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Understanding NDIS pricing arrangement and price limits

NDIS participants must follow the rules set by the NDIS Pricing Arrangements and Price Limits (previously the NDIS Price Guide), unless they are self-managed. Below, support workers and clients will both find an explanation of how NDIS Pricing Arrangements and Price Limits work and how they apply to support work booked through Mable. 

What do you need help with?

What are NDIS Pricing Arrangements and Price Limits?
Why are there price limits?
How to to check if worker rates are above the NDIS price limits
What can affect the NDIS price limit?
How could NDIS price limits affect payments?
Understanding Mable service categories and how they align with NDIS support items

 

What are NDIS Pricing Arrangements and Price Limits?

The NDIS Pricing Arrangements and Price Limits are rules set by the National Disability Insurance Agency (NDIA).

The NDIA releases new NDIS Pricing Arrangements and Price Limits each year on 1 July, and regular reviews and updates are made throughout the year.

The funding for every NDIS plan, except for participants who are self-managed, is decided using the rates and guidelines stated in this document. The NDIS Pricing Arrangements and Price Limits is important because it ensures support workers know how much to charge for their services and it helps NDIS participants understand how they can spend their funding. 

Price limits are different depending on the service, timing, location, and intensity of support being provided.

On Mable, support workers negotiate their rates and can charge less than the maximum NDIS price limits, to meet client expectations. Maximum rates are intended for use by NDIS Registered Providers who tend to have higher overheads reflecting their regulatory responsibilities. As a non-registered, small business with lower overheads, you have the opportunity to charge a more cost-effective rate benefiting you and your clients.

 

Why are there price limits?

The NDIS Pricing Arrangements and Price Limits keep the cost of support work fair.

The National Disability Insurance Scheme Act 2013 says the cost of support must be reasonable and relative to the support provided and the costs of alternative support. 

The NDIAs regular updates to the NDIS Pricing Arrangements and Price Limits considers market trends, average wage rates and changes to how much things cost.

 

How to to check if worker rates are above the NDIS price limits

To check the rate is within NDIS price limits follow the steps below.

  1. Look up NDIS price limits, by service type, time, and location.
  2. Include Mable’s client platform fee by calculating:
    • NDIS price limit ÷ 1.0795 = Max agreed rate that can be charged.

If a rate is entered that’s higher than the NDIS price limit, the Mable platform will alert the user and provide further information.

 

What can affect the NDIS price limit?

Time and day of a support session

NDIS price limits will be different based on the day and time of the support session. If support is provided at different times and days of the week, support workers may want to include different rate options in their agreement. 

To cross check price limits with the time you are providing support please see the NDIS Pricing Arrangements and Price Limits

In the NDIS Pricing Arrangements and Price Limits, the following terms are used to describe different times of day and days of the week:

  • Weekday Daytime Support: Between 6 am and 8 pm on a single weekday (unless it is a Night-time Sleepover Support).
  • Weekday Evening Support: Between 8 pm and finishing at or before midnight on a single weekday (unless it is a Night-time Sleepover Support).
  • Weekday Night Support (Active Overnight – hourly rate): Starting at or before midnight on a weekday and finishing after midnight on that weekday, or between 6 am on a weekday and finishing on that weekday (unless it is a Public Holiday, Saturday, Sunday or Night-time Sleepover Support).
  • Public Holiday Support: Starting at or after midnight on the night before a Public Holiday and ending before or at midnight of that Public Holiday (unless it is a Night-time Sleepover Support).
  • Saturday Support: Starting at or after midnight on the night before a Saturday and ending before or at midnight of that Saturday (unless it is a Public Holiday or Night-time Sleepover Support).
  • Sunday Support: Starting at or after midnight on the night before a Sunday and ending before or at midnight of that Sunday (unless it is a Public Holiday or Night-time Sleepover Support).
  • Night-time Sleepover Support (Passive Overnight – flat rate): Starts before midnight on a day and finishes the following day; and is for a continuous period of at least eight hours; and the worker is allowed to sleep when they are not providing support. Includes up to two hours of active support during the support session. An additional hour of active support may be charged at Saturday rates on weekdays or at applicable rates on other days (Saturdays, Sundays or Public Holidays).

Nursing support time and day of the week are calculated differently.  

