S09E10 - NDIS Price Guide - What OTs really need to know

What Occupational Therapists Need to Know About the 2026–27 NDIS Pricing Update

The 2026–27 NDIS Pricing Schedule and Annual Pricing Review have now been released.

For Occupational Therapists, the immediate headline is relatively positive. OT rates remain unchanged, avoiding the cuts seen across several other allied health professions.

However, while pricing may appear stable on the surface, the update raises important questions around billing, travel and the long-term sustainability of OT services.

OT pricing remains unchanged

The maximum hourly rate for Occupational Therapists remains unchanged at $193.99 per hour, with provider travel remaining at $97 per hour.

Given concerns about possible pricing cuts, many OT providers will see this as a positive outcome. While there has been no increase to reflect rising wages and operating costs, there has also been no reduction.

For many practices, this was likely the best realistic outcome.

The biggest issue is missing guidance

The biggest challenge is not the pricing itself, but the lack of guidance.

Unlike previous years, the Pricing Schedule currently provides rates and line items without the detailed billing guidance providers usually rely on.

This means there is still uncertainty around travel claiming rules, billing caps, support definitions and claiming requirements.

Right now, OTs know the rates, but not exactly how some of those supports can be claimed in practice.

Travel remains unclear

Travel is one of the biggest unresolved issues.

Although provider travel remains listed at $97 per hour, there is no clear guidance confirming whether existing travel caps still apply.

There is still uncertainty around whether the 30-minute metro cap remains, whether the 60-minute regional cap still applies, or whether travel rules have changed more broadly.

This is particularly important for mobile OT services and regional providers.

New billing line items mean immediate updates

One of the biggest practical changes is the introduction of new billing line items.

The updated structure separates direct service, cancellation, non-face-to-face work, provider travel, telehealth and NDIA requested reports into separate billing categories.

This creates greater billing clarity, but also means many practices will need to urgently update billing systems, CRMs, invoicing templates and internal workflows.

Non-face-to-face billing is becoming clearer

One positive change is the clearer distinction between standard non-face-to-face work and NDIA requested reports.

General non-face-to-face tasks appear to include preparation, documentation, case notes and standard reporting such as functional capacity assessments.

NDIA requested reports generally refer to reports used to support funding decisions, such as assistive technology, home modifications and home and living reports.

This distinction will be important for compliant billing moving forward.

Pricing decisions are shifting

One of the most important long-term changes is how future pricing decisions are being made.

This year, the NDIA used more than 16 million therapy transactions to benchmark therapy pricing against Medicare, private health and comparable government schemes.

This reflects a clear shift toward external market benchmarking and less emphasis on provider operating realities such as wage pressures, overheads and workforce challenges.

This has significant implications for private OT practice sustainability.

Demand is rising while providers are falling

Another major theme is the changing therapy market.

Therapy supports now account for approximately 10% of total NDIS expenditure, while demand for therapy continues to grow.

At the same time, active therapy providers have declined by 3.9%, with unregistered provider numbers declining by 4.9%.

Demand is rising while provider numbers are shrinking, increasing pressure on service access, waitlists and workforce sustainability.

What this means for Occupational Ther