The annual release of the NDIS Price Guide, now officially known as the NDIS Pricing Arrangements and Price Limits (PAPL), is a crucial event. The National Disability Insurance Scheme (NDIS) Price Guide outlines the rules and maximum prices for the supports and services available through your NDIS plan. The release of the NDIS Price Guide 2025-26 brings with it some significant updates that are important to understand.

This guide is much more than just a list of prices. It's a key tool that ensures the NDIS remains sustainable and fair for everyone involved. It promotes transparency, helps protect participants from being overcharged, and ensures providers are paid fairly for the vital services they deliver.

What is the NDIS Price Guide?

The NDIS Price Guide, along with the NDIS Support Catalogue, sets out the pricing arrangements and price limits for supports funded by the NDIS. The National Disability Insurance Agency (NDIA) uses these documents to regulate prices and ensure a fair market for disability supports. The new 2025-26 version is effective from 1 July 2025.

Understanding Your NDIS Plan and Support Budgets

The NDIS allocates participant budgets into three main purposes, which determine how the funds can be spent:

• CORE Supports: These are designed for daily living activities and offer a high level of flexibility.
• CAPITAL Supports: These cover significant investments, including assistive technologies, equipment, home or vehicle modifications, and Specialist Disability Accommodation (SDA). Funding for this purpose is restricted to specific items in your plan.
• CAPACITY BUILDING Supports: These funds are specifically for building your independence and skills.

Please note: All NDIS supports must help you achieve the goals in your plan.

Key Changes in the NDIS Price Guide 2025-26

1. Price Limits and Their Applicability

While the NDIA doesn't set the exact prices providers charge, they do set price limits that providers of Agency-Managed and Plan-Managed supports must adhere to. This ensures that you aren't charged more than the official NDIS price limit.

• Agency-Managed Participants: Your registered provider must not charge more than the price limits and must be a registered NDIS provider.
• Plan-Managed Participants: Your plan manager must ensure that providers, whether registered or not, do not charge more than the price limits set by the plan.
• Self-Managed Participants: If you self-manage your plan, you are exempt from the NDIS price limits.

2. Important Claiming Rules

The new NDIS Price Guide 2025-26 clarifies several claiming rules for providers.

• Provider Travel: Providers can only claim for travel costs if specific conditions are met and agreed upon in advance. Travel costs are split into labour and non-labour components. In remote and very remote areas, price limits can be 40% to 50% higher to account for additional travel and operational costs.
• Short-Notice Cancellations: The NDIS Price Guide provides clear rules for short-notice cancellations to protect providers. In most cases, if a participant cancels a service on short notice, providers are entitled to claim 100% of the agreed fee.
• Non-Face-to-Face Supports: Providers can claim for non-face-to-face support provision, such as writing reports or making calls related to your support. However, administrative tasks such as processing claims or developing service agreements are not billable as a separate support and are covered by the overhead component of the price limits.

3. Introducing "My Providers" for PACE Plans

For participants with plans developed in the new PACE system, a new feature called "My Providers" has been introduced. By adding a provider to your list, you streamline the payment process, as claims are typically paid within two to three days.

4. A New Age Limit for Early Childhood Support

In a significant change for families with young children, the age limit for the Early Childhood approach has been extended from 7 to 9 years old. This adjustment acknowledges the importance of providing consistent support through these crucial early years and gives families more time to transition into the NDIS scheme.

5. Disability-Related Health Supports

The NDIS Price Guide 2025-26 provides specific guidance on claiming for disability-related health supports such as nursing and therapy. The guide categorises these supports and clarifies which support items to use for claiming. This includes nursing supports delivered by Enrolled Nurses, Registered Nurses, and Clinical Nurses, with different price limits for each.

Here is an example of the updated rates for nursing supports:

Leah Betts’s Commitment To You

We at Leah Bett Nursing & Disability Support Services are focused on giving you the best, most personal care possible. We stay up-to-date with every change to the NDIS Price Guide 2025-26 to ensure our services are always fair, transparent, and aligned with your plan. 

Please contact us if you have any questions about these changes or need assistance with your NDIS plan. We are here to help and provide the support you need.