How are NDIS Price Guides managed in SupportAbility?

The National Disability Insurance Agency (NDIA) releases periodic updates to the  NDIS Pricing Arrangements and Price Limits. SupportAbility relies on the official Support Catalogue CSV Price Guide data published by the NDIA. 

The NDIA is responsible for determining and publishing the pricing and rules for supports delivered under the NDIS. The NDIA states that 'a comprehensive listing of support ‘line items’ will be kept up to date on the NDIS website'. For these reasons, SupportAbility only uses Price Guide rules and Support Catalogue data that are officially published on the NDIS website.

Whenever the NDIA releases a new Price Guide, we upgrade SupportAbility to include this updated information. 

Audience: Authorised Representatives, Finance Team, Operations Management, Team Leaders, and anyone tasked with working with Client Funding records. 

Summary

The following list summarises the content within this article. Click on the links below to take you to the relevant sections:

Scope of amendments required

The scope of amendments in these Price Guide releases is not, however, restricted to the types of Support Items available and their respective pricing. In previous years, the Agency has also made complex changes to:
  • the mechanics of the scheme itself and the rules for using these Supports,
  • the rules that govern how and when Providers can transition to use the new prices in the Price Guide release,
  • the compliance requirements around billing and reporting to Participants,
  • the compliance requirements around service bookings and processing Bulk Payment Requests,
  • the compliance requirements around group service Staff-to-Participant ratios,
  • the Bulk Payment Request file format specification,
  • the compliance requirements around gathering evidence and support logs for these supports, and 
  • many other things.
To compound this:
  • The earliest the NDIA has published a new Price Guide and Catalogue is two weeks before it was due to take effect on July 1st. However, Price Guides are often amended several times, even after July 1st, to fix issues and errors.

    There is no pre-determined date that the Agency has communicated for the release of new Price Guides. Therefore the team at SupportAbility are all on standby in the weeks leading up to the Price Guide, waiting for it to be released and to then respond accordingly. This means that our Engineering team needs to design, architect, build, test and deliver complex (and often financially impacted) solutions as a priority to a very tight deadline. Our Customer Success team is tasked with generating the associated learning material within this timeframe while simultaneously handling all provider communications and questions during this period.
  • The Agency often releases information and changes the Price Guide rules without providing the level of detail that providers require to transition and comply with the new Price Guide. Subsequently, this needs to be clarified, and our channels to receive this clarification are the NDS, email to the NDIA directly, and feedback from our subscriber base.

Return to Summary

When is the latest Price Guide updated in SupportAbility?

Generally, the NDIA publish new versions of the Price Guide with two key documents:

  • NDIS Price Guide: The NDIS Price Guide is published on the NDIA website in PDF/DOCX format and explains the rules around how supports in the Support Catalogue are to be delivered and claimed.
  • NDIS Support Catalogue: The NDIS Support Catalogue is a Comma Separated Values (CSV) file containing a list of every support that is valid for the Price Guide release and contains pricing and other information for each support.  This is the file we import into SupportAbility.  

SupportAbility requires the NDIA to publish the Support Catalogue CSV as well as the NDIS Price Guide before we can begin work on including this in SupportAbility.

As a general rule, we update SupportAbility to include the new Support Catalogue within 1-2 weeks of the NDIA releasing the Support Catalogue CSV version associated with a new Price Guide.  This may differ in cases where:

  • There are issues with the NDIA price guide released, and several amendments are made before the 'final' version of the price guide is released, and
  • The NDIA has changed the structure of the Support Catalogue or made significant changes to the rules of the Scheme in the Price Guide in which case, additional programmatic changes to the product need to be made.

IMPORTANT: On most of the previous Price Guide releases, the NDIA has released several versions of the Price Guides to amend serious issues in the data. If the Agency releases amendment versions of the Price Guides, this can postpone the integration date for SupportAbility.

Return to Summary

Is this being reviewed regularly so that SupportAbility is using the latest Price Guide?

Yes. Our Engineering team reviews the published Support Catalogue CSV data on a regular basis to check if a new version has been published, as historically, the NDIA has not communicated when a revised version has been published.

What happens when a new Price Guide is added to SupportAbility?

Once a new NDIS Price Guide is added, Price Guide Transitions are created for all NDIS Direct Client Funding records that span a period of two or more Price Guides. 

By default, Price Guide Transitions for all Clients is set to 'As soon as available'; therefore, SupportAbility will update all Activities that fall on or after the commencement of the new Price Guide, e.g. July 1st, that have not been Signed Off, to ensure that Client NDIS Support Allocations reference the latest Price Guide. For more information on this, please review the  Price Guide Transition article linked below. 

N.B. Where a Client Support Log exists, this locks the Client's NDIS Support Allocations, therefore the only exception to the above rule is if a Client Support Log had been completed, then these Allocations will not be updated. 

Regardless of the transition settings, specific rules regarding which Claim Types can be used, for example, will always follow the rules of the NDIS Price Guide valid on the date of the Activity. 

Return to Summary

What if Supports are removed from the latest Price Guide?

If a Support Item included in the Client's NDIS Direct Client Funding record is removed from the latest Price Guide and the Client's Price Guide Transition is set to 'As soon as available', this means that the latest NDIS Price Guide is in use in the Activities the Client participates in from July 1st. 

However, any removed Support Items that were valid for the Funding Period of the Direct Client Funding record will also be available to use or select from in the NDIS Support Allocations window of the Activity, e.g. 01_028_0115_1_1 was removed from the 2020/21 NDIS Price Guide, however, this may be Allocated and utilised in Activities after the 1st of July as it was valid at the time the Client's Funding record was entered:

Any removed Supports from the current Price Guide will display an information message to indicate they belong to a different Price Guide than the one in use. This also applies for Legacy Support Items. 

In addition to this, a feature is available from SupportAbility v6.21 (18th of August, 2020) for all NDIS Direct Client Funding records that commence on or after the 1st of July, 2020, to specify if Support Items from the previous Price Guide period are required to be added to the Funding record: 

This allows providers to add Support Items that have been removed from the latest Price Guide. 

For comprehensive details regarding this, please review the 'Supports from the previous Price Guide setting' section of the Price Guide Transition article linked below for reference. 

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