Therapy Services - Making the NDIS Work for You
Many NDIS participants have some type of therapy in their plan, such as physiotherapy, speech therapy, occupational therapy or support from a dietician. For many, therapy is crucial to achieving the goals in their NDIS plan – but accessing it with your NDIS funds can be complex and hard to understand. Various therapies and supports can feature in several categories, so it’s often difficult to keep track of your spending and sometimes therapists struggle to find out how to invoice their services or what price to charge.
This article explains how therapy works in the NDIS and gives you some tips on how to get the most out of your NDIS therapy budgets.
What types of therapy are covered by the NDIS?
In its own words, the NDIS will cover “therapeutic supports, including behaviour support.” But, given how many kinds of therapies exist, what exactly does that mean? It depends on the goals you’ve set out in your NDIS plan and what’s considered "reasonable and necessary". As a general rule, if you can show that a therapy relates to your disability, will deliver an expected outcome, and is aligned with your goals and objectives, the NDIS will fund it.
There are three main categories in your NDIS plan that can cover your therapies:
1. Improved Daily Living
This is usually the support category that covers therapy services in your NDIS plan, and it includes most of the major therapeutic treatments. As the name of the category suggests, it covers all therapy that can ‘improve your daily living skills’, from speech therapy to art therapy.
The maximum hourly rates in this category can vary depending on the type of therapy, from up to $43.48 for community engagement assistance to up to $193.99 an hour for general individual assessment, therapy and/or training. And while that’s all that’s needed in some situations, your particular therapy might actually be covered under a more specific support category with a higher hourly rate, such as in the other two categories, Improved Relationships and Improved Health & Wellbeing.
2. Improved Relationships
Therapies that are covered under this category are intended to help you make positive changes to your ability to socialise and relate to others. It can provide funding to help control concerning behaviours, and can include supports like psychologists, behavioural therapists and psychiatrists.
In this category, there are three different rates, depending on the type of support. The highest rate of up to $214.41 an hour (in ACT, NSW, QLD and VIC) is for highly specialised ‘behavioural intervention support’.
3. Improved Health & Wellbeing
This category covers funding for activities which can help you support, maintain or increase your physical mobility or wellbeing. It can include funding for supports like dieticians, exercise physiology and personal trainers.
In this category, maximum hourly rates can vary, depending on the type of supports, from up to $55.66 for group exercise physiology to $193.99 for individual dietician support.
How do I get my therapy service included in my NDIS plan?
At Plan Partners, we see many people who have Improved Daily Living supports in their NDIS plan, but require specialist therapies that should actually be covered by one of the two other categories mentioned above. They often run into trouble when their therapist invoices them for more than the maximum rate that can be charged within Improved Daily Living Skills.
To prevent this from happening and ensure you get therapies under Improved Relationships or Improved Health & Wellbeing included in your NDIS plan, there are some key things you should do:
- Firstly, ask for these therapies in your planning or annual review meeting.
- Make sure you link your request back to your goals and be as specific as possible.
- Take any supporting documentation with you that might help to show the benefits of therapy and how it relates to your goal. This might include a reference from your therapist, a testimonial from a carer, or even photos from a therapy session.
- If you don’t have a planning meeting or annual review coming up, you can contact the NDIS and request a review of your NDIS plan. Please note that this can take quite some time.
If you have any questions relating to your specific situation, please contact us or give our friendly team a call on 1300 333 700.
- Ensure you tell your service provider what support category you have funding for. If they invoice for the wrong item, the payment may not be processed quickly, resulting in delays and potential disruptions to your care.
- If you think your Improved Daily Living therapy should actually be covered under Improved Relationships or Health and Wellbeing, you could consider requesting a review of your plan.
- Don’t be afraid to ask your planner to include Improved Relationships or Health and Wellbeing funding in your plan, as it’s common for them to be lumped under Improved Daily Living. Take any supporting documentation with you.
- If you’d like to know the exact hourly rates for the therapies your receive, make sure to check the NDIS price guide.
- Speak with an expert, like Plan Partners, if you have any questions around getting a specific therapy covered in your plan.
More information? Just call our friendly team on 1300 333 700 or leave your details here.
This is the fifth article in our 'Making the NDIS work for you' series. Read the other articles here:
- Playing sport
- Meal preparation and delivery
- Gardening, cleaning and home maintenance
- Equipment and Assistive Technology
- iPads, smartwatches and other tech
- Finding and keeping a job
- Sex therapy and family planning