Frequently Asked Questions
Understanding the NDIS
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The National Disability Insurance Scheme (NDIS) provides funding to eligible people with disability to access reasonable and necessary supports that help them pursue their goals, increase independence and participate in everyday life.
NDIS funding may assist participants to build skills, engage with their community, increase social and economic participation, and improve their quality of life.
The NDIS can also provide information and connections to community, mainstream and government services that may support people with disability, their families and carers.
For more information about the NDIS and eligibility requirements, visit the NDIS website.
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The NDIS provides funding for eligible participants to access supports and services that help them pursue their goals, increase independence and participate in everyday life.
NDIS funding may support areas such as:
daily living and independence
social and community participation
employment and training
assistive technology
therapies and capacity building supports
health and wellbeing supports that are directly related to a participant's disability and meet NDIS requirements
When developing a participant's plan, the NDIS considers whether supports meet the legislative requirements for NDIS funding.
In general, funded supports should:
be related to the participant's disability
help the participant pursue their goals and increase independence
represent value for money
be likely to be effective and beneficial
not be more appropriately funded by another service system
The NDIS also considers other supports available to the participant, including family, carers, community supports and mainstream services.
Only the NDIS can determine what funding is included in a participant's plan. Plan Managers process claims in accordance with the participant's approved plan and applicable NDIS requirements.
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The NDIS is not designed to fund supports that are more appropriately funded or provided by the health system.
Assessment, diagnosis and treatment of health conditions, along with medications and hospital care, generally remain the responsibility of the health system.
As a general guide, the following health-related services and supports are usually not funded through the NDIS:
Items and services covered by the Medicare Benefits Schedule (MBS) or Pharmaceutical Benefits Scheme (PBS), including Medicare gap fees.
Medical diagnosis, treatment and clinical care provided by doctors, medical specialists and hospitals.
Assessments, services and treatments provided as part of diagnosing, treating or managing a health condition.
Ongoing treatment and management of chronic health conditions.
Medically prescribed treatment, surgery and care for an acute illness or injury, including post-acute care, convalescent care and rehabilitation.
Sub-acute care, including palliative care, end-of-life care and geriatric care.
In general, the NDIS does not fund supports that are the responsibility of the Australian health system.
However, some disability-related health supports may be funded by the NDIS where they are directly related to a participant's disability, meet NDIS funding requirements and are not more appropriately funded by another service system.
For more information, refer to the NDIS Disability-Related Health Supports Operational Guideline and the NDIS website.
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Your NDIS plan may include funding across three main budget types:
Core Supports
Core Supports help with everyday activities, disability-related needs and working towards your goals.
Examples may include:
assistance with daily living
community participation
consumables
transport supports
Core funding is generally the most flexible budget in an NDIS plan, although some supports (such as transport funding) may have specific rules.
Capacity Building Supports
Capacity Building Supports help you build skills, independence and confidence to achieve your goals.
Examples may include:
Support Coordination
Improved Daily Living (therapy and assessments)
Employment Supports
Improved Relationships
Improved Health and Wellbeing
Improved Life Choices (Plan Management)
Capacity Building funding is generally allocated to specific support categories and cannot usually be moved between categories.
Capital Supports
Capital Supports fund higher-cost items and modifications that help meet a participant's disability-related needs.
Examples may include:
Assistive Technology
Home Modifications
Specialist Disability Accommodation (where approved)
Capital funding can only be used for the specific supports approved in your plan.
What Are Stated Supports?
Stated supports are specific supports identified in your NDIS plan. Funding allocated to a stated support can only be used for that support and cannot be used for something else.
What Are In-Kind Supports?
In-kind supports are services that have already been funded by a government program or arrangement. These supports are delivered by the nominated provider and are not paid for using your NDIS funding.
What Does "Quote Required" Mean?
Some supports require additional information, such as quotes or specialist reports, before funding can be approved or released by the NDIS.
If you are unsure how your funding can be used, contact your NDIS Planner or refer to your NDIS plan for further information.
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Generally, no.
The NDIS is designed to fund disability-related supports that help participants pursue their goals, increase independence, and participate in everyday life. It does not usually pay for everyday living expenses that everyone is expected to pay, whether they have a disability or not.
