Introduction

Understanding NDIS funding is crucial for any provider working in the disability sector. It determines how services are paid for, what’s covered, and how to ensure compliance when invoicing.

Yet, many providers struggle with funding rules, leading to delayed payments, rejections, or lost opportunities. This guide breaks down the different NDIS funding categories, how payments work, and how providers can navigate the system effectively.

NDIS Funding Categories

NDIS funding is divided into three main support categories:

1. Core Supports – Everyday needs and activities

✅ Personal care (e.g., showering, dressing)

✅ Transport assistance

✅ Consumables (e.g., continence products)

✅ Social and community participation

2. Capacity Building Supports – Skill development and independence

✅ Therapy services (e.g., OT, speech therapy)

✅ Support coordination

✅ Employment assistance

✅ Health and well-being programs

3. Capital Supports – Equipment and home modifications

✅ Assistive technology (e.g., wheelchairs, communication devices)

✅ Home modifications (e.g., ramps, accessible bathrooms)

✅ Vehicle modifications

Each participant’s funding is allocated differently based on their goals, needs, and plan management type.

How Do NDIS Payments Work?

NDIS providers don’t get paid upfront—they must claim payments through one of these methods:

1. Agency-Managed (NDIA)

🔹 Providers claim payments directly from the NDIA portal

🔹 Only NDIS-registered providers can offer services

🔹 Payments are typically processed within 3-5 business days

2. Plan-Managed

🔹 Providers send invoices to a plan manager who handles payments

🔹 Both registered and unregistered providers can work with participants

🔹 Payment time depends on the plan manager (usually 2-7 days)

3. Self-Managed

🔹 Participants pay providers directly and claim reimbursement from the NDIA

🔹 Works well for flexible arrangements, but payment time varies

Case Study:

A physiotherapy provider initially struggled with slow payments when relying solely on agency-managed plans. After partnering with plan managers and targeting self-managed participants, they reduced payment delays from 3 weeks to 5 days, improving cash flow significantly.

How to Ensure Smooth NDIS Payments

1️⃣ Understand Plan Types – Know whether a participant is agency, plan, or self-managed before invoicing.

2️⃣ Use Correct NDIS Pricing – NDIS has strict pricing rules. Overcharging or incorrect billing can lead to rejections.

3️⃣ Submit Invoices Properly –

✅ Include participant details & NDIS number

✅ List services correctly as per the plan

✅ Use the right support category

4️⃣ Work With Plan Managers – They process payments faster and help with compliance.

5️⃣ Keep Clear Records – Document all services provided to avoid disputes.

Common Mistakes Providers Make

❌ Not checking how a participant’s plan is managed – Invoicing the wrong entity leads to delays.

❌ Using incorrect pricing codes – Can cause claim rejections.

❌ Failing to communicate with plan managers – Results in misaligned expectations.

❌ Not keeping service agreements – Leads to disputes over payment and service scope.

Conclusion

NDIS funding may seem complex, but understanding how payments work, which funding categories apply, and how to invoice properly can make a huge difference.

By staying compliant and building strong relationships with plan managers and participants, providers can ensure steady payments, fewer rejections, and business growth.