FAQs

  • The NDIA sets price limits for some of the supports included in your plan. The price limit is the maximum price that a registered provider can charge you for your NDIS funded disability support or service.

    Providers decide their prices based on the cost of delivering supports or services. The NDIA does not set the prices that providers charge you. You can negotiate with your provider and they cannot charge you more than the price limit.

    In general, providers shouldn’t charge you more than they do for anyone else for the same support. If they do, then need to let you know the reasons for the difference.

    If your plan is NDIA-managed or plan-managed, your provider must follow NDIS pricing arrangements and price limits. Self-managed participants can use registered or unregistered providers and are not subject to the pricing arrangements.

  • Plan managers should work with participants to reduce any potential of overspending on their plan. This will involve regular reporting of plan-managed budgets as outlined in the NDIS Guide to Plan Management.

    The plan manager should discuss with participants effective and efficient ways to utilise approved funds.

    If a participant’s NDIS plan funds are being spent faster than anticipated and there is a risk that funds will be exhausted before the next review, the plan manager should discuss this with you.

    If you require additional funding (for example, due to a change in circumstances), contact the NDIS to discuss your options.

  • The NDIS is not designed to fund supports more appropriately funded or provided by the health system.

    Assessment, diagnosis and treatment of health conditions, along with medications and hospital care, remain the responsibility of the health system.

    As a general guide, the following health-related services and supports are not provided or funded through the NDIS:

    Items and services covered by the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS), nor Medicare gap fees.

    Treatment, services or supports delivered by a doctor or medical specialist, including diagnosis and assessment of a health condition.

    Items and services provided as part of diagnosis, early intervention and treatment of health conditions, including ongoing care of chronic health conditions.

    Medically prescribed care, treatment or surgery for an acute illness or injury including post-acute care, convalescent care and rehabilitation.

    Sub-acute care including palliative care, end of life care and geriatric care.

  • The NDIS provides funding to eligible people with disability to gain more time with family and friends, greater independence, access to new skills, jobs, or volunteering in their community, and an improved quality of life.

    The NDIS also connects anyone with disability to services in their community.

    Find out more information

  • All registered and unregistered NDIS providers and their workers are required to comply with the NDIS Code of Conduct. There are guidelines available to help both NDIS providers and workers understand their obligations under the NDIS Code of Conduct.

    Self-managed participants and registered plan managers can make unregistered providers and their workers aware of their obligations under the NDIS Code of Conduct.

  • NDIS Commission

    The NDIS Quality and Safeguards Commission (NDIS Commission) is an independent agency established to improve the quality and safety of NDIS supports and services.

    • Responds to concerns, complaints and reportable incidents, including abuse and neglect of NDIS participants

    • Registers and regulates NDIS providers and oversees the new NDIS Code of Conduct and NDIS Practice Standards.

    • Monitors compliance against the NDIS Code of Conduct and NDIS Practice Standards, including undertaking investigations and taking enforcement action

    • Monitors the use of restrictive practices within the NDIS with the aim of reducing and eliminating these practices

    • Implementation of a national NDIS Worker Screening check (from 1 February 2021)

    NDIS

    The National Disability Insurance Scheme (NDIS) is a national scheme governed by the NDIS Act 2013.

    • Provides funding for an estimated 500,000 Australians who have a permanent and significant disability

    • Provide all people with a disability with information and connections to services in their communities, such as doctors, sporting clubs, support groups, libraries and schools, as well as information about what support is provided by each state and territory government.

    NDIA

    The National Disability Insurance Agency (NDIA) is the Commonwealth agency responsible with delivering the NDIS.

    • Administers access to the Scheme

    • Provides individualised plans for NDIS participants

    • Enables the payment for supports delivered by registered NDIS providers to NDIS participants who have their NDIS funds managed by the Agency

    • Detection and investigation of allegations of fraud

    Find out more.

  • 1. Log in to MyGov and choose National Disability Insurance Scheme from the ‘Your services’ tiles.

    2. If you’re a nominee, you’ll need to select the NDIS participant name from the drop-down menu called ‘acting as’. This is right up the top of the page

    Then, click on the tile that says, for example, ‘Jane’s plan’.

    3. If you’re a participant, click on ‘my plan’.

    4. Click on the tile called ‘view my plan’ or ‘view Jane’s plan’ (for example).

    5. Make sure you’re viewing the right plan if you or the participant have more than one. If you need to change to another plan, use the drop-down box to choose the right one.

    6. Then use the link that says, ‘print this plan to PDF’.

    The plan will automatically download in a new window or tab. From there you can choose to download, save, or print your plan.

  • The NDIS Worker Screening Check is an assessment of whether a person who works, or seeks to work, with people with a disability poses a risk to them. The assessment will determine whether a person is cleared or excluded from working in certain roles with people with disability.

    The NDIS Worker Screening Check will be conducted by the Worker Screening Unit in the state or territory where a person applies for the Check. The Worker Screening Unit also makes the decision about whether a person is cleared or excluded.

