Your Quick Guide to NDIS Line Items (2024-25): Codes, Prices & Explanations
Section 1: Introduction - Navigating NDIS Line Items
The National Disability Insurance Scheme (NDIS) provides funding for a wide range of supports and services. Understanding how these are categorized, coded, and priced is crucial for participants, their families, carers, support coordinators, and providers. This guide serves as a practical, quick reference for specific NDIS line items requested by users, based on the 2024-25 NDIS framework. It aims to demystify these codes and provide clarity on associated pricing and rules.
What is an NDIS Line Item?
Every support or service funded by the NDIS is assigned a unique NDIS Line Item. This consists of two parts: a brief description of the support delivered and a unique numerical code. These line items act as specific identifiers, allowing the National Disability Insurance Agency (NDIA) to track spending against a participant’s plan budget and ensuring providers invoice correctly for the services provided.
The numerical code itself has an underlying structure, typically following a pattern like: Support Category_Sequence Number_Registration Group_Outcome Domain_Support Purpose. While this structure provides some logic (e.g., the first two digits often indicate the broad Support Category), the sequence numbers can be used inconsistently by the NDIA, so it’s generally not advisable to rely solely on the number structure to determine the exact nature of the support. The official name and description associated with the code are the reliable identifiers.
Why Understanding Line Items Matters
A clear understanding of NDIS line items benefits everyone involved. For participants, it helps in tracking their budget usage, ensuring the services they receive align with their plan funding, and verifying provider invoices. For providers, using the correct line item is essential for accurate claiming, compliance with NDIS rules, and avoiding payment delays or rejections.
The Official Sources: PAPL and Support Catalogue
The definitive information regarding NDIS pricing and supports comes from two key official documents published by the NDIA:
- NDIS Pricing Arrangements and Price Limits (PAPL): This document acts as the ‘rulebook’. It outlines the pricing framework, rules, and conditions under which supports can be claimed, including details on travel, cancellations, and non-face-to-face support.
- NDIS Support Catalogue: This document functions as the ‘price list’ or database. It lists all available support items with their codes, official names, descriptions, and the maximum price limits providers can charge.
It is crucial to consult both documents for a complete understanding. The Support Catalogue provides the price, but the PAPL explains the rules governing when and how that price can be applied, including any additional charges permitted (like travel) or specific conditions (like cancellation policies). Relying solely on the price list without understanding the associated rules in the PAPL can lead to errors in claiming or budgeting.
These documents are typically updated annually around July 1st, but amendments can occur throughout the year. Therefore, always check the NDIS website for the most current versions before making decisions. The latest versions relevant to this guide are effective from October 1, 2024.
- (https://www.google.com/search?q=https://www.ndis.gov.au/providers/pricing-arrangements%23toc-ndis-pricing-arrangements-and-price-limits)
- (https://www.google.com/search?q=https://www.ndis.gov.au/providers/pricing-arrangements%23toc-ndis-pricing-arrangements-and-price-limits)
Additionally, supplementary documents called Addenda may be released for specific circumstances, such as bereavement or temporary measures like those related to COVID-19. These must be read in conjunction with the main PAPL document.
Section 2: Quick NDIS Budget & Pricing Overview
Before diving into the specific line items, it’s helpful to understand the broader context of NDIS budgets and pricing rules.
NDIS Budget Types
NDIS plans typically organize funding into three main budget types:
- Core Supports: Funds supports related to everyday activities, daily living needs, community participation, consumables, and transport. This budget is generally the most flexible.
- Capital Supports: Funds investments like assistive technology (AT), equipment, home or vehicle modifications, and Specialist Disability Accommodation (SDA). This budget is generally not flexible.
- Capacity Building Supports: Funds supports aimed at building independence and skills, such as therapy, support coordination, finding employment, or improving relationships. Funding is generally not flexible between different capacity building categories.
Budget Flexibility Explained
Flexibility refers to the ability to use funding allocated for one support category or item on another.
- Core Budget Flexibility: The Core budget offers the most flexibility. In most cases, funds can be moved between the different Core support categories (Assistance with Daily Life, Consumables, Assistance with Social & Community Participation). Transport funding within Core often has specific rules and may be less flexible.
- Limited Flexibility Across Budget Types: Crucially, funding generally cannot be moved between the three main budget types (Core, Capital, Capacity Building). Core funds must be used for Core supports, Capital for Capital, and Capacity Building for Capacity Building.
- Stated Supports: Some funding within any budget type might be designated as ‘Stated Support’ (or ‘stated item’). This means the funds are specifically allocated for a particular item or service (e.g., Plan Management fees, a specific piece of Assistive Technology) and cannot be used for anything else without NDIA approval. This significantly reduces flexibility, even within the Core budget. Participants must check their plan document to identify any stated supports. Changing a stated support typically requires a plan variation or review.
