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The 2023-24 APR analysis of other schemes showed that while some have increased their pricing or funding levels, NDIS price limits remain consistent with the majority of therapies provided across these schemes. It is important to note, that there is significant variation in therapy pricing and funding levels among different schemes.
The analysis of private billing rates for NDIS-related weekday in-room therapy services in the 2023-24 period offers detailed insights into the therapy market. The dataset, consisting of 1,791 observations, was compiled by the NDIA from provider websites across Australia. This sample size is derived from previous annual pricing reviews, ensuring continuity and comparability over time.
The sample reveals a wide distribution of therapy types, with physiotherapists, psychologists, clinical psychologists, and dietitians the most common observation. This diversity highlights the varied therapeutic needs catered to by the NDIS, reflecting the scheme’s comprehensive coverage. Such insights are vital for the NDIA as it aims to ensure that the NDIS price limits are competitive and equitable, aligning closely with the market rates to adequately support providers while ensuring affordability for participants.
Overall, the private billing rates analysis provides a crucial benchmarking tool for the NDIA, helping to align NDIS pricing structures with the market and ensuring the sustainability of therapy services under the scheme. These analysis indicates that NDIS price limits generally match or exceed the rates for most therapies nationwide. However, regression analysis highlights statistically significant variances among therapies, which could correspond to differences among therapy professionals such as in qualifications, skills, and experience.
1.3.1 Psychology
Review of the current price limits for Psychologists against private billing rates and other comparable government schemes, it is apparent that the current limits generally sit below the prevailing market rates.
Analysis reveals that the mean billing rate for psychologists exceeds the NDIS price limits in both state groupings, with a mean rate of $228.6 and $260.3 for Psychologists and Clinical Psychologists, respectively. Similarly, median billing rates for these professionals surpass NDIS limits, standing at $228.0 and $255.0. Moreover, the 75th percentile billing rates indicate that a significant portion of appointments exceeds NDIS price limits, highlighting a clear difference between market rates and NDIS price limits. This suggests that it is appropriate for the NDIA to increase price limits to better align with prevailing market rates and ensure fair compensation for psychology services.
Recommendation 6
The NDIA should increase the price limits for supports delivered by a Psychologist on 1 July 2024 in line with the weighted movement over the
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previous twelve months in the ABS Wage Price Index (Australia, total hourly rates of pay excluding bonuses) and the ABS Consumer Price Index (All Groups, weighted average of eight capital cities) over the 12 months to the March Quarter immediately preceding the indexation date (with an 80/20 weighting). Specifically, this should be for support line items: ’Assessment Recommendation Therapy or Training – Psychologist (15_054_0128_1_3), ‘Early Childhood Supports – Psychologist (15_001_0118_1_3)’, and ‘Specialist Behaviour Intervention Support (11_022_0110_7_3)’.
1.3.2 Other Therapists
Review of the alignment of the NDIS price limits for other therapists against the private billing rates and other comparable schemes suggests a general compatibility between the NDIS price limits and prevailing market rates. In general, for most therapists, mean and median billing rates closely mirror the NDIS hourly price limits, which are set at $193.99 in most regions, suggesting that the current NDIS price limits adequately reflect market norms. Even when considering some therapies which means, medians and 75th percentile billing rates exceed NDIS price limits, the frequency of such instances does not indicate a systemic pricing concern that hinder participants from accessing these services relative to other clientele.
Recommendation 7
The NDIA should not make any further structural adjustments to the pricing arrangements for therapy supports at this time and should not index the price limits for all other therapy-related supports on 1 July 2024.
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The APR will have an increased focus on participants, with a dedicated consultation paper to gather participants’ perspectives. This participant engagement will ensure that the APR is inclusive of the voices of both providers and participants.
In particular, the APR will review the pricing arrangement and price limits:
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b) for therapy supports to ensure participants receive value for money, while providers strive to improve quality of service and increase efficiency, with a particular emphasis on pricing benchmarks;
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2.4 Consultation overview
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2.4.1 Consultations with other government insurance and funding schemes
The NDIA collaborated with 16 Commonwealth and State Schemes to obtain their therapy pricing. Responses from 13 schemes were received. Schemes that assisted with information were:
- Catastrophic Injuries Support (CIS) Scheme,
- ComCare,
- Department of Veterans’ Affairs (DVA),
- Home and Community Care Program for Younger People (HACC-PYP),
- Lifetime Support Scheme (LSS),
- Motor Accidents Insurance Board (MAIB),
- Medicare Benefit Scheme (MBS),
- National Injury Insurance Scheme Queensland (NIISQ),
- Return To Work SA (RTWSA),
- State Insurance Regulatory Authority (SIRA),
- Victorian Transport Accident Commission (TAC),
- WorkSafe VIC, and
- WorkCover WA.