  • It is not mandatory for Non- registered providers and providers delivering supports to self-managed participants to obtain an NDIS worker screening clearance or have an acceptable check under the transitional and special arrangements. However, self-managed participants and unregistered providers can request workers who are providing supports and services to demonstrate they have an NDIS worker screening clearance or an acceptable check, or request that the worker applies for one.

    Registered NDIS providers need to ensure that the workers they engage in risk assessed roles have an NDIS worker screening clearance or an acceptable check that meets requirements under the transitional and special arrangements that apply in the state or territory where they provide NDIS supports and services to people with disabilities.

  • Participants who choose a plan management provider can access supports and services from both registered and non-registered providers for most supports. All NDIS Providers – registered or non-registered – are regulated by the NDIS Commission and are required to comply with the NDIS Code of Conduct and must adhere to the NDIS price control arrangements.

  • When you buy goods and services including disability-related purchases, you have rights under law.

    The Australian Competition and Consumer Commission has information about your rights and where to go for help, including:

    Your rights when you buy something – in Easy Read and 8 languages.

  • Plan management is a type of disability service funded through the National Disability Insurance Scheme (NDIS). Plan management providers can purchase supports on behalf of participants from either registered or unregistered providers.

  • To be plan managed, you must have ‘Improved Life Choices’ included in your NDIS plan. At your planning meeting or review, you can tell NDIS staff that you would like a plan manager to support you. If you are mid-plan and want to change, contact the NDIA on 1800 800 110 to discuss how you can include plan management in your plan.

  • Plan Management fees are added to your plan and are separate from your other NDIS funding.

  • The role of a plan manager is to ensure support providers adhere to the NDIS Price Guide and are in alignment with the scope of the NDIS plan.

    They also make sure that the participant’s plan is being implemented as intended, which includes ensuring that funds are being spent in accordance with the plan and in line with expected NDIS plan spend.

    In addition, a plan manager’s role does not extend to deciding what supports a participant can access and does not extend to determining whether supports or services which have been purchased are ‘reasonable and necessary.

    The participant’s individualised plan will already have funding included for the reasonable and necessary supports that have been approved by the Agency at the planning stage.

  • A plan manager can help you:

    • increase your financial and plan management skills

    • learn how to self-manage your plan

    • pay providers

    • increase your choice of providers

    • get NDIS plan budget reports and greater budget oversight.

  • A plan manager will pay providers for supports delivered. A plan manager will help you monitor your funds, and provide financial reporting.

    A support coordinator will support you to understand and implement supports included in your plan. A support coordinator will link you to providers and other community and government services. A support coordinator will also support you to build skills and direction.

    An NDIS Partner in the Community delivering Local Area Coordination or early childhood services may provide plan implementation and monitoring support to you. Partner organisations are appointed by the NDIA to help you understand the NDIS, and find providers of support suited to your needs.

  • Plan management providers, except those in Western Australia, are required to be registered with the NDIS Quality and Safeguards Commission.

  • The NDIS Pricing Arrangements and Price Limits is the document that explains the NDIS pricing rules and the way that price controls for supports and services work in the NDIS.

    NDIS Pricing Arrangements and Price Limits set out:

    • general claiming rules

    • different types of support budget in your plan

    • support categories and how they align with your goals or outcomes.

    The NDIS Support Catalogue lists the specific supports, sometimes called ‘support items’ that have a maximum price.

    The Support Catalogue also lists helpful things like:

    • support item numbers, sometimes called ‘codes’

    • the date a support was introduced and if it has ended

    • if a support needs a quote

    • which supports allows your provider to claim their travel costs from your plan

    • when a provider can claim non-face-to-face costs for a support

    • when a provider is allowed to charge more for delivering a support in a remote or very remote area.

  • It is the responsibility of everyone involved with the NDIS, including providers, to maintain the integrity of the Scheme and prevent any misuse or fraud.

    Your responsibilities to ensure Scheme integrity within the NDIS include:

    • acting in accordance with Australian Consumer Law

    • charging within the price limits and pricing arrangements where specified in the NDIS Pricing Arrangements and Price Limits

    • declaring prices to participants before delivering a service

    • providing a receipt to participants to acquit against their plan

    • making a payment request only after that support has been delivered or provided

    • submitting payment requests for NDIA-managed participants within a reasonable time (and no later than 90 days from the end of the service booking)

    • keeping full and accurate records of supports delivered

    • proactively managing perceived and actual conflicts of interest.

  • The NDIS funds a range of supports and services which may include education, employment, social participation, independence, living arrangements and health and wellbeing.

    In order to be considered reasonable and necessary, a support or service:

    • must be related to a participant’s disability

    • must not include day-to-day living costs not related to your disability support needs, such as groceries

    • should represent value for money

    • must be likely to be effective and work for the participant, and

    • should take into account support given to you by other government services, your family, carers, networks and the community.

    A participant's reasonable and necessary supports take into account any informal supports already available to the individual (informal arrangements that are part of family life or natural connections with friends and community services) as well as other formal supports, such as health and education.