Plan Management Types & Impact
How a participant chooses to manage their NDIS funding impacts provider choice and pricing adherence:
- Self-Managed: The participant (or nominee) directly manages the funds, pays providers, and claims reimbursement. This offers maximum flexibility: participants can use registered or unregistered providers and can negotiate prices, potentially paying above the NDIS price limits if they choose.
- Plan-Managed: A registered Plan Manager manages the funds, pays provider invoices, and handles claims. Participants gain support with financial administration while retaining flexibility in provider choice: they can use registered or unregistered providers, but providers must adhere to NDIS price limits. Funding for plan management is typically a stated support in the Capacity Building budget.
- Agency-Managed (NDIA-Managed): The NDIA manages the funds and pays providers directly. This option involves the least administration for the participant but offers the least flexibility: participants must use NDIS registered providers, and providers must adhere to NDIS price limits.
Understanding the interplay between budget type, stated supports, and plan management type is essential. For instance, having flexible Core funding for ‘Assistance with Daily Life’ means different things depending on management type. A self-managed participant could potentially pay a preferred, unregistered support worker a rate above the NDIS limit, while a plan-managed participant using the same worker would be restricted to the NDIS price limit. This multi-layered check (Budget Type -> Stated Item? -> Management Type) is vital for practical decision-making.
Pricing Variations
Several factors influence the maximum price limit for a support item:
- Maximum Limits: Price limits in the Support Catalogue are maximums for Agency- and Plan-Managed participants. Negotiation for lower prices is always possible and encouraged. Self-managed participants are not bound by these limits.
- Location (Modified Monash Model - MMM): The NDIS uses the MMM system to classify geographical areas based on remoteness. Higher price limits apply to account for increased service delivery costs in remote areas:
- MMM 1-5 (Metropolitan, Regional Centres, Regional Areas): Standard National price limits apply.
- MMM 6 (Remote): Price limits are generally 40% higher than National rates.
- MMM 7 (Very Remote): Price limits are generally 50% higher than National rates.
- Participants and providers can check a location’s MMM classification using the Health Workforce Locator tool (ensure the ‘2019’ MMM box is ticked as per NDIS guidelines).
- Time of Day/Week: For supports delivered by disability support workers (primarily in Core and some Capacity Building categories), different price limits apply depending on the time and day the support is provided (e.g., Weekday Daytime, Weekday Evening, Weekday Night, Saturday, Sunday, Public Holiday).
- Intensity: Some supports have higher price limits for ‘High Intensity’ delivery, applicable when participants require frequent assistance with complex behaviours or need support workers with specific high-intensity skills.
The application of higher price limits in remote areas acknowledges the genuine increased costs of operating in these regions. However, if budget allocations are not proportionally increased for remote participants, this can lead to challenges where the same nominal funding amount buys fewer hours of support compared to metropolitan areas, potentially impacting service access equity. The complexity of varying rates also demands careful attention to detail during invoicing and budget tracking.
Section 3: Understanding the Line Item Tables
The following sections detail the specific NDIS line items requested by the user, grouped by their primary Support Category. Each table provides a quick reference with the following information:
- Line Item Code: The unique numerical identifier used by the NDIS.
- Official Name: The formal name of the support item as listed in the NDIS Support Catalogue 2024-25.
- Brief Description: A simplified explanation of the support provided, based on official definitions and common usage.
- Price Limit (National): The maximum price per unit for services delivered in MMM1-5 locations, based on the NDIS Support Catalogue 2024-25 (effective Oct 1, 2024). Note that higher limits apply for Remote (MMM6) and Very Remote (MMM7) locations.
- Unit: The unit of measure for the price limit (e.g., Hour, Each, Day, Week, Per Km).
- Key Conditions: Flags indicating common rules associated with the item:
- Quote Req?: Indicates if a quote typically needs NDIS approval before funding.
- Stated?: Indicates if this item is often funded as a ‘stated support’, meaning funds are restricted to this item only.
- Rules Apply: Notes whether specific NDIS rules for Provider Travel, Non-Face-to-Face (NF2F) supports, or Short Notice Cancellations (SNC) typically apply to this type of support. These rules are explained in detail in Section 5.
Section 4: NDIS Line Items - Detailed Listings
01 – Assistance with Daily Life
Category Definition: This Core Supports category funds assistance or supervision for personal tasks in day-to-day life, enabling participants to live as independently as possible. Supports can be provided individually in various environments, including the participant’s home. It covers a wide range, from basic personal care to more complex arrangements like Supported Independent Living (SIL) and Short Term Accommodation (STA)/Respite. Many items in this category have price variations based on time of day, day of week, and support intensity, reflecting the 24/7 nature of these needs and alignment with support worker award conditions. High-cost items like SIL and STA often require quotes.
