NDIS Provider Pricing and Claims Update 2025–26: and NDIA Payment hold implications

This Forum provides a concise, practical update on NDIS funding changes effective 1 July 2025, designed to keep providers informed and compliant. Attendees will learn about the Annual Pricing Review, the removal of therapy supports from Core, and updated travel claim rules for therapy providers.

NDIS Pricing and Claims Update 2025–26: Navigating New Rules for Sustainable Service Delivery

The session will cover:

•    Annual Pricing Review 2025–26 – updated pricing arrangements and limits.
•    Disability-Related Health Supports (DRHS) – claiming therapy supports under Capacity Building only.
•    NDIS Travel Claim Rules – correctly claiming travel time and associated costs.

•    Practical implications for providers – invoicing, planning, and budgeting for participant supports.

Attendees will gain the knowledge needed to navigate new funding rules, avoid claim rejections, and plan sustainable service delivery under the updated NDIS framework.

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NDIA Payment Holds and Provider Compliance : 
As NDIS/ SIL providers strive to maintain high-quality care for participants, navigating the evolving compliance landscape becomes an increasingly complex challenge.

Recent Federal Court rulings have reinforced the NDIA’s authority to impose payment holds, highlighting the need for strict adherence to the NDIS Act and accurate record-keeping. However, cases such as Affinity Care Services Pty Ltd v NDIA and Northern Disability Services Pty Ltd v NDIA also bring to light concerns about procedural fairness, delayed payments, and the financial pressures they impose on providers.

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With over 1,000 active payment holds disrupting vital services, providers face significant financial risks, which in turn affect their ability to deliver the best care for participants.

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This session will address:

• How NDIA payment holds impact NDIS / SIL business operations and financial sustainability.

• The challenges of balancing compliance with the financial realities of running a business while prioritising participant care.

• Approaches to challenging unreasonable NDIA decisions without compromising the quality of care provided to participants.

​​By the end of this session, attendees will understand how NDIA payment holds impact NDIS and SIL provider operations, financial sustainability, and service delivery.

 They will gain insight into the legal and regulatory framework governing payment holds, learn strategies to maintain compliance while managing financial and operational risks, and explore practical approaches to challenge or respond to NDIA decisions without compromising participant care

​​Who should attend? 

​This session is ideal for:

• NDIS providers (including SIL providers)

• Therapy providers and allied health professionals

• Support coordinators and plan managers

• Finance and compliance officers in disability services

• Organisations managing participant supports under the NDIS

• Any stakeholder responsible for service delivery, invoicing, or compliance under the NDIS framework

​Attendees will gain the knowledge and strategies needed to navigate funding updates, understand regulatory compliance, and manage NDIA payment holds while maintaining high-quality services.

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