Table of Contents
Understanding the NDIS Pricing Arrangement
Who Needs to Follow the Price Guide?
Other Relevant Pricing Documents
While the Price Guide is the primary reference for pricing, several other guides and documents are pertinent:
- The NDIS Support Catalogue
- Any addenda to the Price Guide
- The NDIS Pricing Arrangements for Specialist Disability Accommodation
- The NDIS Assistive Technology, Home Modifications and Consumables Code Guide
Pricing Considerations
Charging Self-Funded vs. NDIS Participants: Providers typically cannot charge NDIS participants more simply due to their participation in the scheme. Charging higher prices for NDIS participants compared to self-funded participants may be acceptable, but it must be justified by valid reasons, such as additional administration costs.
Charging Different Prices Depending on Location:
Price limits in the Price Guide may vary according to the participant’s location. Providers might be able to charge higher rates for participants in very remote areas. Additionally, prices may fluctuate for some services based on the day and time of delivery.
Charging in Advance for Services:
The NDIS allows prepayments for services only in specific situations, such as certain home modifications and assistive technology supports. If your service requires a significant upfront payment, you can contact the NDIA to request approval for invoicing the participant in advance.
Charging an Exit Fee:
It’s important to note that providers cannot charge an exit fee if a client wishes to cancel their services. The NDIS places a strong emphasis on participants having the freedom to change providers without incurring financial penalties. However, in some circumstances, you may be able to charge cancellation fees for pre-booked shifts, provided you meet the conditions outlined in the Price Guide.
Consequences for Non-Compliance
Failure to align your services or invoices with the Price Guide can result in non-payment. Plan managers working with plan-managed clients have the authority to reject invoices that do not comply with the Price Guide. They can refuse to pay for non-compliant services or request you to issue a compliant invoice. Moreover, participants or other providers may report non-compliance to the NDIS Quality and Safeguards Commission.
The Importance of a Service Agreement
To ensure compliance with the Price Guide and Australian Consumer Law when providing goods and services, we strongly recommend documenting the provider-participant relationship through a client service agreement.
Key Takeaways
Service providers should thoroughly acquaint themselves with the pricing limits and claim conditions specified in the Price Guide. Registered providers must strictly adhere to its guidelines. It’s crucial for providers not to misrepresent that the NDIS sets the service pricing at the maximum amount. Compliance with these regulations fosters a transparent and supportive NDIS ecosystem for both providers and participants.