Examples of everyday living costs that are generally not funded by the NDIS include:
Groceries and everyday food items
Rent, mortgage repayments, and household bills
Electricity, gas and water costs
Internet and phone plans
Standard household items and appliances, such as fridges, washing machines, dishwashers, furniture and kitchen utensils
In some circumstances, the NDIS may fund a disability-related support, modification, or specialised item that helps address a participant's disability support needs. However, standard everyday living costs are generally not considered NDIS supports.
If you're unsure whether an item or service can be funded through your NDIS plan, speak with your Plan Manager, Support Coordinator, or NDIS Planner before making a purchase.
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Reasonable and necessary supports are the disability-related supports that the NDIS can fund to help you pursue your goals, increase your independence, and participate in everyday life.
When deciding whether a support can be funded, the NDIS considers whether it:
Is related to your disability support needs
Helps you pursue the goals in your NDIS plan
Is likely to be effective and beneficial for you
Represents value for money compared to alternative supports
Is legal and safe to use
Is not more appropriately funded by another service system, such as health, education, housing or employment services
The NDIS generally does not fund supports that are everyday living expenses, unrelated to a participant’s disability, or the responsibility of another government service.
Because every participant’s circumstances are different, a support that may be funded for one person may not be funded for another.
If you're unsure whether a support is likely to meet the NDIS funding criteria, speak with your Plan Manager, Support Coordinator, or NDIS Planner before making a purchase.
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Replacement supports are certain everyday items that the NDIS may approve to replace an existing NDIS-funded support in your plan.
A replacement support is not extra funding. Instead, it replaces an existing NDIS support and must:
Replace a support that is already funded in your NDIS plan
Help you achieve the same or better outcome as the support it replaces
Cost the same or less than the support it replaces
Meet your disability support needs
Currently, replacement supports are limited to specific items approved by the NDIS, including:
Standard household items, such as a washing machine or dishwasher
Smartphones
Tablets
Smart watches
Accessibility or communication apps
It's important to know that these items are not automatically funded. You must receive NDIS approval before they can be used as a replacement support.
If you're considering a replacement support, speak with your NDIS Planner to discuss whether you're eligible and what approval process applies. Plan Managers cannot approve replacement supports or make changes to your NDIS plan.
Plan Management
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Plan Management is a type of NDIS-funded support that assists participants with the financial administration of their NDIS funding.
A Plan Manager helps process provider invoices, make payments on behalf of participants, monitor budgets and provide information about funding utilisation.
Participants who choose Plan Management can generally use both registered and unregistered providers, giving them greater flexibility and choice when accessing supports.
Plan Managers process claims in accordance with the participant's NDIS plan and applicable NDIS requirements.
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A Plan Manager helps with the financial administration of your NDIS funding.
This includes:
processing provider invoices and payments
providing budget reports and funding updates
helping you track your NDIS spending
monitoring available funding
assisting with claims processing in line with NDIS requirements
A Plan Manager can help you understand how your funding is being used, but they do not:
decide which supports you can access
approve supports on behalf of the NDIS
determine whether a support is reasonable and necessary
approve additional funding
These decisions are made by the NDIS.
Plan Managers process claims in accordance with your NDIS plan, available funding and applicable NDIS requirements.
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No.
Funding for Plan Management is included separately in your NDIS plan and does not reduce the funding available for your approved supports and services.
If Plan Management is included in your plan, the NDIS provides additional funding to cover the cost of your Plan Manager.
This means you can receive Plan Management services without using your Core, Capacity Building or Capital support budgets.
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To use Plan Management, your NDIS plan must include funding for Improved Life Choices (Plan Management).
When discussing your plan with the NDIS, you can tell your NDIS planner or representative that you would like Plan Management included as your preferred plan management option.
If you already have an NDIS plan and would like to change to Plan Management, you can contact the NDIA on 1800 800 110 to discuss your options.
Funding for Plan Management is generally provided separately to your other support budgets and does not reduce the funding available for your approved supports.
For more information about Plan Management options, visit the NDIS website or contact the NDIA.
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We aim to process invoices as quickly as possible once we receive them.
In most cases, correctly submitted invoices are processed within 2–5 business days. However, processing times may vary depending on invoice volume and whether additional information is required.
To avoid delays, invoices should include:
The participant's name
The provider's details
The date(s) of service
A clear description of the support provided
The correct NDIS support item (where applicable)
The invoice amount and payment details
Sometimes an invoice may be placed on hold if information is missing or if we need to verify that the support aligns with NDIS requirements and the participant's available funding.