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3.2 NDIS supports
Disability Support Workers (DSWs) are an essential part of the NDIS, bridging the gap between healthcare services and daily living assistance for individuals with disabilities. DSWs provide personalised support that enhances the independence of NDIS participants.
Therapy supports, including early childhood interventions, are also an essential part of the NDIS by playing an important role in assisting participants to achieve their personal goals. These supports are delivered by a diverse range of professionals, such as Occupational Therapists (OT), Speech Pathologists (SP), Physiotherapists, Psychologists, and many others.
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5. Therapy Supports
5.1 Context
Therapy supports play an important role in assisting participants to achieve their personal goals. Early therapeutic interventions enhance participant outcomes and reduce long-term cost by building capacity and independence. These supports are delivered by a diverse range of professionals, such as Occupational Therapists (OT), Speech Pathologists (SP), Psychologists, Physiotherapists, and many others, including therapy assistants who operate under the supervision of therapists. This ensures a broad and inclusive delivery of therapeutic interventions, that meet the diverse needs of the NDIS participants.
Therapy supports are organised into several registration groups, with the majority of therapy supports delivered under three main categories - Therapeutic Supports for improving functional skills (0128), Early Intervention Supports for Early Childhood for children with developmental delays (0118), and Exercise Physiology & Personal Wellbeing Activities for physical health (0126). There are other additional categories provide supports for specific needs like behaviour management and hearing services.
Pricing for therapy services under the NDIS varies by service type, delivery method, location, and whether the services are provided to individuals or groups (see Table 13). The Scheme also allows for claiming of non-face-to-face supports, travel and cancellations. This structure supports the delivery of personalised, effective therapy services to NDIS participants, aiming to improve their independence and participation in daily activities. Additional information on the Pricing Arrangements and Price Limits for therapy supports can be found here.
This chapter reviews the pricing arrangements for therapy supports in the NDIS, assessing their alignment to comparable schemes, and with the private therapy support market.
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Table 13: Price Limits for Therapy Supports as at 1 January 2024
| 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 | $214.41 | $234.83 | $328.76 | $352.25 |
| 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 2023-24
5.2 Scheme statistics
5.2.1 The number of therapy providers continues to grow
In the six months to 31 December 2023, 379,296 participants, representing 59% of the total 646,449 active participants, as of 31 December 2023, purchased therapy supports through their plans. Table 2 shows that the number of providers delivering therapy supports increased during this period, with 52,736 providers receiving payments, a 14% rise compared to the year before. The total amount claimed by unregistered providers in the six months to 31 December 2023 grew by 60% compared to the same time the previous year. However, most of the total amount claimed for provision of therapy supports is still through registered providers (65%, or $1.3 billion, of therapy supports claimed).
Refer to Table 14, Table 15 and Table 16 for further breakdown of the number of registered and unregistered providers delivering supports to NDIS participants.
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| Statistics | July – December 2022 | July – December 2023 | Percentage Change |
|---|---|---|---|
| Total amount claimed by unregistered providers of Therapy supports | $0.4 billion | $0.7 billion | +60% |
| Average amount claimed by unregistered providers of Therapy supports | $11,764 | $15,651 | +33% |
Source: NDIS internal administrative data
Please note a discrepancy in the total number of ‘active’ therapy providers, attributable to two factors. 1) some providers offer a mix of registered and unregistered supports, leading to their classification in both categories. 2) a small fraction of providers with undetermined registration status contributes to total payment figures but is excluded from detailed tabulation, representing less than 1% of the overall financial transactions.
Figure 21 shows NDIS payments on therapy supports in the six months to December 2023, which amounted to $2.1 billion. This expenditure accounts for just over 10% of the NDIS’s total expenditure of $20.4 billion during this six-month period, reflecting a 28% increase from the previous year’s spending on therapy supports.
