Did you know that the NDIS is introducing a new way providers must claim for group support? Providers are required to move to the new way of claiming group support by 31 December 2023.
The NDIS has allowed some time for providers to move into the new model but the deadline is fast approaching for when the transitional (old) support codes will be removed.
Transitional Item Numbers vs New Pricing Model Item Numbers
The transitional item numbers (or the old items numbers) can easily be identified as the ratio of how many participants per support worker is included as part of the line item description. For example, below is an item number for support provided at a 1:2 ratio. These line items remain in the price guide to allow providers time to move into the new model. These codes will not be available for support provided from the 1st January 2024.
The new item numbers look like the example below and do not provide information about the ratio, as this will need to be calculated separately.
There are some differences used to choose which item number in the new and old models.
Transitional (old) Item Numbers include information about:
- The location the support was provided (in the community or centre)
- Time/Day of the week
- Intensity of the support
- Ratio of participant to support worker (eg: 1:2. 1:3 etc)
New Group Item Numbers include information about:
- Time/Day of the week
- Intensity of the support
The location that the support is provided is no longer used to select the line item using the new model.
However since the ratio of support for the group activity is no longer calculated in the pricing, the hourly rate charged to each participant must be calculated by the provider by either dividing the hourly rate or the number of hours by the participants in the group.
What other charges can apply to the new item numbers?
The transitional (old) item numbers are all inclusive of the non face to face support provision and the capital cost expenses for the centre, these can not be charged in addition to the rate.
However the new model these costs are separate and need to be calculated individually for each participant.
Provider travel or activity based travel may still be applicable to both the old and new method depending on the situation.
How does this work?
Let’s look at the example below of a group support provided to two participants, on a Monday in a centre for 3 hours. Participant 1 needs 30 minutes of non face to face support (NF2F). Participant 2 does not need non face to face support.
Old method
04_165_0136_6_1 (Group Activities In A Centre – 1:2 – Standard – Weekday Daytime) = $39.10 per hour
No extra charges can be claimed for NF2F or Capital Costs. Session cost is hourly rate multiplied by the hours.
New method
04_102_0136_6_1 (Group Activities – Standard – Weekday Daytime) = *$65.47 at a 1:1 rate
*This is a group support for 1:2 so the hourly rate must be divided by 2 participants.
Extra charges can be claimed for NF2F or Capital Costs. Session cost is hourly rate multiplied by the hours.
How much time do I have to get this in place?
Providers are required to move to the new pricing arrangement by 31 December 2023. This means that the support provided after this date will need to be using the new item numbers.
All supports provided prior to the deadline that are claimed using the transitional line items must be submitted to Parent to Parent before 31st March 2024, after this date the codes will no longer be able to be used.
However if the support was provided to the participant after the 1st of January, this will need to be claimed using the new method.
Where can I find more information?
The NDIS has resources available to providers regarding this change
New Group-based support pricing information: Click here (it will download a Word Doc)
Pricing Arrangements and Limits Document.
- General claiming rules for group based support: pages 28-30
- New group codes and information: pages 60-62
- Old transitional codes and information: pages 63-71
Recording of NDIS provider webinar: Click here