NDIS Funding Changes 2025: What Every Provider Needs to Know

NDIS Funding Changes 2025: What Every Provider Needs to Know

The National Disability Insurance Scheme (NDIS) is implementing several significant updates from July. These changes will impact registered NDIS providers, allied health professionals, and support coordinators across Australia, especially in cities like Sydney, Melbourne, Brisbane, Perth and regional communities. The focus is on how therapeutic supports are funded and how much providers can charge. These updates are designed to ensure the long term sustainability of the scheme, improve consistency and provide value for money.

End of Core Funding for Therapies
Participants will no longer be able to use their Core funding to pay for therapeutic services. This includes allied health professionals such as physiotherapists, occupational therapists, speech pathologists, psychologists, podiatrists and dietitians. These supports must now be funded exclusively through the Capacity Building budget. Providers should proactively audit client plans to ensure they reflect these changes and adjust internal booking systems accordingly. If you are a sole practitioner, consider preparing simple language resources that help clients understand these shifts. Larger organisations may want to assign team leads to monitor Capacity Building fund usage trends across their caseloads and adjust service pathways accordingly.

Reduction in Therapy Rates
Physiotherapy rates will reduce by $10 per hour, down to $183.99, while dietitians and podiatrists will see a $5 reduction to $188.99. To adapt, conduct a pricing impact analysis to identify which services are profitable under the new model. Consider streamlining less profitable services to preserve value. For example, if a 45 minute session no longer covers your overheads, assess whether offering a full one hour session instead of a 45 minute session could better cover your operating costs and align with the updated pricing, while maintaining value for the client. Also explore whether you can use group therapy or assistant-led interventions as a way to continue delivering outcomes at a sustainable cost.

Removal of Regional Loadings
For providers in regional locations, the removal of regional loadings could impact service viability. Consider assessing cost per service in each region, and where needed, redesign your outreach model. This might include reducing frequency of visits, centralising services in fewer hubs or transitioning to remote support options. Some providers are exploring monthly visits to a centralised hub and encouraging clients to travel in. Others are leveraging technology by offering hybrid models combining telehealth consultations with quarterly in person sessions. If you are a regional provider, network with other providers to explore co-location opportunities to share overheads.

Changes to Travel Reimbursements
The reduced travel reimbursements require a shift in how appointments are scheduled. Providers should evaluate route efficiency, group sessions geographically and potentially introduce a minimum booking policy per travel area to recover costs more effectively. Another consideration is re-evaluating how travel time is factored into your staff KPIs. Are you expecting full billable hours from therapists who spend two hours a day driving? Could you instead explore clustered delivery blocks or virtual service provision during high travel days?

Plan Management Fee Changes
With setup fees and remote loadings discontinued, plan managers should look at their cost to serve per client and introduce efficiencies via automation, digital onboarding or reduced administrative overhead. Plan managers may also wish to consider refining their ideal client profile focusing on participants with more complex plans may justify the reduced fee structure if paired with strategic use of software and reporting.

Complex Behaviour Support Policy Update
Psychologists and behaviour support providers should review the new intensive and complex behaviour framework and align their service models accordingly. This might involve investing in staff training or specialist clinical tools that help meet compliance requirements. Consider building specialised roles or practice leads into your organisation who can oversee compliance and deliver supervision to others. For sole practitioners, forming informal peer networks to stay on top of policy updates and case complexities may prove invaluable.

Updated Cancellation Policies
Ensure your cancellation terms align with the new rules. Update service agreements, educate staff and inform clients. Introduce automated reminders to reduce no shows and lost revenue. Build cancellation patterns into forecasting models to buffer potential cash flow gaps. You might also consider offering a ‘waitlist fill’ policy or allowing clients to swap session times within the week if they provide notice. This flexibility helps protect revenue while offering service continuity to clients.

New Pricing Arrangements and Documentation
Review the updated NDIA pricing arrangements thoroughly. Create a pricing compliance checklist to share with staff and integrate changes into client management software. Offer internal training so all team members understand pricing boundaries and claimable items. Consider allocating responsibility to a dedicated compliance lead or admin team member to keep your documentation up to date and audit ready.

Preparing Your Business for Change
Schedule a strategy session with your leadership team. Map out how these pricing changes impact each business unit. Build a 12 month plan that includes pricing adjustments, marketing efforts to reach new clients and client education campaigns. For solo providers, set aside a quarterly review day to update your pricing structure, review client mix and update communications. For growing businesses, invest in financial modelling to project revenue under different client volumes, travel patterns and cancellation scenarios.

Why Knowing Your Numbers is Essential
Break down every cost involved in service delivery from admin wages to subscriptions, room hire and insurance. Use this data to calculate your breakeven hourly rate and compare it to the revised NDIS limits. Build out different financial scenarios including staffing changes, travel reductions or new program launches. For example, if your breakeven rate is $162 per hour, a drop to $183.99 still offers margin. But if you are also paying travel, admin, CPD and software costs, your margin could be tighter than you think. Reviewing your profit per service stream helps you decide where to scale or pivot.

Optimising Scheduling and Travel
Introduce batching software or route planning tools to reduce drive time. Restructure days by location or service type. Evaluate the viability of hybrid delivery models and create a decision framework for when to offer telehealth versus in person visits. For instance, you might run three days of telehealth and two days of local travel. Alternatively, structure your calendar around high demand suburbs to cut unnecessary cross town driving. Use client feedback to test new scheduling patterns and adjust based on satisfaction and clinical outcomes.

Educating Clients on Funding Changes
Design a client communication kit explaining the upcoming changes, what it means for their support and how they can prepare. Include a checklist for plan reviews and a templated letter they can bring to planning meetings requesting Capacity Building funding. Run webinars or small info sessions for clients or families to explain these changes and support them in feeling confident and informed. This also positions your business as a trusted guide, strengthening relationships and increasing client retention.

Strategic Planning for Regional Service Viability
Audit your rural and regional service models. Compare cost to revenue by location. Explore subcontracting, pop up clinics or shared practitioner models with other providers to maintain presence without bearing full costs alone. Consider partnering with local community centres, GPs or Aboriginal health services to reduce facility costs and improve accessibility. Think long term, how can you build relationships in these communities that lead to trust, demand and sustainable service delivery?

Exploring New Service Delivery Models
Research new programs or delivery modes. Consider launching group therapy sessions, mentoring programs, supervision services or community education offerings. Trial new services in small batches and monitor outcomes. For example, a podiatrist might offer a monthly diabetes foot health clinic in collaboration with a nurse or nutritionist. A speech pathologist could pilot a fortnightly parent coaching group. These options increase access and spread delivery costs across multiple clients.

The NDIS changes are here to stay, and adapting proactively is key. Revisit your business strategy, upskill your team, revise your pricing and client engagement approach and stay across updates. If you need help redesigning your business model or implementing changes, I am here to guide you through it. Let us ensure your services continue delivering impact while remaining financially strong.