Table: 01 – Assistance with Daily Life Line Items
| Line Item Code | Official Name | Brief Description | Price Limit (National MMM1-5, 2024-25) | Unit | Key Conditions |
|---|---|---|---|---|---|
01_002_0107_1_1 | Assistance With Self-Care Activities - Standard - Weekday Night | Standard intensity assistance/supervision for personal tasks (e.g., hygiene, mobility) during weekday overnight hours (active support, not sleepover). | $75.82 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_004_0107_1_1 | Assistance with Personal Domestic Activities | Assistance with domestic tasks (e.g., cleaning, laundry, shopping) that the participant cannot undertake due to their disability, often aimed at skill-building for home maintenance. | $57.23 | Hour | Quote Req: Yes. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_010_0107_1_1 | Assistance With Self-Care Activities - Night-Time Sleepover | Overnight support where the worker is present and available but can sleep when not actively providing support. Price typically includes a set amount of active support time. | $286.56 | Each | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_011_0107_1_1 | Assistance With Self-Care Activities - Standard - Weekday Daytime | Standard intensity assistance/supervision for personal tasks (e.g., showering, dressing) during weekday daytime hours (Mon-Fri, 6 am-8 pm). | $67.56 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_012_0107_1_1 | Assistance With Self-Care Activities - Standard - Public Holiday | Standard intensity assistance/supervision for personal tasks provided on a public holiday. | $150.10 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_013_0107_1_1 | Assistance With Self-Care Activities - Standard - Saturday | Standard intensity assistance/supervision for personal tasks provided on a Saturday. | $95.07 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_014_0107_1_1 | Assistance With Self-Care Activities - Standard - Sunday | Standard intensity assistance/supervision for personal tasks provided on a Sunday. | $122.59 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_015_0107_1_1 | Assistance With Self-Care Activities - Standard - Weekday Evening | Standard intensity assistance/supervision for personal tasks during weekday evening hours (support starts after 8 pm, finishes by midnight). | $74.44 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_019_0120_1_1 | House or Yard Maintenance | Performing essential house and/or yard activities (e.g., lawn mowing, garden care, basic repairs) that the participant cannot undertake. | $55.21 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_020_0120_1_1 | House Cleaning And Other Household Activities | Performing essential house cleaning activities (e.g., dusting, vacuuming, laundry) that the participant cannot undertake. | $56.23 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_058_0115_1_1 | STA And Assistance (Inc. Respite) - 1:1 - Weekday | Short Term Accommodation (STA) including personal care and accommodation costs for 1 participant with 1:1 support worker ratio, provided on a weekday. STA typically up to 14 days. | $2,098.80 | Day | Quote Req: Sometimes. Stated: Sometimes. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_134_0117_8_1 | Capacity Building and Training in Self-Management and Plan Management | Training and support to strengthen a participant’s ability to manage their own NDIS plan and funding, including budgeting and understanding policies. | $77.00 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
01_301_0104_1_1 | Item Not Found/Legacy | This item code was not clearly identified as a standard, active support in the 2024-25 information reviewed. It may be legacy or used in specific contexts only. Please verify with the official NDIS Support Catalogue. | - | - | - |
01_400_0104_1_1 | Assistance With Self-Care Activities - High Intensity - Weekday Daytime | High intensity assistance/supervision for personal tasks during weekday daytime for participants with complex needs (e.g., frequent challenging behaviours, high medical needs) requiring workers with additional skills/experience. | $73.09 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
01_661_0128_1_3 | Assessment Recommendation Therapy or Training Supports - Occupational Therapist | Occupational Therapy (OT) services (assessment, therapy, training) related to disability health needs, delivered by a registered OT or supervised assistant (for participants >7 yrs). | $193.99 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
01_701_0128_1_3 | Assessment Recommendation Therapy or Training Supports - Psychologist | Psychology services (assessment, therapy, training) related to disability health needs, delivered by a registered Psychologist or supervised assistant (for participants >7 yrs). (Note: Price varies by state in some sources, but Catalogue usually shows national limit). | $222.99 (ACT/NSW/QLD/VIC) / $244.22 (NT/SA/TAS/WA) | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
01_741_0128_1_3 | Assessment Recommendation Therapy or Training Supports - Other Professional | Therapy/assessment/training by other allied health professionals (e.g., dietitian, speech pathologist, audiologist - not OT, Physio, Podiatrist, Psychologist, SpPath listed elsewhere) related to disability health needs (for participants >7 yrs). | $193.99 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
01_799_0104_1_1 | Provider travel - non-labour costs | Covers non-labour travel costs (e.g., tolls, parking, km allowance up to $0.97/km) incurred by providers when travelling to deliver High Intensity Daily Personal Activities (Reg Group 0104) supports. | $1.00 (Represents claimable cost, not price limit) | Each | Quote Req: No. Stated: No. Rules Apply: Specific travel cost rules apply (see Section 5). |
01_821_0115_1_1 | Assistance in Supported Independent Living - Weekly | Weekly rate for supports provided within a Supported Independent Living (SIL) arrangement. Amount is usually determined by a SIL quote and stated in the plan. | As stated in plan/agreed with NDIA | Week | Quote Req: Yes. Stated: Yes. Rules Apply: SIL specific rules, Travel, NF2F, SNC (7 days DSW). |
03 – Consumables & Core Supports
Category Definition: This Core Supports category funds everyday items needed to manage disability-related aspects of life. It covers a wide range of low-cost items like continence products, nutritional supplements, personal care aids, and low-cost assistive technology (generally under $1,500). While the budget is generally flexible within Core, purchases must be reasonable, necessary, and directly related to the participant’s disability needs.
