DISCLOSURE LOG - FOI 23/24-0860 - DOCUMENTS DOCUMENT 2
NDIS Independent Review of Pricing of Art and Music Therapy Terms of Reference
DISCLOSURE LOG - FOI 23/24-0860 - DOCUMENTS
1. Purpose
1.1 The National Disability Insurance Agency (NDIA) is appointing an independent expert to:
- review the NDIA pricing of music and art therapy compared with other allied health therapies; and
- review the NDIA’s ‘review of evidence’, which found that there is limited evidence about the effectiveness of art and music therapy as evidence-based, therapeutic supports for most people with disability.
2. Background
2.1 The NDIA Pricing Arrangement and Price Limits (PAPL) sets out price limits for NDIS supports. Providers that deliver services to Agency managed and plan managed participants must adhere to these price limits. Prices are reviewed annually through the Annual Price Review (APR) process. The prices for therapy services are at Attachment A.
2.2 The 2024-25 price limits for music and art therapy are $193.99 per hour. The 2024-25 price limit for Participation in Community, Social and Civic Activities is $67.56 per hour. The price limits for therapy services have not changed since 1 July 2019, except for psychology being indexed at 4% over 2024-25.
2.3 On 3 October 2024, legislative changes to the NDIS Act came into effect. These changes included lists of what is a NDIS funded support and what is not (section 10). The ’Supports that are NDIS supports’ list outlines therapeutic supports are supports that provide evidence-based therapy to help participants improve or maintain their functional capacity in areas such as language and communication, personal care, mobility and movement, interpersonal interactions, functioning (including psychosocial functioning) and community living. This includes an assessment by health professionals for support planning and review as required.
2.4 The Agency has an obligation under the NDIS Act to ensure support will be effective and beneficial for a participant and is current good practice. This requires the Agency to consider the available evidence of the effectiveness of the support. For evidence-based therapy to be funded through the Scheme,
DISCLOSURE LOG - FOI 23/24-0860 - DOCUMENTS
there needs to be evidence that the therapy helps participants improve or maintain their functional capacity in areas such as language and communication, personal care, mobility and movement, interpersonal interactions, functioning, and community living.
2.5 The Government is establishing an Expert Advisory Committee to make determinations regarding evidence-based supports that are appropriate NDIS supports. The Committee will commence operations by July 2025. The NDIA is required to review and apply evidence in accordance with the legislation, and to update guidance to delegates accordingly, ahead of the commencement of operations of the Committee.
2.6 The NDIA undertook a review of available evidence, which showed there is insufficient evidence to conclude that art and music therapy are effective to maintain or improve functional capacity for most people with disability. Arising from this review of evidence, the NDIA considers the pricing arrangements should be revised to reflect the evidence. Proposed revisions are that:
2.6.1 Art and music programs can still be funded under Participation in Community, Social and Civic Activities which has a price limit of $67.56 per hour.
2.7 The current price limit of $193.99 per hour should only be used if either:
- Art or music therapy was a stated support in a participant’s plan, where there is an evidence base of effectiveness for the specific needs and circumstances of a participant; or
- Art or music therapeutic support is provided in a group setting with a minimum of four participants (in which case the price charged to each participant would be $193.99 divided by the number of participants).
2.8 The NDIA recognises that there have been concerns raised by Music and Art Therapists and their representative organisations about this policy.
2.9 Therefore, ahead of the commencement of the operation of the Expert Advisory Committee, the NDIA is appointing an independent expert to review the proposed NDIA pricing of art and music therapy and the evidence review undertaken by the NDIA.
DISCLOSURE LOG - FOI 23/24-0860 - DOCUMENTS
3. Scope
3.1 The Independent Review will report on:
3.1.1 The pricing arrangements for music and art therapy. This will be informed by pricing benchmarking analysis for art and music therapy and benchmarking with other allied health therapy professions and qualifications. The NDIA will make available the data that it uses to set prices in therapy.
3.1.2 The NDIA review of the evidence base supporting the effectiveness of music and art therapy for most participants and provide advice about the consistent application of this evidence to requirements under the Act. The Independent Review should also provide relevant stakeholders with an opportunity to make submissions and contribute relevant evidence.
4. Reporting
4.1 It is expected that the Independent Review will provide expert opinion to the CEO of the NDIA.
4.2 The CEO will ensure the Board and Minister are briefed on the Independent Review.
4.3 The advice should take the form of a written report.
4.4 It is recommended that the Independent Review deliver its findings by no later than 14 March 2025.
5. Roles and responsibilities
5.1 The Independent Review’s role and responsibility is to:
DISCLOSURE LOG - FOI 23/24-0860 - DOCUMENTS
5.1.1 Provide expert opinion to the CEO on whether the music and art therapy will be, or is likely to be, effective and beneficial for participants, having regard to current good practice.
5.1.2 Consider the NDIA review of music and art therapy.
5.1.3 Consult with stakeholders to ensure that the views of people with disability are reflected in the recommendations and that all available evidence is considered.
5.1.4 Meet at least once every 3 weeks with a senior representative of the NDIA to discuss the progress of the Review.
5.1.5 Report findings and recommendations to the CEO, with the CEO to ensure that the Minister and the NDIA Board are briefed with the Independent Review.
5.1.6 Provide expert advice on the pricing approach for music and art therapy.
6. Membership
6.1 The Review will be conducted by an expert who brings deep knowledge and experience in allied health, pricing, markets, disability sector and public value for money.
6.2 The appointment is for a fixed term of up to 3 months.
DISCLOSURE LOG - FOI 23/24-0860 - DOCUMENTS
Attachment A
Table 1: Price limits for Therapy Services as at 1 July 2024 — (per hour)
| Type of Therapist | NSW / VIC / QLD / ACT | SA / WA / TAS / NT | Remote | Very Remote |
|---|---|---|---|---|
| Art Therapist, Audiologist, Developmental Educator, Dietitian, Music Therapist, Occupational Therapist, Orthoptist, Podiatrist, Rehabilitation Counsellor, Social Worker, Speech Pathologist, and Other Professional | $193.99 | $193.99 | $271.59 | $290.99 |
| Counsellor | $156.16 | $156.16 | $218.62 | $234.24 |
| Exercise Physiologist | $166.99 | $166.99 | $233.79 | $250.49 |
| Physiotherapist | $193.99 | $224.62 | $314.47 | $336.93 |
| Psychologist | $222.90 | $244.22 | $341.91 | $366.33 |
| Therapy Assistant - Level 1 | $56.16 | $56.16 | $78.62 | $84.24 |
| Therapy Assistant - Level 2 | $86.79 | $86.79 | $121.51 | $130.19 |
Source: NDIS Pricing Arrangements and Price Limits 2024-25
DISCLOSURE LOG - FOI 23/24-0860 - DOCUMENTS
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