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For Providers: Understanding & Making Pricing Decisions

Providers play a vital role in the lives of NDIS participant through their provision of necessary supports and services. While providers can set their own prices for these necessary supports, there are some regulations the NDIS has in place that need to be followed and understood when it comes to making pricing decisions. By taking the time to understand the ins and outs of the NDIS Pricing Arrangements and Price Limits, providers can make more informed pricing decisions to better assist themselves and their participants.

Four people in an office looking at a computer
Four people in an office looking at a computer

Understanding the Pricing Arrangements & Price Limits

The NDIS Pricing Arrangements and Price Limits (formerly known as the NDIS Price Guide) helps to outline price controls for supports and services with the NDIS, the current pricing regulations, and a list of available supports with the corresponding item numbers which can be used to claim delivered supports.

The Pricing Arrangements also provides information on:

  • Current and previous price limits for each support item

  • Claim types including travel and non-face-to-face supports

  • Price limits for different times of day

How often is Pricing Arrangements and Price Limits updated?

The Pricing Arrangements and Price Limits is updated as needed throughout the year with minor updates. However, a full review is completed annually in line with the end of financial year. Typically, this review is released at the end of each June and officially commences on the 1st of July each year.

The NDIA uses a combination of market data research, public consultation, and industry engagement to inform the necessary adjustments to be made to the Pricing Arrangements and Price Limits.

As providers, it is important to ensure that you keep up to date with the latest changes, as this may impact your invoices.

Setting your Provider Pricing

The NDIS Pricing Arrangements and Price Limits shows the maximum price that registered providers can charge NDIS participants. It does not show a set price. This means that supports can be negotiated at a lower rate than what is set in the Pricing Arrangements and Price Limits, but not a higher rate.

While NDIS registered providers must adhere to the Pricing Arrangements and Price Limits, unregistered providers are not locked into the same agreement. However, it is recommended that unregistered providers follow the same pricing guidelines as registered providers to ensure that NDIS participants can receive the supports they need at a fair price.

Whether you are registered with the NDIS or unregistered, discussing the price of your supports and services is an important first step in not only outlining the expected cost but also establishing a service agreement and clear communication with your NDIS participants.

Here are some considerations to think about when setting prices for your supports and services:

  • What is the maximum amount listed in the Pricing Arrangements and Price Limits for each service you provide?

  • What price would be considered fair and provide value for money for each service provided?

  • Have you discussed pricing with the NDIS participant you are supporting?

  • Does there need to be an adjustment in the pricing that has been set?

  • Is there a pricing difference based on whether the support is in person or not in person?

Help the participant understand your pricing

Communication is key in any relationship, especially between a participant and a service provider. You should discuss your pricing reasoning with each participant to ensure they understand all prices they may be charged. This discussion should include:

  • An understanding of the prices in the Pricing Arrangements and Price Limits

  • What pricing has been set by you in line with the Pricing Arrangements and Price Limits regulations

  • Whether there is any additional pricing like travel on top of the provider service costs

  • What your protocol is if the NDIS makes an update to the Pricing Arrangements and Price Limits (i.e., how will you let the participant know if there are pricing adjustments)

It is important for participants to be confident they are receiving value for money when it comes to their plan budget.

If you have a participant who is plan managed with First2Care, you can register your details with our First2Care team for quick and easy payment processing. Read more about First2Care Plan Management here.



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