Understanding NDIS Price Guide: What to Claim And What Not To?

How do you ensure that the cost of NDIS services are fair and consistent across Australia? Even though you are not paying out of your pocket, knowing the NDIS price guidelines prevents you from overpaying. In fact, it benefits NDIS providers when they are learning justifiable charges for the disability support.

However, learning the set price limits is not always possible. That is where an NDIS plan management in Queensland is helpful for ensuring fair and just pricing.

In this blog, you will get a detailed understanding of funded services and rules of NDIS price guide. Alongside, you will also discover the role of a plan manager. So, continue reading it till the end.

What is the NDIS Price Guide?

The NDIS price guide is the maximum price limit of a specific service category under NDIS. It means that no provider can charge more than the determined price for an NDIS support. Along with this, you also get the following information within the guide:

• Funded services under NDIS
• Rules for claiming and paying for services

NDIA keeps on changing the NDIS price guide annually to ensure fair pricing for both the participants and providers. It is best to read the full and detailed NDIS price guide from the NDIS official website.

If you are opting for the NDIS plan management in Queensland, you can even consider help directly from your plan manager to get new updates on pricing guidelines.

How Does NDIS Price Guide Work?

When it comes to understanding the process of NDIS funding, you need to learn specific categories and rules for claiming the support.

Typically, it is divided into three categories: Core Supports, Capacity Building Supports, and Capital Supports. Let’s discover the specific service and their funding that you can claim under NDIS.

Funded Services Under NDIS 

Here is a comprehensive list of supports that you can claim to receive funds from the NDIS.

Core Supports (Daily Living & Independence)

Core Support implies the daily living assistance for NDIS participants.

• Household Tasks (cleaning, gardening, meal preparation)
• Personal Care (Getting in and out of bed, brushing, bathing, dressing, grooming)
• Social and Community Participation (Attending local events, hobby classes, social workshops)
• Consumables (Continence aids and assistive technology)
• Transport (if included in your NDIS plan)

Tip: Each of these services under NDIS funding are flexible. This means that you can choose to adjust funds across these various supports.

It is worth consulting with your NDIS plan management in Queensland for their reputation in making the most of the funds.

Services You Can’t Claim:

• Rent or mortgage payments
• Food and groceries
• Personal entertainment like movies or attending concerts.

You must budget for these expenses personally as NDIS do not pay for the items but only the support for your disability.

Capacity Building Supports (Skill Development and Independence)

Capacity Building Supports assist NDIS participants to improve their quality of life and learn essential life skills for gaining independence.

• Therapy Services (Speech, Occupational, Physiotherapy)
• Social Skill Training (gaining confidence, building communication skills)
• Behaviour Management Therapy (positive behaviour techniques and reinforcement)
• Employment Support and Training (resume-building skills, navigating disability-friendly jobs, and networking)
• Support Coordination (plan management support)

Tip: There is a fixed funding for specific support services under Capacity Building. You must find out the services with fixed and flexible funding with the guidance of the plan manager.

NDIS plan management in Queensland is serving participants with guidance on using the funds optimally, while keeping in mind the budget and your NDIS goals.

Services You Can’t Claim:

• Course fees
• Family therapy or child protection therapy
• Employment programs and workplace modifications
• Diagnosis of medical conditions, recovery-oriented services, & mental health treatments.

Capital Supports (Equipment & Home Modifications)

Under Capital Supports, you receive disability-related equipment, technology devices, or certain home modifications.

• Assistive Technologies (wheelchairs and hearing aids)
• Home modifications (construction of ramps, hoists, grab rails in kitchen and bathroom)
• Vehicle modifications (wheelchair hoists and lifts, modified seating, pedal, hand controls, and automatic door openers)

Tip: You are entitled to get one-time funding for these supports and cannot use the funding for anything else.

Services like NDIS plan management in Queensland from reputable organisations always ensure that every spending on these services is worthwhile for your well-being and convenience.

What You Can’t Claim:

• General Home renovations
• Smart home devices unrelated to your disability
• Car purchase and maintenance
• Service and repairs on home and vehicle
• Fuel and insurance costs

NDIS Pricing Rules

Here are a few rules you must follow even though your plan manager is responsible for handling your NDIS plan. Before submitting your claim, it is best to ensure NDIS funding eligibility.

• The service must be related to your disability.
• Your NDIS plan must cover the specific support.
• The service must be reasonable and necessary which aligns with your NDIS funding criteria.
• The provider must charge fair price within the NDIS pricing arrangements
• You must receive the full extent of services before claiming the funds.

Keep in mind that NDIS do not accept claims if your chosen provider fails to comply with NDIS price limits.

The key point to focus here is to use an NDIS plan management in Queensland which verifies the provider’s compliance with NDIS price limits. Along with that, the plan manager also reviews each invoice thoroughly to ensure all the details are correct.

How Long Does a Plan Manager Take for Processing Payments?

A plan manager accepts invoices directly from your service provider. And in most cases, they let you read invoices to ensure the correct entries of services and due dates. Soon after, there is a processing time of at most 5 days for making NDIS claims.

Final Words

We hope you found this blog useful. As you see, the NDIS price guide is a key document. You learn everything about the NDIS funding in terms of the services and rules for accessing funds.

Remember, having a dedicated NDIS plan management in Queensland makes it easy to comply with the NDIS pricing arrangements. As long as you are trusting the right plan manager from Sky Plan Management, you are all set to gaining independence.