Got a question?
Here are the answers to some of the recent changes to the NDIS legislation. If you can’t find the answer you need, please contact us.
General
The NDIS has published a list of Approved and Non-approved supports.
The approved support list documents all supports claimable under the NDIS, not all supports will be included in your plan. Generally you can find more information about what types of supports you can access by looking at your plan document and your funding categories (components).
Items on the Non-approved support list are not able to be claimed from your plan. It is important to check if you are unsure to avoid being out of pocket for these expenses.
You can read more on the NDIS website: Supports funded by the NDIS
The NDIS only funds supports that meet the reasonable and necessary criteria.
A support will usually be funded if it meets all of the following:
- It relates to your disability or early intervention needs
- It helps you work towards your goals
- It supports your social and/or economic participation
- It is value for money
- It is effective and beneficial for you
- It helps maintain your informal supports
- It is considered an approved NDIS support under legislation
Even if you have funding available in your plan, a support must still meet these criteria to be claimable.
No, participants are unable to claim supports from the non-approved supports list unless one of the following situations apply.
- It is a replacement support (please note, this has a set process to follow).
- It is funded in your current plan or supported by a letter from the Administrative Appeals Tribunal (AAT).
- You receive written permission from the NDIA to allow the purchase of the non-approved item.
Some items are generally not approved NDIS supports, but in certain circumstances, you may be able to request them as a Replacement Support.
A replacement support:
- Must be approved by the NDIA in writing
- Is not automatic
- Is not an extra support
- Replaces an existing support in your plan
Important: Replacement supports usually only apply to items such as:
- Standard commercially available household items (for example, a washing machine or dishwasher)
- Smart watches
- Tablet devices
- Smartphones
- An app for accessibility or communication
We cannot process payment unless written NDIA approval is provided. If you are unsure, please contact us before purchasing the item.
This request needs to be sent to the NDIA. You can contact the NDIA through:
- Your MyNDIS contact or planner (written on your NDIS plan)
- Email to enquiries@ndis.gov.au
Unfortunately, the NDIA has confirmed that written authorisation or approval is required to support the claim of items that are no longer approved. Until written approval from the NDIS is provided to your plan manager, we are unable to process the claim; this is to make sure that you are not asked to pay money back to the NDIS or face other compliance action.
Unfortunately, letters of support from providers, even therapists is not sufficient evidence to claim a Non-approved item through NDIS funding.
Plan managers are not able to approve a non-approved support claim. This is because these supports are not available from NDIS funding and claiming the invoice can put the plan management organisation and the participant at risk of being asked to pay the money back.
The NDIA is increasing their audits on invoices and it is becoming more common for claims to be checked. If your invoice is checked and the NDIA decides it is not an appropriate use of NDIS funding they can take compliance action.
This can include:
- Cancelling your claims before the money is sent to the provider.
- Asking you to pay the money back.
- Changing how your plan is managed (ie. making your funding NDIA managed).
The changes to the legislation are continuously being updated and all providers including plan managers are working to update our systems and processes as quickly as we can.
This means that there may be times a plan manager needs to ask you or your providers for clarification. P2P may also continue to provide updates about supports that are no longer funded by the NDIS as more information is shared by the NDIA.
If you would like to read more about the changes, the NDIA is regularly publishing new information on their frequently asked questions page.
Your NDIS plan will list the supports included, some parts of your plan have more flexibility than others.
You may be asked for a copy of the plan, or a new copy to allow your plan manager to review the supports and make sure that purchases are in line with your budget.
Other claiming
No, all providers providing services to a participant with a plan managed plan are only able to claim up to the maximum rate set by the NDIA.
Extra fees such as gap fees are not able to be claimed and are considered a breach of the NDIS rules.
No, typically the NDIS does not allow paid support from family members as this can impact the family relationship and the informal supports a participant receives.
The NDIA only supports relatives and family members being paid for services in very special cases and this needs to be confirmed in writing by the NDIA.
No, all claims must be submitted to the NDIA within two years of the support date. After this, it is no longer claimable.
A banning order is a formal order sent to a service provider by the NDIS Quality and Safeguards Commission. Providers with a banning order are not permitted to submit or claim invoices for services delivered to NDIS participants.
If you are concerned your provider may have been banned, you can search for banning orders on the NDIS Commission website.
A conflict of interest occurs when a provider or organisation has competing interests that may influence their decisions or actions.
NDIS providers should avoid situations where their personal, financial or professional interests could affect the supports provided to participants.
Providers must act in the best interests of participants and be transparent about any potential conflicts of interest.
