As with everything NDIS, there are rules and regulations for claiming supports based on the day the support is delivered and even the time the support is delivered. It’s important to know how to claim for the correct day and time the support is delivered, to understand what the exceptions are, and how this can impact the speed of your payments.
How to know what pricing limit can be claimed
To determine which pricing limit is relevant to a support there are two simple steps (and a sub-step here or there… it is the NDIS after all!)
Step 1: Establish the day of the week the support is being provided
Step 2: Establish the time of day the support is being provided
It’s important to establish the day of the week before the time of day as the pricing limits can vary depending on the day and the time of day.
Once the day and the time of day the support is being provided has been established, next you’ll need to consider if there are any other factors that may contribute to or impact the pricing limit to be claimed.
Get to Know Day-Evening-Night Support Times
Public Holiday Support Times
Public Holiday Supports: Starts on or after midnight the night prior to a public holiday and finishes before or on midnight of that public holiday (exceptions include Night-time Sleepover Support).
Weekend Support Times (Saturday & Sunday)
Saturday Supports: Starts on or after midnight on the night prior to a Saturday and finishes on or before midnight of that Saturday (exceptions include public holidays or Night-time Sleepover Support).
Sunday Supports: Starts on or after midnight on the night prior to a Sunday and ends on or before midnight of that Sunday (exceptions include public holidays or Night-time Sleepover Supports).
Weekday Support Times (Monday to Friday)
Disability Support Workers:
Day Supports: Starts on or after 6.00am and finishes on or before 8.00pm on the same day (exceptions include public holidays or Night-time Sleepover Support).
Evening Supports: Starts on or after 8.00pm and finishes on or before midnight on the same day (exceptions include public holidays or Night-time Sleepover Support).
Night Supports: Starts on or at or before midnight on a weekday and finishes after midnight on that weekday OR starts before 6.00am on a weekday and finishes on that weekday (exceptions include public holiday, Saturday, Sunday, or Night-time Sleepover Support).
What is a 'Shift Boundary'?
When a particular support crosses over a shift boundary and the same worker delivers the entire support, the higher of the relevant price limits applies to the entire support. When a provider makes a claim, they should be making a claim against the relevant support item – in this case it would be at the higher relevant price limit for the support item.
For example, if the same support worker works from 6pm-midnight, it may be permissible to invoice the entire period as weekday evening support.
Providers are required to discuss all billing arrangements with the participant they are delivering a support to.This makes it critical to establish a service agreement with a participant. Note that this scenario is quite rare and it is much more common to invoice for two separate supports.
Night-time Sleepover Supports vs. Night-time Supports
A Night-time Sleepover Support is a support delivered to a NDIS participant on a weekday, weekend or public holiday that commences before midnight on one day and finishes after midnight on the next day.
This support provides assistance with, or supervision of personal daily life tasks where overnight support is needed. This support runs for a continuous period of eight hours or more with up to two hours of active supports provided to the participant throughout the duration of the sleepover support. Providers can claim for a third or additional hour at Saturday rates on weekdays, or at applicable rates on other days (Saturday, Sunday, or Public Holidays).
Providers giving Night-time Sleepover Support are allowed to sleep when they are not providing support. This is different for providers giving Night-time Supports as they are not allowed to sleep.
The below table helps to further break down the differences between Night-time Sleepover Supports and Night-time supports.
Night-Time Sleepover Support
Flat rate for the 8 hour period - current cap is $262.16
Hourly rate charged for the number of hours worked
Up to 2 hours active support
Allowed to sleep when not providing support
Actively supporting the participant throughout the night
Public Holidays and Weekends
The same flat rate applies
Hourly rate is charges at the agreed Saturday, Sunday, or public holiday rate
If you have any questions, you can contact the First2Care team on 1300 322 273 or email firstname.lastname@example.org.
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.