If your invoice has been delayed, please contact our team and we'll be happy to provide an update.
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If an invoice has been placed on hold, it doesn't necessarily mean there's a problem. Sometimes we simply need more information before we can process the payment.
Common reasons an invoice may be placed on hold include:
Missing information, such as service dates, provider details, or payment information
An unclear description of the support provided
Pricing that appears inconsistent with NDIS pricing arrangements or the agreed service rates
Insufficient funding available in the relevant budget category
A need to confirm that the support is related to the participant's NDIS plan and funding
If we need additional information, we'll contact the provider or participant as soon as possible to help resolve the issue.
Our role as a Plan Manager is to ensure invoices meet NDIS requirements and can be processed correctly. Placing an invoice on hold is a standard part of that process and helps avoid payment errors or delays later on.
If you have questions about a specific invoice, please contact our team and we'll be happy to explain the next steps.
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No.
Plan Managers cannot approve supports, add funding to a plan, or decide whether a new item or service can be funded by the NDIS.
A Plan Manager's role is to process payments, manage your NDIS funding, and help ensure invoices comply with NDIS requirements. Plan Managers must follow the funding and support decisions already included in your NDIS plan.
Only the NDIA can determine what supports are funded under your plan. If you're unsure whether a new support, service, or item can be funded, you should contact your NDIS Planner for advice.
If a support isn't clearly included in your plan or listed in the NDIS guidelines, we may need to place the invoice on hold while further information is obtained.
If you believe you need additional supports or funding, the best next step is to contact your NDIS Planner to discuss your options, including whether a plan reassessment or plan change may be appropriate.
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Generally, no.
The NDIS has specific rules about funding periods. Supports must be paid from the funding period in which they were delivered. Funding from a later period cannot be used to pay for supports delivered in an earlier period.
For example, if a support was provided during a funding period that has already been fully used, a Plan Manager cannot use funding from a future funding period to pay that invoice, even if there is funding available later in the plan.
This isn't a discretionary decision. Plan Managers are required to follow NDIS funding rules and cannot move funding between funding periods or approve exceptions.
If an invoice cannot be paid because the relevant funding period has been exhausted, the participant should contact their NDIS Planner to discuss their circumstances and whether any changes to their plan may be required.
If you're unsure which funding period applies to a particular service, please contact our team and we'll be happy to help explain your available funding and payment options.
My NDIS Plan
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Your NDIS plan may include funding across three main budget types:
Core Supports
Core Supports help with everyday activities, disability-related needs and working towards your goals.
Examples may include:
assistance with daily living
community participation
consumables
transport supports
Core funding is generally the most flexible budget in an NDIS plan, although some supports (such as transport funding) may have specific rules.
Capacity Building Supports
Capacity Building Supports help you build skills, independence and confidence to achieve your goals.
Examples may include:
Support Coordination
Improved Daily Living (therapy and assessments)
Employment Supports
Improved Relationships
Improved Health and Wellbeing
Improved Life Choices (Plan Management)
Capacity Building funding is generally allocated to specific support categories and cannot usually be moved between categories.
Capital Supports
Capital Supports fund higher-cost items and modifications that help meet a participant's disability-related needs.
Examples may include:
Assistive Technology
Home Modifications
Specialist Disability Accommodation (where approved)
Capital funding can only be used for the specific supports approved in your plan.
What Are Stated Supports?
Stated supports are specific supports identified in your NDIS plan. Funding allocated to a stated support can only be used for that support and cannot be used for something else.
What Are In-Kind Supports?
In-kind supports are services that have already been funded by a government program or arrangement. These supports are delivered by the nominated provider and are not paid for using your NDIS funding.
What Does "Quote Required" Mean?
Some supports require additional information, such as quotes or specialist reports, before funding can be approved or released by the NDIS.
If you are unsure how your funding can be used, contact your NDIS Planner or refer to your NDIS plan for further information.
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Some NDIS plans include funding periods. A funding period is the amount of funding available to use during a set period of time, such as one, three, six or twelve months.
Funding periods help make sure funding is available throughout the life of your plan and reduce the risk of funding being used too quickly.
Do Funding Periods Change My Total Funding?
