NDIS Psychology fees

NDIS Psychology Fees – A brief overview

If you have been provided with an NDIS funding plan, funding would have been allocated to NDIS services that fall under billing items that are designated under the NDIS billing schedule[1]. To obtain NDIS funding and access NDIS services, it is vital to understand the criteria of what an ongoing, permanent and significant disability is.

It can be overwhelming trying to figure out the requirements for NDIS funding eligibility, relevant NDIS entitlements and NDIS Psychology fees on your own, for yourself or a family member. Having a clear breakdown of the criteria, requirements, entitlements, NDIS Psychology fees that you may incur, early on, will help you, your caregiver or your guardian.

If you would like to get started on your NDIS funded psychological services immediately, feel free to skip ahead to the “NDIS Psychologist Services at Chat Clinic” section. 

Eligibility criteria to access NDIS funded services and funding that covers NDIS Psychology fees

    • Be between the age of 7 and 65. [2]
    • Be a resident of Australia and be either an Australian citizen, permanent resident of Australia or protected special category visa. [2]
    • Be able to demonstrate that you require support from an individual as a result of an ongoing, permanent and significant disability. [2]
    • In specific cases, evidence of special equipment being used as a result of ongoing, permanent and significant disability. [2]
    • Be able to demonstrate that you need support now that will have an impact on your future needs [2]

If you would like to access NDIS funding and use a part of your NDIS funding for NDIS Psychology fees to pay for services of an NDIS psychologist under the following categories:

    • Providing core supports (Assistance with Daily Life) [1]
    • Providing capacity building supports and, in the context for Early Childhood Interventions[1]
    • Providing assessments, necessary recommendations, therapy and/or training. This may or may not include the use of Assistive Technology[1]
    • Specialist Support Coordination[1]

You will need to present relevant reports from a treating health professional regarding your disability that demonstrates [3]:

    • Having a permanent disability – this would indicate that the impact of your disability is likely to be lifelong. [2]
    • Having a significant disability – that your disability has a substantial impact on your ability or capacity to undertake/complete daily activities. [2]

Managing your NDIS funds to pay for your NDIS Services or NDIS Psychology Fees

It’s also important to know the differences between how your NDIS funded plan is managed and who manages it:

  • Plan-managed funding

    • Your plan manager manages the funding in your NDIS plan[4][5].
    • Your plan manager must be registered with the NDIS and is paid by the NDIA[4][5].
    • Your plan manager pays your NDIS service provider or NDIS psychologist for the services that have been provided to you[4][5].
    • Under a plan managed NDIS plan, your selection of providers is unlimited. It is at your discretion whether you use an NDIS registered or unregistered provider. To find out more please click here to be directed to the ‘NDIS registered vs. unregistered provider’ section[4][5].
    • Your NDIS service provider or NDIS psychologist would prepare invoices for your plan manager. Your plan manager would undertake the task of reimbursing your NDIS service provider or NDIS psychologist[4][5]
    • The NDIS funded amounts available for each type of service within a specified period such as, core or capacity building will be clearly stated in your NDIS plan[4][5].
    • The Plan Manager can view your plan on the Myplace portal and undertake tasks such as[4][5]:
      • Keeping track of your budget
      • Financial reporting
      • Assisting in the selection of providers if so required
    • Your NDIS service provider or NDIS psychologist will enter into a service agreement with you [4][5]
    • Fees for services, cancellations, telehealth, non-face to face services, etc., will be clearly stated in the service provider’s service agreement[4][5]
    • Please take note that if your NDIS plan is managed by the NDIA or Plan managed, your NDIS provider or NDIS psychologist must follow NDIS pricing arrangements and price limits[4][5].
  • NDIA-managed funding

    • The funding for your NDIS plan is managed at an Agency level, by the NDIA[4][5].
    • The selection of providers is limited to NDIA-registered providers or NDIA registered psychologists[4][5].
    • Your NDIS service providers and NDIS psychologists will be reimbursed by the NDIA on your behalf[4][5].
    • Claims by NDIA registered providers will be completed online. You will retain the ability to review any claims made by a service provider on the Myplace portal. Similar to being Plan Managed, you can review claims made by a provider from your NDIS funding and monitor your budget through Myplace. Except in this option, any book-keeping and financial records are managed at the Agency level (NDIA) [4][5].
    • The NDIS funded amounts available for each type of service within a specified period such as core or capacity building will be clearly stated in your NDIS plan[4][5].
    • Your NDIS service provider or NDIS psychologist will enter into a service agreement with you[7][8].
    • Fees for services, cancellations, telehealth, non-face to face services, etc., should be clearly stated in the service provider’s service agreement [7][8]
    • Please take note that if your NDIS plan is managed by the NDIA or Plan managed, your NDIS provider or NDIS psychologist must follow NDIS pricing arrangements and price limits[4][5].
  • Managing your funding on your own (Self-managed)

