NDIS Price Limits and How They Affect Your Supports

Most participants never open the pricing document, and that is a defensible choice — the current edition runs to a few hundred pages and is written for providers. But a surprising amount of what people find confusing about their plan comes straight out of it.

Why your plan bought fewer hours this year than last. Why one therapist charges $194 an hour and another charges $157 for what sounds like the same thing. Why you were billed for a cancelled appointment, or for travel time, or for a report you didn’t ask for. Why a provider says they can’t do something “because of pricing.”

This guide explains the system in plain terms, covers what changed on 1 July 2026, and flags two changes coming in December 2026 and January 2027 that will affect a lot of people. It is written for participants and families, not providers.

What a price limit actually is

The NDIA publishes the NDIS Pricing Arrangements and Price Limits — still widely called the price guide — alongside a Support Catalogue listing every support item and its code. Together they set the maximum a provider may charge for each support.

Three things follow from that, and the first two surprise people.

It’s a ceiling, not a price. A provider can charge less, and some do. Nothing requires a provider to charge the maximum, and for a participant who shops carefully this is real money.

It’s not a guarantee of availability. A price limit says what may be charged, not that anyone will deliver at that price. Where the limit sits below what it costs to deliver — which has happened in several categories — the service quietly stops being available, particularly in regional areas.

It applies to the support, not the provider’s costs. Two providers with very different cost structures face the same ceiling.

Price limits are updated annually, with changes taking effect on 1 July, following the NDIA’s Annual Pricing Review.

Who has to follow them, and who doesn’t

This is the part most participants get wrong, and it matters because it changes who you can engage.

NDIA-managed participants must use registered providers, and those providers must stay within the price limits. No exceptions.

Plan-managed participants can use registered or unregistered providers, but the plan manager can only pay up to the price limit. A provider charging above it will not be paid the excess from the plan.

Self-managed participants are not bound by the price limits. You can agree to pay more than the published limit if you choose. Your budget is still your budget, so paying above the limit means buying fewer hours — but the choice is yours. This is one of the genuine advantages of self-managing and one of the least understood.

Our guide on plan management options covers the three management types in full.

One change worth watching: a Bill introduced on 14 May 2026 would allow the Minister to make prices legally enforceable for all providers. If that passes in its current form, the self-managed exemption described above may narrow. Worth confirming current rules before relying on it.

What changed on 1 July 2026

The 2026-27 arrangements were published on 22 June 2026 and took effect for supports delivered from 1 July. This was not a routine indexation year — several things moved in different directions.

Support worker rates went up

The standard disability support worker rate rose about 4.8%, reflecting the annual wage review and the increase in superannuation to 12%.

Remote and very remote loadings apply on top of these. The SIL establishment fee rose to $735.80.

For participants, a rate rise is a mixed thing. It supports wages in a sector with serious retention problems — and worker turnover is one of the biggest drivers of poor outcomes in supported living. But if your plan was funded at last year’s rates and hasn’t been adjusted, the same funding now buys fewer hours. If your plan runs past 1 July and your roster is tight, that arithmetic is worth doing early rather than discovering it in May.

Providers can only claim the increased rates once participants have agreed to the changed service agreement.

Allied health moved three different ways

Some rates rose, some were frozen, and some fell sharply.

The psychology increase was the headline, and it responded to genuine access problems — participants were routinely unable to find psychologists willing to work at the previous rate.

The “other professional” cut of roughly 19.5% is the one to watch. That category covers a wide range of practitioners who don’t have their own line item, and a cut of that size in a single year tends to show up as reduced availability rather than cheaper services. Early childhood supports were excluded from the cut and remain at $193.99.

A new item was created for orientation and mobility specialists at $156.16, where previously they claimed under “other professional.”

Therapy billing was restructured

Each therapy discipline now has six separate line items rather than one, distinguished in the catalogue by a suffix on the main code:

• Direct service
• _CA — cancellation
• _NF — non-face-to-face work (report writing, preparation, documentation)
• _PT — provider travel
• _RR — NDIA-requested reports
• _TH — telehealth

The practical effect for participants is transparency. Those charges always existed; now they appear as distinct lines on an invoice rather than being folded into one. If you have been wondering what you were actually paying for, this change makes it visible.

Worth knowing how each is treated: provider travel is charged at 50% of the direct service rate; cancellations are charged at the full direct service rate; telehealth is charged at the full rate; and NDIA-requested reports are charged at the direct service rate.

A broader review of therapy pricing, including how travel and non-contact time are handled, is planned during 2026-27.

