Get the facts on NDIS therapy funding
We asked our Support Coordination team to answer some of the most frequently asked questions they get asked about NDIS therapy funding.
Where can I access my therapy funding in my NDIS plan?
The therapy budgets are usually categorised under Improved Daily Living, Improved Relationships and Improved Health and Wellbeing. Recently, the NDIA have allowed for greater flexibility in accessing the core support budget for disability related supports. Check with your service provider to see whether they are able to utilise funding in either of these categories.
What can I use the therapy funding for?
The therapy budget can be used for allied health services such as Occupational Therapy (OT), Physiotherapy, Exercise Physiology, Speech Pathology, Behaviour Support Therapy and Podiatry. Keep in mind that if you are already accessing these supports through other government schemes such as Medicare, the NDIA may not fund for these supports in your NDIS plan.
Where can I access allied health supports?
There are many NDIS registered allied health services available across NSW and Sydney. The NDIA have created a provider list, which can assist in finding the best service provider. Visit: ndis.gov.au/participants/working-providers/find-registered-provider
In addition, attending your local disability expo will provide you with the information to help you find the best service provider for your needs. These disability expos are usually advertised online throughout the year.
You may also like to do a Google search of service providers in your area to provide you with useful information. Lastly, your Support Coordinator will be able to provide you with recommendations that suit your needs.
Will my therapy funding be rolled over in the next NDIS plan?
In most cases, the NDIS funds are not automatically rolled over in every plan. A request for continued funding may need to be submitted to the NDIA for the required funding. This can be requested during your NDIS plan review meeting. The therapy budgets are considered ‘capacity building supports’. This means that these are limited supports that will gradually decrease over time.
How do I apply for therapy funding?
The NDIA will fund for therapy supports if there is a reasonable and necessary requirement for therapy. The NDIA will require progress reports and supporting letters from therapists to maintain additional funding. An overall OT functional report will be helpful in supporting the need for funding in other allied health areas, too. Your Support Coordinator can assist you with organising these reports and submitting them to the NDIA.
Does everyone on the NDIS get therapy funding?
The NDIA will fund for therapy funding if there is a reasonable and necessary requirement for the therapy for the individual. This means that the amount of therapy funding provided may differ from one person to next. The amount of therapy funding provided is dependent on a variety of factors, which may include type of disability, age and living situation to name a few.
What if the therapy funding I receive is insufficient?
If you are not satisfied with the amount of therapy funding you have been approved for, you can request for a review of the decision by submitting an application for review to the NDIA. Additional supporting documents will need to be provided to explain the need for the request. For more information, please visit ndis.gov.au/participants/how-review-planning-decision
Which service providers can access the therapy budget?
In most cases, all service providers who provide allied health services can access the therapy funding in an NDIS plan. However, it would be beneficial to check with your service provider which category of funding they are registered to provide services for. For example: Improved Daily Living, Improved Health and Wellbeing, Improved Relationships or Core Supports.
How much do therapy providers charge?
The NDIS price rate will vary depending on the type of service you are requesting. The NDIA price guide is available on the NDIA website, which lists all the service rates for all services provided under the NDIA. Visit: ndis.gov.au/providers/price-guides-and-pricing#ndis-price-guide-2020-21
Your service provider will provide you with a statement of service prior to commencing services. This will outline the price rate that will be charged. The participant or plan nominee will be required to consent to the statement of service prior to service delivery.
Can I negotiate the prices for the therapy services?
If you are plan managed or self managed and are accessing non-NDIS registered service providers, you may be able to negotiate prices with the service provider. This is dependent on the service provider policies. For NDIS registered service providers, they will charge at the NDIS price rate listed in the NDIS price guide.