How NDIS funding pays for therapies

For some time now, National Disability Insurance Scheme (NDIS) participants have been able to claim for disability-related health supports using their Core Supports budget, and sometimes this has included supports from providers like psychologists, dieticians, and occupational therapists.

Although the claiming arrangements were put in place in 2019, they were always meant to be temporary – and pending updates to the NDIS Pricing Arrangements and Price Limits will soon mean that people can’t use Core Supports funding for general therapies.

Instead, from 1 July onwards, participants will not only have to make sure the therapies they access are related to their disability and in line with their NDIS plan, but they’ll also need to have funding available to pay for them in the Improved Daily Living category of Capacity Building Supports.

What are disability-related health supports?

According to the National Disability Insurance Agency (NDIA), disability-related health supports are ‘health supports that relate to the things you can and can’t do because of your disability’.

The Agency won’t fund supports to treat a health condition – it says that’s the job of the health system – but if a participant’s disability causes a health condition, or if they need help to manage a health condition because of their disability, NDIS funding can sometimes be used.

For example, the Agency may fund things like training for participants and their providers, someone (like a support worker) to provide disability-related health supports to a participant, or specific types of equipment to aid management of a relevant condition.

What’s changing?

In the NDIS Pricing Arrangements and Price Limits there are lots of Core Supports line item codes, and from what we know, it’s only intended that those related to therapeutic supports will be removed.

That’s because there’s been a double-up for a while now, with therapies sometimes claimed from both Capacity Building Supports and Core Supports, and amendments made to the NDIS Act in late 2024 are tightening things up.

The changes to disability-related health supports will affect participants who are currently claiming – or who’ve previously claimed – for services provided by:

• speech pathologists
• occupational therapists
• dietitians
• podiatrists
• physiotherapists
• psychologists

Providers known as ‘other professionals’ have also been able to invoice using Core Supports codes (sometimes) – but if they’re providing therapeutic supports, then they’ll need to use Capacity Building Supports codes instead.

Nursing care and some assistive technology for disability-related health matters (such as pressure care cushions and cough assist machines) will still be able to be claimed from Core Supports, if the supports align with a participant’s plan.

What does this mean?

Put simply – to access general therapy supports, participants will need to have the right type of funding available in the Improved Daily Living category of their Capacity Building Supports budget. Claims for services delivered on or after 1 July 2025 will only be paid by the NDIA if that funding is available.

Everyone’s situation is different, which is why it’s important participants speak with their support networks, providers, and the NDIA sooner rather than later, so they can decide what they want to do next.

What should you do next?

If participants have service agreements in place with their health or allied health providers – or if they plan to use their services – we recommend they get in touch with their support coordinator or NDIA contact as soon as possible to discuss next steps.

We suggest providers take a close look at the NDIS Pricing Arrangements and Price Limits to determine whether the supports they provide are disability-related health supports or general therapy supports – and they may also benefit from discussing their situation with the Agency.

Service agreements are an effective tool for ensuring both participants and providers have a clear understanding of their roles and responsibilities, and we encourage people to establish service agreements before supports are delivered and/or received.

With the NDIS in a state of flux following the 2024 changes to the NDIS Act, it’s important to keep checking this web page to find out more as the NDIA updates its guideline on disability-related health supports.