Short Term Accommodation was unbundled

The old bundled STA daily rate ended on 30 June 2026. Accommodation and support are now claimed separately: accommodation at $162.85 per day for the participant, with support hours claimed at the ordinary hourly rates by day of week, plus a sleepover item at $311.79. High intensity support items can also be claimed where applicable.

If you use respite, this is the change most likely to show up on your invoices. The total cost for a given stay may be similar, higher or lower depending on the support hours involved — a low-support weekend may cost less than it did, a high-support one more.

Our guide on SIL, SDA, ILO, STA and MTA covers how respite sits alongside the other accommodation supports.

Unchanged

Occupational therapy, speech pathology and audiology all held at $193.99. Support coordination levels 1 to 3 were unchanged. The plan management fee remains $104.45 per month.

Two changes coming that aren’t price limits

These are frequently discussed alongside pricing and are a different thing, so it’s worth separating them.

From 1 December 2026, the claiming window shortens from two years to 90 days. Providers must claim within 90 days of delivering the support. For participants this mostly matters in one scenario: if a provider has been slow to invoice, those claims now have a hard deadline, and a provider who misses it may try to bill you directly. Check that your providers are invoicing promptly, and query anything that appears months late.

From 1 January 2027, price limits for social, community and civic participation supports delivered by unregistered providers drop by 10%, and stop being indexed. Registered providers keep the full limit and continue to receive annual increases. This is the first time the NDIA has set different price limits based on registration status, and it will not be the last — the approach may extend to other categories.

If you use an unregistered provider for community participation, this is worth raising with them before January. Separately, and more significantly for most people, budget allocations for that category are being reduced — covered in our guide on social and community participation funding.

Checking whether your plan still stretches

A short exercise worth doing once a year, ideally in July when the new rates land.

Work out your actual weekly cost. Take your roster — hours by day of week, including any sleepovers — and multiply through at the current rates. Weekday, Saturday, Sunday and public holiday hours all price differently, and a roster weighted toward weekends costs substantially more than the same number of weekday hours.

Multiply by the weeks remaining in your plan, and add public holidays separately. There are around eleven a year depending on your state, each charged at the public holiday rate, and they are the single most commonly forgotten line in this calculation.

Add the irregular items — therapy, equipment, consumables, plan management fees at $104.45 a month, support coordination.

Compare that to what’s left in each budget category, not just the total. Core funding is largely flexible between its subcategories, but Capacity Building and Capital are not interchangeable with Core, so a healthy overall balance can still conceal a category that will run dry.

If the arithmetic says you run out before the plan ends, act early. A variation requested in month four is a manageable conversation; the same request in month eleven, with services about to stop, is a crisis. The NDIA responds better to evidence and lead time than to urgency.

Why the limits are set where they are

A little background helps make sense of decisions that otherwise look arbitrary.

Price limits are meant to balance three things that pull against each other: participants getting value from a finite budget, providers being able to deliver sustainably, and workers being paid properly under the relevant award. Move one and the others shift.

The Annual Pricing Review is where this is worked through each year. The NDIA examines cost data, market conditions, award changes and availability problems, then publishes recommendations which flow into the new arrangements on 1 July. Submissions are open during the review, and participants can make them — most don’t, and the submissions that do arrive come overwhelmingly from providers.

Several structural forces shape the outcome:

Award wages set the floor for support work. Most of what a support hour costs is wages, superannuation, leave loading and on-costs. When the Fair Work Commission hands down an annual wage increase and superannuation rises, support worker price limits must move or services become unviable. The 2026-27 increase reflected exactly that.

Allied health is benchmarked against comparable markets — private practice, insurance schemes, public health. Where NDIS rates drift below what a profession can earn elsewhere, practitioners leave the scheme, which is what drove the psychology increase.

Thin markets are a known weakness. Price limits are national, with remote loadings, but costs vary more than those loadings capture. This is why availability is patchy in regional areas even where the published rate looks adequate.

Scheme sustainability sits behind all of it. The NDIS is a large and growing commitment, and pricing is one of the few levers available to moderate cost growth. Several of the 2026-27 reductions should be read in that light rather than as judgements about the value of the service.

None of this makes a cut easier to absorb. But it does explain why rates move in different directions in the same year, and why “the NDIA cut our rate” and “the NDIA raised our rate” are both true depending on who you ask.

What to do when a provider says pricing is the problem

A common conversation, and one worth being able to navigate.

Sometimes it is true. A provider genuinely cannot deliver a two-hour community support shift forty minutes’ drive away at the published rate with travel capped — the economics don’t work. Pushing harder won’t change that.

Sometimes it isn’t true, and pricing is being used to decline something inconvenient.