    • Under the self-managed option, you will manage the funding for your NDIS plan, which means you have the autonomy to fund support services agreed to from your NDIS plan independently [4][5].
    • Your selection of providers is unlimited. It is at your discretion whether you use an NDIS registered or unregistered provider. To find out more please click here to be directed to the ‘NDIS registered vs. unregistered provider’ section [4][5].
    • You have the discretion to utilise the funding from the NDIA in a way that empowers your choice in the types of support that you decide to access. This gives you control and flexibility as to how you can achieve specific goals and outcomes from your NDIS Plan [4][5].
    • You are responsible for the management of your NDIS funding which includes, ensuring that your budget adheres to the scope of what was agreed to in your NDIS plan and, deciding independently as to the service providers and types of supports you utilise [4][5]
    • Under a self-managed plan, while it is possible to negotiate the price you pay for support with your service provider, it’s important to take into consideration the cost at which services can be provided within your NDIS plan funding and throughout your NDIS plan [4][5]. For example, within the NDIS pricing schedule determined by the NDIS, the permissible fees for an NDIS psychologist’s services are currently at $214.41 per hour. It would be important to take into consideration the Australian Psychological Society’s current recommended fee rate of $260 per hour (APS)[9].
  • Opting for a combination of the above managing services

    • It is possible to have a part of your NDIS services managed by the NDIA or a Plan Manager and the remainder self-managed [4][5].
    • This hybrid option gives you the flexibility to manage a part of your NDIS funding and to assign the management of other parts of your NDIS plan to plan managers or the NDIA. The choice and flexibility to decide what supports you need, the ability to manage parts of your plan and to outsource others, gives you the freedom to pursue your NDIS goals in the way that you choose [4][5].
    • When you can combine being able to make decisions about:
      • what supports you acquire; [4][5]
      • which support providers you engage with; [4][5]
      • how your supports are provided; [4][5]

Alongside being able to:

    • engage NDIS plan managers or the NDIA[4][5]
    • employ contract staff directly[4][5]
    • have someone employ staff on your behalf[4][5]

This gives you the ability to:

    • negotiate on the pricing of your supports [4][5]
    • focus on what you consider value-based services, [4][5]
    • improve on the quality and amount of support[4][5]
    • Think creatively about how you can use your funds to best meet your needs. [4][5]
    • Be the person of focus in your NDIS plan and, take control and responsibility for your NDIS budget[4][5]
    • Resources to explore into if you are interested in self-managing or want to take a hybrid approach to manage your NDIS plan[4][5]:
      • Local Area Coordinators (LAC)
      • NDIA planners
      • Learning from other NDIS Participants who are self-managing
      • Self-management peer support group
      • NDIS guides to self-management or hybrid management of NDIS funding plans
      • Talk to our staff at Chat Clinic!

Regardless of the type of funding option, you have chosen, ensuring that your choice and control over ensuring and evaluating whether your services are working for you and fit in your budget, are yours [4]. During your NDIS planning meeting, you will be consulted as to your preferences of managing your NDIS funding during your planning meeting [6]. Talk to us beforehand to understand your options.

Service agreements with your NDIS service provider or your NDIS psychologist

When you engage an NDIS service provider or your NDIS psychologist, you will be provided with a service agreement that clearly states[7][8][9][1]:

    • the prices of services and necessary supports
    • what your provider would be responsible for during the period of the service agreement
    • your responsibilities during the period of the service agreement
    • the duration of the service agreement
    • how amendments or customisations to service agreements can be made
    • how to resolve a dispute in the case a difference of opinion or conflict occurs
    • if items such as the following are billable, including:
      • telehealth services [1]
      • Non-direct services [1]
      • This includes non-face to face support for participants, such as,
        • Drawing up of reports for co-workers and other providers about the participant’s progress
        • Undertaking research as a provider within the context of capacity-building specifically where the information required is linked to the needs of a participant
        • Provider travel
        • NDIA Requested Reports

NDIS Psychology fees, pricing arrangements, price limits

If you have been approved for NDIS psychological services, your NDIS plan would indicate that part of your funding has been allocated for psychological services. It’s important to check and receive a written confirmation from your NDIS delegate if you have been approved for psychological services.

The fees set in the NDIS pricing schedule [1] for psychological services are set at $214.41 per hour. The following NDIS services undertaken by an NDIS psychologist are covered in the NDIS fee schedule[1] and fall into the following categories:

    • Core supports in the context of Assistance with Daily Life
    • Capacity building support
    • Capacity building support for Early Childhood Interventions
    • Where assessments, necessary recommendations, therapy and/or training may be required. Note: May or may not include the use of Assistive Technology
    • Where Specialist Support Coordination services are necessary

The prices that are quoted to you from your service provider or NDIS psychologist will be based on whether you are plan, agency or self-managed[1][4].

Plan – managed or NDIA managed pricing

  • If your NDIS plan is NDIA or Plan managed, your NDIS provider or NDIS psychologist must follow NDIS pricing arrangements and price limits [4].