Figure 21: NDIS Expenditure on Therapy Supports Since January 2021 Relative to Total NDIS Expenditure
[Chart showing NDIS expenditure on therapy supports and percentage of total scheme from January-June 2021 to July-December 2023]
Source: NDIS internal administrative data | Total payments for therapy | Percentage of Total Scheme
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Over the last three years payments for therapeutic supports have comprised about 14% of total NDIS payments to registered therapy support providers and about 37% of payments to unregistered therapeutic providers. From January to December 2023, the top three payment support categories for registered providers for therapy supports were:
- Daily Activities (51% of payments)
- Social Community and Civic Participation (22% of payments)
- Capacity Building Daily Activity (13% of payments)
5.2.2 Participants
Participants access a broad range of therapies. In the six months to 31 December 2023, participants claimed therapy supports, predominantly from Occupational Therapists ($441.6 million from 214,271 participants), followed by Early Childhood Professionals ($357.9 million from 93,154 participants), Behavioural Therapists ($287.7 million from 53,064 participants), Physiotherapists ($202.2 million from 95,095 participants) and Speech Pathologists ($198.2 million from 109,829 participants). See Table 17 for more information.
The average payment for a participant receiving therapy supports was $5,458, a 9% increase from the previous period, while the average claim per provider was $39,257, up 12%. This data underlines the significant role of therapy supports in the NDIS, highlighting both the extensive use of these services by participants and the corresponding financial investment by the Scheme.
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Table 17: Scheme Expenditure by Type of Therapy, July to December 2023
| Type of Therapist | Total Payments ($ million) | Number of Participants | Number of Providers |
|---|---|---|---|
| Occupational Therapist | $441.6 | 214,271 | 8,633 |
| Early Childhood | $357.9 | 93,154 | 13,881 |
| Behavioural Therapist | $287.7 | 53,064 | 1,454 |
| Physiotherapist | $202.2 | 95,095 | 10,134 |
| Speech Pathologist | $198.2 | 109,829 | 5,733 |
| Psychologist | $173.9 | 99,042 | 12,660 |
| Other Professional | $156.0 | 101,727 | 24,139 |
| Exercise Physiologist | $76.9 | 41,765 | 4,712 |
| Therapy Assistant | $42.5 | 40,393 | 4,045 |
| Counsellor | $27.4 | 19,966 | 4,364 |
| Social Worker | $22.9 | 13,842 | 2,141 |
| Dietitian | $20.4 | 23,672 | 2,053 |
| Travel | $20.1 | 104,182 | 11,146 |
| Podiatrist | $10.7 | 28,251 | 2,738 |
| Miscellaneous | $9.4 | 5,135 | 2,914 |
| Music Therapist | $8.1 | 5,208 | 1,039 |
| Art Therapist | $6.9 | 4,787 | 1,272 |
| Development Educator | $5.9 | 3,316 | 440 |
| Orthoptist | $0.7 | 1,250 | 234 |
| Rehabilitation Counsellor | $0.7 | 724 | 314 |
| Audiologist | $0.4 | 840 | 152 |
| TOTAL | $2,070.3 | 379,296 | 52,736 |
Source: NDIS internal administrative data
Note: The total for both the number of participants and providers represent unique counts with the July to December 2023 period. ‘Other Professional’ refers to a diverse group of therapy providers offering services such as assessments, recommendations, and group therapies, which may encompass a variety of therapy disciplines not individually listed.
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5.2.3 Providers
Market growth ensures diverse therapy options for expanding participant demand
In the six months to 31 December 2023, as shown in Table 3, 52,736 providers received payments for therapy supports. Most claims were made by ‘Other Professionals’ (24,139 providers), Early Childhood Professionals (13,881 providers), Psychologists (12,660 providers), Physiotherapists (10,134 providers) and Occupational Therapists (8,633 providers).
Registered provider numbers decreased by 16% from 8,778 to 7,392 providers in the six months to 31 Dec 2023. Of the $2.1 billion paid to providers, $1.3 billion was paid to registered providers (Table 15). This is an increase of $174 million from the six months to 31 December 2022. The decline in registered providers, as shown in Figure 22, is attributed to 1,562 providers switching to unregistered status and 1,470 registered providers no longer receiving therapy related payments in the six months to 31 December 2023. In contrast to the decline, 1,327 new providers registered to deliver therapeutic supports in the NDIS in the six months to 31 December 2023 compared to the same period in the previous year.
Figure 22: Registered Therapy Provider Volume Change Between July to December 2022 and July to December 2023
[Chart showing volume change of registered therapy providers]
Source: NDIS internal administrative data
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Figure 23 shows the distribution of NDIS therapy payments by provider registration status for half-year periods from January 2021 to December 2023. Over this period, therapy payments made to unregistered providers has increased from 18% to 35%. Moreover, payments made to registered providers still accounts for 65% of the totally payment for therapy supports six months to 31 December 2023.
