NDIS Pricing Arrangements and Limits Update – June 2022
- Date of Change:
- 01 July 2022
- Takes Effect:
- 01 July 2022
The NDIA announced on 22 June updates to the NDIS Pricing Arrangements and Price Limits that come into effect on 01 July 2022. Most notably, the NDIS Disability Support Model price limits have been increased to cover the costs that providers incur from recent minimum wages increases, SCHADS Award changes, the Superannuation Guarantee increase and general operating costs (including pressures from COVID-19). Other areas that have been addressed include:
- Single price limit for High Intensity Support (for intensive positive behaviour support or high intensity daily personal activities)
- Adding Travel for Core Supports (remote and very remote) and return travel
- Updates in classifying remote or very remote locations
- Extending transitional pricing for Group Based Community Participation supports
- Reduction in Temporary Transformation Payment (TPP) loading to 3.0%
- Price indexing applied for Nursing supports and Level 1 Support Coordination (Support Connection)
- Clarifying ‘other professionals’ with respect to Early Childhood Intervention supports
- New line items for Specialist Disability Accommodation (SDA) providers to simplify claiming
- New Bereavement Addendum – for Plan Managers and Supported Independent Living providers
- Extending the COVID-19 Addendum, as well as being able to claim $100 per worker for Booster vaccinations in certain registration groups
For providers registered for Plan Management, Support Coordination (Levels 2 and 3) and Therapeutic Support, no changes in pricing have been made at this time. Further reviews are currently being undertaken and further information is due to be released.
What does this Mean for Your Business?
NDIS Disability Support Model
The NDIS Disability Support Model determines price limits for supports related to assistance with activities of daily living, and social, community and economic participation. Within this pricing update, the Model has been updated to reflect changes within the sector, most notably the increase to base wages within the SCHADS Award. The price limit increases are also intended to address the increased costs experienced by providers for managing the COVID pandemic, the NDIS quality and safeguards regulatory requirements, the recent Fair Work decision on a minimum wage increase, and the recent changes to the superannuation guarantee.
From July 1, price limits for supports delivered by disability support workers will be increased by 9%. This factors in:
- 1.7% increase to base prices,
- 2% temporary loading (to be reviewed annually),
- 4.6% increase to award minimum wages, and
- 0.5% increase to the superannuation guarantee charge.
Price Control Framework - High Intensity Supports
A new single price limit has been introduced for High Intensity supports (varying by time of day and day of week), set at the previous Level 2 price. Level 1 and Level 3 has been removed. The NDIS has updated the price limits to clarify what determined high intensity supports. The new definition explains high intensity supports as supports provided to a person:
- who needs frequent (one instance per shift) assistance to manage challenging behaviours that require intensive positive behaviour supports, and/or
- who has support needs that require the skills decried by the NDIS Commission as “High Intensity Daily Personal Activities”
The NDIS Pricing Arrangements and Price Limits have been updated to ensure 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.
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. Both line items allow for providers to make claims after a participant’s death in the event they need to continue to carry out activities in respect to the participant.
Group Based Community Participation Supports
As previously announced in April 2022, the transitional pricing arrangements for group based core supports will be extended until 30 June 2023 to allow providers more time to adjust to the pricing arrangements introduced on 1 July 2020.
Further information on this extension can be found here.
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.
Temporary Transformation Payment Arrangements
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.
Early Childhood Intervention Supports
Further information has been provided within specific line items to better clarify ‘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.
Specialist Disability Accommodation
A new SDA line item will be introduced from 1 July 2022 creating 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.
Regional, Remote, and Very Remote 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.
The current remote and very remote loadings will be maintained for pricing and planning purposes.
Level 1 support coordination will be indexed inline with other supports as determined by the Disability Support Worker Model from 1 July 2022. There have been no changes to Level 2 or 3 Support Coordination price limits in this update.
Expect price limits for nursing supports to be indexed on 1 July 2022 to align with the Wage Price Index and Consumer Price Index.
No changes have been made to therapeutic supports or plan management price limits within this update, however the NDIA indicated these line items are still under review and announcements will be made in due course.
Making it Work in Your Business
NDIS Disability Support Model
From 1st July 2022, price limits for all NDIS supports delivered by disability support workers will increase by 9%, including a 2% temporary loading in 2022-23 (reviewed annually). Participants’ plans will be indexed and all current NDIS plan budgets will be automatically increased to account for these price limit changes.
Providers will need to ensure relevant accounting processes including invoicing and quoting information is updated to reflect these changes. In particular, there have been many support items that have been removed. We recommend that providers download the NDIS Support Catalogue in Excel format and check the Legacy Support Items Tab for items that have been removed and the date they will no longer be claimable. You can also use the filter function on the columns (the small arrows at the top of column names) to help sort and find relevant information quicker.
Any changes that are relevant to the services you provide will need to be discussed and agreed with participants so they are aware of changes that will impact them.
Additionally, if not already completed, providers will need to update relevant staff wage payments to align with the SCHADS Award and Fair Work Commission updates. For more information, see the SCHADS Award article here.
It will be important to update financial budgets/planning to account for the increased costs experienced with the wages and superannuation increases, as well as the relevant changes to the NDIS Price Guide. Therefore if there are supports that are not sustainable, you can make informed decisions about how to approach your ongoing services.
Registered Plan Managers can claim $104.45 per 30 days for a maximum to 90 days after a participant’s death if they are required to undertake usual plan management activities (e.g. processing invoices, payment integrity, etc.) in respect of a participant.
In the month of the participant’s death, a Plan Manager is still eligible to claim the normal monthly processing fee. To be eligible to claim this payment, the participant must have passed away on or after 01/07/2022 and registered Plan Managers:
- must be registered for the registration group: 0127: Management of Funding for Supports in Participants’ Plans,
- must have engaged the participant before the participant’s death,
- must ensure that the National Quality and Safeguards Commission is notified of the participants death date,
- must lodge any claims for this payment within 90 days of the participant’s death date,
- Can only lodge up to 3 claims per participant, and
- must only lodge claims where the plan manager processes invoices or undertakes activities directed by the NDIA.
Invoices for goods or services delivered after the participant dies will be rejected in the portal. These invoices will need to be sent via the Payment Enquiry function within the portal. The Payments team will review these invoices and inform you of the next steps.
From 1 July 2022, Supported Independent Living providers can claim support following a participant’s permanent exit from a SIL due to their death. This can be claimed weekly for a period of up to 28 days or 4 weeks, at the rate specified in the participant’s plan.
These claims need to be made via the Payment Enquiry function. All claims of this type must be done via invoice.
Support workers may also charge for two-way travel if you’re located in a regional or remote area. They must inform you about the travel charges and gain your agreement before the travel occur, and plan agreements will need to be updated to reflect any changes.
The maximum time that can be billed per trip is 30 minutes (60 minutes return), or 60 minutes (120 minutes return) according to the remoteness of the location.