Self-managed pricing

  • Under a self-managed plan, it is possible to negotiate the price you pay for support with your service provider [5]. It’s important to take into consideration the cost at which services can be provided within your NDIS plan funding and throughout your NDIS plan. For example, within the NDIS pricing schedule determined by the NDIS, the permissible fees for an NDIS psychologist’s services are currently at $214.41 per hour. It would be important to be aware of the Australian Psychological Society’s current recommended fee rate of $267 per hour (APS)[9].

Price of initial assessment reports from a treating health professional

You will need to present relevant reports from a treating health professional regarding your disability and submit these to access an NDIS funding plan[3]. The following are appropriate professionals who can provide the necessary evidence in your specific circumstances:

Approved Treating Health Professionals 

  • If possible, gather any relevant documentation from your treating health professional
  • In certain circumstances, you may need to pay out of pocket for an assessment of your condition
  • Check if assessment services are covered through your private health insurer

Kindly note that the cost of assessment reports are not covered under Medicare Australia.

Registered and unregistered providers

Between registered and unregistered providers, particularly amongst registered psychologists who provide services to NDIS participants, registration is based on the preference of the psychology practice and is optional.

Psychology practices that are not formally registered with the NDIS are restricted from seeing NDIA-level participants. Psychologists who have chosen not to register with the NDIS are permitted to work with plan and self-managed participants[4]. It is important to note that the participant has the right to change their management of psychology-focused services such as capacity-building, from NDIA managed to Plan or self-managed[5].

When working with registered or unregistered providers, particularly in the context of working with an NDIS psychologist, it is important to undertake the necessary due diligence and verify if your NDIS psychologist meets Psychology Board of Australia registration requirements and, has the capacity to provide you with approved services and supports in your NDIS plan. For example, this could involve checking if the registered psychologist you are about to work with is listed under the Register of Practitioners with AHPRA [10] and has the availability to work with you consistently.  

To sum up, unregistered providers can still deliver the services, support or provide services to you. While working together with your NDIS psychologist, one of the most important predictors of successful outcomes is if you have a therapeutic alliance with the psychologist. This goes further than providing you with a service as a healthcare professional and ensures that you’re working with a psychologist who has your best interests at heart [11].

Do your NDIS Psychology Fees change based on the management of your NDIS plan?

Plan – managed or NDIA managed

  • If your NDIS plan is managed by the NDIA or Plan managed, your NDIS provider or NDIS psychologist must follow NDIS pricing arrangements and price limits[4][5].

Self-managed

  • Under a self-managed plan, it is possible to negotiate the price you pay for support with your service provider. It’s important to take into consideration the cost at which services can be provided within your NDIS plan funding and throughout your NDIS plan [4][5]. For example, within the NDIS pricing schedule determined by the NDIS, the permissible fees for an NDIS psychologist’s services are currently at $214.41 per hour. It would be important to be aware of the Australian Psychological Society’s current recommended fee rate of $267 per hour[9].  

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References

  1. National Disability Insurance Scheme. (2022b, March 1). Pricing arrangements. https://www.ndis.gov.au/providers/pricing-arrangements
  2. National Disability Insurance Scheme. (2021f, November 24). Am I eligible? https://www.ndis.gov.au/applying-access-ndis/am-i-eligible
  3. National Disability Insurance Scheme. (2019, August 2). Types of disability evidence. https://www.ndis.gov.au/applying-access-ndis/how-apply/information-support-your-request/types-disability-evidence
  4. National Disability Insurance Scheme. (2021d, August 11). Ways to manage your funding. https://www.ndis.gov.au/participants/creating-your-plan/ways-manage-your-funding
  5. National Disability Insurance Scheme. (n.d.). NDIS guide to Self Management. https://www.ndis.gov.au/media/1004/download
  6. National Disability Insurance Scheme. (2021d, August 11). Preparing for your planning meeting. https://www.ndis.gov.au/participants/creating-your-plan/preparing-your-planning-meeting
  7. National Disability Insurance Scheme. (2021d, July 7). Making a service agreement. https://www.ndis.gov.au/participants/working-providers/making-service-agreement
  8. National Disability Insurance Scheme. (2021d, July 6). Service agreements. https://www.ndis.gov.au/providers/working-provider/connecting-participants/service-agreements
  9. Australian Psychological Society. (2021, August). Psychologists’ fees in 2021–22. https://psychology.org.au/for-members/publications/inpsych/2021/august-special-issue-3/psychologists-fees-in-2021-22
  10. Australian Health Practitioner Regulation Agency. (2022). Look up a health practitioner Health Profession. Https://Www.Ahpra.Gov.Au. https://www.ahpra.gov.au/registration/registers-of-practitioners.aspx
  11. Ardito, R. B., & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: historical excursus, measurements, and prospects for research. Frontiers in psychology, 2, 270. https://doi.org/10.3389/fpsyg.2011.00270