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NDIS

How NDIS cap rates could affect your supports

Last updated 27 June 2022

If you’re a support worker providing assistance to people living with disability, there’s a good chance your client is an NDIS participant. This means they receive funding that is subject to cap rates/price limits set by the National Disability Insurance Agency. Cap rates may be affecting the amount of work you are receiving on the Mable platform, so here are some things to bear in mind.

What are cap rates/price limits?

Cap rates (or 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. Over 30% of clients living with a disability on the Mable platform self-manage their NDIS funding – this means they are not subject to cap rates. However, almost 80% of NDIS participants on Mable are either plan managed or NDIA managed.

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.

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. Most recently, the NDIA released the NDIS Pricing Arrangements and Price Limits 2022-23 (previously the NDIS Price Guide) on June 22, 2022. It is important that clients and independent support workers are aware of current cap 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 5% client service fee, which adds a small cost to the overall amount. 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.

If your weekday payment rate is $55 and you provide one hour of support to a client, your client will pay Mable $55 plus a 5% service fee which amounts to $2.75.

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 $64.68 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.

To read more about different NDIS cap rates around other supports, such as sleepover or respite care, take a look at the NDIS Price Guide.

If you know your client’s NDIS cap rates and which service fees apply to them, you can use our NDIS Cap Rate Calculator which can be found at the end of this article.

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 June 2022 for accuracy and relevance.

    Tags

  • NDIS cap rates
  • NDIS funding
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