Automatic changes to AT funding in plans
On 28 February 2022, we automatically made the appropriate funding available for many participants with an outstanding quotable AT item up to $15,000 in their current plan.
Over the next week, we will send an alert (SMS / email) to impacted participants to confirm the change and automatic update.
If AT suppliers had submitted a valid, reasonable AT quote under $15,000 directly to the NDIA through the myplace provider portal, we approved that quote and issued a service booking on 28 February 2022.
If there is more than one valid quote in a plan, we will manually review these plans and funding (and a service booking) will be updated over the coming weeks.
For plans with an open quotable AT item but no loaded quote, we added the appropriate amount to available funding.
- These funds remain stated, so they can only be used for this support. You will need to create a service booking and claim using that support item code.
- The amount made available may not match any of the quotes you have given the participant to submit for that support – this is not an error. These funds should be sufficient to cover most of the participant’s AT needs. If necessary, the participant can also use other funds in their Capital (AT) budget.
If the funds are now available, you won’t need to wait for further approvals from the NDIA before working with the participant to get the right AT for their needs. Participants need to get independent written advice from their AT advisor before purchasing/ordering the AT.
After a participant has decided on the most suitable item and negotiated a reasonable price, their AT supplier can create a service booking and make their claim against the budget (or plan manager if this is how the plan is managed). If their plan is self-managed, usual arrangements would apply as they will pay the costs from their plan.
Once all claims are finalised and/or the current plan reviewed and replaced with a new plan, we will withdraw old quotable AT codes.
Some quotable AT items plans will not be automatically updated, these plans will be referred to an NDIA staff or partner to action. We have also tried to contact these participants to explain this.
Claiming for mid cost AT
We will be removing existing quotable AT codes valued under $15,000 from the NDIS Support Catalogue.
These codes have been replaced with:
- New claiming codes for AT (in place of existing quotable codes) with market-informed price limits.
- Nine new Supplementary Charge codes to permit a claim where the reasonable price for the AT the participant needs exceeds the NDIA catalogue item price limit.
- This will help participants with complex needs.
- You cannot claim more than the price agreed with the participant or the budget approved by the delegate, whichever is lower.
You will not be able to claim from a plan built after 28 February 2022 using:
- mid cost AT codes (05_0001_XXXX_X_X) even though these appear in the plan
- old composite or quotable codes under $15,000 value
- the ‘Supplementary Charge’ code only – this must be used in conjunction with a specific AT item code
You should only use old quotable codes for claiming where they are specifically listed in the plan.
You need to use new codes for all other cases. Your payment may be delayed if you use old codes when claiming from new plans and we may ask you to re-submit these claims.
Actions for providers
- Do not submit quotes for AT less than $15,000 to the NDIA. You should provide a quote to a participant, their support coordinator, or AT advisor if they ask for one.
- Create a service booking. Where a quotable AT item has been automatically accepted but a service booking was not automatically created, you should work with the participant to put a service agreement in place and create a service booking against the quotable line item in the plan for the agreed price.
- Ask the participant for the item code of the AT as described in their plan.
- Remember for new plans there is a mid cost item shown, but a more specific AT item described in the comments beside that item. This will make sure the participant uses their plan correctly and makes claiming easier.
- If the code is incorrect for the item the participant needs, they should discuss this with their NDIS contact.
- Stop using ‘fractional claiming’ for AT where the unit is ‘each’, unless specifically indicated in the Assistive Technology, Home Modifications and Consumables Code Guide.
- If you need to claim more than the NDIA system will pay for that item and the participant has agreed to that cost, you must claim any balance using the relevant Supplemental Charge Code.
Support coordinators will need to understand these changes to support participants who may have questions