NDIS Price Guide, Effective 1/07/2019

Key Updates Include;

- General price increases and specific increases for therapists, attendant care and community participation;


- The introduction of a Temporary Transformation Payment (TTP);


- Increases to remote and very remote loading's;


- Updates to travel, non - face - to - face services and cancellation billing policies;


- Updates to Assistive Technology and Home Modifications;


- Outcomes from the WA Market Review and Therapy Services Review.

The increased price limits across listed supports from 1 / 07 / 2019:

- 4.5% for supports listed under Assistance with Daily Activities and Social and Community Participation. This is in response to the Fair Work Commission annual wage review decision and the Equal Remuneration Order.


- 2.3% for capacity building supports, including support coordination and therapy. This is in line with the ABS Wage Price Index


-1.3% for supports listed under Consumables, Assistive Technology and Home Modification and Specialised Disability Accommodation. This is to align with the ABS Consumer Price Index between Match 2018 and March 2019. 

Temporary Transformation Payment (TTP):

Providers of attendant care and community participation supports who meet the eligibility criteria set our below will have access to a higher price limit through a Temporary Transformation Payment (TTP). This conditional loading will assist providers to continue transforming their businesses in the move towards a more competitive marketplace. This replaces the Temporary Support for Overheads. 

In order to access the higher TTP price limits, providers will have to:

- Publish their service prices;

- List their business contact details in the Provider Finder and ensure those details are kept up - to date; and

 

- Participate annually in an Agency - approved market bench-marking survey.

TTP Providers will have to until 31 December 2019 to meet these requirements, and to include in their contractual arrangements with their participants that they are entitled to use the TTP support items (and price limits) because they are compliant with the TTP terms. 

That is, in the first year, providers can commence making claims using the TTP items from 1 / 07 / 2019, and will have until 31 / 12 / 2019 to meet the three compliance requirements. In later years, providers will need to be compliant by the start of the financial year, noting that the Bench-marking Requirement is met up until 31 December of any year by the provider's intention to take part in the next Bench-marking Survey, and after that date by actual participation in the most recent Bench-marking Survey.

 

Providers who become non - compliant during a financial year should not claim for TTP items while they are non - compliant.

Every support item in scope of the TTP has two support items and two price limits. The non - TTP items should be used by providers who are not complaint with the TTP conditions. The TTP  items should be used by providers who are compliant with the TTP conditions, an example is given in the following Table.

There will be no formal registration process for TTP providers. Provides indicate that they intend to fulfil the TTP conditions by making a claim for a TTP support item through the payment system. They will be required to acknowledge compliance to the Price Guide terms, including the TTP terms if applicable, when submitting a payment request through the My-place Provider Portal. By claiming TTP items through the NDIA payment system, or from a plan manager, providers are warranting that they have complied with the TTP conditions or intend to comply with the TTP conditions by the relevant time.

Plan managers will not be responsible for ensuring providers are TTP compliant. They can accept the claim for a TTP support item by a registered provider as prof of TTP compliance. However, non - registered providers are not eligible for the TTP and plan managers should not use TTP line items to claim for services delivered by non - registered providers.

 

Claims for the new TTP support items can be made against existing service bookings that were made at the support category level. 

Updates sourced from the NDIS Price Guide, More info at; https://www.ndis.gov.au/providers/price-guides-and-information#ndis-price-guide-2019-20