Breaking: New NDIS price caps

Increases for support work, but price freeze continues for most Capacity Building supports. Rob has the details. ͏ ͏ ͏

By Rob Woolley

Updated 28 Jun 202429 Jun 20243 min read
Purple background with a pink and green toy calculator and two stacks of toy yellow coins

Forget Christmas. Forget Eurovision. Forget Grand Final Day. Even forget the new series of Bridgerton dropping. The biggest day of the year has arrived: new Pricing Arrangements and Price Limits (PAPL) Day. The NDIA just released the new PAPL document, there are some big changes for us to get into. But before we do, it's worth noting that in classic NDIA fashion, this critical document is released just half a business day before it becomes effective for tens of thousands of providers across the country. We’ve been refreshing the NDIS website every hour for a month now. Not ok, NDIA.

ID: Meme with the text ‘When you’re convinced the PAPL will be here any second’. Four shots of Mr Bean waiting in a meadow, looking at his watch, sitting on the ground, lying down. Falling into increasing despair.This PAPL arrives against the backdrop of potential new legislation, constant chatter about Scheme sustainability, and the ongoing debate about the recommendations in the NDIS Review (which the government still has not responded to). We didn’t expect huge changes to the PAPL while these major reforms are still being debated. But, all the same, there are some big ticket items in this PAPL. 

Here’s a summary of the most significant changes:

Increase in price caps…but only for some services

Early in June 2024, the Commonwealth Government announced a 3.75% increase to the minimum wage. The minimum wage increase affects minimums in all Awards, including the SCHADS Award, on which the Disability Support Worker (DSW) Cost Model is based. The NDIA uses the DSW Cost Model to calculate the price limits for supports delivered by support workers. 

While prices have increased as a result, the NDIA has removed the temporary 1% loading meaning price caps will only increase by 3.19%. While this might look like a price cap boost on the surface, there has been no increase to overheads for important stuff like quality improvement and staff training and providers will have increased staff costs under Award. For all intents and purposes, this is a price cut at a time where participants and providers need more security and stability.

No change to therapy, Support Coordination Levels 2 & 3, or Plan Management…but PRC and Support Connection do increase

Many supports in the PAPL are not based on the DSW Cost Model, and most of these price caps did not increase. Meaning yet another year of price freeze for Support Coordination Level 2 and 3, most therapy supports, and Plan Management. With the cost of living and business pressures we are currently facing, a price freeze is a de facto cut - and for the fifth consecutive year.

The price cap increases are mostly in Core supports, but do also include Psychosocial Recovery Coaching (PRC) and Support Connection (Level 1 Support Coordination). This means that PRC is now priced above Support Coordination Level 2 for the first time.

Psychology and “nursing and other supports” price increase

The price caps for psychology and nursing supports have increased, although only by the ABS Wage Price Index. This equates to an increase of 3.9%.

Behaviour support services will also see an increase to the price cap of 3.9%. Given how tight and thin the market is for behaviour support services, and how important the services are to support progress towards reduction and elimination of restrictive practices, this is a modest but welcomed increase.

Change to Short Notice Cancellation policy

There was a significant change to the Short Notice Cancellation policy. In the Pricing Review Report, the NDIA stated that in the last three years, costs linked to Short Notice Cancellations have nearly doubled (from around $60million to around $120million). Therapy and early childhood supports account for 37% of all Short Notice Cancellation claims. This is clearly a cost pressure, so the NDIA has revised the Short Notice Cancellation terms to distinguish between cancellations for DSW Cost Model-based services and non-DSW Cost Model-based services.  

For services not under the DSW Cost Model (i.e. those not covered by the SCHADS Award), Short Notice Cancellations can now only be charged if they are within 2 clear business days. For services delivered by a support worker and those under the DSW Cost Model, Short Notice Cancellation remains at 7 days. 

If you’re not sure which rule your services fall under, it’s explicit in the PAPL. Look for Short Notice Cancellation above the blue boxes with Item Numbers in it, and you’ll see either “7 days” or “2 clear business days”. The full terms are also on page 23 of the PAPL.

Removal of TTP line items

Temporary Transformation Payment (TTP) was additional funding available to some providers to help aid the transition to the NDIS. It was a loading on top of the standard hourly price limit. The additional loading started at 7.5% in 2020 and has been reducing by 1.5% each year since. We knew that 2023/24 would be the final year of TTPs existence. As such all TTP line items have been removed from the PAPL. This will make selecting the right line item much easier. 

For services delivered before 1 July 2024, but billed after 1 July 2024, TTP line items are still available temporarily as Legacy Line Items. Check the Legacy Support Items tab in the Support Catalogue to find them (noting the End Date in column L).

1% COVID & Quality and Safeguarding loading removed (as planned)

There was also another 1% loading removed from many Core items. Like TTP, this was the planned reduction. The temporary additional loading was provided to cover extra costs and pressures associated with the impact of COVID, and quality and safeguarding requirements.  It started at 2% in July 2022 then was reduced to 1% in July 2023, and coming to an end in July 2024. 

Plan values indexed

As usual, all plans will be indexed to reflect these new price caps. This means people’s Plans will increase in line with the price caps. But this only applies to the parts of the plan built on supports that have seen a cap increase. So if a person has some Assistance with Daily Life and some Support Coordination in their plan, only the Assistance with Daily Life value will increase. Also be aware that in previous years this has taken a few weeks to trickle through, and can be buggy.

Change to Support Categories from PACE

One thing we were hoping for was a spring clean of Item Numbers to reflect changes to Support Categories in the new PACE system. For example, Supported Independent Living services in PACE no longer live in Assistance with Daily Life (they are now in the new Home & Living Support Category), but neither the Item Numbers nor the eligibility for Programs of Support have changed to reflect this. So more logistical gymnastics for providers and invoicing systems.

Portal maintenance this weekend

As if all this wasn’t enough, the portal is down this weekend! From 4:30am Saturday 29 June to 12pm on Sunday 30 June. Various NDIA portals and systems will be inaccessible. This will cover the app, participant portal, and both the myplace provider portal and the new PACE portal. Well, there goes my weekend.

There’s also some minor tweaks to the wording in many other parts of the PAPL. The changes will be covered in our 2024 PAPL Update workshop.

As is usual practice, the NDIA has also released an updated Disability Support Worker Cost Model alongside the PAPL update. The Annual Pricing Review report is also a good read, particularly over some mulled wine.

Authors

Rob Woolley

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