Warning over NDIS patients being slugged up to 68 per cent more for some therapies

Similar to a “wedding tax”, the National Insurance Disability Insurance Agency claims providers are slapping on an “NDIS tax” for some therapies.

Disability providers have been charging ‘NDIS premiums’ for some therapies – jacking up prices by up to 68 per cent – according to the agency that runs the scheme.

The National Insurance Disability Insurance Agency (NDIA) said it had looked at Medicare data, private health insurance claims and data from 13 comparable government schemes and found NDIS therapy pricing limits are out of step with broader market rates.

Similar to a “wedding tax”, the agency claims providers are slapping on an “NDIS tax” for some therapies.

“The data confirms that people with disability have been paying ‘NDIS premiums’ for certain therapies, while those same services are being delivered broadly to other Australians at lower rates,” the NDIA said in a statement.

The analysis was conducted as part of the agency’s Annual Pricing Review, which sets out the maximum rate providers can charge for individual services each year. The new price index, which was released on Wednesday, will come into force on July 1.

The National Insurance Disability Insurance Agency found NDIS therapy pricing limits are out of step with broader market rates. Picture: Mark Wilson

It’s not good news for providers offering therapies, with some services facing a price freeze for the sixth year in a row, while others face cuts.

A report by the independent Pricing Committee – set up by former NDIS Minister Bill Shorten – was also released on Wednesday, criticising the NDIA’s pricing scheme.

“Essentially it says it isn’t fit for purpose,” National Disability Services CEO Michael Perusco, representing providers, said.

He said NDIS cases were often extremely complex, which was why there needed to be a range of rates for some services, something he said the Independent Pricing Committee also recognised.

Michael Perusco, National Disability Services CEO

“We are deeply concerned that today’s pricing decision will lead to quality providers exiting the market, particularly early childhood providers,” Mr Perusco said.

“The Independent Pricing Committee’s report validates what we have been saying and that is quality providers are not being adequately compensated for.

“The committee’s report says that the current pricing model is a blunt instrument and is incentivising low-cost providers and under compensating those providers who are doing more complex work. What that means is the ones who are doing that work are going broke while at the same time you have a lot of providers who you don’t want in the market making money.”

Mr Perusco said he would like to see a justification of the NDIA’s claims about “NDIS premiums” being slapped onto the cost of services.

Occupational Therapy Australia (OTA), the national peak body for the profession, said the decision not to increase rates for occupational therapists will see more walk away from NDIS work amid rising costs, burnout and unsustainable pricing.

It said the therapy support rate, which remains at $193.99 per hour, has not changed since 2019.

Occupational Therapy Australia chief occupational therapist Michelle Oliver.

“It’s devastating to see that the highly skilled professionals keeping the NDIS afloat have once again been ignored,” chief occupational therapist at OTA, Michelle Oliver, said.

“The government expects occupational therapists to deliver complex, life-changing care to vulnerable Australians, but doesn’t think that work is worth even a cent more than it was in 2019.

“There is no NDIS without allied health. Freezing prices for another year does not just threaten provider viability. It directly undermines participant outcomes. It is not just unfair, it is dangerous.”

Dietitians Australia President Dr Fiona Willer said the review was a “devastating outcome”

for people with disability who rely on the NDIS for nutrition care, after the maximum rate claimable had been cut by $5 an hour.

“We are deeply concerned about the impact this will have on NDIS participants’ ability to access the dietetic services they need for their function.

“We have already raised concerns this week that people with disability are presenting at the hospital with nutrition care issues, as they have nowhere else to go.

“We cannot afford to leave people with disability at risk in this way.”

Therapy supports on the NDIS cost the taxpayer $2.4 billion in the six months to December 2024.

The agency said almost 413,000 participants access therapy supports which account for more than 10 per cent of total cost of the NDIS.

It said, at the same time, the number of unregistered therapy providers in the market increased around six per cent.

On Wednesday the new fee limits saw a number of price points reduced, which the agency said was to align to non-NDIS market rates.

The NDIA said frontline disability support workers would receive a pay rise of 3.95 per cent.

Originally published as Warning over NDIS patients being slugged up to 68 per cent more for some therapies