    These supports will help participants to:

    • pursue their goals, objectives and aspirations

    • increase their independence

    • increase community and workplace participation, and

    • develop their capacity to actively take part in the community.

  • A service provider is a person, business or organisation that delivers funded services. Service providers have different areas of experience and expertise.

    It's important to work out what you want and find the right providers to meet your needs. Providers can include large companies, charities, small not-for-profits, sole traders, or any other type of business. Providers who are registered with the NDIS are called ‘NDIS registered providers. They meet strict government quality and safety requirements.

    If your NDIS funding is NDIA-managed, you can only use NDIS registered providers to deliver your services. If you have been working with a support worker or provider for several years and they are not an NDIS registered provider, encourage them to register so you can continue to work with them, using your NDIS funding.

    Participants who self-manage or have a Plan Manager to manage their NDIS plan, can use NDIS registered providers and non-registered providers.

  • There are three types of support budgets that may be funded in your NDIS plan:

    • Core Supports budget

    • Capacity Building Supports budget

    • Capital Supports budgetCore Supports budget

    Core Supports

    Core supports help you with everyday activities, your current disability-related needs and to work towards your goals. Your Core Supports budget is the most flexible, and in most cases, you can use your funding across any of the following four support categories. However, there are instances where you do not have flexibility in your funding, particularly for transport funding.

    Assistance with Daily Life (Daily Activities)
    For example, assistance with everyday needs, household cleaning and/or yard maintenance.

    Consumables
    Everyday items you may need. For example, continence products or low-cost assistive technology and equipment to improve your independence and/or mobility.

    Assistance with Social & Community Participation
    (Social, community and civic participation)
    For example, a support worker to assist you to participate in social and community activities.

    Transport
    This is support that helps you travel to work or other places that will help you pursue the goals in your plan.

    How you can spend your transport funding and how it is paid to you (whether upfront or in regular payments) will be different for each person. Your LAC will explain how you can use this budget.

    Capacity Building Supports budget

    Capacity Building Supports help build your independence and skills to help you pursue your goals. Unlike your Core Supports budget, your Capacity Building Supports budget cannot be moved from one support category to another. Funding can only be used to purchase approved individual supports that fall within that Capacity Building category.

    Support Coordination
    This is a fixed amount for a Support Coordinator to help you use your plan.

    Improved Living Arrangements (CB Home Living)
    Support to help you find and maintain an appropriate place to live.

    Increased Social & Community Participation (CB Social Community and Civic Participation)
    Development and training to increase your skills so you can participate in community, social and recreational activities.

    Finding & Keeping a Job (CB Employment)
    This may include employment-related support, training and assessments that help you find and keep a job, such as the school leaver employment supports.

    Improved Relationships (CB Relationships)
    This support will help you develop positive behaviours and interact with others.

    Improved Health & Wellbeing (CB Health and Wellbeing)
    Including exercise or diet advice to manage the impact of your disability. The NDIS does not fund gym memberships.

    Improved Learning (CB Lifelong Learning)
    Examples include training, advice and help for you to move from school to further education, such as university or TAFE.

    Improved Life Choices (CB Choice and Control)
    Plan management to help you manage your plan, funding and paying for services.

    Improved Daily Living (CB Daily Activity)
    Assessment, training or therapy to help increase your skills, independence and community participation. These services can be delivered in groups or individually.

    Capital Supports budget

    Capital Supports include higher-cost pieces of assistive technology, equipment and home or vehicle modifications, and funding for one-off purchases you may need (including Specialist Disability Accommodation). It is important to remember that funds within the Capital Supports budget can only be used for their specific purpose and cannot be used to pay for anything else. The Capital Supports budget has two support categories: Assistive Technology and Home Modifications.

    Assistive Technology
    This includes equipment items for mobility, personal care, communication and recreational inclusion such as wheelchairs or vehicle modifications.

    Home Modifications
    Home modifications such as installation of a hand rail in a bathroom, or Specialist Disability Accommodation for participants who require special housing because of their disability.

    Stated supports – not flexible

    Any services listed as ‘stated supports’ are not flexible. This means funding has been allocated for a specific support or service, and you can’t use this funding for something else. You cannot swap ‘stated supports’ for any other supports.

    In-kind supports – pre-paid

    If there are supports in your plan that are listed as ‘in-kind’, it means the service has already been paid for by your state, territory or the Australian government.

    When you use an in-kind service your existing provider will deliver your in-kind supports and you will not need to pay from them with your NDIS plan funds. If you have a concern about using a specific in-kind provider or service, you can talk to your ECEI Coordinator, LAC or NDIA planner.

    Quote required

    Where a support is listed as ‘quote required’ additional information such as quotes and/or specialist reports will be required before funding can be made available in your plan.

    Mobility allowance

    When you become a participant in the NDIS your plan will include any supports that the NDIS will fund, including any reasonable and necessary transport-related funded supports.

    If you are receiving Mobility Allowance when you receive an approved NDIS plan, your eligibility for the Mobility Allowance payment ceases.

    You cannot receive Mobility Allowance once you have a plan with the NDIS. However you will keep your Health Care Card if you have one.