There may be a limit on how much you or your providers can claim for different types of 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 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: NDIS registered providers can claim up to the maximum price in the Pricing Arrangements and Price Limits for each support.
- Managed by a registered plan manager: They can claim up to the maximum price in the Pricing Arrangements and Price Limits for each support.
- Self-managed: You can choose how much to pay for each support and you can pay more than the maximum price in the NDIS Pricing Arrangements and Price Limits.
- You, or the person managing your plan need to make sure there’s enough funds in your plan to pay for supports. You also need to check your funding will last for the whole length of your plan details are correct.
- Learn more about How to claim from my plan
If you have self-managed transport funding in your plan, we will pay this as recurring support funding in regular instalments to your nominated bank account. This means you don’t need to claim each time you use your transport supports.
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 a support isn’t in the NDIS Pricing Arrangements and Price Limits , you’ll need to agree on a price with the provider.
Example 1
Omar self-manages his funding. His health and well-being 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.
Example 2
Kristy uses her increased social and community participation budget to buy 4 hours of support each week 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 join her friends at the pub every few weeks.
When do you need an assessment or quote before buying supports?
Sometimes we decide you need a quote before you can claim the funding in your plan. This helps us ensure 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 make the funding available in your plan.
We may do this for supports like:
For some supports, the funding is available but you need to get an assessment before you buy the support.
We may do this for high cost assistive technology, complex home modifications, or supports with more risk. We’ll let you know in your plan if you need to get an assessment before buying a support.
What if you self-manage your funding?
You can choose how much to pay for each support as long as you don’t spend more than the total funding for the support in your plan. This means you can claim more than the NDIS price limits. You should use the price limits to ensure you’re getting the best value from your providers.
There are some things you need to do if you self-manage your funding. 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 about self-managing .