How to navigate the NDIS Price Guide
Released annually, the NDIS Price Guide is basically the NDIS rule book. It provides an overview of how participants can use their funding and how service providers can charge for their services.
But given it’s more than 50 pages long and uses some rather complex language, the Price Guide can seem a rather daunting document to the uninitiated – so in this guide, we explore how you can navigate the Price Guide with confidence.
Plan Partners’ NDIS Price Guide Navigator
To make navigating the NDIS Price Guide easier, we created this handy tool. Browse support categories or search for a particular product, service or NDIS code.
What is the Price Guide?
On July 1 of every year, the NDIS release a new Price Guide. As the name suggests, the Price Guide outlines pricing arrangements for various supports, including how providers must invoice, any price caps that apply, and whether a quote is required. It also contains the latest rules and regulations that apply for the year ahead.
While it’s mostly used by service providers, participants can use the Price Guide to look up supports and get an idea of how they will spend their budgets.
How do I use the Price Guide?
The Price Guide contains information on more than 800 different kinds of supports, often with complex descriptions. To make it easier to find what you’re after, we created Plan Partners’ Price Guide Navigator. The Navigator is essentially an interactive version of the Price Guide, letting you browse support categories or search for a particular product, service or NDIS code to discover more about its pricing arrangements.
In order to use the Price Guide effectively, it helps to familiarise yourself with how the NDIS categorises supports…
Support Purpose: All NDIS supports fall into one of three support purposes: Core, Capital and Capacity Building. Core Supports are basic things people with disability need in their life; Capital Supports are more significant, one-off purchases; and Capacity Building Supports help participants build their independence.
Support Categories: Each support purpose is divided into support categories, which participants receive funding for in their NDIS plans. Core support budgets can be used flexibly – that is, to fund any other Core support – however Capital and Capacity Building support budgets can only be used for that specific support category. There are 15 support categories to navigate.
Line item: Every service delivered under the NDIS has a line item attached to it. This is basically the code that tells the NDIS which of a participant’s support category budgets the service should be paid from. There are more than 800 line items and they often have very difficult names. Plan Partners’ Price Guide Navigator helps you find the right line item easily.
How do price limits work?
One of the most important parts of the Price Guide are the price limits set by the NDIS, which are the maximum amount that service providers can charge to deliver a particular support.
There are some key things to keep in mind when it comes to price limits:
- The maximum amounts listed include GST.
- For each support, the Price Guide will show three amounts depending on a participant’s location: The more remote an area is, the more providers can charge.
- Not all supports have a price limit.
- Assistance with Daily Life (Category 1) and Assistance with social and community participation (Category 4) have different price levels depending on whether the support is delivered during the day or evening (after 8pm), and whether it’s a weekday, weekend, or public holiday. Each scenario has its own line item.
- Assistance with Daily Life (Category 1) and Assistance with social and community participation (Category 4) also have different price levels depending on the intensity of support being delivered. These range from level 1-3, with levels 2 and 3 requiring a more experienced support worker. Once again, each scenario has its own line item.
- Services that can be delivered by TTP eligible providers include a separate line item and price limits that factor in the 6% loading (TTP stands for Temporary Transformation Payment, a charge that’s intended to help service providers meet the costs that come with transitioning to the NDIS).
What if a support can be covered by several line items?
There are some NDIS supports that could be covered by several support categories, or even specific line items. In these cases, the most appropriate support category budget must be used first and Core Support budgets used last. This helps ensure participants aren’t left with non-flexible funding that they’re unable to use.
For example, if a participant rents a piece of equipment it should be paid for using their Assistive Technology (Capital) budget first. If there’s no funds remaining in that budget, then it can come out of their Consumables (Core) budget.
A participant’s Exercise Physiology session should be paid out of their Improved Health and Wellbeing (Category 12) budget. If they have no Category 12 funding in their plan, then it can come out of Improved Daily Living (Category 15) budget.
Find out more
We know that navigating the NDIS Price Guide can be very complex. Our Price Guide Navigator makes it a lot easier. If you still have questions, just give our friendly team a call on 1300 333 700 or leave your details here and we will contact you.