Figure 23: Total Payments for Therapy Support Items by Provider Registration Status, January 2021 to December 2023
[Chart showing total payments by provider registration status]
Source: NDIS internal administrative data
In the six months to 31 December 2023, the five leading therapy categories by total NDIS payments, excluding ‘Other Professionals’, were Occupational Therapists ($441.6 million), Early Childhood Professionals ($357.9 million), Behavioural Therapists ($287.7 million), Physiotherapists ($202.2 million), and Speech Pathologists ($198.2 million). Together, these categories represented $1.5 billion in claims, accounting for approximately 72% of the NDIS’s $2.1 billion expenditure during this period as detailed in Figure 24.
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Figure 24: Largest Ten Therapy Types Based on Total NDIS Payments, January 2021 to December 2023
[Chart showing largest ten therapy types]
Source: NDIS internal administrative data
Note: Before July 2022, the NDIS grouped various therapies under ‘Other Therapy’ support. Post-categorisation changes, expenditure on specific therapies like Occupational Therapy and Speech Pathology were more distinctly tracked.
Top 10 providers sustain market share despite a drop in market share
As detailed in Figure 25 and Figure 26, the market share of the top ten registered therapy providers has seen a modest decline, from 14% to just under 11% from January to December 2023. This shift occurred alongside an expansion of the therapy market, with an overall increase of $174 million in payments to registered providers in the six months to December 2023 compared to the same period in the previous year. Although there has been a notable increase in unregistered providers, this does not necessarily indicate a downturn for registered providers, who are still experiencing substantial business growth. The rising number of unregistered providers suggests a broadening of the market landscape rather than a displacement of the existing registered providers’ activities, as the total payments to and number of participants serviced by registered providers continue to grow, demonstrating an expanding and robust NDIS therapy provider market.
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The increase in unregistered providers is common for all areas
Table 18 highlights a decrease in the number of registered therapy support providers in non-remote areas, with a drop from 8,509 providers in the six months to 30 June 2021 to 7,326 in the six months to 31 December 2023. Conversely, unregistered providers have risen in all areas, growing from 27,528 to 45,543 in non-remote areas within the same periods (Table 19). This growth in unregistered providers contributes to the declining market power of the top ten providers which may signal increasing a less concentrated market. This is further explored in the market concentration section with the Herfindahl-Hirschman Index (HHI).
Table 18: Registered Providers by Remoteness for Therapy Supports, January 2021 to December 2023
| Remoteness | January – June 2021 | July – December 2021 | January – June 2022 | July – December 2022 | January – June 2023 | July – December 2023 |
|---|---|---|---|---|---|---|
| Non-Remote | 8,509 | 8,695 | 8,552 | 8,735 | 8,252 | 7,326 |
| Remote | 537 | 553 | 534 | 520 | 522 | 519 |
| Very Remote | 268 | 288 | 282 | 300 | 298 | 324 |
| Total for Registered | 8,552 | 8,745 | 8,595 | 8,778 | 8,302 | 7,392 |
Table 19: Unregistered Providers by Remoteness for Therapy Supports, January 2021 to December 2023
| Remoteness | January – June 2021 | July – December 2021 | January – June 2022 | July – December 2022 | January – June 2023 | July – December 2023 |
|---|---|---|---|---|---|---|
| Non-Remote | 27,528 | 31,964 | 34,090 | 37,940 | 41,938 | 45,543 |
| Remote | 407 | 511 | 583 | 660 | 775 | 944 |
| Very Remote | 169 | 209 | 250 | 299 | 346 | 427 |
| Total for Unregistered | 27,740 | 32,205 | 34,350 | 38,206 | 42,260 | 45,961 |
Source: NDIS internal administrative data
Note: The total for registered providers of therapy supports and total for unregistered providers of therapy supports does not align with the total number of therapy support providers. The reasons for this are: 1) One provider can provide multiple supports, being registered for some supports and unregistered for others (different registration groups) in the same period, so they are accounted for in both groups of providers; 2)
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Providers with unknown registration are captured in total amounts but not presented in this table as they make up a very small percentage of total payments; and 3) Some participant location details at the time of transaction were not available, so provider remoteness could not be determined.
