Assessment Recommendation Therapy or Training - EC - Other Professional | 01_740_0118_1_3

Where a provider claims for travel time in respect of a support then the maximum amount of travel time that they can claim for the time spent travelling to each participant (for each eligible worker) is 30 minutes in MMM1-3 areas and 60 minutes in MMM4-5 areas. (Note the relevant MMM classification is the classification of the area where the participant is when the support is delivered.)

In addition to the above travel, providers delivering core and capacity-building supports are permitted to claim for provider travel in respect of a support item can also claim for the time spent travelling from the last participant to their usual place of work. Note, this travel is only claimable when the provider must pay their worker for the return travel time.

Where a worker is travelling to provide services to more than one participant in a ‘region’, then it is reasonable for a provider to apportion all of the travel time (including the return journey where applicable) between the participants who received support from the worker. This apportionment should be agreed with each participant in advance as part of the service agreement.

Claims for travel in respect of a support must be made separately to the claim for the primary support (the support for which the travel is necessary) using the same line item as the primary support and the “Provider Travel” option in the myplace portal.

When claiming for travel in respect of a support, a provider should use the same hourly rate as they have agreed with the participant for the primary support (or a lower hourly rate for the travel if that is what they have agreed with the participant) in calculating the claimable travel cost.

Providers can only claim from a participant’s plan for a Short Notice Cancellation of the delivery of a support item to the participant if all of the following conditions are met:

• The NDIS Pricing Arrangements and Price Limits indicates that providers can claim for Short Notice Cancellations in respect of that support item; and
• The proposed charges for the activities comply with the NDIS Pricing Arrangements and Price Limits; and
• The provider has the agreement of the participant in advance (that is, the service agreement between the participant and provider should specify that Short Notice Cancellations can be
  claimed); and
• The provider was not able to find alternative billable work for the relevant worker and are required to pay the worker for the time that would have been spent providing the support.

Claims for a short notice cancellation should be made using the same support item as would have been used if the support had been delivered, using the “Cancellation” option in the myplace portal.

There is no hard limit on the number of short notice cancellations (or no shows) for which a provider can claim in respect of a participant. However, providers have a duty of care to their participants and if a participant has an unusual number of cancellations, then the provider should seek to understand why they are occurring.

The NDIA will monitor claims for cancellations and may contact providers who have a participant with an unusual number of cancellations.

Providers can only claim from a participant’s plan for a NDIA Requested Report if all of the following conditions are met:

• The NDIS Pricing Arrangements and Price Limits indicates that providers can claim for NDIA Requested Reports in respect of that support item and the proposed charges for the activities comply with the NDIS Pricing Arrangements and Price Limits; and
• The provider has the agreement of the participant in advance (i.e., the service agreement with the participant should specify that NDIA Requested Reports can be claimed); and
• The report is requested by the NDIA.

A report is considered to have been requested by the NDIA if it is a report that is required at the commencement of a plan that outlines plan objectives and goals, or at plan review that measures functional outcomes against the originally stipulated goals, or that makes recommendations for ongoing needs (informal, community, mainstream or funded supports).

Providers may also claim for other NDIA-requested therapy report that is stipulated as being required in a participant’s plan.

Providers can only claim from a participant’s plan for the Non-Face-to-Face delivery of a support
item if all of the following conditions are met:

• The NDIS Pricing Arrangements and Price Limits indicates that providers can claim for Non-Face-to-Face Support Provision in respect of that support item; and
• The proposed charges for the activities comply with the NDIS Pricing Arrangements and
  Price Limits and with the Service Agreement with the participant; and
• The activities are part of delivering a specific disability support item to that participant or in the case of group-based supports, are required to enable the group support to be delivered (rather than a general activity such as enrolment, administration or staff rostering); and
• The provider explains the activities to the participant, including why they represent the best use of the participant’s funds (that is, the provider explains the value of these activities to the participant); and
• The provider has the agreement of the participant in advance (that is, the service agreement between the participant and provider specifies that Non-Face-to-Face supports can be claimed).