In this post we will clarify the new NDIS Group-Based Supports Pricing Change that is effective from 1 January 2024. All group based activities must be invoiced and claimed under the new arrangements from 1 January 2024 to avoid rejections. You can refer to the NDIS website for more information.
Until 31 December 2023, the transitional arrangements mean that providers delivering group or centre based supports in the Assistance with Social, Economic and Community Participation Support Category who require time to transition to the new group-based pricing arrangements can choose to continue to use the pricing arrangements and support items that were in place in 2019-20.
The transitional arrangements have price limits that are inclusive of Non-Face-to-Face Support
Provision and Centre Capital Costs, and so these components cannot be claimed separately by
providers using the transitional support items.
Until 31 December 2023, a provider has two options for pricing arrangements for each group and
centre-based supports:
- Providers continue using the transitional pricing arrangements for each group and centre based support individually; or
- Providers switch to the new pricing arrangements for each group and centre based
supports individually.
However from 1 January 2024 providers must invoice and claim under the new arrangement. This requires when a support item is delivered to more than one participant at the same time (a group of participants) then, unless the NDIS Pricing Arrangements and Price Limits states otherwise, the price limit for each participant is the applicable price limit set out in the relevant support table divided by the number of participants in the group.
Providers can only claim for supports that are related to the reasonable and necessary needs of a
participant. Where a participant attends a group-based session then a provider should only claim
for the time of more than one worker against that participant’s plan if all those workers were
involved in the direct support of the participant for the time claimed.
New Group and Centre Based Activities – Standard Arrangement Line Items & Pricing
Providers should make a claim for each participant using the relevant support item as below.
- Provider Travel – Non-Labour Costs using the support item 04_799_0136_6_1
- Activity Based Transport – Social, Economic and Community Participation Supports
using support item 04_591_0136_6_1 - Centre Capital Costs using support item 04_599_0136_6_1, when the support is provided
in a centre rather than in the community.
Supports must be claimed using the following codes and the hourly rate divided by the number of participant within the group for billing each participant:
New Group and Centre Based Activities – High Intensity Arrangement Line Items & Pricing
Providers should make a claim for each participant using the relevant support item as below.
- Provider Travel – Non-Labour Costs using the support item 01_799_0104_6_1
- Activity Based Transport – Social, Economic and Community Participation Supports
using support item 04_592_0104_6_1 - Centre Capital Costs using support item 04_599_0104_6_1, when the support is provided
in a centre rather than in the community.
Supports must be claimed using the following codes and the hourly rate divided by the number of participant within the group for billing each participant:
