Your Allied Health Rates Just Split Into Six Line Items — Is Your Practice Billing All of Them?
Your Allied Health Rates Just Split Into Six Line Items — Is Your Practice Billing All of Them?
The 2026-27 NDIS Pricing Schedule didn't just move a few rates. It unbundled the invoice — and most practices are still charging like it's one line.
Three weeks into the 2026-27 NDIS Pricing Schedule, most of the commentary aimed at allied health providers has focused on the headline rate movements. Psychology went up. Dietetics went down again. That's the easy story. The harder, more consequential story is structural: travel, non-face-to-face time, report writing and telehealth have all been pulled out of the direct service rate and turned into their own separately billable line items. For a practice still invoicing the old way, that's not a rate change — it's revenue sitting unclaimed in the appointment book.
What Actually Changed on 1 July
The NDIA's Annual Pricing Review, released 22 June and effective from 1 July 2026, moved three allied health rates. Psychology is the only discipline to rise — up $20.00 to $252.99 an hour, an 8.6% lift, benchmarked at the 75th percentile against the Medicare Benefits Schedule ($260.00) and private health insurance rates ($250–252). Dietetics was cut for the second year running, down $10.00 to $178.99, after sitting well above both benchmarks. Exercise physiology dropped $5.00 to $161.99. Physiotherapy, occupational therapy, speech pathology, audiology and podiatry held flat.
|
+8.6%
Psychology's rate rise to $252.99/hour — the only allied health discipline to move up this year, benchmarked against MBS and private health insurance 75th-percentile rates.
|
6
Separate billable line items now sitting behind a single allied health service: Direct Service, Cancellation, Non-Face-to-Face, Provider Travel, NDIA Requested Reports and Telehealth.
|
The Real Change Isn't the Rate — It's the Unbundling
Under the 2026-27 schedule, every therapy profession now carries a suffixed family of line items alongside its direct service code: cancellation (_CA), non-face-to-face time (_NF), provider travel (_PT), NDIA-requested reports (_RR) and telehealth (_TH). Provider travel is priced at 50% of the relevant service's hourly rate — for a dietitian that's $89.50 a trip, for an exercise physiologist $81.00, for a counsellor-rate item roughly $78.08.
None of this is hidden. It's published in the pricing arrangements on the NDIS website. But most practice management software and most billing habits were built around a single bundled service fee, and old habits are sticky. Travel time that used to be quietly absorbed into the consult fee, report-writing that used to be treated as a courtesy, telehealth sessions still invoiced under the old undifferentiated item — none of that is technically wrong in the sense of overcharging. It's the opposite problem. It's revenue the schedule now explicitly allows for, going unclaimed.
It also changes how a practice should be quoting new service agreements. If your standard client-facing rate card still shows one all-in figure per service type, it's now out of step with how the NDIA itself expects the work to be priced and claimed. New participant agreements drafted this quarter should reference the current line-item structure directly — partly so families aren't surprised by a travel or report-writing charge they didn't expect, and partly so the practice's own books reconcile cleanly against what NDIA systems are set up to pay against.
Take a mid-sized allied health practice running a handful of dietitians and exercise physiologists doing home and community visits. Say each practitioner does around 15 home visits a week, averaging 30 minutes' travel each way, and that travel has historically been folded into the consult price because that's how the old schedule worked and nobody updated the invoicing template. Under the new schedule, that travel is separately claimable — for a small team, the unclaimed travel component alone can run into four figures a week. Report-writing time for NDIA-requested reports is a smaller line item individually, but across a caseload it adds up the same way. None of it shows up as a problem until someone actually reconciles appointment notes against what was invoiced.
Where Providers Are Most Likely Under-Billing
In practice, the gaps tend to cluster in the same few places:
- Provider travel logged in the appointment note or practitioner diary, but never invoiced as its own _PT item — often because the old rate card had no field for it.
- Time spent preparing NDIA-requested reports treated as unbilled admin rather than claimed under the new _RR line item, particularly for longer functional capacity reports.
- Telehealth sessions still billed under the old generic code instead of the _TH suffix, which can create a mismatch if a claim is ever reviewed against session notes.
- Cancellations invoiced at the full direct service rate instead of the specific _CA item, which understates the record of what was actually delivered and can misstate both revenue and compliance history.
A Practical AI-Assisted Billing Check
This is a reconciliation problem, and reconciliation problems are exactly what AI tools are good at when they're pointed at the right data. The idea is straightforward: take your appointment records — visit notes, travel logs, telehealth flags, report-writing time — and check them against what was actually invoiced under the current schedule's line items, rather than against last year's invoice template. Done properly, this surfaces the gaps in minutes instead of a full billing audit.
We're exploring something similar internally at PFL for clients dealing with exactly this kind of multi-line-item reconciliation. It's early days — not ready to talk about in detail yet — but the underlying principle holds regardless of which tool does the matching: your source of truth has to be the current pricing schedule, not the invoice template you built two years ago.
A sensible first pass doesn't need to cover every appointment ever billed. Start with the last four weeks since the schedule changed, since that's where any gap has had the least time to compound and is easiest to correct through a supplementary claim. From there, most practices find it's worth setting a standing monthly check rather than a one-off clean-up — the schedule itself is reviewed annually, and the line-item structure is clearly here to stay even if individual rates move again next year.
What To Check Before Your Next Billing Run
- Confirm your practice management software's item catalogue has actually been updated to the 2026-27 codes, not just the headline rates.
- Spot-check a week of appointments against invoices to see whether travel and report-writing time are being captured at all.
- Check telehealth sessions are landing under the _TH suffix, not the old undifferentiated code.
- Review how cancellations are coded — this affects both revenue and your audit trail if NDIA reviews a claim.
Not sure your billing has caught up with the new schedule?
PFL provides senior-level outsourced finance, management reporting, and AI automation for Australian NFP, NDIS, and SME organisations — including reconciling billing against pricing schedule changes like this one.
Talk to PFL →
Comments
Post a Comment