Table: 03 – Consumables & Core Supports Line Items
| Line Item Code | Official Name | Brief Description | Price Limit (National MMM1-5, 2024-25) | Unit | Key Conditions |
|---|---|---|---|---|---|
03_040000919_0103_1_1 | Disability-Related Health Consumables - Low Cost | Low-cost (under $1,500), non-durable health consumables needed due to disability (e.g., wound care, incontinence aids). | $1.00 (Represents claimable cost, not price limit) | Each | Quote Req: No. Stated: No. Rules Apply: Consumables rules apply. |
03_090000911_0103_1_1 | Low Cost AT - Personal Care And Safety | Low-cost (under $1,500) assistive technology specifically for personal care and safety (e.g., non-slip mats, grab rails, personal alarms). AHP letter may be needed. | $1.00 (Represents claimable cost, not price limit) | Each | Quote Req: No. Stated: No. Rules Apply: Consumables/Low-Cost AT rules apply. |
04 – Assistance with Social, Economic and Community Participation
Category Definition: This Core Supports category funds supports enabling participants to engage in community, social, civic, or recreational activities. It can cover support workers assisting with participation, transport related to activities, or costs associated with group/centre-based programs.
Table: 04 – Assistance with Social, Economic and Community Participation Line Items
| Line Item Code | Official Name | Brief Description | Price Limit (National MMM1-5, 2024-25) | Unit | Key Conditions |
|---|---|---|---|---|---|
04_102_0125_6_1 | Access Community Social and Rec Activ - Standard - Public Holiday | Standard intensity support worker assistance to participate in community, social, or recreational activities on a public holiday. | $150.10 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
04_102_0136_6_1 | Group Activities - Standard - Weekday Daytime | Support worker assistance for participation in group-based community, social, or recreational activities during standard weekday daytime hours. | $67.56 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW), Group rules apply. |
04_103_0125_6_1 | Access Community Social and Rec Activ - Standard - Weekday Evening | Standard intensity support worker assistance to participate in community, social, or recreational activities during weekday evening hours (8 pm-midnight). | $74.44 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
04_104_0125_6_1 | Access Community Social and Rec Activ - Standard - Weekday Daytime | Standard intensity support worker assistance to participate in community, social, or recreational activities during weekday daytime hours (6 am-8 pm). | $67.56 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
04_105_0125_6_1 | Access Community Social and Rec Activ - Standard - Saturday | Standard intensity support worker assistance to participate in community, social, or recreational activities on a Saturday. | $95.07 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
04_106_0125_6_1 | Access Community Social and Rec Activ - Standard - Sunday | Standard intensity support worker assistance to participate in community, social, or recreational activities on a Sunday. | $122.59 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
04_111_0136_6_1 | Group Activities In The Community - 1:2 - Standard - Weekday Daytime | Support worker assistance for participation in group-based community activities with a 1:2 staff-to-participant ratio during standard weekday daytime hours. (Verify against official catalogue due to potential snippet confusion) | $36.66 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW), Group rules apply. |
04_210_0125_6_1 | Community Social And Recreational Activities | Covers costs of community engagement, social, and recreational activities themselves (e.g., class fees, camp costs), not the support worker time. | No Price Limit (Subject to quote/agreement) | Each | Quote Req: Yes. Stated: Sometimes. Rules Apply: Specific rules apply. |
04_400_0104_1_1 | Access Community Social and Rec Activ - High Intensity - Weekday Daytime | High intensity support worker assistance to participate in community, social, or recreational activities during weekday daytime hours for participants with complex needs. | $73.09 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
04_590_0125_6_1 | Activity Based Transport | Covers non-labour costs of transport provided by a support worker to enable participation in community, social, or recreational activities (e.g., km allowance, tolls, parking). | $1.00 (Represents claimable cost, not price limit) | Each | Quote Req: No. Stated: No. Rules Apply: Specific transport cost rules apply (see Section 5). |
04_799_0125_6_1 | Provider travel - non-labour costs | Covers non-labour travel costs (e.g., tolls, parking, km allowance up to $0.97/km) incurred by providers when travelling to deliver Participation in Community, Social and Civic Activities (Reg Group 0125) supports. | $1.00 (Represents claimable cost, not price limit) | Each | Quote Req: No. Stated: No. Rules Apply: Specific travel cost rules apply (see Section 5). |