No. Funding periods do not change the total funding in your NDIS plan.
They simply determine when portions of your funding become available.
What Happens to Unused Funding?
Unused funding will generally roll over to the next funding period within the same plan.
Can I Use Funding From a Future Funding Period?
Generally, no.
Funding from future funding periods is not usually available before it is released. In some circumstances, the NDIA may decide to bring funding forward, but only the NDIA can make this decision.
What Happens If There Is Not Enough Funding Available?
Supports can only be paid from the funding available in the relevant funding period.
If funding is exhausted for a funding period, funding from a future funding period cannot generally be used to pay for supports that have already been delivered.
If your support needs or circumstances change, you should contact the NDIS as soon as possible to discuss your options.
How Do Funding Periods Affect Plan-Managed Participants?
Your Plan Manager can help you understand your available funding and provide budget reports showing:
available funding
funding already used
upcoming funding releases
spending trends
Plan Managers must process claims in accordance with your NDIS plan, available funding and funding periods.
Where Can I View My Funding Periods?
Funding period information can usually be viewed in:
your NDIS plan
the my NDIS app
the participant portal
If your plan is managed by First Avenue Plan Management, we can also help you understand your available funding and funding periods.
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You can usually access and download a copy of your current NDIS plan through your my NDIS account linked to myGov.
Sign in to your myGov account and access your NDIS account.
If you are a nominee, select the participant you are acting for.
Open the participant's current NDIS plan.
Check that you have selected the correct plan if multiple plans are available.
Locate the option to view, download or print the plan.
Save or print a copy of the plan for your records.
Please note that portal layouts, menu names and navigation options may change from time to time as the NDIS updates its online systems.
If you are unable to access your plan online, contact the NDIS on 1800 800 110 or visit the NDIS website for assistance.
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A stated support is a support that has been specifically approved by the NDIS for a particular purpose and can only be used for that purpose.
Unlike flexible funding, stated supports cannot be moved to a different support category or used for a different service, even if there is funding available.
For example, if your plan includes funding for a specific assistive technology item, home modification, or other stated support, that funding must be used for the support identified in your plan.
Flexible funding works differently. Flexible budgets allow you to choose from a range of supports within the relevant support category, provided they meet NDIS requirements and are related to your disability support needs.
If you're unsure whether a support in your plan is stated or flexible, your Plan Manager can help you understand how your funding has been allocated. However, Plan Managers cannot change stated supports or move funding between support categories.
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Sometimes, but not always.
Whether you can move funding between categories depends on how your NDIS plan has been set up.
Many Core supports are flexible, which means funding can often be used across different Core support categories if the support is related to your disability support needs and meets NDIS requirements.
However, some funding is restricted and cannot be moved. This may include:
Stated supports
Capital supports, such as Assistive Technology or Home Modifications
Certain Capacity Building budgets
Supports that have been specifically allocated for a particular purpose
Because every NDIS plan is different, it's important to check your plan before making any changes to how funding is used.
Your Plan Manager can help you understand which parts of your funding are flexible and which are not. However, Plan Managers cannot move restricted funding or change the way funding has been allocated in your plan.
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If your available funding has been fully used, we won't be able to process any further invoices from that budget category until additional funding becomes available.
The NDIS can only pay for supports when there is sufficient funding available in the relevant budget and funding period. Once funding has been exhausted, Plan Managers cannot approve extra funding, move restricted funding from another category, or pay invoices using future funding.
If you're concerned that your funding may not last for the full duration of your plan, it's important to review your budget as early as possible. This may help you make informed decisions about how your remaining funding is used.
If your funding has already run out, the best next step is to contact your NDIS Planner to discuss your circumstances and whether a plan reassessment or plan change may be appropriate.
Providers
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A service provider is a person, business or organisation that delivers supports and services to NDIS participants.
Service providers can help with a wide range of supports, including:
personal care and daily living assistance
community participation
therapy supports
cleaning and household tasks
assistive technology and equipment
support coordination
Service providers may be registered or unregistered with the NDIS, depending on the supports they provide and how your NDIS funding is managed.
Choosing the right provider is important. You should consider whether the provider's services, experience and approach are a good fit for your individual needs and goals.
If your plan is managed by First Avenue Plan Management, you can generally choose from both registered and unregistered providers.
