How to Navigate the NDIS Pricing Arrangements & Price Limits

How to Navigate the NDIS Pricing Arrangements & Price Limits

What are the Pricing Arrangements & Price Limits?

Every fiscal year, the Pricing Arrangements and Price Limits are made public to accurately reflect the most current market cost of services. Even though the guide is revised and published every year, there are some instances in which revisions may be necessary (like with Covid-19). When something like this happens, the guide is updated on the website, and the NDIS will post a statement on their website advising users of any modifications that have been made.

The pricing for supports, as well as how providers should charge for their services, price restrictions, and whether or not a quote is necessary, are all outlined in this guide, along with any applicable laws and regulations for the upcoming year. This handbook provides a wealth of information that is both informative and helpful regarding your potential eligibility for NDIS funding claims as well as the categories under which those claims can be submitted.

Guide to the Pricing Arrangements and Price Limits and How to Use Them

The book includes a listing of hundreds of different supports along with their respective descriptions. Therefore, to quickly traverse the guide, you will first need to comprehend how the NDIS classes various forms of support.

The National Disability Insurance Scheme (NDIS) classifies support as “Support Purposes,” “Support Categories,” and “Support Items.”

Help Achieve Objectives

Your Support Goals Can Be Broken Down Into These Categories:

The term “core supports” refers to the primary category of assistance that a person receives to assist with day-to-day tasks, as well as to access and engage in their community.

The Assistive Technology and Home Modification categories are included in the Capital Supports category.

Supports that are designed to help you acquire skills and independence in your day-to-day life, as well as help you achieve your goals, are referred to as capacity-building supports.

Categories of Assistance

Your support purposes can be further broken down into three categories: core, capital, and capacity building. Support categories.

The support for your Core is organized into these four primary sections. They are as follows:

  • Help with the Tasks of Daily Life
  • Consumables
  • Assisting with Participation in Social and Community Activities
  • Transport

The majority of your capital is supported by one of two primary types. They are as follows:

  • Technology Designed to Help People
  • Alterations Made to the House

Your Support for Capacity Building can be broken down into eight different areas. They are as follows:

  • Enhancements to the Living Conditions (sometimes referred to as “CB Home Living”)
  • Participation in social and community activities at a higher level (sometimes referred to as “CB Social Community and Civic Participation”).
  • Obtaining and Maintaining Gainful Employment (also known as “CB Employment”)
  • Enhancement of Relationships (also known as “CB Relationships”)
  • Better Health and General Well-Being (also known as “CB Health and General Well-Being”)
  • Enhancement of Learning (also known as “CB Lifelong Learning”)
  • Choices that are Much Better (or CB Choice and Control)
  • Betterment of Everyday Life (or CB Daily Activity)

Items Used in Support

Every support that is given to a participant by a provider can be categorized as one of the support items that are described in the guide. Payments are demanded by providers against the support item that corresponds to the service that they have provided.

Example of a supporting item:

It specifies the item number (or line item), the item name and comments, and the unit (or how frequently it is charged, such as each, hourly, daily, weekly, monthly, and annual), and then it lists the pricing restrictions for national, remote, and very remote areas respectively.

Since you are now aware of how the NDIS classifies supports, all that remains for you to accomplish is the following:

Locate the support category and the support purpose (i.e., Core Support, Assistance with Daily Life)

Examine the various choices available under the support heading and select the one that is most pertinent to your situation.

Proceed to the page that has the appropriate number.

Examine the aforementioned support’s pricing limits as well as the description of the license.

What exactly is a line item?

Simply told, every single one of the support services that you get will have a line item, or to put it another way, a code, that is associated with it. After that, your service providers will use this code on your bills to indicate to the NDIA what kind of support service they delivered, and the NDIA will use it to figure out which of your support budgets is responsible for paying for the assistance.

What should be done if support qualifies for more than one line item?

Some NDIS services could be classified as belonging to support categories (Core, Capital, or Capacity Building) or line items that are different from one another. If this is the case, you should always select the appropriate line item from either your Capital or Capacity Building Support budget before selecting a line item from the Core Supports category in your budget. The reason for this is that, in general, neither the budget for Capital Supports nor the budget for Capacity Building Supports is adjustable, whereas the budget for Core Supports is flexible.

You could make use of your Core Support budget if you no longer have any available funds in either your Capital or Capacity Building Support budgets.

It’s possible that the NDIS Pricing Arrangements and Price Limits can leave you feeling overwhelmed and confused. Contact either your Support Coordinator, your Local Area Coordinator (LAC), or a member of our support team if you require assistance in better comprehending the functionality of the guide.


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