If a participant cancels a support at short notice or does not attend a scheduled support (no show), the provider may still be able to claim the cost of that support from the participant’s NDIS funding, in line with the NDIS Pricing Arrangements and the service agreement.
Generally, this applies when less than 2 clear business days’ notice is provided (or 7 days for some support work supports).
Providers can only claim if they were unable to find alternative work for that time and the worker still needed to be paid. Providers may choose to waive cancellation fees depending on the circumstances
Got a question?
If you can’t find the answer you need, please contact us.
Short Term Respite (STR)
Short Term Accommodation allows you to have time apart, for at least one night, from your primary informal supports such as family and friends who give you the majority of your unpaid, active, disability-related support.
This provides the opportunity for you to be supported by someone else, while giving your family or friends a short break from their usual caring responsibilities. It lets you try something else and helps you pursue your goals like increasing your independence or building your skills.
The NDIS generally funds up to 28 days of STA per calendar year, for up to 14 days at a time. Sometimes a specific number of days of STA will be set out in your Plan.
Any STA you choose to use must be in line with what is shown in your Plan. For example, if your Plan gives you STA only on, say, weekdays or for support on a 1:3 basis then that is how you should use it.
Any usage at a higher support ratio than that set out in your plan will likely impact the amount of time you can access STA or impact funding available for other supports. This is because your budget is calculated based on the STA rate for the ratio of support that is listed in your Plan.
For more information you can speak with your NDIA planner, LAC or SC about what has been included.
- STA is not typically funded by the NDIA if:
- If you live alone independently and don’t have drop-in supports.
- You get more than 18 hours paid supports in your home each date, regardless of who you live with.
- You’re not having a break from your family or friends who you live with, or give your significant daily drop-in support.
- It’s a day-to-day living cost that anyone is expected to pay, for example your mortgage, rent or utilities.
- You’re waiting for home modifications to be done.
- You’re living in a supported independent living (SIL) arrangement and are considered to already have time apart from family and informal supports.
- You have funding for primary or supplementary individualised living options.
- You’re in a housing crisis situation (if you are homeless or need somewhere to live you can contact homeless services in your State or Territory.
- Holidays - You can’t use it to go on a cruise or tour or holiday. You can’t use it for accommodation on holidays or airfares or other holiday or travel items, including interstate and overseas travel for holidays. It’s also not for your family or friends to stay in accommodation or to attend programs.
- Transport - you can’t use your STA funding to pay for transport to get to your respite accommodation or activity if you can travel or use public transport independently. If you need specialised transport this may be paid for. If your plan includes separate funding for Transport, you can continue to use this funding to travel to and from your STA. The NDIS will not fund a claim for Activity Based Transport where your carer did not stay and support you in your activity in the community.
- Meals - Your food or meals while staying in short term accommodation, you can’t use your NDIS funding for this. These are day-to-day living costs and are not NDIS supports.
- Activities - You can’t use your NDIS funding to pay for activities, such as tickets, entry fees, equipment, or membership fees for yourself, your support worker or your family or friends.
You can use your STA funding in a range of non-moving accommodation settings such as a respite facility, hotel, motel, short stay rental, cabin, cottage, homestay or your own home. It cannot be on a cruise or tour.
Generally, you are expected to use STA in your home State or Territory in Australia. If you live in a remote or very remote area or a border town, you may be funded to use your closest STA in your neighbouring State or Territory.
The answer is yes, however, certain exceptional circumstances must apply to you before you can begin the process of applying for STA support for your child.
For more information you can speak with your NDIA planner, LAC or SC.
Community Support and Activities
The general costs of your social and recreation activities are considered an everyday cost. This means you’ll pay for things like membership, basic equipment or entrance fees.
If you need extra help to participate in social and recreation activities because of your disability, the NDIS may be able to fund this. This might include: support to attend and participant in the activities, some specialised equipment
More information can be found in the Operational Guidelines for Social and recreational supports.
If you need modifications, or specialised equipment to participate in an activity, the NDIS may be able to claim this.
Typically if you are participating as a professional, for example competitive sports, this is not able to be claimed.
Therapy
There are a number of therapy supports that can be claimed. This may depend on your plan and what supports have been included.
Therapy should be delivered by professionals with an allied health registration and qualification.
A few examples of therapy supports that may be able to be claimed include: occupational therapy, speech therapy, physiotherapy, psychology etc.
The non-approved support list provides some examples of therapies that the NDIS believes are not evidence based. These are unable to be claimed.
A few examples include: animal therapy, cuddle therapy, hair therapy, yoga therapy etc.
The NDIS has determined that art and music therapy remain allowed however there has been a change to the maximum rate these providers can charge.
Providers of these supports must meet minimum qualification requirements to be eligible to claim as a therapy support.