Don’t you just love the NDIS Pricing Arrangements?! We mean, couldn’t the NDIA have made them easier to read? They could but… they didn’t because everyone wanted an open market.
Jokes aside though, we really do understand how difficult it is to understand the NDIS Pricing Arrangements.
I mean they used to be called the NDIS Price Guide. And they still didn’t make a whole lot of sense to people. And the number of pages… yep, we get it… you are not even going to try to read the document.
So, allow us to break it all down for you.
NDIS Pricing has rules
Let’s start with the fact that the NDIS Pricing arrangements have rules and prices, and those lovely line items that you all love to hate.
Think of it like this though.
Without those rules and prices do you think it would be an even more of a free-for-all and people with a disability would be taken advantage of way more.
So that is why the NDIS Pricing Arrangements exist. While there is a lot of pages, we believe we can interpret the information in the 100+ pages pretty good.
We will start in this blog with the biggest one that gets everyone confused…
You got it… Provider Travel and Transport.
So what is the difference between the two?
It is actually pretty easy… when you think about it as we describe here.
Transport
There are two types.
One is with the Participant – you know when you take them out in the community to access their other mainstream services, go grocery shopping, visit family or friends if they need help with that, go to the movies with support… the list is endless. But basically it is outside of where they live. This Transport is called ‘Activity Based Transport’.
The other is when the Participant uses mainstream transportation on their own or it is not related to their disability or the delivery of supports they need because of their disability. The funding for this is usually paid directly to the Participant or their Nominee, and cannot be accessed by providers.
Activity Based Transport
The Transport to go into the community called ‘Activity Based Transport’ has very specific line items and the line item must be associated to the direct service delivery of other social and community participation supports either in the community or centre-based.
There are specific line items to be used and they can be found directly above the item number for the direct service and in Core Funding they all start with 04_. If there is no item number then it means you can’t charge for Activity Based Transport.
Provider Travel
There are two types here too – time and kilometres.
Just a reminder before we continue that these can only be charged with an agreement with the Participant, their Child Representative or Nominee. And where you have to pay the worker or are a Sole Trader or Independent Provider.
Charging for time is called Provider Travel – Labour Costs. It is the same hourly rate as the service delivered directly to the Participant. The maximum time that can be charged depends on the location of the service delivered to the Participant.
So if they are in a suburb of a major city it is a maximum of 30 minutes one way. The item number (we must encourage you to use them because if your invoice has to go to the NDIA because the plan has run out of funds your invoice will be rejected) is the same as the direct service but you had next to it “Provider Travel” adding “- Labour Costs” or “- Time” is very helpful as there is a code that has to be used when payment is requested.
Charging for kilometres is called Provider Travel – Non-Labour Costs. It is the number of kilometres you travelled to the Participant. There is no maximum, but you cannot go from home to the supermarket and then to the Participant – it is direct to the Participant. The item number for this always has _799_ as part of it and the right one for the direct service you have delivered is above the item number you use in the NDIS Pricing Arrangements.
The time and kilometres to the first participant, from the last participant to the primary place of business and between participants (with agreement) can be, and it is encouraged to be shared where possible, between all the participants you see in one day. Remember there is a maximum time that can be charged unless the participant resides in a remote or very remote location.
Essentially there is a pattern to all the different line item numbers and when the right ones are used together then the puzzle pieces are put together correctly. Using all the right item numbers will also reduce issues with compliance checks on your invoices.
Now remember, you can only claim form your participant’s plan for travel costs when you deliver support if all of the following conditions are met:
- The NDIS Pricing Arrangements and Price Limits indicates that providers can claim for Provider Travel for the support item that has been delivered; and
- The proposed charges for the activities comply with the NDIS Pricing Arrangements and Price Limits; and
- The activities are part of delivering a specific disability support item to that participant; and
- The primary support is delivered directly (face-to-face) to the participant; and
- The provider explains the activities to the participant, including why they represent the best use of the participant’s funds (that is, the provider explains the value of these activities to the participant); and
- The provider has the agreement of the participant in advance (that is, the Agreement between the participant and provider should specify the travel costs that can be claimed); and
- The provider is required to pay the worker delivering the support for the time they spent travelling as a result of the agreement under which the worker is employed; or the provider is a sole trader and is travelling from their usual place of work to or from the participant, or between participants.
Did you see all the ‘ands’ above? That’s right all, not just one or two or some, but all of the above must be met.
And we know you aren’t going to read it, but we just have to put the link to the NDIS Pricing Arrangements so – you know – if you want to confirm where we got our information from you can.
To view the NDIS Pricing Arrangements, please refer to the following link:
https://www.ndis.gov.au/providers/pricing-arrangements
Where you are a Participant (or Child Representative or Nominee to a Participant) with 101 Plan Management or a provider partner to one of our mutual Participants, and would like to discuss any of the above further, please make contact with us via email or call us on 08 7071 1555.