04_801_0133_5_1 | Supports in Employment - Weekday Daytime | Support worker assistance provided within a workplace setting during standard weekday daytime hours to help a participant obtain or retain employment. | $67.56 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (7 days DSW). |
07 – Support Coordination & Specialist Support Coordination
Category Definition: This Capacity Building category funds assistance to help participants understand and implement their NDIS plan, connect with services (NDIS, community, mainstream), and build their capacity to coordinate their own supports. Funding is usually stated and cannot be used flexibly for other categories. There are different levels based on complexity.
Table: 07 – Support Coordination & Specialist Support Coordination Line Items
| Line Item Code | Official Name | Brief Description | Price Limit (National MMM1-5, 2024-25) | Unit | Key Conditions |
|---|---|---|---|---|---|
07_002_0106_8_3 | Support Coordination Level 2: Coordination of Supports | Assistance to build skills to understand and use the NDIS plan, connect with supports, manage service delivery, and live more independently. For participants with more complex needs than Level 1. | $100.14 | Hour | Quote Req: No. Stated: Yes. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
09 – Increased Social and Community Participation
Category Definition: This Capacity Building category funds participation in skills-based learning and activities to develop independence in accessing the community. It focuses on building skills rather than just providing access support (which falls under Core Category 04).
Table: 09 – Increased Social and Community Participation Line Items
| Line Item Code | Official Name | Brief Description | Price Limit (National MMM1-5, 2024-25) | Unit | Key Conditions |
|---|---|---|---|---|---|
09_006_0106_6_3 | Life Transition Planning Incl. Mentoring Peer-Support And Indiv Skill Develop | Planning and support for significant life transitions (e.g., leaving school, moving home), including mentoring, peer support, and individual skill development to navigate the transition. | $77.00 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
09_008_0116_6_3 | Innovative Community Participation | Supports participation in innovative community activities, often through mainstream providers, designed to build skills and inclusion in new ways. | No Price Limit (Subject to quote/agreement) | Each | Quote Req: Yes. Stated: Sometimes. Rules Apply: Specific rules apply. |
09_009_0117_6_3 | Skills Development And Training | Individual or group training to increase skills for independence in daily personal activities or community/social/recreational participation (e.g., public transport training). | $77.00 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW), Group rules apply if delivered in group. |
09_011_0125_6_3 | Community Participation Activities | Covers costs of tuition fees, classes, camps, or similar activities that build skills and independence (e.g., art class, sports coaching). Includes establishing volunteer arrangements, mentoring, peer support. | No Price Limit (Subject to quote/agreement) | Each | Quote Req: Yes. Stated: Sometimes. Rules Apply: Specific rules apply. |
10 – Transport
Category Definition: This Core Supports category helps participants pay for transport needed to achieve their plan goals, such as travelling to work, appointments, or community activities. Funding is often provided as a periodic payment directly to the participant (Recurring Transport) or can be used to pay providers for transport services. It’s generally for participants who cannot use public transport without significant difficulty due to their disability. Transport funding often has specific rules and may be less flexible than other Core categories.
Table: 10 – Transport Line Items
| Line Item Code | Official Name | Brief Description | Price Limit (National MMM1-5, 2024-25) | Unit | Key Conditions |
|---|---|---|---|---|---|
10_016_0102_5_3 | Employment Assistance | Workplace assistance to help a participant obtain or retain employment, including skill building, career planning, job exploration, and transition support. (Note: This item appears under Cat 10 in user query but description aligns with ‘Finding and Keeping a Job’ - Cat 10 in PAPL) | $77.00 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
10_021_0102_5_3 | School Leaver Employment Supports | Capacity building supports for students transitioning from school to employment, focusing on skill development, work experience, and pathway planning. (Note: This item appears under Cat 10 in user query but description aligns with ‘Finding and Keeping a Job’ - Cat 10 in PAPL) | No Price Limit (Subject to quote/agreement) | Each | Quote Req: Yes. Stated: Yes. Rules Apply: SLES specific rules apply. |
(Note: The user provided items 10_016_0102_5_3 and 10_021_0102_5_3 under Category 10 - Transport. However, based on NDIS structure and descriptions, these relate to Support Category 10 - Finding and Keeping a Job, which is a Capacity Building category. The table reflects this correction.)
