How NDIS cap rates could affect your supports

NDIS Cap rate

If you are NDIS funded and use the Better Caring platform, you may be subject to NDIS cap rates. These cap rates affect how much you spend on supports from health service providers like Better Caring. If you’re wondering how NDIS cap rates might affect your supports via the Better Caring platform, continue reading.

Cap rates (or price controls) apply to NDIS funded individuals whose funding is managed by a Registered Provider or by the National Disability Insurance Agency (NDIA). Cap rates are monetary limits that allow the NDIA to maintain the costs charged by Registered Providers and independent support workers like those on the Better Caring platform.

It’s important to note that cap rates are not applicable to NDIS funded clients who self-manage their supports.

The National Disability Insurance Scheme Act 2013 claims that the cost of supports must be reasonable and relative to the support provided and the costs of alternative support.

The NDIA updates cap rates annually to take into account market trends, changes in costs and wage rates. Although the NDIA is set to update NDIS cap rates on July 1, 2018, it is important that independent support workers, coordinators and clients are aware of current cap rates.

The most commonly applied cap rates are those under assistance with self-care activities. These rates fall anywhere between $44.72 and $96.96 per hour depending on the time and day support is provided. You can see the standard self-care activity cap rates on page 29 of this document.

If you’d like to see which cap rates apply to your funding, the current Price Guides for NDIS service providers are a useful guide. You can view current Price Guides for New South Wales, Victoria, Tasmania and Queensland here and current Price Guides for the Australian Capital Territory, Northern Territory, South Australia and Western Australia here.

If you are a consumer on the Better Caring platform and your NDIS funds are managed by a Registered Provider, you should consider these three costs:

  • Better Caring’s 5% client service fee which is added to the cost of your support worker’s services;
  • the hourly rate set by the support worker on Better Caring;
  • any service fees charged by your plan manager or Registered Provider.

The above costs may cause your supports to exceed NDIS cap rates. If you’re concerned about this, contact your Registered Provider.

These examples can help you understand how service fees and payment rates can affect your supports.

Example 1: Exceeding the cap rate

If your supports fall under the description “Assistance with self-care activities during daytime weekdays [reference number 01_011_0107_1_1]”, the current cap rate for this service in NSW is $44.72 per hour according to the 2017-18 NDIS Price Guide.

Your support worker might have a weekday payment rate of $40 per hour and you might agree to one hour of support from them totaling to $40. A 5% Better Caring service fee of $2.00 will also be charged to you.

Your NDIS Registered Provider may also charge a 12% service fee which will add to the payable amount. In this case, the service fee is $5.04. These fees vary from provider to provider, so this rate is only illustrative. Please check with your Registered Provider to confirm what your service fee is, if relevant.

The total of the pay, the Better Caring service fee and the management service fee is $47.04. This amount exceeds the NDIS cap rate and your NDIS funding will not cover this cost.

Example 2: Falling within the cap rate 

If your supports fall under the description “Assistance with self-care activities on Saturdays [reference number 01_006_0104_1_1]”, the current cap rate for this service in NSW is $62.03 per hour according to the 2017-18 NDIS Price Guide.

Your support worker might have a weekend payment rate of $35.50 and you might agree to 3 hours of support from them totaling to $106.50. A 5% Better Caring service fee of $5.32 will also be charged to you.

Your NDIS Registered Provider may also charge a 12% service fee which will add to the payable amount. In this case, the service fee is $13.42. These fees vary from provider to provider, so this rate is only illustrative. Please check with your Registered Provider to confirm what your service fee is, if relevant.

The total of the pay and the service fee is $125.24 (or $41.75 per hour). This amount is within the applicable cap rate and your NDIS funding will completely cover the cost of your support.

There are many different cap rates and each individual receiving NDIS funding may require different levels of core supports.

If you’re hoping to receive support from an independent support worker but are concerned their payment rates and applicable service fees exceed your NDIS cap rate, you can always discuss altering the payment rate with them.

NDIS Cap Rate Calculator

To find out how cap rates can affect your support, use our NDIS Cap Rate Calculator. This calculator is based on the most common support provided through Better Caring. For more information on different cap rates, visit the 2017-18 NDIS Price Guide.

Please note, the calculator and information in this article are designed as a guide and should not be solely relied on when designing your NDIS plan. We recommend that if you have questions about the NDIS, accessing the scheme, or your plan specifically, to get in touch with the NDIA or visit the NDIS Pricing and Payment site.

Better Caring is not an NDIS-registered provider, however you can use your NDIS funding to hire support workers directly through the Better Caring platform. Find out more here.

The Better Caring platform has a range of quality disability support workers that provide unique services and offer independent rates. If you’re looking to improve your supports, start searching for workers in your area now.