Has it felt like keeping your business afloat gets harder every year? Well, unfortunately, you're not alone. Rising inflation, staff wages, insurance premiums, and even the cost of keeping the lights on and the car running, all adds up. And if you're in the business of supporting National Disability Insurance Scheme (NDIS) clients, the figures can look even tougher.
Add to that the growing admin burden of audits, compliance, and policy changes that shape your day-to-day, and the cost of care keeps growing.
But most people don’t choose this work for the money. They do it because they care deeply about improving lives – and we’re willing to bet you’re one of them.
Many providers go above and beyond, sometimes doing unpaid work just to keep the doors open and not let their clients down. That’s admirable, but it's definitely not sustainable. So, when the Australian Government recently announced price cuts to a number of NDIS services – including some therapies – it’s no surprise there was pushback.
You can read more about the rule changes that brought these cuts in here, but you’ve probably heard about the concerns from a number of peak bodies and providers across the sector anyway.
According to the National Disability Insurance Agency (NDIA), the latest round of price cuts has been geared in favour of participants and designed to keep the Scheme viable. The Agency says it’s all about tackling inflation and creating fairer and more equitable pricing that’s more in step with broader market rates.
But there's a major factor missing here – making it harder for providers to operate means fewer providers overall. That means less choice for participants, fewer options, and less control over the supports they need. And isn’t choice and control what the NDIS is supposed to be all about?
The Australian Physiotherapy Association (APA) has called for action from the Federal Government, saying recent price cuts to physiotherapy have stretched NDIS providers to breaking point. It says experienced clinicians are likely to exit the sector, reducing the availability of support for participants.
“We must act now to ensure the viability of our profession and protect the people we serve,” says the APA.
Occupational Therapy Australia reports the price freeze in its domain has left hundreds of occupational therapy businesses ‘on the brink of financial ruin’, with thousands of NDIS clients at risk of being left without care.
Meanwhile, the Australian Greens have called on the Federal Government and the NDIA to ‘engage in urgent and meaningful consultation with health professionals and disability support providers’.
Senator Jordon Steele-John, Australian Greens spokesperson for Disability Inclusion and the NDIS, says the pricing changes will affect the quality and accessibility of services for NDIS participants, and could result in professionals leaving the sector altogether and some provider organisations being forced to shut their doors.
Teresa Wilkinson, a physiotherapist from Move For Life Therapy, says pricing in the Scheme hasn’t kept pace with growing operational costs or inflation.
“Wages, insurance, fuel, and equipment costs have all increased substantially, yet NDIS pricing has not adjusted accordingly,” says Ms Wilkinson. “This growing gap forces providers to operate on increasingly tight margins, risking service withdrawal and reduced availability for participants.”
Ms Wilkinson says providing NDIS supports carries unique obligations that aren’t present in mainstream healthcare, including compliance, high level communication, reporting, and travel – and for providers like mobile physiotherapists, these costs are significant and unavoidable.
“To provide quality care, we work closely with families, support coordinators, and health professionals, which is something less frequently done in a clinic setting, where care may be limited to a straightforward injury,” she says.
“Higher rates are not about overcharging but about reflecting the true cost of safe, compliant, and individualised service delivery. Communicating this transparently to participants and the NDIA helps maintain trust.”
The NDIS Quality and Safeguards Commission says fair pricing means there’s no major difference between the cost of a product or service for an NDIS participant and the price applied to other customers. It says if a provider sets a higher price for NDIS participants and can’t justify the difference, they may be in breach of the Code of Conduct which now includes rules about price differentiation.
Providers say there’s sometimes a disconnect between rules and reality.
According to Ms Wilkinson, complex NDIS participants often require longer sessions, more provider travel, and additional reporting – all of which increase the cost to serve. She says higher price limits would make service delivery more sustainable and provider consultation is vital to ensuring NDIS pricing is realistic and fair.
“Lower prices will discourage provider registration and may lead to withdrawal of existing providers,” she says. “For small and mobile services, sustainability under the current price limits is increasingly difficult.”
“If more providers exit, participants will have fewer choices, longer wait times, and reduced access to essential supports. This will particularly affect participants in regional or outer-metro areas. For participants with mobility challenges or those living in regional areas, mobile physiotherapy (and other therapy providers) may become harder to access. Ultimately, this decreases the Scheme’s ability to provide choice and control.”
Ms Wilkinson says many providers have cut back on travel, limited their service areas, and reduced the time they spend on administration and reporting in order to absorb the price cuts and freezes and stay sustainable.
“While these measures may help businesses survive, they could come at the expense of quality participant care, flexibility and access,” she says.
“We continue to provide NDIS supports because we’re committed to helping people achieve their goals, maintain independence, and improve quality of life. Despite the challenges of the current pricing framework, we remain dedicated to participant outcomes.
“While we certainly need to work together to ensure cost efficiency, price reductions do not take into account the real costs of mobile service delivery. Lower prices may stretch participant budgets on paper, but if providers cannot sustainably deliver services at these rates, then access and quality will start to decline.
“Unfortunately, we’re starting to decline to see participants in certain locations that we would have previously covered before pricing changes.”
Ms Wilkinsons says sustainable pricing in the NDIS isn’t about inflating costs, but instead about ensuring long term access, quality, and choice for participants.
“Recently, it seems there is a clear disconnect, with the NDIA prioritising cost control, the participants seeking quality and choice, and providers struggling with rising costs,” she says. “This can be addressed through genuine consultation, transparent cost reviews, and recognition of different service models.”
“Balancing affordability with sustainability is essential for the long-term success of the Scheme.”
The NDIA is clearly trying to make the Scheme more sustainable, and that’s something we absolutely support. It’s important the NDIS works long term for everyone involved, but sustainability needs to include the people delivering the supports too. This sector is one big ecosystem, and when one part struggles, it affects the whole thing.
Hopefully, future changes will take into account the voices of providers (people like you doing the work on the ground) and find a balance that keeps the Scheme strong and the sector thriving.
