2022/23 Price Guide Released

With barely a week left in the financial year, the NDIA have just released the 2022-23 Price Guide. Most supports will see the biggest increase in pricing to date – but there are some notable exceptions. Here’s the lowdown:

Support work prices increased by 9%

Prices dependent on the Disability Support Worker Cost Model have been increased by 9%. This includes:

• Assistance with self-care activities and establishment fees

• Self and plan management capacity building

• Assistance in SIL

• Assistance to access community, social and recreational activities, including group supports and establishment fees

• Supports in employment

• Psychosocial Recovery Coaching

• Tenancy support

• Life transition planning

• Individual skills development

• Transition through school and to further education

• Training for carers/parents

This significant increase is designed to address the major cost pressures on providers, including changes to the SCHADS Award, minimum wage and superannuation guarantee and costs associated with NDIS registration and the pandemic. It has been calculated based on:

• 1.7% increase to base prices

• 2% temporary loading, reviewed annually 

• 4.6% increase in award minimum wages 

• 0.5% increase to superannuation guarantee charge

While it’s great to see many of the cost pressures addressed, there are still some key gaps in the DSW Cost Model, which assumes that all workers are paid 4 weeks annual leave (while the Award requires shift workers be paid 5) and corporate overheads remain at 12%, despite their own benchmarking evidence showing that only a fraction of providers are operating at this level.

No increase in prices for therapy, support coordination and plan management

Providers of therapy, support coordination and plan management will be frustrated to see that the NDIA are not increasing pricing for the second year in a row. While the Pricing Updates page states that “further review” is required, the Annual Pricing Review Final Report is fairly adamant that prices not be increased, stating:

• "On balance, it is not considered that an increase in the price limits for Level 2: Coordination of Supports services and Level 3: Specialist Support Coordination services price limit is justified at this time." (p. 25)

• "It is therefore recommended that the price limits for plan management fees should not be changed." (p. 152)

• And perhaps most troublingly, in relation to therapy: "On balance, the available evidence argues for a decrease in the current price limits for therapy supports. However, there is significant risk that such a decrease would disrupt the provision of supports to participants in some regions. [...] It is therefore recommended that no structural change should be made in the pricing arrangements for therapy supports at this time; and that the price limits for therapy supports should not be indexed on 1 July 2022" (p. 121)

The exception to this is Level 1: Support Connection, which is based on the DSW Cost Model. However, only 0.5% of Support Coordination hours are funded at this level.

No more level 3 high intensity supports

Where previous Price Guides included support work prices for 3 levels of complexity, the new Guide includes only two: the standard price, and a single “high intensity” price, which is defined as support provided to a person:

• For whom frequent (at least 1 instance per shift) assistance is required to manage challenging behaviours that require intensive positive behaviour support; and/or

• Who requires assistance from a disability support worker who has one or more of the high intensity support skills specified in the NDIS Commission’s NDIS Practice Standards: skills descriptors

The NDIA have introduced this change as “simplifying” the arrangements, which always raises red flags for me. And this was no exception – in a move that probably surprises nobody, simplifying here meant wiping out the highest pricing tier (level 3) and setting prices based on the previous level 2 rates.

Short notice cancellations now 7 days

 In a pretty major change, the definition of "short notice" has been extended in the provider's favour. Previously set at 2 days for shorter supports or 5 days for others, the definition is now set as a situation where a person:

•  Does not show up for a scheduled support within a reasonable time, or is not present at the agreed place and within a reasonable time when the provider is travelling to deliver the support; or

•  Has given less than seven (7) clear days’ notice for a support.

 Providers are now also allowed to bill for Centre Capital Cost in the event of a short notice cancellation.

Nursing Supports up by 2.94%

Prices for nursing supports will be indexed by 2.94% in line with the Wage Price Index and Consumer Price Index.

Changes to provider travel rules

Core support providers are now also able to bill for journeys from the participant back to the usual place of work, provided that the person consents and the worker is paid for this trip (or that the worker is a sole trader). The maximum time billable per trip is 30 minutes (ie. 60 minutes return) or 60 minutes for people in remote/very remote areas. This brings core supports in line with the existing rules for capacity building supports.

Restructured line items

The Improved Daily Living support category has had a makeover, with new line items created for each allied health profession.

There are no longer line items for capacity building in plan management under either the plan management or support coordination support categories. This is actually a good thing – because of the way plan flexibility works, most people weren’t able to access these line items (only 0.1% of all plan managing people!). People are now being encouraged to access this support from core, using the line item Capacity Building and Training in Self- Management and Plan Management.

New Bereavement Addendum

Claiming for supports after a person has died has long been an arduous task at a difficult time. The new NDIS Bereavement Addendum provides a special line item for plan managers to claim for the continued processing of payments for up to 90 days after a person’s death, as well as instructions for how SIL providers can claim a support for up to 4 weeks.

TTP down to 3%

The Temporary Transition Payment (TTP) is approaching its final years. It will be at 3% for 2022-23.

You can the full Pricing Arrangements and Price Limits documents here. The findings of the Annual Pricing Review have also been released, which we will be covering in a future article.