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NDIS PRICE GUIDE UPDATE FOR SERVICE PROVIDERS – OCTOBER 2019

NDIS PRICE GUIDE UPDATE FOR SERVICE PROVIDERS – OCTOBER 2019

The NDIS have made another major change to its Pricing Guide, this time expanding the scope of what can be funded under the NDIS.

 

From the 1st of October, NDIS participants will be able to use their funds to cover disability-related health supports.

 

This change is a big step in the right direction for the sector, putting an end to lots of uncertainty amongst NDIS participants and service providers about where funding for these supports is coming from.

 

WHICH HEALTH SUPPORTS ARE COVERED?

The first thing to make clear is that the NDIS will only fund health supports that are directly related to a person’s disability and are considered ‘reasonable and necessary’, just like all other NDIS funded supports. In addition, the disability-related health supports have to be related to ongoing conditions. In other words, if someone slips in the shower and hurts themselves, they won’t be able to use their NDIS funds to pay for the doctor’s visit; but if they have diabetes, they’ll be able to fund the implementation of a diabetic management plan.

 

Covered by the NDIS Covered by the health system

Health supports that are…

  • Required on a regular basis, and 
  • Related to a person’s disability and considered ‘reasonable and necessary’

 

For example:

  • Swallowing therapy associated with dysphagia
  • Nutritional meal plan
  • PEG feeding
  • Wound and pressure care
  • Catheter maintenance and care
  • Epilepsy seizure monitoring
  • Diabetic management support 

Health supports that are…

  • Not required on a regular basis
  • Not related to a person’s disability
  • Acute and provided in a hospital or other health setting

 

For example:

  • Emergency services
  • Outpatient care
  • Preventative health care
  • Dental care and other clinical treatments

 

 

For a full overview of the types of disability-related health supports covered, visit the NDIS website: https://www.ndis.gov.au/understanding/supports-funded-ndis/disability-related-health-supports

 

DO I NEED TO DO ANYTHING DIFFERENTLY UNDER THE NDIS?

You will need to keep a few things in mind when providing disability-related health supports:

 

Training         

The NDIS requires support workers and nurses to be appropriately trained to support people with a disability. The NDIS have now also introduced 5 categories of nurses, which will impact the price limit.   

 

Invoicing       

Ensure you know how to invoice under the NDIS. This includes things like knowing the correct line item number, knowing the maximum price limit, and including all relevant information. If your customers are being Plan Managed by Plan Partners we can help you with invoicing correctly under the NDIS. You can even easily create and submit invoices online through our Fast Payment System. Find out more about invoicing under the NDIS with Plan Partners herehttps://planpartners.com.au/getting-your-invoices-paid-faster-and-easier.

 

If you’re relatively new to the NDIS, we encourage you to download our service provider eBook ‘Working with the NDIS’ and familiarise yourself with the NDIS and how invoicing works.


SUPPORT CATEGORIES FOR HEALTH SUPPORTS

The updated price guide includes over 90 disability-related health supports. These will not receive a new support category of their own, but will rather fit into the existing categories. The table below shows which health support is funded by which category. For a full breakdown of what’s now covered under the NDIS, see the updated NDIS Price Guide.

 

Health Support Type Funded by support category
Disability-related health support that’s provided by a disability support worker

CORE funding category 1 – Assistance with Daily Living

Health related Assistive Technology (under $1,500)

 CORE funding category 3 – Consumables

Health related Assistive Technology (over $1,500)

Category 5 – Assistive Technology.

(The NDIA will likely need to approve a quote before providing funding)

Disability-related health support that’s provided by a nurse or therapist

Category 15 – Improve Daily Living.

NOTE: If you don’t have funding for Category 15 you are able to use CORE funding category 1 – Assistance with Daily Living (this is a temporary measure and will be removed once the NDIA has reviewed all plans).

 

It’s important to note that participants won’t immediately receive any additional funding to cover these disability-related health supports, so any health supports they receive will come out of their existing funds and may impact the supports they can receive. As such, we strongly recommend agreeing on a price ahead of time and establishing a service agreement with the customer.

 

MORE INFORMATION?

Contact the NDIS on 1800 800 110 if you would like to know what impact this change might have on your business.

Of course, you can also give our friendly team a call on 1300 333 700. At Plan Partners, Australia’s leading expert in NDIS Plan Management and Support Coordination, we have supported thousands of NDIS participants and their service providers navigating the NDIS.

 

FOR NDIS Participants

Click here to read our article for NDIS participants about the new Price Guide changes.

 

TOP TIPS

  • You can start providing disability related health items from 1st October 2019 (note that the NDIS won’t cover any health items or services purchased before 1st October).
  • While disability support workers can provide health related support, the NDIS requires them to receive appropriate training.
  • As the NDIS has not increased the participant’s funding for these supports, always check with your customer if they have sufficient funds. We suggest you sign a service agreement with your customers outlining the total cost of support.
  • If your customer does not have sufficient funds under Category 15 for therapy and nurse support, the NDIS has temporary allowed providers to claim from Core supports, category Assistance with Daily Living. Access to CORE funding will be removed once NDIA has reviewed all plans.
  • Our Fast Payment System has included all the new line items, so you easily start creating and submitting invoices for disability-related health supports.

 

6
Barry Mckee (not verified)   03rd October, 2019

I am partly paralyzed and over weight and find it extremely hard to exercise to keep the weight off. As part of the new scheme can I use some of my funds too seek a dietician yo draw up an initial plan for me and then say a quarterly review to keep thr weight loss in place.
Also I believe I am suffering from sleep apneay which is affecting my day by day activities and falling asleep at any given time with no given notice, subject to getting quotes can it be covered by NDIS.

Thanks

Plan Partners   03rd October, 2019

Hi Barry,

Thank you for your question. The NDIS will fund what they deem 'reasonable and necessary' for a participant's individual circumstances.

If you would like, give us a call on 1300 333 700 and we can assess your personal situation and discuss how we may be able to assist you in getting the supports you need.

Warm regards,
The Plan Partners team

Alicia Brook (not verified)   04th October, 2019

Hi, just wondering how much cleaners are allowed to charge?

Plan Partners   04th October, 2019

Hi Alicia,

Thank you for your question. Currently, "Household Cleaning and Other Household Activities" have maximum prices of $49.16 (non-remote), $68.82 (remote) and $73.74 (very remote) according to the latest NDIS Price Guide.

You can download the full Price Guide here: https://www.ndis.gov.au/providers/price-guides-and-information

Warm regards,
The Plan Partners team

Wendy Borovina (not verified)   09th October, 2019

Our Dietitians will do home visits in Gold Coast Area

Plan Partners   09th October, 2019

Hi Wendy,

Thank you for letting us know. We work with thousands of NDIS registered and unregistered providers all around the country and have our own Plan Partners Service Provider Network. If you would like to be a part of our network, you can learn more about the benefits and sign up here: https://www.planpartners.com.au/service-providers

Warm regards,
The Plan Partners team

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