Herfindahl-Hirschman Index - Increasing provider diversity signals less concentration in the therapy market
The Herfindahl-Hirschman Index (HHI) measures market concentration and offers insight into the competitive dynamics of therapy support providers within the NDIS from January 2021 to December 2023. A HHI below 1500 signals a concentrated market, and the observed decrease in the HHI during this timeframe indicates a growing level of concentration. This trend has correlated with the diminishing market share of the top ten providers, which has dropped to just under 11%, and the growth in the market share of unregistered providers, which has almost doubled from 18% to 35%.
Adjustments to the HHI have been made, assuming the total market is equivalent to the sum of payments made to providers for therapy supports, due to the absence of comprehensive financial data for the Australian market and individual providers’ financial statements. This approach offers a practical snapshot of the market’s competitive environment, as visually represented in Figure 27.
The adjusted HHI index has remained low for non-remote areas between the observation period of six months to June 2021 and six months to December 2023. The perceived lack of concentration of providers has been most pronounced in the very remote areas; however, this situation has improved over the observation period. This is one metric to assist the Agency understand the health of the therapy market, with this trend suggesting an increasing diversity in provider options and potential benefits for NDIS participants in the therapy market.
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Figure 27: Herfindahl-Hirschman Index for Therapy Supports, January 2021 to December 2023
[Chart showing Herfindahl-Hirschman Index by remoteness]
Source: NDIS internal administrative data
Note: Adjustments were made to HHI as the overall size of the Australian market and providers’ financial statements are unknown at the time of the analysis. Therefore, the NDIA assumed that the size of the market is equal to the total amount of payments made to providers for DSW-related supports.
Provider claiming analysis – Unregistered providers are more likely to be charging below price limits
Approximately 34% of services are paid under the published price limit, showing a slight decrease over recent periods across all providers. These claiming patterns are shown in Table 20 that distinguish between services priced at the price limit for both provider types. This shows a consistent increase in the proportion of services billed at the price limit across all providers, with registered providers more likely to charge at the limit compared to unregistered ones.
While this trend is common to both registered and unregistered providers, unregistered providers more frequently offer services below the price limit (57% claimed at the price limit compared to registered providers’ 70% in the six months to December 2023). Compared to total claims, the share of payment claims by unregistered providers has almost doubled from 18% to 35% from the first half of 2021 to the end of the 2023.
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Table 20: Claiming Patterns at Price Limit Analysis for Therapy Supports, January 2021 to December 2023
| Claiming patterns – At price limit | January – June 2021 | July – December 2021 | January – June 2022 | July – December 2022 | January – June 2023 | July – December 2023 |
|---|---|---|---|---|---|---|
| Registered | 64% | 66% | 68% | 69% | 70% | 70% |
| Unregistered | 41% | 45% | 49% | 52% | 56% | 57% |
| All Providers | 59% | 61% | 63% | 64% | 65% | 66% |
Source: NDIS internal administrative data
Note: All Providers above are inclusive of providers with the unknown registration status at the time of the transaction.
5.3 Business dynamism in the NDIS therapy support market
This section assesses the activity and change among providers in the therapy market. Business dynamism is gauged by the frequency of new providers joining and existing ones becoming inactive in the market, which serves as an indicator of the market’s overall health, and market competition.
To further assess the market dynamics, the NDIA reviewed the payment activities of registered providers over a three-year period from January 2021 to December 2023. ‘New activity’ is characterised by providers receiving payments in the half-year who did not receive payments in the preceding half-year. Conversely, ‘inactivity’ refers to providers not receiving payments in a half-year after having received payments in the previous one. Each providers activity is quantified as a percentage of the total payments within that half-year for new activity, of the prior half-year for inactivity. The NDIA recognises that this method does not perfectly measure market exits but provides the best estimation with the data available.
Despite a decrease in the number of registered therapy providers, they still accounted for 65% of total payments in the six months to 31 December 2023. This, in conjunction with the HHI findings, suggesting that while the market is contracting in registered provider numbers, it continues to remain an important part of the therapy market.
Among registered therapy providers, 1,086 providers became inactive during this period; however, just under 840 providers of this group remained financially active by receiving payments for other services. Further analysis shows that 78% of these inactive therapy support providers had consistently received payments under $10,000 every six months, indicating that smaller providers could have contributed to the NDIS therapy market’s fluctuation.
