationery, websites and social media channels.
More information about Use of the NDIS logo is available on the NDIS website.
The Terms of Business state that “ … at least monthly invoices must be provided to participants detailing services delivered, and the amount charged for those services.” Is this arrangement required for all participants?
The Terms of Business have been updated to make it clear that providers must ensure that the participant is regularly provided with, or has access to details of, the services they have been delivered and the amount charged for those services.
This could include, for example, ensuring that a participant is reviewing their myplace account.
If a participant is unable to access myplace, then the provider must look at other ways of ensuring a participant has visibility of the services they have received.
Providers must also abide by relevant consumer laws regarding the provision of receipts and itemised bills.
The Terms of Business state that “A claim for payment is to be submitted within a reasonable time and not later than 60 days from the end of the Service Booking.” If this timeline is not met, will there still be a mechanism for providers to make payment requests?
Providers are encouraged to submit their Payment Requests not later than 60 days from the end of the Service Booking. This is necessary to support participants to manage their supports and individuals budgets.
Making Payment Requests outside of this period is strongly discouraged as it impacts the ability of participants to track their supports and budget.
Guide to Suitability
What is the Guide to Suitability?
The 'Guide to Suitability' is the key document to assist you to understand what supports you will be providing and what your obligations are as providers of these NDIS supports.
It is available in the Key Resources section of the Provider Toolkit.
Who determines if a provider is a specialist disability service?
Service types that constitute a ‘specialist disability service’ have been agreed between each state/territory, the Commonwealth Government and NDIA.
Each state is different, and you will need to read the ‘Quality and Safeguards Working Arrangements’ for your state/territory.
The Working Arrangements are available in the Guide to Suitability which is in the Key Resources section of the Provider Toolkit.
What does it mean when I have a support that is noted as ‘Pending State Approval’? What is the process I need to follow?
If you receive a certificate that shows some of your supports as ‘pending state approval’, it is because you have applied for a specialist disability support that is required to meet the quality and safeguard standards as set out in your state.
The NDIA requires evidence that you have met your State/Territories quality and safeguard requirements before you can be registered.
Further information is available on the NDIS website.
How does the NDIA address complaints and issues regarding the quality and safeguards working arrangements?
During transition providers are subject to the quality and safeguarding arrangement’s in their state/territory.
Further information can be found on the NDIS website.
What is meant by ‘best fit’?
Providers should consider the types of services they want to deliver, and read the Guide to Suitability to determine what registration group they should apply for.
The ‘best fit’ will be the registration group that aligns with (1) the services you want to deliver, and (2) your professional qualifications and experience.
The Guide to Suitability is available in the Key Resources section of the Provider Toolkit.
Service Agreements and Service Bookings
What is the difference between a Service Agreement and a Service Booking?
A Service Agreement is a formal agreement between a participant and provider. They help to ensure there is a shared understanding of:
expectations of what supports will be delivered and how they will be delivered, and
each party’s responsibilities and obligations and how to resolve any problems that may arise.
A Service Booking is the way a participant engages with their chosen provider(s) online. The service booking nominates the type of service, dates of support, and funding to be allocated to a given provider.
Do I have need to have a Service Agreement with a participant?
No. However, it is strongly advised that you do have one in place as they are a matter of best practice.
The participant has a Support Coordinator, do I work with them or the NDIA?
The role of the support coordinator is to support implementation of all supports in the plan, including providing specialist assistance where it is funded for participants with high support or complex needs. Providers should maintain contact with both the participant and their support coordinator.
Where a participant has particularly complex needs, the support coordinator will liaise with the provider about the support model and pricing, and provide this information to both the participant and the Agency. Further information can be found on Support Coordination on the NDIS website.
Is it the participant’s or the provider’s responsibility to create a Service Booking?
Either the participant or the provider can initiate the Service Booking.
If the Service Booking is initiated by the provider, it will need to be accepted by the participant. The provider can indicate the participant’s acceptance in myplace.
If the Service Booking is initiated by a participant, the provider has 21 days to accept it in myplace.
For further information on Service Bookings refer to Section 5 of the Provider Toolkit.
Can a provider make a payment request for services provided to a participant without a Service Booking?
No. Payments can only be made where a Service Booking has been created.
A Service Booking acts in a similar way to a purchase order. A Service Booking cannot be made without the available budget.
If I can’t claim now but I’m already providing supports, will I be out of pocket?
No, providers should not be out of pocket because:
Supports funded in a plan that are agreed by the participant and aligned with the Agency price guide can be claimed from plan approval using a Service Booking with a backdated start date.
Governments are continuing to monitor planned and actual transition rates and are making payment adjustments as necessary.
There may be circumstances where a participant wishes to choose a different provider for their continued provision of supported independent living services. The plan will contain both appropriate supports to sustain the existing accommodation and facilitate the participant’s goal to explore alternate housing arrangements.
