Major Changes to the New Price Guide

The NDIA have just released “Version 1.1” of the 2019/20 Price Guide with a note that it is subject to change. Here’s what's been changed and clarified:


Group Prices

The prices for groups have been substantially revised since last week’s release. Here’s what’s changed:

  • There are no group-based supports that have had a price reduction (even before accounting for TTP).

  • The NDIA have clarified that the previous reduction in group-based supports was accounting for the fact that providers could additionally charge non face-to-face time. This decision has now been reversed and the non-participant facing time allowance has been built into the line item and providers can not charge additional non-F2F time.

  • The anomaly in Weekday Evening ratios has been fixed, so 1:5 is now rightfully cheaper than 1:4 and 1:3.


CLARIFICATIONS

Participant plans will be indexed to include TTP

Update: An earlier version of this article stated that Plans would not be indexed for TTP. The NDIA have now announced that indexation will include TTP:

NDIS funding in existing participant plans has been adjusted to reflect indexation, the changes in the price limits for therapy, attendant care and community participation and the application of the Temporary Transformation Payment.

Non-registered providers can not charge TTP prices

The Agency have clarified that non-registered providers will not be allowed to charge TTP included prices. This primarily impacts Plan Managers and participants with plan managed funds, who will need to ensure that the unregistered providers they work with charge no higher than the TTP-excluded price.

Capacity building providers can charge travel both ways

It looks like Core Supports and Capacity Building Support providers will still have different travel rules. While Core Supports providers may only charge up to 30 minutes of travel (or 60 minutes in regional areas) for supports where travel is allowed, it has now been clarified that providers of Capacity Building supports will also be able to charge for the return back to their usual place of work.


The Low Cost Assistive Tech price limit has not reduced

This clarification is good news but frankly a bit silly. Although the Support Catalogue lists items for Low Cost AT as maximum $100 each, the newly updated Assistive Technology and Consumables Code Guide has provided the clarification that this is in fact not a maximum price per unit but simply a Unit of Measurement (UOM). Under the heading 2.2 Low cost assistive technology (mostly items <$1,500), it gives the examples that to claim:

a $530 digital text player the provider would submit a payment request for 5.3 units of 03_220300911_0113_1_1 (Low Cost AT for Vision Related AT) at total cost of $530

$60 for modified cutlery the provider would submit a payment request for 0.6 units of 03_220300911_0113_1_1 (Low Cost AT for Vision Related AT) at total cost of $60.

Therapeutic supports have higher prices in some states

The prices for some therapeutic supports are up to 15% higher in NT, WA, TAS and SA than in the East to support market growth. Initially the Support Catalogue had the prices noted incorrectly, so it appeared that prices were higher in the East. This has now been corrected.

Rules around additional charges also apply to self managed funds

The Price Guide has clarified that while people spending self managed funds are still free to set their own prices for supports, registered providers are not allowed to then add any additional fees such as credit card surcharges, ‘gap’ fees, late payment fees or cancellation fees outside of the NDIS prescribed rules.

Service bookings will need to be manually updated

The NDIA announced on Tuesday that they will not be automatically increasing the value of service bookings. This means providers will need to end and create new service bookings or update the ‘Allocated Dollar’ amount in all service bookings.

This will be frustrating news for all service providers, but particularly those who provide a low number of hours of support per plan, like Plan Management, Support Coordination and some therapies where the cost of manually amending service bookings will sometimes be higher than the benefit it would bring.

Participants must agree to be charged Level 3 prices

The February Price Guide update introduced a third tier of pricing for personal care and community access, sometimes called “very high intensity”. Where prior to February, a Participant paid either standard or high intensity rates consistently throughout the plan, this change made the price dependent on the worker’s SCHCADS level, so that more highly paid worker meant a higher price for the Participant. This left many confused about who would be responsible for deciding which worker attended which shift and then managing the budget accordingly.

This Price Guide provides the following clarification:

In general, the Level 2 price limit applies to most high intensity supports. However, if the particular instance of support is delivered by a worker who does not have the skills and experience to deliver a high intensity support then the Level 1 price limit should be applied. If the particular instance of the support is delivered by a more highly skilled or experienced worker then the provider can consider applying the Level 3 price cap, with the participant’s prior agreement.


View the updated Price Guide & Support Catalogue


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