Introduction

When you’re an NDIS participant, managing your funding wisely is key. But what happens when a provider charges more than they should—or worse, charges for something you didn’t receive?

Unfortunately, overcharging does happen. Sometimes it’s a misunderstanding. Other times, it’s non-compliance. Either way, you have the right to question it.

In this blog, we’ll help you:

• Understand NDIS pricing rules
• Spot signs of overcharging
• Know what to do if you think something’s wrong
• Learn how Assist Providers helps prevent this issue

💸 NDIS Pricing Limits: What Providers Can Charge

The NDIS sets clear price limits on most supports via the NDIS Pricing Arrangements and Price Limits.

These limits apply to:

• Support work
• Therapies
• Transport
• Coordination
• Capacity building
• Group-based activities

✅ Providers must not charge more than the capped rate, unless the service is not subject to a price limit (and you agree upfront).

📌 Example (2024–25 rates):

• Level 2 Support Coordination: $100.14/hour (max)
• Community Access weekday: $66.45/hour

🚨 Signs You Might Be Overcharged

Here’s what to watch for:

1. Hourly rate above the price cap

If you’re plan- or NDIA-managed, price limits must be followed.

2. You were charged for time not spent

For example:

• Full hour billed for 30-minute visit
• Charged for cancellations without a valid policy
• Travel time that exceeds limits

3. You didn’t agree to the charges

Charges added for:

• Setup fees
• Admin costs
• Additional workers you didn’t request
• These must be explained and documented.

4. Services claimed that you didn’t receive

This is serious. Common red flags:

• Recurring services claimed while you were away
• Duplicate claims from multiple providers
• Billing for group services delivered 1-on-1

Important: The NDIA will not reimburse overcharged funds once they’re spent—so catching it early is vital.

🔍 Real Example: James & Community Access Charges

James, an NDIS participant with autism, noticed his support worker was billing $80/hour—$14 above the capped rate. He also discovered he was being billed for 1.5 hours of travel time per visit, even though the drive was 15 minutes.

His plan manager escalated it. The provider refunded $900 and updated their practices.

✅ How to Check If You’re Being Overcharged

1. Request an itemised invoice
   • Check dates, hours, and hourly rate
   • Compare to services you actually received
2. Compare prices to the current NDIS price guide
   • You can download the latest NDIS Pricing Arrangements
3. Check your service agreement
   • Are rates clearly listed?
   • Are you being charged extra for things not listed?
4. Ask your plan manager or support coordinator to review
   • They can flag issues or raise concerns directly with providers

📄 What to Do If You Suspect Overcharging

1. Raise it with the provider (in writing if possible)
   • Most will correct errors when flagged
2. Contact your plan manager or support coordinator
   • They may do a formal reconciliation or report it if needed
3. Report to the NDIS Quality and Safeguards Commission
   • If it’s serious or recurring
   • Website: www.ndiscommission.gov.au | Phone: 1800 035 544

🧰 How Assist Providers Can Help

✅ Invoice audits and overcharge reviews

✅ Budget tracking tools and alerts

✅ Staff training on NDIA-compliant billing

✅ Participant support with escalating complaints

✅ Templates for service agreements with clear pricing

We help both participants and providers stay compliant, transparent, and accountable.

🛑 Common Mistakes to Avoid

🚫 Not asking for itemised invoices

🚫 Assuming “it’s probably fine”

🚫 Not checking pricing guides

🚫 Thinking you can’t speak up

🚫 Not reviewing your budget regularly

🏁 Final Thoughts

Your NDIS plan is meant to support you—not inflate provider profits.

By knowing what to watch for, you can make sure every dollar is used properly, ethically, and in a way that benefits your goals.

Need help reviewing invoices or tracking your budget? Assist Providers is here to make it simple.