How will Service Bookings be created for participants who lack the capacity or do not have Internet access to make a Service Booking in myplace? Can a provider create a Service Booking on their (or their nominee’s) behalf?
Participants can be supported by their Local Area Coordinator, Plan Manager or Support Coordinator to access on-line assistance in creating the Service Booking.
Alternatively, participants (or their nominee) can ask their providers to create and accept a Service Booking on their behalf.
The participant’s (or their nominee’s) acceptance of the Service Booking will be flagged and recorded in the system.
Do Service Bookings apply to old and new NDIS plans or just new plans?
Service Bookings will be required for all NDIS plans, including those Plans that were created before 1 July 2016.
How do Plan Managers (who make the one and only service booking) commit funds to multiple providers?
Where Plan Managers are involved, the Plan Manager will have a service booking for the delivery of Plan Management and will submit a Payment Request in myplace.
Where a participant requires services from other providers, the Plan Manager will receive invoices from providers that have a Service Agreement with the participant. The Plan Manager will verify the invoice with the participant. Once verified the Plan Manager will pay the provider on behalf of the participant.
Where NDIS plans are extended beyond their original end date, do the service booking end dates automatically extend as well?
Yes, a Service Booking can be extended as long as the plan has available budget.
This will be subject to annual review.
I’ve been told that I can’t create a service booking because plans are on hold, paused or incomplete?
Approved plans are not on hold, incomplete or paused. Some funded supports require an additional step before they can be implemented and a service booking made. These funded supports include where the participant requires an assessment or the chosen provider is required to submit a quote.
Payment Requests (previously known as claims)
Can I request payment for support provided to existing clients from the time they have an approved NDIS plan?
Yes, under the condition that a service booking has been created for this period, you are a registered provider of the NDIS and have nominated for the equivalent registration groups. The system will then allow service bookings to be created from the date the plan was approved. Provision of support will need to align with the plan and service agreement made with the participant.
Sometimes there are delays in being able to create a service booking while a provider is negotiating a quote with the Agency. This is because a service booking can’t be created without an agreed price in the participant's plan. Once the quote is agreed Providers can liaise with the participant to confirm their acceptance of the service booking. Once the service booking is completed providers can request payment for the funded support provided.
Do I need to submit payment requests in myplace for both old and new NDIS plans?
Yes, providers can submit a Payment Request in myplace for all plans including old and new NDIS plans.
How long do I have for submitting a payment request?
The Terms of Business require providers to submit a Payment Request within 60 days from the end of the service booking.
For further information on Payment Request refer to Section 6 of the Provider Toolkit.
What is the turnaround time for payments?
The Agency will endeavour to pay a provider that has submitted a valid Payment Request within 2 business days.
Are bulk uploads for payment requests possible?
Yes. A Bulk Payment Requests Step By Step Guide and video that walks you through the process of bulk uploading and explains when it should be used is available in the Provider Toolkit.
Specialist Disability Accommodation
How can I register for Specialist Disability Accommodation (SDA)?
Information on how to register for SDA is available on the NDIS website.
Please email SDAregistration [at] ndis.gov.au for further information.
Supported Independent Living
I’ve been told there are delays in processing quotes for supported independent living?
Some delays may be experienced by providers where a quote is greater than the amount specified in the Price Guide. In the majority of cases this is because the provider has included in the quote supports that are broader than assistance with and supervision of tasks of daily life. These other supports need to be ‘unbundled’ from the quote.
For instance, some providers include within their quotes supports such as coordination, transport and therapy. Where these types of supports are reasonable and necessary they are funded separately under the participant’s plan and not part of supported independent living.
How can I speed up the process so I can claim successfully?
You can reduce the timeframe for quote approval by ‘unbundling’ all the services you have agreed to deliver to the participant, and including in the quote the services that meet the definition of the support item you have been requested to provide.
For supported independent living, providers should detail their service offerings in the quote along with the prices for each service offering to the Agency to help speed up the process.
Will there be more information about how to provide a NDIS quote for supported independent living?
The Agency is developing a tool to assist providers. The Supported Independent Living (SIL) Benchmark Guide Tool has been designed to allow users to compare provider quotes to an expected price range, consisting of the NDIS benchmark and a standard SIL service. The purpose of the tool is to fast track a common understanding of the SIL service where participants and providers can create service agreements that meet the needs of both parties. The tool is currently being trialled and information on the release of the tool will be included in our regular newsletters.
Help and Support
Is there support material available for providers?
The Provider Toolkit has a range of support materials.
Who do I contact if I have questions and/or difficulties with using myplace?
In the first instance, refer to the Step by Step Guides in the Provider Toolkit.
If you need further assistance, contact NDIA by phone on 1800 800 110.
How do I keep informed about what the Agency requires me to do when providing supports to an NDIS participant?
In addition to update notices on the Provider Toolkit site, there is also sign up to the monthly Provider Newsletter to receive regular email updates. When changes are made to the myplace provider portal, you will also receive notification through the messaging system on the portal.