A few questions that separate the two:

“Which item are you claiming this under, and what’s the limit?” A provider with a genuine pricing constraint can answer immediately and specifically.

“Is the issue the rate, the travel, or the shift length?” Short shifts and travel are usually the real problem rather than the hourly rate, and both are sometimes solvable — a longer shift, a different day, combining with another participant’s support, or a worker who lives closer.

“Would this work if it were rostered differently?” Frequently yes.

“Is there a loading that applies here?” Remote and very remote loadings exist and are sometimes overlooked.

If a provider genuinely cannot deliver within the limits and you are self-managed, you can choose to pay more. If you are plan-managed or agency-managed, you cannot — and the answer is a different provider, a different arrangement, or raising the availability problem with the NDIA.

How to read your own invoices

A few things worth knowing when checking what you have been charged.

Every charge should map to a support item code. If an invoice has a line you don’t recognise, ask which item it was claimed against. A legitimate provider can tell you immediately.

Travel should be proportionate and explained. Provider travel at 50% of the service rate is legitimate, but the time claimed should reflect the actual journey, and there are limits on how much can be claimed. Travel from a provider’s office to you, charged in full for an hour each way, warrants a question.

Cancellation rules are specific. Short notice cancellation can be charged at the full rate, but only within defined notice periods and subject to limits. If you are being charged for every missed appointment regardless of notice, check the terms.

Non-face-to-face time must be agreed. Report writing and preparation are legitimately chargeable, but should be discussed with you rather than appearing unannounced.

Your service agreement should state the rates. Not “at NDIS price limits” but the actual figures. A provider unwilling to put numbers in writing is telling you something.

Check your spending against your plan periodically. The myplace portal shows claims against your budget. A monthly glance catches errors while they are still fixable — and catches the far more common problem of a category quietly going unspent.

When pricing becomes your problem

Two situations where price limits stop being abstract.

When you can’t find anyone. If every provider you call declines, is full, or quotes above the limit, the limit is probably below the cost of delivery in your area. This is most acute in regional and remote areas, in thin-market specialties, and in categories that took a cut. Options: ask about remote loadings if applicable, consider telehealth where clinically appropriate, ask your support coordinator what others in the area are doing, and if you are self-managed, consider whether paying above the limit for fewer hours is worth it. It is also worth telling the NDIA — availability problems inform the next Annual Pricing Review.

When your plan funds fewer hours than you need. Price rises without a matching budget increase produce exactly this. The response is a plan variation or reassessment, supported by evidence of the hours actually required. “Prices went up” is not on its own a strong argument; “here is the roster that meets my assessed needs, and here is what it now costs” is better.

A quick glossary

Terms that appear on invoices and in provider conversations, in plain language.

Support item — a specific fundable service, each with a code. Everything claimed against your plan maps to one.

Support Catalogue — the full list of items and codes, published alongside the pricing document and updated each year.

Price limit — the maximum claimable for an item. Not a set price.

Line item — the individual charge on an invoice, tied to a support item code.

Loading — an uplift applied in defined circumstances, most commonly for remote and very remote locations.

Non-face-to-face — chargeable work done away from you, such as report writing and preparation. Must be agreed, not assumed.

Provider travel — time spent travelling to deliver your support, charged at 50% of the service rate and subject to limits.

Short notice cancellation — a cancellation inside the defined notice period, which may be charged at the full rate. Notice periods and annual limits apply.

Establishment fee — a one-off payment when a provider begins delivering certain supports, intended to cover setup. Claimable once per provider, not per plan.

Indexation — the annual adjustment of price limits, applied from 1 July.

Registered / unregistered provider — registration is with the NDIS Quality and Safeguards Commission. From 1 January 2027 the two attract different price limits in at least one category.

Where to next

Understanding your plan budgets covers how Core, Capacity Building and Capital funding work and which parts are flexible. Plan management options covers who is bound by these limits and who isn’t. For what the pricing changes mean in one specific category, see social and community participation funding.

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We’re a registered NDIS provider delivering supported independent living across NSW, and we charge within the published price limits. If you want to understand what your funding actually buys at current rates, call 1300 271 824 — we’ll go through the arithmetic with you, including when the honest answer is that the plan is short.

General information only, current at the time of writing. Rates quoted are national standard rates from the 2026-27 NDIS Pricing Arrangements and Price Limits; remote and very remote loadings, and some state variations, apply. Price limits change annually on 1 July and the NDIA issues updates between editions. Several reforms referenced here were announced but not fully in effect at the time of writing. Always confirm current rates and rules in the official Pricing Arrangements and Support Catalogue at ndis.gov.au or on 1800 800 110.