What are NDIS Price Limits?
NDIS Price Limits apply to NDIS participants whose funding is managed by a plan manager or the National Disability Insurance Agency (NDIA). These rates are monetary limits that allow the NDIA to monitor the costs charged by Registered Providers and independent support workers like those on Mable. Clients who self-manage their NDIS funding are not subject to cap rates.
If you provide support to an NDIS participant on Mable, your rate may be reviewed by the client’s Registered Provider to ensure that it does not exceed the cap rate.
The limits are updated annually in the NDIS Pricing Arrangements and Price Limits.
Why are there cap rates?
The National Disability Insurance Scheme Act 2013 claims that the cost of supports must be reasonable and relative to the support provided and the costs of alternative support.
The NDIA updates cap rates annually to take into account market trends, changes in costs and average wage rates.
How can they affect my work?
If you’re a disability support worker providing support through Mable, and you are charging a higher hourly payment rate than the core support cap rates, clients living with disability may not hire you. The most commonly applied cap rates are those that fall under assistance with self-care activities. These rates can be anywhere between $62.17 and $213.53 per hour depending on the time and day support is provided, and the state in which your client lives.
When considering your hourly payment rate on Mable, you should also take into account Mable’s client service fee. Your client’s Registered Provider may also implement a service fee that could increase your client’s payable amount.
Example: exceeding the cap rate
If your client lives in NSW and receives core supports under the support item ‘Assistance with self-care activities during daytime weekdays [reference number 01_011_0107_1_1]’, their cap rate for this service is $62.17 per hour according to the NDIS Pricing Arrangements and Price Limits 2022-23. (Please note this is just an example and these rates have since changed.)
If your weekday payment rate is $55 and you provide one hour of support to a client, your client will pay Mable $55 plus their Mable platform fee (7.95%) which amounts to $4.37.
Your client’s NDIS Registered Provider may also have a service fee that will add to the amount. In this case, the service fee is 12% and will amount to $6.93. These fees vary from provider to provider, so this rate is only illustrative. Please check with your client to confirm what service fees are applicable to them.
This means that the total amount is $66.30 and this exceeds the NDIS cap rate for your client. Your client will not be able to pay for this cost with their NDIS funding.
Exceeding NDIS price limits can result in in your support hours being rejected by an NDIS plan manager, and rejected hours may not be paid. If the rates you enter in an agreement exceed price limits, you will be alerted by the Mable platform.
What does this mean for me as a support worker?
If you’re looking to provide support to people living with disabilities, when you are discussing rates, it’s important to have a conversation about whether they are NDIS funded and ensure the agreed rate will fall within the NDIS price limits for the items included in their plan. Ensuring this is clear from the outset will avoid unnecessary delays when the NDIA processes your invoices.
We want to provide support workers with opportunities to connect with clients and help create lasting support connections. To start giving back to your community and begin working for yourself, sign up to Mable today.
Please note, the information in this article is designed as a guide and should not be solely relied on when designing your NDIS plan. If you have questions about the NDIS, accessing the scheme, or your plan specifically, we recommend getting in touch with the NDIA or visiting the NDIS Pricing and Payment site.
Editor’s note: This article has been updated in April 2023 for accuracy and relevance.