11 – Improved Relationships
Category Definition: This Capacity Building category funds supports to help participants develop positive behaviours, interact better with others, and build social skills. It often involves behaviour support specialists or therapists and may include assessments and plan development to address behaviours of concern.
Table: 11 – Improved Relationships Line Items
| Line Item Code | Official Name | Brief Description | Price Limit (National MMM1-5, 2024-25) | Unit | Key Conditions |
|---|---|---|---|---|---|
11_024_0117_7_3 | Individual Social Skills Development | One-on-one coaching and support to develop and practice social skills, improve communication, build relationships, and enhance community participation. | $77.00 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
12 – Improved Health and Wellbeing
Category Definition: This Capacity Building category funds activities to support participants manage the impact of their disability on their health and wellbeing, such as exercise physiology or personal training tailored to disability needs, or dietetic advice. It does not cover general fitness or health costs like gym memberships.
Table: 12 – Improved Health and Wellbeing Line Items
| Line Item Code | Official Name | Brief Description | Price Limit (National MMM1-5, 2024-25) | Unit | Key Conditions |
|---|---|---|---|---|---|
12_027_0126_3_3 | Advice provided by an Exercise Physiologist regarding exercise required | Provision of exercise advice and programs by a qualified Exercise Physiologist, tailored to manage the impact of the participant’s disability. | $166.99 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
15 – Improved Daily Living Skills
Category Definition: This Capacity Building category funds assessment, training, and therapy supports to help participants increase their skills, independence, and community participation in daily life. This is a common category for allied health therapies like Occupational Therapy (OT), Psychology, Speech Pathology, etc., aimed at building long-term capacity.
Table: 15 – Improved Daily Living Skills Line Items
| Line Item Code | Official Name | Brief Description | Price Limit (National MMM1-5, 2024-25) | Unit | Key Conditions |
|---|---|---|---|---|---|
15_035_0106_1_3 | Assistance With Decision Making Daily Planning and Budgeting | Time-limited support to develop skills in daily budgeting, planning purchases, and making decisions related to managing daily life. | $67.56 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
15_043_0128_1_3 | Individual Counselling | Counselling provided by a qualified counsellor to assist participants with managing emotional, psychological, or behavioural challenges related to their disability. Requires appropriate accreditation (e.g., PACFA, ACA). | $156.16 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
15_045_0128_1_3 | Community Engagement Assistance | Assistance to engage effectively in the community, often through a group approach, to achieve goals, gain insight, and improve interactions with social networks. | $49.61 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
15_053_0128_1_3 | Therapy Assistant - Level 2 | Delivery of therapeutic supports by a Therapy Assistant (Level 2 - higher skill level, works more independently) under the supervision of a qualified therapist. | $86.79 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
15_054_0128_1_3 | Assessment Recommendation Therapy or Training - Psychology | Psychological assessments, interventions, therapy, or training delivered by a registered Psychologist or supervised assistant to support mental health, well-being, and functioning related to disability. (Note: Price varies by state in some sources, but Catalogue usually shows national limit). | $214.41 (ACT/NSW/QLD/VIC) / $234.83 (NT/SA/TAS/WA) | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
15_056_0128_1_3 | Assessment Recommendation Therapy or Training - Other Professional | Assessment, therapy, or training by other allied health professionals (not specifically listed elsewhere, e.g., Music Therapist, Art Therapist, Dietitian) meeting NDIS Q&S Commission requirements for Therapeutic Supports. | $193.99 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
15_222400911_0124_1_3 | Low Cost AT - Support Capacity Building | Legacy/COVID Item. Originally for low-cost AT to support continuity during COVID-19 restrictions. Should no longer be used for standard Low Cost AT. | $1.00 (Represents claimable cost, not price limit) | Each | Quote Req: No. Stated: No. Rules Apply: Legacy item rules. |
15_617_0128_1_3 | Assessment Recommendation Therapy or Training - Occupational Therapist | Occupational Therapy (OT) services including assessment, therapy interventions, and training delivered by a registered Occupational Therapist or supervised assistant to improve daily living and functional abilities. | $193.99 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
15_622_0128_1_3 | Assessment Recommendation Therapy or Training - Speech Pathologist | Speech Pathology services including assessment, therapy, and training delivered by a qualified Speech Pathologist or supervised assistant to address communication (speaking, listening, reading, writing, social skills) and swallowing difficulties. | $193.99 | Hour | Quote Req: No. Stated: No. Rules Apply: Travel, NF2F, SNC (2 business days non-DSW). |
Section 5: Important Rules & Conditions Explained
The ‘Key Conditions’ column in the tables flags common rules that affect how line items can be used and claimed. Understanding these is essential for correct NDIS plan utilisation.
