If you are NDIS funded and use the Mable platform, you may be subject to NDIS cap rates. These cap rates affect how much you spend on supports from health service providers like Mable. If you’re wondering how NDIS cap rates might affect your supports via the Mable platform, continue reading.
Cap rates (or price controls) apply to NDIS funded individuals whose funding is managed by a Registered Provider or by the National Disability Insurance Agency (NDIA). Cap rates are monetary limits that allow the NDIA to maintain the costs charged by Registered Providers and independent support workers like those on the Mable platform.
It’s important to note that cap rates are not applicable to NDIS funded clients who self-manage their supports.
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 wage rates. If you’re a support worker, coordinator or client in the disability sector, it’s important to be aware of current cap rates.
The most commonly applied cap rates are those under assistance with self-care activities. These rates fall anywhere between $48.14 and $104.08 per hour depending on the time and day support is provided. You can see the standard self-care activity cap rates on page 32 of this document.
If you’d like to see which cap rates apply to your funding, the current Price Guides for NDIS service providers are a useful guide. You can view current Price Guides for New South Wales, Victoria, Tasmania, and Queensland here and current Price Guides for the Australian Capital Territory, Northern Territory, South Australia and Western Australia here.
If you are a consumer on the Mable platform and your NDIS funds are managed by a Registered Provider, you should consider these three costs:
- Mable’s 5% client service fee which is added to the cost of your support worker’s services;
- the hourly rate set by the support worker on Mable;
- any service fees charged by your plan manager or Registered Provider.
The above costs may cause your supports to exceed NDIS cap rates. If you’re concerned about this, contact your Registered Provider.
These examples can help you understand how service fees and payment rates can affect your supports.
Example 1: Exceeding the cap rate
If your supports fall under the description “Assistance With Self-Care Activities – Standard – Weekday Daytime” [reference number 01_011_0107_1_1]”, the current cap rate for this service in NSW is $48.14 per hour according to the 2018-19 NDIS Price Guide.
Your support worker might have a weekday payment rate of $45 per hour and you might agree to one hour of support from them totaling to $45. A 5% Mable service fee of $2.15 will also be charged to you.
Your NDIS Registered Provider may also charge a 12% service fee which will add to the payable amount. In this case, the service fee is $5.40. These fees vary from provider to provider, so this rate is only illustrative. Please check with your Registered Provider to confirm what your service fee is, if relevant.
The total of the pay, the Mable service fee and the management service fee is $52.55. This amount exceeds the NDIS cap rate and your NDIS funding will not cover this cost.
Example 2: Falling within the cap rate
If your supports fall under the description “Assistance With Self-Care Activities – Standard – Saturday [reference number 01_013_0107_1_1]”, the current cap rate for this service in NSW is $66.77 per hour according to the 2018-19 NDIS Price Guide.
Your support worker might have a weekend payment rate of $37.50 and you might agree to 3 hours of support from them totaling to $112.50. A 5% Mable service fee of $5.62 will also be charged to you.
Your NDIS Registered Provider may also charge a 12% service fee which will add to the payable amount. In this case, the service fee is $14.17. These fees vary from provider to provider, so this rate is only illustrative. Please check with your Registered Provider to confirm what your service fee is, if relevant.
The total of the pay and the service fee is $132.29 (or $44 per hour). This amount is within the applicable cap rate and your NDIS funding will completely cover the cost of your support.
There are many different cap rates and each individual receiving NDIS funding may require different levels of core supports.
If you’re hoping to receive support from an independent support worker but are concerned their payment rates and applicable service fees exceed your NDIS cap rate, you can always discuss altering the payment rate with them.
NDIS Cap Rate Calculator
To find out how cap rates can affect your support, use our NDIS Cap Rate Calculator. This calculator is based on the most common support provided through Mable. For more information on different cap rates, visit the 2018-19 NDIS Price Guide.
Please note, the calculator and information in this article are designed as a guide and should not be solely relied on when designing your NDIS plan. We recommend that if you have questions about the NDIS, accessing the scheme, or your plan specifically, to get in touch with the NDIA or visit the NDIS Pricing and Payment site.