What is NDIS group-based supports pricing?
NDIS group-based supports pricing refers to the cost structures established for supports provided to multiple participants simultaneously in a group setting. This includes various activities such as social outings, community participation, and group therapy sessions. These supports encourage social engagement, skills development, and community inclusion for people with disabilities.
Understanding the pricing change
The new pricing arrangement for group-based supports was introduced to offer more flexibility in managing costs and sharing among participants. The National Disability Insurance Agency (NDIA) has announced changes to NDIS pricing as part of broader reforms to strengthen the provider market.
The pricing changes were introduced in July 2020, and the transition period ended on 31 December 2023.
- New Pricing Model: The pricing for group-based supports has transitioned from a per-participant rate to a group rate, where costs are divided among participants. Separate claims are now allowed for Centre Capital Costs and Non-Face-to-Face (NF2F) supports, giving more flexibility and better alignment with individual participant needs.
- Programs of Support (POS): Introduced as an optional arrangement, POS allows participants and providers to agree on supports for up to six months, potentially offering cost stability for both parties. Providers must establish POS agreements with each participant and can only automatically renew these with a fresh agreement.
- Non-Face-to-Face (NF2F) Costs: Providers can claim NF2F costs that specifically meet the needs of individual participants or the group, such as planning and preparation tasks. These must be agreed upon in advance and documented properly.
- Centre Capital Costs: These can now only be claimed when a support activity is genuinely available in a designated centre, distinguishing it from temporary or community-based facility costs like rented pools.
- Documentation and Claiming Rules: Providers must document NF2F costs, POS terms, and cancellation policies clearly. POS agreements allow claims for unscheduled absences, while cancellations require a two-week notice.
- Focus on Individual Outcomes: The new framework emphasises individual participant goals, encouraging providers to offer supports that align with participants’ aspirations for independence and social participation.
Who is affected by the change?
These pricing changes affect both NDIS providers and participants involved in group-based supports. Providers need to update their billing practices and communicate these changes to their participants. Participants receiving group-based supports may see changes in how they are charged, particularly concerning non-face-to-face support costs and longer-term support programs.
What does this change mean for providers?
Providers are now required to adopt the new pricing arrangements, which involve agreeing on non-face-to-face support fees upfront with participants. This change aims to enhance transparency and reduce administrative burdens by allowing more averaged approaches to pricing.
Additionally, providers must align with the extended maximum duration of programs of support from 12 weeks to 6 months, offering more flexibility to cater to individual participant needs.
Why was the change made?
The NDIA made the changes following consultation with the sector, aiming to improve cost transparency, reduce administrative burdens, and provide greater flexibility for both participants and providers. These updates respond to feedback from providers and participants to better accommodate their needs and streamline the pricing arrangements in line with the current economic conditions and market dynamics.
Has your current software provider adopted the changes?
As these changes are mandated by the NDIS, software providers supporting NDIS billing and claims should have now integrated these updates into their systems. It is crucial to check with your software provider to ensure they have adopted the new pricing arrangements to avoid disruptions in service delivery or billing issues.
To successfully navigate these changes, providers must stay informed and align their practices with the new pricing arrangements.
The NDIS continues to offer resources and support to help providers transition smoothly and avoid some of the funding mistakes providers make.
For further information on adopting these changes, consider partnering with CTARS, a leading provider of NDIS compliance software, which can help ensure you meet all requirements effectively.