Quote Required
- What it means: For certain supports, especially those that are high-cost, complex, or highly tailored, the NDIA requires a formal quote from the provider to be submitted and approved before funding is allocated in the plan or before the support can be claimed.
- When it typically applies: Commonly required for higher-cost Assistive Technology (often over $1,500), Home Modifications, Specialist Disability Accommodation (SDA), complex Supported Independent Living (SIL) arrangements, and specific items noted in the PAPL or Support Catalogue (like
01_004_0107_1_1Assistance with Personal Domestic Activities,04_210_0125_6_1Community Social And Recreational Activities,09_008_0116_6_3Innovative Community Participation,09_011_0125_6_3Community Participation Activities, and10_021_0102_5_3SLES). - Practical Implications: Participants and providers need to factor in extra time for obtaining quotes and waiting for NDIA approval. This process ensures value for money on significant investments but can delay access to the support. Clear communication and timely submission of detailed quotes are vital.
Stated Support
- What it means: Funding allocated as a ‘stated support’ is strictly ring-fenced for that specific purpose and cannot be used flexibly for any other item, even within the same budget category. The plan will explicitly state which supports are funded this way.
- When it typically applies: Common examples include funding for Plan Management (
14_001_0127_8_3), Support Coordination (07_002_0106_8_3), Specialist Disability Accommodation (SDA), specific high-cost Assistive Technology, and sometimes SIL or other supports as determined by the planner. - Practical Implications: Stated supports limit participant choice and control if their needs or preferences change during the plan period. Using these funds for something else requires a plan variation or review. Participants need to carefully review their NDIS plan document (not just the portal summary) to identify any stated supports and understand the limitations on those funds.
Non-Face-to-Face (NF2F) Supports
- What it means: This refers to time spent by a provider working on tasks directly related to a specific participant’s support needs, but when the participant is not physically present. Examples include writing participant-specific reports, researching tailored solutions, or preparing specialised materials for a session.
- Rules: Providers can claim for NF2F time only if:
- The activity is directly linked to delivering a specific support item for that participant.
- It is not part of general overheads or administrative tasks like invoicing, staff training, rostering, or standard record keeping.
- The participant has agreed to these charges in advance, usually documented in the Service Agreement.
- The provider explains the activity and why it represents value for money.
- The claim is made using the same support line item as the direct service, selecting the ‘Non-Face-to-Face’ option in the claiming portal.
- Practical Implications: NF2F charges can add to the overall cost of support delivery. Clear communication and explicit agreement in the Service Agreement are essential to avoid disputes. Providers must be able to justify the time spent and link it directly to the participant’s support. Participants should understand what NF2F activities they are agreeing to pay for.
Provider Travel
- What it means: NDIS allows providers to claim costs associated with travelling to deliver face-to-face supports to participants. This acknowledges the time and expense involved, particularly for mobile services or in regional/remote areas.
- Rules:
- Agreement: Travel costs must be agreed upon by the participant in advance, typically in the Service Agreement.
- Travel Time: Providers can claim for the time spent travelling to a participant. The maximum claimable time depends on the location’s MMM zone: up to 30 minutes each way for MMM 1-3 (major cities/regional centres) and up to 60 minutes each way for MMM 4-5 (regional areas). For MMM 6-7 (remote/very remote), travel time is as agreed up to the support’s hourly rate. Travel time is charged at the agreed hourly rate for the support item (or lower).
- Return Travel: Travel time from the last participant back to the provider’s usual place of work can sometimes be claimed (under the same MMM time limits), but only if the provider is required to pay their worker for that return travel time.
- Multiple Participants: If travelling to see multiple participants in one trip, the travel time and costs should be reasonably apportioned (split) among them, with prior agreement.
- Non-Labour Costs: Providers can also claim for non-labour costs like road tolls, parking fees, and vehicle running costs. Vehicle running costs can be claimed up to $0.99 per km for standard vehicles or $2.76 per km for modified/accessible vehicles. These are claimed using specific ‘Provider travel - non-labour costs’ line items (often ending in ‘799’) or ‘Activity Based Transport’ line items (often ending in ‘59x’).
