NDIS plans fund a great deal of children’s occupational therapy in Australia, yet the practical mechanics of using a plan are explained to almost nobody. This article covers the three ways a plan can be managed, what each one means for which providers you can see, and a few habits that make a plan stretch further.
The three ways a plan is managed
Every NDIS plan is managed in one of three ways, and the choice quietly determines which therapists you can book.
- Self-managed. You (or the plan nominee) pay invoices and claim the money back through the NDIS portal. You can see any provider you like, registered or not
- Plan-managed. A plan manager, funded by the plan itself at no cost to you, pays invoices on your behalf. You can still see any provider; the plan manager just handles the paperwork
- NDIA-managed, also called agency-managed. The NDIA pays providers directly, and can only pay NDIS-registered providers, so your choice is limited to the registered list
That last distinction matters more than most families realise, because many good paediatric therapists, including us, are not NDIS-registered. Registration is a significant administrative undertaking for a small practice, and being unregistered says nothing about qualifications: our therapy is delivered by an AHPRA-registered occupational therapist either way. We work with self-managed and plan-managed participants. If your plan is NDIA-managed we can’t invoice it, though management type can be changed at a plan review, and plenty of families do exactly that to widen their choice of providers.
What OT is funded under
Occupational therapy for children usually comes out of the Capacity Building (Improved Daily Living) part of a plan. It covers therapy sessions, and it can also cover assessments and reports, therapist travel for home, school and kinder visits, and the time a therapist spends writing notes or talking with your child’s educators.
Prices are governed by the NDIS pricing arrangements, which set an hourly limit for occupational therapy. Providers may not charge NDIS participants above it, and the better ones charge the same rate to everyone, funded or not. Ours are published in full on the fees and funding page, including how travel is billed. Travel is capped at half the hourly rate.
Habits that make a plan go further
- Agree costs in writing before starting. A service agreement should spell out session rates, travel, report costs and cancellation terms. If a provider is vague about money, keep looking
- Put goals in the plan’s language. Therapy claimed under a plan needs to connect to the plan’s stated goals, so a therapist who writes goals with you, in words you would say, makes every review easier
- Use parent coaching deliberately. Sessions that build your skills are often the best-value spend in a plan, because you’re there for the other 167 hours of the week. Our parent capacity building service exists for exactly this
- Mix formats. Telehealth check-ins between home visits keep momentum without paying travel every week, a pattern we use a lot across the suburbs we visit
- Keep reports purposeful. A good assessment or report earns its cost at review time. A report nobody asked for is plan money spent on a PDF, so ask what a report is for before commissioning it
Starting before the plan exists
You don’t need to wait for an NDIS plan, or any diagnosis, to start therapy. Many families begin privately while an access request is in progress and move to plan funding once it’s approved. Medicare rebates (with a GP chronic condition management plan) and private health extras can help bridge the gap. The fees and funding page walks through every pathway.
If you’re weighing it all up for your own child, get in touch. Tell us how the plan is managed and what you’re hoping will change, and we’ll give you a straight answer about what’s possible, including when the honest answer is that our funding pathways don’t fit yours.