An Update on NDIS Billing for Plan Managed Participants

The NDIS has introduced several major changes to allied health pricing and billing arrangements for 2025. These updates affect how physiotherapists and other allied health professionals are able to deliver services, and they have significant implications for both providers and participants.

At Connected Health Alliance, transparency is a key priority. We want to explain what is changing, why these changes matter, and how we are adapting so that we can continue offering high quality, hypermobility-specific care.

Reduced Price Limits for Allied Health in 2025

In June, the NDIS published their updated Pricing Arrangements and Price Limits for 2025-26, which included reductions to the maximum rates that most allied health services can invoice. Changes included:

• Physiotherapy - reduced from $193.99 per hour to $183.99 per hour

• Dietetics - reduced from $193.99 per hour to $188.99 per hour

• Speech Pathology - maintained at $193.99 per hour

• Psychology - increased from $222.99 per hour to $232.99 per hour

Although these adjustments are part of broader cost-management strategies by the NDIS, the updated limits do not reflect the real-world costs of delivering safe, skilled, and compliant healthcare - particularly for participants complex needs and disabilities such as hypermobility conditions. Operating an in-person private practice has become significantly more expensive over the past two years, which makes long-term viability increasingly challenging.

Are Gap Fees Allowed?

Following the release of the 2025–2026 NDIS Pricing Arrangements, there has been limited transparency and some conflicting information about how the new rules would be applied. Recent communications from the NDIS indicate the intention to prohibit gap fees for plan-managed participants.

This means that if the cost of delivering a service exceeds the NDIS price limit, providers cannot charge the difference to the participant through their plan manager. While this policy is designed to prevent unexpected out-of-pocket costs, it creates significant challenges for providers when funding limits fall below the true cost of service delivery. Without flexible pricing options, many practices are being forced to reduce services or reconsider their capacity to continue operating within the NDIS framework.

Connected Health Alliance is committed to providing quality, accessible healthcare for people with hypermobility conditions. However, the combination of reduced price limits and restrictions on gap fees means we cannot sustainably absorb the financial shortfall while maintaining the standard of individual therapy and interdisciplinary care our clients need.

New Physiotherapy Billing for Plan Managed Participants

Self Managed Participants

If you are a self-managed participant, there will be no changes to how you are invoiced for any allied health therapy, as self-managed clients are not bound by NDIS price limits. You may continue to access services at our standard rates.

Plan Managed Participants

We will continue to accept plan-managed participants across all of our allied health therapies. To comply with the updated NDIS Pricing Arrangements and evolving billing guidelines, we will be adjusting the cost of all allied health consults to align with the NDIS price limits.

In addition, we will now be invoicing for all non-face-to-face work required as part of your care. This includes finalising clinical notes, writing letters and mandated post-consult reports, and informal case conferencing with your healthcare team.

These activities are essential to providing coordinated, interdisciplinary care. While dietetics has always invoiced for this time, this will be new for physiotherapy under our updated billing model.

In Summary,

As an ACNC registered charity and not-for-profit organisation dedicated to supporting people with hypermobility conditions, Connected Health Alliance continues to prioritise accessible, safe, and coordinated care. We are committed to maintaining transparency and working closely with participants, plan managers, and healthcare teams to ensure allied health therapy remains effective and meaningful.

If you have any questions about the updated model for invoicing NDIS Plan Managed Participants, please do not hesitate to email us at admin@connectedhealthalliance.org.au.

We appreciate the ongoing trust and support of our community and remain focused on advocating for participants while continuing to deliver the best possible outcomes under the updated NDIS framework.

Nicole, Megan and Savvy - Connected Health Alliance Directors