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The amount an NDIS provider can charge depends on the type of support being provided, how your plan is managed, and whether NDIS price limits apply.
The NDIS sets maximum price limits for many supports through its Pricing Arrangements and Price Limits. These limits help ensure participants receive value for money and are protected from excessive charges.
For Plan-managed pricing may be negotiated with the provider. However, participants should make sure they understand any fees or charges before agreeing to services.
Before engaging a provider, it's a good idea to:
Ask for a copy of their rates and fees
Review any Service Agreement carefully
Understand any cancellation charges that may apply
Check whether there will be any out-of-pocket costs
If you're unsure about a provider's pricing, your Plan Manager can help you understand how the charges may affect your available funding. However, Plan Managers cannot set provider prices or approve charges that don't comply with NDIS requirements.
We recommend discussing pricing with your provider before services begin so there are no unexpected costs later.
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The NDIS sets pricing rules for many supports through its Pricing Arrangements and Price Limits. These rules help ensure participants receive value for money and provide consistency across the NDIS.
For many supports, the NDIS publishes a maximum price that providers can charge. These price limits may vary depending on factors such as:
The type of support being provided
The day and time the support is delivered
Whether the support is provided in a regional, remote, or very remote area
Whether additional claiming rules apply, such as travel or cancellation charges
Not all supports have a set price limit. Some supports may be quoted or negotiated directly between the participant and provider.
Plan-managed participants may have more flexibility in provider choice and pricing arrangements.
Before starting services, it's important to understand your provider's rates, any additional charges that may apply, and the terms of your Service Agreement.
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Yes.
If your NDIS plan includes Plan Management, you can generally choose to use both registered and unregistered providers for most supports. This gives you greater flexibility and choice when selecting the providers that best meet your needs.
Registered providers are approved by the NDIS Quality and Safeguards Commission and must meet specific quality and safety requirements. Unregistered providers can also deliver NDIS supports, provided the supports are consistent with your NDIS plan and applicable NDIS requirements.
Before engaging a provider, it is important to discuss the services they offer, their fees and any service agreements so you understand what to expect.
If you are unsure whether a support or provider can be claimed from your NDIS funding, please contact your Plan Manager for guidance.
Rights & Responsibilities
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If you're unhappy with a service you've received, the first step is usually to raise your concerns directly with the provider. Many issues can be resolved quickly through the provider's complaints process.
If you're not satisfied with the outcome, or you don't feel comfortable raising the issue with the provider, you can make a complaint to the NDIS Quality and Safeguards Commission.
The NDIS Commission is the independent regulator responsible for overseeing the quality and safety of NDIS supports and services. They can assist with complaints about:
The quality or safety of supports and services
Provider conduct and behaviour
Abuse, neglect, exploitation or misconduct
Restrictive practices
Breaches of the NDIS Code of Conduct
You can contact the NDIS Commission directly through their website at www.ndiscommission.gov.au or by calling 1800 035 544.
If your concern relates to an invoice, payment, or funding query, please contact your Plan Manager first. We'll do our best to help explain the issue and guide you to the appropriate next steps.
Everyone has the right to raise concerns or make a complaint without fear of being treated unfairly.
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A Service Agreement is a written agreement between you and your provider that outlines the supports and services you will receive.
It helps make sure everyone understands what has been agreed, including:
The supports that will be provided
How much the supports will cost
How and when services will be delivered
Cancellation and notice requirements
How invoices and payments will be handled
What to do if you have a concern or complaint
How either party can end the agreement
A Service Agreement is an important document because it helps protect both participants and providers by clearly setting expectations from the start.
Before signing a Service Agreement, make sure you:
Read it carefully
Ask questions if anything is unclear
Understand any fees, charges, or cancellation terms
Keep a copy for your records
You have the right to choose your providers and make informed decisions about the supports you receive.
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The NDIS Worker Screening Check is a background screening process used to help protect people with disability and promote the safe delivery of NDIS supports and services.
The check assesses whether a person who works, or seeks to work, with people with disability may pose a risk to NDIS participants.
Registered NDIS providers are generally required to ensure that workers in certain risk-assessed roles hold a valid NDIS Worker Screening Clearance.
Some unregistered providers and workers supporting self-managed participants may also choose to obtain an NDIS Worker Screening Clearance, even where it is not required.
