We recently published some guidance for providers when invoicing for therapy supports. It is an area that has often been considered a “grey area” or a loophole in NDIS claiming. However, this is not quite the case. In fact, the writing is on the wall for these support items, as the NDIS has slated them for removal from the start of the 2025-26 financial year.
While some participants may wish to use their core funding to pay for therapy, it is important to keep your obligations as a service provider in mind. By issuing a tax invoice with one of these support item codes, you are declaring that the service provided complies with the arrangements specified by the Pricing Arrangements and Price Limits (PAPL). This means that you are indicating that you are providing supports to assist participants in one of the following areas:
Dysphagia
Respiratory
Nutrition
Diabetes
Continence
Wound & Pressure Care
Podiatry
Epilepsy
This is why the number of therapy support items in core is not as extensive as the Improved Daily Living Budget. It is unlikely that an Art Therapist is providing support in one of the above areas, for example, but reasonable that their services could facilitate functional improvement.
A useful way to visualise it is:
Improved Daily Living (15) | Core |
Functional improvement | Disability Related Health Supports |
Maintenance care |
|
Disability Related Health Supports |
|
Source – Pricing Arrangements 2024-25 Version 1.0, pages 37, 85.
We recommend double checking your invoicing systems and working with participants to ensure that claims are compliant and smooth as possible.