NDIS pricing arrangement and price limits: what all disability support workers should know
Many clients on Mable are National Disability Insurance Scheme (NDIS) participants and are subject to NDIS pricing arrangements and price limits.
Support funded by the NDIS needs to:
- Be in line with the participant’s goals, objectives and aspirations as set out in their plan;
- Not include day-to-day living costs that are not related to a participant’s disability support needs;
- Represent value for money; and
- Be likely to be effective and beneficial to the participant.
Many types of support also have price limits. If your client has an NDIS plan manager (plan-managed), exceeding an NDIS price limit will result in your support hours being rejected. Rejected hours will not be paid.
We’ve compiled some helpful FAQs for you to learn more (accurate as of 1 July 2023).
What are NDIS pricing arrangements and price limits?
NDIS Pricing Arrangements and Price Limits (previously the NDIS Price Guide) assist NDIS participants and their disability support providers in understanding how price controls for supports and services work. NDIS price limits are set by the National Disability Insurance Agency (NDIA), which administers the NDIS. Price limits vary depending on the service, timing, intensity of support and location.
NDIS price limits are the maximum hourly rates that can be paid by plan and agency-managed NDIS participants. On Mable, independent support workers negotiate their rates and typically charge less than the maximum NDIS price limits, to meet client expectations.
NDIS Pricing Arrangements and Price Limits are reviewed at least once annually on 1 July.
Why are there price limits?
The National Disability Insurance Scheme Act 2013 states the cost of support must be reasonable and relative to the support provided and the costs of alternative support. The NDIA reviews and updates NDIS price limits to consider market trends, cost changes and average wage rates.
How do I make sure I don’t charge above NDIS price limits?
Price limits apply to most types of support for NDIS plan-managed and agency-managed participants. Self-managed NDIS participants are not restricted by NDIS price limits but are guided by them. All support must be reasonable and necessary to meet a participant’s needs.
To check your rate is within NDIS price limits
- Look up NDIS price limits, by service type, time and location.
- Include Mable’s client platform fee by calculating:
NDIS price limit ÷ 1.0795 = Max agreed rate you can charge.
If you enter a rate that exceeds an NDIS price limit, the Mable platform will alert you and provide further information.
Can I charge lower than the maximum rate?
Yes. Mable gives workers and clients mutual choice and control over rates charged and rates paid. You are encouraged to negotiate your rate with your clients to ensure you can charge a reasonable rate for your skills and experience, and clients can maximise their funding to get the support they need. You can find more information on how to set your rate in our guide: Setting your indicative rates on Mable.
How does the time and day of the week of a support session affect the NDIS price limit?
NDIS price limits can vary based on the day and time of your support session. If you provide support at different times and days of the week, you may want to include multiple rates in your agreement.
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).
How does the location of the support session affect the NDIS price limit?
Standard NDIS price limits usually apply. However, there are a small number of regions that are classified as remote or very remote that have higher price limits. To check your client’s region visit NDIS Pricing Arrangements and Price Limits.
How does the intensity of support required affect the NDIS price limit?
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 one instance 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.
Plan-managed and agency-managed clients
If you are providing support to a plan-managed or agency-managed client, contact us via Live Chat to request a specialised service category.
How do group supports affect the NDIS price limit?
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.
Plan-managed and agency-managed clients
If you are providing group support or other specialised services to plan-managed or agency-managed clients, contact us via Live Chat to request a specialised service category.
How could NDIS price limits affect my payment?
If you support an NDIS plan-managed participant on Mable, your invoice will be reviewed by the client’s funding organisation to ensure it doesn’t exceed the NDIS price limit. If your invoice includes rates higher than the NDIS price limit, your client cannot pay using their NDIS funding and the plan manager will reject your support hours. Rejected hours will not be paid.
If your support hours are rejected by your client’s NDIS plan manager, contact us. With your permission, Mable will void the rejected hours. You can then change your hourly rate to be within the NDIS price limit and resubmit your support hours.
Does this mean I need to monitor my pricing?
Yes, if you’re providing support to people with disability, it’s important to stay up-to-date with NDIS pricing arrangements and price limits. Understanding your clients’ funding arrangements can help you find new clients and avoid payment issues.
When discussing rates with an NDIS-funded client or their representative, ask how their funding is managed. If they are NDIS plan-managed or agency-managed, make sure that your hourly rate (inclusive of the Mable client fee) does not exceed NDIS price limits when setting your Agreed Rate in your agreements.
What if I have further questions?
For more information, contact us.