Worker Screening requirements can vary depending on the type of support being provided and the state or territory where services are delivered.
For the most up-to-date information about Worker Screening requirements, visit the NDIS Quality and Safeguards Commission website.
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These three organisations have different roles within the disability sector:
NDIS (National Disability Insurance Scheme)
The NDIS is Australia's national disability support scheme. It provides funding to eligible people with disability to access supports and services that help them achieve their goals, increase independence and participate in everyday life.
NDIA (National Disability Insurance Agency)
The NDIA is the Australian Government agency responsible for delivering the NDIS.
The NDIA:
assesses eligibility for the NDIS
develops and manages participant plans and funding
provides information about the NDIS
manages payments for Agency-managed participants
NDIS Quality and Safeguards Commission
The NDIS Quality and Safeguards Commission is the independent regulator of NDIS services.
The NDIS Commission:
handles complaints about NDIS providers and services
regulates registered NDIS providers
oversees the NDIS Code of Conduct
monitors worker screening and restrictive practice requirements
investigates serious incidents and compliance concerns
In simple terms:
The NDIS provides the funding.
The NDIA administers and delivers the NDIS.
The NDIS Commission regulates provider quality and safety.
For more information, visit the NDIS website or the NDIS Quality and Safeguards Commission website.
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Each role helps participants in different ways.
Plan Manager
A Plan Manager helps with the financial administration of your NDIS funding.
A Plan Manager can:
process and pay provider invoices
provide budget reports and funding updates
help you monitor your NDIS spending
assist with claims processing in line with NDIS requirements
A Plan Manager does not approve supports, change funding or make decisions on behalf of the NDIS.
Support Coordinator
A Support Coordinator helps you understand and implement your NDIS plan.
A Support Coordinator can:
help you find and connect with providers
coordinate your supports and services
help you build skills and confidence to manage your supports
assist you to work towards your NDIS goals
Support Coordination is only available if it has been included in your NDIS plan.
NDIS Planner
An NDIS Planner is a representative of the NDIA who helps develop and review NDIS plans.
An NDIS Planner can:
assess support needs
approve funding and plan changes
make decisions about what supports are included in a plan
review participant circumstances and goals
Only the NDIS can approve funding, add new supports or make changes to a participant's plan.
Local Area Coordinator (LAC)
A Local Area Coordinator (LAC) helps people understand and access the NDIS and connect with community supports.
A LAC can:
help people apply for the NDIS
provide information about the NDIS
assist participants to understand their plan
connect participants with community and mainstream services
A LAC cannot approve funding, add supports to a plan or make decisions about what the NDIS will fund.
In Simple Terms
Plan Manager = Helps manage your NDIS funding and pay invoices.
Support Coordinator = Helps you use and coordinate your supports.
NDIS Planner = Makes decisions about your NDIS plan and funding.
Local Area Coordinator (LAC) = Helps you understand the NDIS and connect with services.
If you're unsure who to contact, your Plan Manager can help point you in the right direction.
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The NDIS Code of Conduct sets the standards of behaviour expected of NDIS providers and workers when delivering supports and services to participants.
The Code is designed to help ensure that NDIS participants are treated with respect, dignity and care.
Providers and workers are expected to:
act with respect for individual rights, freedom of expression and self-determination
provide supports and services safely and competently
act with honesty, integrity and transparency
respect participant privacy and confidentiality
take steps to prevent and respond to violence, abuse, neglect, exploitation and discrimination
The NDIS Quality and Safeguards Commission is responsible for overseeing the NDIS Code of Conduct and investigating complaints or concerns about provider conduct.
If you have concerns about the behaviour of an NDIS provider or worker, you can contact the NDIS Quality and Safeguards Commission for information and assistance.
For more information, visit the NDIS Quality and Safeguards Commission website.
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When you purchase goods or services, including disability-related supports, you have rights under Australian Consumer Law.
This means you have the right to:
receive services that are delivered with due care and skill
receive services that are fit for their intended purpose
receive products that are safe, of acceptable quality and match their description
be treated fairly by businesses and service providers
ask for a repair, replacement or refund in certain circumstances
If you have concerns about a product or service, you should first try to resolve the issue directly with the provider.
The Australian Competition and Consumer Commission (ACCC) provides information about consumer rights and where to get help if a problem cannot be resolved.
For more information, visit the ACCC website.