From time to time, you may have heard about fees in the National Disability Insurance Scheme (NDIS) and wondered what they are, and when it’s okay for you to charge them.
Or, you might have queried how to present those fees to your clients, so they’re easily understood and justified, and so no curly questions come your way when you submit your invoices.
Brush up on your knowledge and find out which charges you can pass on to your clients and which you need to absorb by reading this breakdown of operational costs in the NDIS – drawn directly from the NDIS Pricing Arrangements and Price Limits.
And once you’ve gone through it all, make sure to talk with your clients and their support networks too – the sooner you open the lines of communication between them and you, the better!
An establishment fee is a once-off charge that covers the non-claimable time required to establish support arrangements with an NDIS participant. Providers who assist participants with the implementation of their NDIS plans can charge this fee if they have an agreement to provide supports for a minimum of 20 hours each month across three or more consecutive months. Examples include:
Personal care supports (Assistance with Daily Life) – supports delivered by providers in the Daily Personal Activities (0107) and High Intensity Personal Activities (0104) registration groups. The National Disability Insurance Agency (NDIA) sometimes refers to this category as Activities of Daily Living.
Participation supports (Social and Community Participation) – supports delivered by providers in the registration groups covering Participation in Community, Social and Civic Activities (0125), Group and Centre Based Activities (0136), Specialised Supported Employment (0133), and High Intensity Daily Personal Activities (0104) when delivered for community access or group supports. The NDIA can sometimes refer to this category as Social, Economic and Community Participation.
Note: If you’re an allied health provider, every support you deliver is aligned to a registration group. Registration groups are located inside the NDIS Pricing Arrangements and Price Limits, under Support Purposes, Support Categories and Support Items, and each item in the Support Catalogue specifies the registration group.
Providers can only claim one establishment fee per participant, regardless of whether they provide services to them through more than one registration group or support category.
Providers can charge participants for time spent on a range of non-face-to-face tasks – things they do when a participant isn’t present to ensure their client can participate in group or centre-based supports. Examples may include:
Providers can’t charge their NDIS clients for training and upskilling staff, supervision, or time spent on administration (things like processing claims or developing service agreements).
Charging a centre capital fee helps providers to meet the costs of running and maintaining physical premises.
The fee can be charged at a per participant/per hour rate if High Intensity Daily Personal Activities (0104), Specialised Supported Employment (0133) or Group and Centre Based Activities (0136) – items in the Assistance with Social, Economic and Community Participation category – are provided to the participant at the premises.
If supports are provided onsite and in the community – but the premises are always available during the period of support delivery – providers can claim the full centre capital fee.
The NDIA doesn’t set price caps for provider travel so, if participants are aware of the fees that are proposed and they consent to them, providers can charge as much or as little as they like.
The NDIS Pricing Arrangements and Price Limits separates the labour and non-labour costs associated with provider travel – with labour costs covering the time spent travelling to/with a participant, and non-labour costs addressing expenses like road tolls, parking fees, and the costs of running a vehicle.
Cancellations are common in the NDIS, and the NDIA has specific rules about charging participants for them.
We explained cancellations to participants in this article.
Where a provider receives a short notice cancellation from a participant (or a no show), they can claim 100 per cent of the agreed fee associated with the activity, subject to the NDIS Pricing Arrangements and Price Limits and the terms set out in the service agreement they have with their client.
Providers can’t charge cancellation fees for costs they didn’t incur, like mileage.
Find out more about cancellations by reading this provider-focused overview.
According to the NDIA, providers can’t charge for ‘meet and greets’ before or after services commence, and fees like credit card surcharges, late payment fees and administration fees can’t be passed on to clients.
NDIS participants aren’t liable for exit fees. But if they end a service agreement early, they may be charged a cancellation fee, depending on the terms of agreement.
The NDIS Pricing Arrangements and Price Limits is the best source of information about fees and charges. Outside of the Agency’s requirements, it’s up to a provider to decide what they’ll charge.
We encourage providers to be fair and transparent and to speak with participants before supports commence to explain what charges they can expect (or what fees they won’t ever see). Many providers offer quotes and explanations about how fees are billed, which can help participants to budget, and we advise our clients to make sure their providers set everything out in writing in a service agreement that’s signed by both parties.
For more information about NDIS fees and charges, give us a call on 1800 861 272 from 8am-6pm (SA time), Monday to Friday.
