S7E02 - What’s Changing Now: NDIS Therapy and Respite Updates Explained

Recent NDIS updates are reshaping how therapy supports and respite services are delivered and justified. Two new documents – the Therapy Support Guideline and the Short-Term Respite Guideline – mark a significant shift in expectations for evidence-based practice, outcome measurement and funding accountability.

For OTs, these changes mean reviewing how group programs, therapy assistant hours and respite recommendations are structured, documented and billed. While the intent is greater consistency and transparency, the practical implications will be felt across paediatric, community and functional assessment work.

New expectations for evidence-based therapy

The Therapy Support Guideline places strong emphasis on therapy being explicitly evidence based, outcome driven and capacity building in nature. It also highlights that therapy must demonstrate measurable improvement in functional capacity, not simply maintenance or general participation.

For many OTs, particularly those in paediatrics, this signals a need to clearly link every intervention to research evidence or documented clinical reasoning. Interventions such as Lego-based social skills groups or animal-assisted therapy can still be justified, but only when delivered as occupational therapy interventions supported by measurable outcomes.

Clinicians running group programs will now need to show the functional gains achieved during participation, gather baseline data before and after sessions and demonstrate how the group supports capacity building rather than maintenance. This represents a move away from broad social or recreational groups toward structured, evidence-backed interventions.

Clarifying qualifications and the role of therapy assistants

The guideline also tightens requirements around professional qualifications. For example, speech pathologists must be certified practicing members of Speech Pathology Australia to provide NDIS-funded therapy. Similar expectations apply across all allied health disciplines, reinforcing that services must be delivered by appropriately accredited practitioners.

It also clarifies how therapy assistants can be used. While assistants remain an important part of therapy delivery, OTs cannot bill for student-led sessions or any time when the supervising clinician is not present. However, supervision time within the participant’s session can still be billed if the OT is directing the work in real time.

These updates underline the NDIA’s focus on value for money and accountability, ensuring that therapy hours funded under plans directly reflect qualified professional input.

Group programs and reporting requirements

Group-based interventions remain permissible but must now show clear evidence of effectiveness and link to functional outcomes. Invoices and program descriptions should reflect that the service is an occupational therapy group, not a “social skills” or “Lego group”, as these labels risk being flagged for non-compliance.

Clinicians are advised to document outcomes in progress reports that are concise but evidence informed. The NDIA’s new reporting preference is for short, factual summaries that show where the participant started, what interventions were delivered, what measurable change was achieved and what recommendations follow.

This shift will require services to collect clearer baseline data, reference clinical evidence where relevant and maintain defensible reasoning behind every intervention.

Capacity building versus maintenance therapy

The distinction between capacity building and maintenance therapy has reappeared after several years of absence from NDIS language. OTs are now expected to define which type of therapy is being delivered, how long it will be required and what measurable change is anticipated.

While maintenance therapy remains fundable in certain contexts, it will require robust justification and alignment with the participant’s goals. Progress reports will need to demonstrate that services c