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Figure 28 displays the change in registered provider activity between January 2021 to December 2023. Over the past three years, inactive registered providers in each half-year contributed to less than 0.4% of total payments. In contrast, registered providers with new activity in a half-year have contributed between 0.5% and 1.2% of total payments for that same period. The trend in the chart shows new providers receiving a smaller portion of total therapy support payments in 2023.
Figure 28: Registered Therapy Provider Activity Movements, January 2021 to December 2023
[Chart showing registered therapy provider activity movements]
Source: NDIS internal administrative data | New Activity as Percent of Total Half-Year Payments | Inactivity as Percent of Prior Total Half-Year Payments
Additional analysis reveals that inactive registered providers had relatively smaller claims averaging $3,129 in each half-year before becoming inactive, of which 88% receiving less than $5,000. This contrasts sharply with active registered providers, who claimed an average of $139,542 each half-year. This difference in payments underscores the extent of market diversification and the relative financial weight of new versus established providers.
Figure 29 offers a more granular look at the number of participants supported by registered providers, showing a trend towards a larger client base in the period between January to June 2021 and July to December 2023. Despite a reduction in the number of registered therapy support providers over this period, the number of providers servicing more than 20 participants increased, with these providers receiving 96.2% of payments in July to December 2023.
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Figure 29: Registered Providers of Therapy Supports and Number of Participants that Claimed, January 2021 to December 2023
[Chart showing registered providers by number of participants]
Source: NDIS internal administrative data | January - June 2021 | July - December 2023
Figure 30 shows the number of registered therapy providers receiving payments from January 2021 to December 2023. Notably, 6,342 (48%) of 13,239 registered providers consistently received payments in all six half-year periods, which made up 94% of total payments. This data points to a common operating model adopted by large, registered providers which serves more participants.
Figure 30: Provider Continuity by Registration Status and Percentage of Total Payments. Registered Providers (Left) and Unregistered Providers (Right), January 2021 to December 2023
[Chart showing provider continuity by registration status]
Source: NDIS Internal administrative data | Number of Providers | Percentage of Total Payments
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5.4 Comparable government and funding schemes
The NDIA compared therapy price limits and arrangements across other comparable government schemes and funding. Overall, the analysis shows that NDIS price limits are broadly in line with other comparable schemes for most types of therapies.
The NDIA collaborated with 16 Commonwealth and State Schemes to obtain their therapy pricing. Responses from 13 schemes were received. For a complete overview of participating scheme, see section 2.4 Consultation overview.
To calculate the effective hourly price limit, NDIA sought information about the regulated length of therapy sessions (for example, the NDIS price limits for therapy are per hour). For comparability, the NDIA generally used standard or subsequent consultations where possible, noting that many schemes have differentiated items and/or pricing for initial consultations and standard/extended consultations.
The NDIA were able to calculate the effective hourly price where the length of a session was provided (for example, price per 20 minutes) or as an average session time, based on the observed length of sessions. In some cases, the length of a session was based on a minimum or maximum length (for example, price for at least 20 minutes). In these situations, some assumptions were made by the NDIA to calculate an hourly price, based on available information. If the length of a session (or an approximation) was not provided, the NDIA were unable to calculate the effective hourly price, and not able to directly compare prices, so these were excluded from the analysis.
As Figure 31 shows, the current NDIS price limits (shown as orange dots) are broadly within the range of the effective hourly rates paid by other schemes for the most common therapy supports, after considering duration of service. Information received indicates that over the past year, most schemes have increased prices for the therapy supports that they provide. Price changes vary by scheme and therapy support, but typically fall between 2% and 8%. This appears to have put NDIS into the middle range for some therapies, such as Audiologists, Counsellors, Exercise Physiologists and Psychologists, acknowledging ranges can be quite broad once scheme prices are turned into a comparable hourly price.
The main Medicare Benefits Schedule (MBS) items for allied health have a scheduled fee of $68.55 per 20 minutes session. This equates to an effective hourly rate of $205.65 which is higher than the NDIS hourly price limit. The Commonwealth funding (MBS benefit) for the hour is 85% ($174.80), but co-payments are common in the MBS and the scheduled fee is a better estimate of the total cost of the support.
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Figure 31: Comparison of NDIS price limits to other government schemes
[Box and whisker chart comparing NDIS price limits to other government schemes]
Source: NDIS calculations of comparable prices of other government funding schemes
Note: All NDIS price limits are shown in purple text. For some therapy supports, the NDIA has two different price limits. One price limit is for the eastern states (NSW, VIC, QLD, ACT) and the other is for all other states (WA, SA, TAS, NT).
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