NDIS price limit impact

The worked example

A physiotherapy, occupational therapy and speech pathology practice turns over $2.5 million with a margin of 9 per cent. Five full time equivalent clinicians work mainly with NDIS participants. Each is paid for 38 hours a week over 46 weeks, 1,748 hours a year, and bills 58 per cent of those hours at an average of $190, which brings in about $963,000 a year, 39 per cent of the practice's revenue.

From 1 July 2026 the NDIS price limits for occupational therapy, speech pathology and physiotherapy stayed where they were. A 4 per cent rise on salaries of $105,000 with 17 per cent on costs costs $24,570 a year and takes the margin to 8.0 per cent. Claiming the reports and other non face to face work the pricing arrangements allow, and rostering home visits into area blocks, lifts billable time to 66 per cent without an extra participant: $132,848 more revenue a year and, after $12,000 of extra administration, a margin of 12.2 per cent. A billable share of 59.5 per cent absorbs the wage rise on its own.

Illustrative example, built from typical figures for a practice of this kind and the NDIS pricing arrangements for 2026 to 2027, not a client engagement. The 4 per cent wage rise and the $190 average rate are assumptions. What can be claimed depends on each participant's plan and service agreement.

How to read the result

Your target billable share absorbs the wage rise

The extra billable time covers the wage rise and the cost of claiming it, and the margin after shows what is left over. The next question is whether the clinicians can bill that share without longer waits or rushed reports.

Your target billable share does not absorb the wage rise

The extra billable time falls short. The result shows the share that would cover both the wage rise and the extra administration; the gap has to come from private fees, the mix of NDIS and private work, or costs.

Psychology

The psychology limit rose $20 an hour from 1 July 2026, so a psychology practice recovers part of the wage rise through price. The calculator holds the rate you enter, so enter your new average rate to see the year ahead.

Questions owners ask

Which unbilled time can we claim?

Non face to face work that is part of delivering a specific support can be claimed when the participant has agreed in advance and the service agreement allows it, and reports the participant's plan requires can be claimed through the report line item. Only completed work can be claimed, and administration such as bookings and processing claims cannot.

Is travel paid?

Provider travel is paid at half the hourly limit and capped at 30 minutes to and from each participant in Modified Monash areas 1 to 3 and 60 minutes in areas 4 and 5. Rostering home visits by area turns driving the cap does not cover back into sessions.

Do the award changes affect us if we pay above the award?

The award sets the minimum. A clinician paid above it needs a rise only when a new minimum overtakes their pay, but graduate rates and the market around them follow the award, so budget each stage of the health professional rates to 30 June 2030.

Should we change how our clinicians are engaged?

Employment and contractor arrangements carry legal, tax and payroll tax consequences that differ by state. Talk to your legal and tax advisers before you change them.

Where do the rules come from?

The prices come from the NDIS Pricing Schedule 2026 to 2027. The claiming rules sit in the NDIA's Pricing Arrangements and Price Limits; check them against the version in force before you change how you claim.

Typical results

For one full time clinician paid for 1,748 hours a year and billing at $190 an hour, each point of billable share is worth $3,321 a year. A 4 per cent rise on a $105,000 salary with 17 per cent on costs costs $4,914, so that clinician needs about 1.5 more points of billable share, or about 26 more billable hours a year, to absorb it at unchanged prices. Practices that already claim their reports and non face to face time start closer to their ceiling, and gain more from travel blocks and fewer short notice cancellations.