Depending on the way your plan is managed, there may be a limit on how much you or your providers can claim for different types of NDIS supports. When we say claim, we mean asking for payment from the funding in your plan after you receive a support.
We set out these price limits in the NDIS Pricing Arrangements and Price Limits .
We update the NDIS Pricing Arrangements and Price Limits often to account for price changes, such as staff wage increases. We may change the amount of funding in your plan if the prices for your NDIS supports change.
The amount of funding you can claim depends on how you manage the funding in your plan. There are different ways to manage your funding. If your funding is:
- Agency-managed: Registered NDIS providers can claim up to the maximum price in the NDIS Pricing Arrangements and Price Limits for each NDIS support.
- Managed by a registered plan manager: Your plan manager can claim up to the maximum price in the NDIS Pricing Arrangements and Price Limits for each NDIS support.
- Self-managed: You can choose how much to pay for each NDIS support and you can pay more than the maximum price in the NDIS Pricing Arrangements and Price Limits.
You can always claim less than the prices in the NDIS Pricing Arrangements and Price Limits – it doesn’t matter how your funding is managed. For example, your provider may charge lower rates, which often means you can get more support from your funding.
If an NDIS support isn’t in the NDIS Pricing Arrangements and Price Limits , you’ll need to agree on a price with the provider.
You or the person managing your plan need to make sure you’re only spending the funding that’s available in your plan. If your plan has funding periods, you won’t be able to claim a support if it would mean you’ve spent more than the funding you have available in this funding period for the funding component amount.
You also need to make sure your funding will last for the whole length of your plan, in line with any funding periods and funding component amounts, and make sure claim details are correct. You can access tools and resources to help you budget and manage your plan in the plan implementation directory .
Learn more about how to claim from my plan .
If you self-manage your funding, you’ll have extra responsibilities. For example, you need to keep receipts of your purchases for 5 years. You’ll also need to be able to show how you’ve used your funding if we ask you.
Learn more aboutself-managing .
If you have self-managed transport funding in your plan, we’ll pay this as recurring support funding in regular instalments to your nominated bank account.
Example 1
Kristy’s plan includes funding for 4 hours of support each week for increased social and community participation, based on the rates in the NDIS Pricing Arrangements and Price Limits . She chooses to use her funding on support to go to cricket matches on the weekend.
She finds a provider who charges less than the rates in the NDIS Pricing Arrangements and Price Limits, and decides to switch to the new provider.
After a couple of months, she’s now saved some extra funding by using this provider. As well as the 4 hours per week for cricket matches, she decides to use the extra funding on support to assist her to join her friends at the pub every few weeks.
Example 2
Omar self-manages his funding. His health and wellbeing budget includes funding for therapy. Omar finds a therapist who is very experienced with his complex disability support needs. The therapist’s rates are higher than the NDIS Pricing Arrangements and Price Limits .
Omar decides he wants to use this therapist, even though it means he will not be able to buy as many hours of support at this higher rate. Omar can do this because he self-manages his funding. Omar thinks he’ll get a much better service, even with fewer hours.
When do you need an assessment or quote before buying NDIS supports?
Sometimes we decide you need a quote before you can claim the NDIS funding in your plan. This helps us make sure the support is value for money, which is one of the NDIS funding criteria.
In these situations, you’ll need to give us at least one quote before we can include the NDIS funding in your plan. We may also need an assessment before we can include the NDIS support in your plan.
We may do this for supports like:
- high cost assistive technology
- complex home modifications
- supports with more risk involved.
We’ll let you know if you need an assessment or a quote before we can include the support in your plan.