  • Weekday Daytime Support: Any support starting before 12 pm on a weekday and finishing on the same day (unless it is a Public Holiday, Weekday Evening, or Weekday Night Support). 
  • Weekday Evening Support: Any support starting no earlier than 12 pm on a weekday and finishing after 6 pm on the same day (unless it is a Public Holiday Support). 
  • Weekday Night Support: Any support starting on or after 6 pm on a weekday and finishing before 7:30 am on the following day (unless it is a Public Holiday Support).

Location of a support session

Standard NDIS price limits usually apply. However, there are a small number of regions that are classified as ‘remote’ or ‘very remote’ and have higher price limits. To check a client’s region visit NDIS Pricing Arrangements and Price Limits.

Intensity of a support session

Some types of support have different price limits based on the intensity of support required. Support may be considered as high intensity if the participant: 

  • Frequently (at least once per shift) requires assistance to manage challenging behaviours that require intensive positive behaviour support; and/or
  • Requires assistance from a disability support worker with one or more high-intensity support skills. 

Visit NDIS Pricing Arrangements and Price Limits to learn more about high-intensity supports and any additional experience and qualifications required for them.

Group supports

Some support types have different pricing limits based on the ratio of participants to support workers. Visit NDIS Pricing Arrangements and Price Limits to learn more about group support.
If group support or other specialised services are being provided to plan-managed or agency-managed clients, contact us via Live Chat to request a specialised service category.


How could NDIS price limits affect payments?

When a support worker provides support to an NDIS plan-managed client on Mable, their invoice will be sent to the client’s plan manager for approval. If the support worker’s rates are above the NDIS price limit, the client cannot pay the invoice and the plan manager will reject the support hours.
If this happens, please contact us. With permission, Mable will remove the rejected hours and the support worker can change their rate to make it lower than the NDIS price limit and resubmit their hours.


Understanding Mable service categories and how they align with NDIS support items

The services support workers provide to NDIS participants who aren’t self-managed must be aligned with one of the support items listed in the NDIS Pricing Arrangements and Price Limits.

When a support worker creates or updates an agreement, services will be automatically assigned a service category based on the job description and the services they’re verified to provide. 

If the auto-selection doesn’t represent the full range of services the support worker has agreed to provide for the rate they agreed on with their client, they can select additional checkboxes for other services they’re verified to provide. They may need to consider changing their rate if the selections cover multiple categories. 

Always create another rate if the service categories use different parts of the client’s budget.

If the support worker is unsure about the types of support they should be providing, speak to the client.

If they believe a service they’re verified to provide is missing from the list, (for example, if they provide a more specialised type of support) they can request assistance from the Mable team to add a service category.

To do this, follow these steps in the rates section of a new agreement, or an agreement being updated, to access an online form:

  • Select Looking for another service category? 
  • Select Request a service

Alternatively, contact us using Live Chat. We’ll do an identity check and send a link to an online form.

Refer to the table below to understand how Mable service categories align with NDIS support items.

Mable service categoryNDIS support itemsServices this includes
Domestic Assistance (general cleaning/ gardening service)Assistance with Personal Domestic Activities– General cleaning and housework 
– General gardening and yard work
Personal Care and/or Daily Living AssistanceAssistance with Self-Care ActivitiesSupport with everyday tasks. For example:
– Meal prep
– Light cleaning
– Personal admin
– Shopping

Personal care
– (Additional qualification required)
– Bathing/showering
– Toileting
– Assistance with eating

May include providing transport during the delivery of services.
Social Support and/or Community AccessAssistance to Access Community, Social and Recreational ActivitiesEnabling a participant to engage in community, social and recreational activities. This may include:

– Attending appointments and social events
– Attending community events, sports or personal interest events.

May include providing transport during the delivery of services.

Mable service categoryNDIS support items
Nursing Services
(The Mable platform will refer to the services you’re verified to provide.)
Delivery of Health Supports by a Registered Nurse (Capacity Building)

Or

Delivery of Health Supports by an Enrolled Nurse (Capacity Building)
Occupational TherapyAssessment Recommendation Therapy or Training – Occupational Therapist
PhysiotherapyAssessment Recommendation Therapy or Training  – Physiotherapist
PsychologistAssessment Recommendation Therapy or Training – Psychologist
Speech PathologistAssessment Recommendation Therapy or Training – Speech Pathologist

For more information about NDIS support categories and support items, refer to the NDIS Pricing Arrangements and Price Limits.