- Invoicing: Travel time and non-labour costs must be claimed separately from the primary support on invoices.
- Practical Implications: Travel costs can significantly impact a participant’s budget, especially for those living further from providers. Clear discussion and documentation in Service Agreements are vital. Participants should understand the MMM zone rules and agree on how travel time and costs will be calculated and potentially apportioned.
Short Notice Cancellations (SNC)
- What it means: If a participant cancels a scheduled support appointment without providing sufficient notice, the provider may be able to charge a cancellation fee. This policy aims to compensate providers for income lost due to last-minute changes.
- Rules (Effective July 1, 2024): The required notice period now differs based on the type of support:
- Disability Support Worker (DSW) Supports: For supports typically delivered by disability support workers (e.g., personal care, community access under Core supports), the short notice period remains 7 clear days.
- Non-DSW Supports: For supports typically delivered by therapists, plan managers, support coordinators, etc. (most Capacity Building supports), the short notice period is 2 clear business days.
- Other Conditions: To claim an SNC fee (up to 100% of the agreed price for the cancelled support - check latest PAPL for exact percentage), the provider must demonstrate that:
- The cancellation policy is stated in the Service Agreement.
- They could not find alternative billable work for the staff member scheduled for the appointment.
- The claim is made using the relevant support item with the ‘Cancellation’ option selected.
- Practical Implications: This dual timeline requires careful attention from both participants and providers. Participants need to be aware of the specific notice period required for each type of support they receive to avoid unexpected fees. Providers must ensure their Service Agreements clearly reflect the correct cancellation terms for different service types. This change was introduced partly due to rising cancellation costs, particularly for therapy services.
The complexity arising from these varied conditions highlights the critical need for transparent communication and comprehensive Service Agreements. Misunderstandings about whether a quote is needed, if funding is stated, or how travel and cancellation rules apply are common sources of confusion and potential disputes. Navigating these requires diligence from all parties.
Section 6: Tips for Using This Guide & Finding More Help
This guide provides a snapshot of specific NDIS line items based on the 2024-25 framework. However, the NDIS is a dynamic system. Here are some tips for effectively using this information and finding further assistance:
- Always Check Official Sources: While this guide aims for accuracy based on information available up to October 2024, the NDIS Pricing Arrangements and Price Limits and the NDIS Support Catalogue on the official NDIS website (www.ndis.gov.au) are the definitive sources. Always refer to the latest versions before making final decisions.
- Price Limits vs. Actual Costs: Remember that the prices listed are maximum limits for Agency-Managed and Plan-Managed participants. Providers cannot charge more than these limits. However, participants (especially those who are Self-Managed) and providers can negotiate lower rates.
- Use Online Tools Cautiously: Several third-party organisations offer helpful online NDIS price guide search tools and calculators (e.g., MyCareSpace, Plan Partners, Plan Tracker). These can be convenient starting points, but always verify the information against the official NDIS documents, as third-party tools may not always be instantly updated with the latest changes. The official NDIS website also has a Provider Finder tool to locate registered providers.
- The Importance of Service Agreements: A clear, written Service Agreement between the participant and provider is crucial. It should detail the specific supports to be delivered (including line items), agreed prices (especially if lower than the limit), and how conditions like travel, NF2F activities, and cancellations will be handled. This document helps prevent misunderstandings and provides a reference point if issues arise.
- Seek Support When Needed: Navigating NDIS line items, budgets, and rules can be complex. Don’t hesitate to seek assistance. Your Support Coordinator, Plan Manager, Local Area Coordinator (LAC), or the NDIA National Contact Centre can provide clarification and guidance tailored to your specific situation and plan.
Ultimately, while this guide provides specific data points, its greater value lies in equipping users with the understanding of how the system works – how prices vary, what conditions mean, and where to find definitive answers. This knowledge empowers users to navigate the NDIS more effectively, both now and as the scheme continues to evolve.
Section 7: Conclusion
Understanding NDIS line items is a fundamental part of managing an NDIS plan effectively. This guide has provided a quick reference for specific line items requested by users within the 2024-25 NDIS framework, detailing their codes, names, descriptions, national price limits, and key associated conditions.
By familiarizing themselves with these details and the broader context of NDIS budgets, pricing rules (including variations for location and time), and plan management options, participants and providers can make more informed decisions, ensure accurate claiming, and better utilize NDIS funding to achieve participant goals.
Remember that the NDIS landscape is subject to change. Always consult the latest official NDIS Pricing Arrangements and Price Limits and the NDIS Support Catalogue, and utilize the support available through Support Coordinators, Plan Managers, LACs, and the NDIA to navigate your NDIS journey successfully.