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Ensuring sustainable NDIS pricing for physiotherapists

 

Ensuring sustainable NDIS pricing for physiotherapists

The Australian Physiotherapy Association (APA) is advocating for a transparent, evidence-based approach to NDIS pricing that reflects the real cost of delivering physiotherapy services and supports ongoing participant access to care.

Since the 2025 NDIS pricing changes, the APA has worked closely with members, government and the National Disability Insurance Agency (NDIA) to highlight the impact of pricing decisions on physiotherapy providers and the people who rely on their services.

This page provides the latest information on NDIS pricing developments, the APA's response to the 2026–27 Annual Pricing Review, and the independent evidence informing our advocacy, including the Nous Group review of physiotherapy pricing.

The APA will continue to advocate for pricing decisions that are informed by robust data, reflect the realities of physiotherapy service delivery and support the long-term sustainability of the NDIS market.

NDIS Annual Pricing Review 2026–27

Physiotherapy price limits remain frozen following 2025 cuts

The NDIA’s Annual Pricing Review for the 2026/27 financial year maintained the maximum hourly price limit for physiotherapy supports at $183.99. This decision follows a reduction of $10 per hour in 2025 and comes after 5 years of frozen pricing that has failed to keep pace with rising operational costs, workforce pressure and service complexity.

In the APA’s formal submission to the National Disability Insurance Agency’s 2025–26 Annual Pricing Review consultation, the APA highlighted the structural flaws in the current NDIS pricing method that fail to reflect the true cost and professional demands of service delivery within the Scheme. The submission was informed by the independent Nous Group review and the lived experiences of APA members providing NDIS supports across diverse settings.

The Nous review provided robust independent economic evidence demonstrating a significant gap between the current physiotherapy price limit and sustainable market rates. However, subsequent pricing decisions have not addressed these findings or reflected the real cost of delivering physiotherapy supports.

The current review reinforces this position. The NDIA’s own analysis identifies sensitivities in its benchmarking approach, but these are not reflected in the final pricing outcome and are instead deferred for further analysis, despite the absence of a clear, evidence‑based cost foundation, while current pricing settings are maintained.

While the APA has consistently engaged with the NDIA across successive pricing reviews, there remains a clear gap between the evidence and market intelligence provided by the profession and the outcomes reflected in pricing decisions.

This risks undermining provider sustainability, limiting participant access to physiotherapy services and weakening the long-term effectiveness of the Scheme.

New claiming arrangements from 1 July 2026

One of the most significant changes arising from the APR is a restructure of therapy claiming arrangements. From 1 July 2026, separate NDIS line items will apply for:

  • Direct service delivery 
  • Travel Cancellation charges 
  • Non-face-to-face time, including preparation, documentation and NDIS-requested reporting.

The NDIA has stated that the new structure is intended to improve transparency and consistency in claiming practices across the scheme.

The APA will closely monitor the implementation of these arrangements and their potential implications for future pricing reviews and policy development. As more data becomes available through the application of itemised claiming, it will be important to understand how this information is used to inform future decisions affecting physiotherapy services within the NDIS.

Pricing methodology and workforce cost considerations

The review confirms that therapy pricing continues to be benchmarked against the Medicare Benefits Schedule (MBS), private health insurance data and other compensation schemes, rather than being directly linked to allied health wage costs.

The APA recognises the importance of a transparent and evidence-based pricing methodology. However, it is also important that pricing reviews adequately reflect the real costs of delivering physiotherapy services within the NDIS, including workforce, compliance, travel and operational costs.

The APA maintains that benchmarking NDIS physiotherapy services against Medicare and private health insurance data risks understating the true cost of service delivery, as these funding systems were not designed to support the same levels of complexity, coordination, travel and participant-specific requirements that exist within the NDIS.

This is particularly relevant given upcoming changes to the Health Professionals and Support Services (HPSS) Award following the Fair Work Commission's gender undervaluation review. Wage increases mandated within this review will apply from 1 October 2026, meaning many physiotherapy providers will face higher staffing costs without corresponding changes to NDIS pricing in the current review period.

Registration and future pricing reforms

While physiotherapy pricing was not subject to differentiated pricing in the 2026–27 Annual Pricing Review, the NDIA introduced a 10% reduction in prices from 1 January 2027 for unregistered providers within Social, Community and Civic Participation supports.

The APA notes that the APR identifies registration status, qualification levels and service complexity as factors that may be considered in future pricing reviews. While no changes have been proposed for therapy supports at this stage, these developments may signal a broader shift towards recognising the additional obligations, quality requirements and professional standards associated with regulated and registered providers.

Physiotherapists are already regulated health professionals under Ahpra and deliver evidence-based care within a strong professional and clinical governance framework. The APA will continue to monitor future pricing reforms and advocate for approaches that recognise the role of qualified health professionals in supporting participant outcomes.

Many of the concerns identified in the Nous review remain unresolved following the 2026–27 Annual Pricing Review. The report continues to provide a critical evidence base for the APA's advocacy, demonstrating the need for pricing decisions that are informed by comprehensive and representative data, and that accurately reflect the cost of delivering physiotherapy services under the NDIS.

Independent economic evidence – Nous Group Review

The APA continues to take a sustained evidenced-based approach to NDIS pricing reform. A key component of this work is the analysis undertaken by Nous Group.

Commissioned by the APA following the 2025 NDIS price changes, the report provides detailed insight into the costs of delivering physiotherapy services within the Scheme and remains an important evidence base in ongoing discussions with the NDIA and government about the methodology used to determine physiotherapy pricing and the data informing those decisions.

The report identified several methodological and evidence gaps that contributed to concerns about physiotherapy pricing. The latest Annual Pricing Review has reinforced the importance of these findings, with many of the underlying issues remaining unresolved.

  • The national price limit for physiotherapy of $183.99 is well below sustainable market benchmarks. Independent market analysis indicates that the actual 75th percentile market rate is between $215 and $259 per hour, highlighting a clear gap between the NDIA price cap and the cost of care.
  • The NDIA’s pricing methodology relied on insufficient and unrepresentative data points, limiting its ability to capture the true cost of delivering safe, high-quality physiotherapy services across diverse settings.
  • Private health insurance data reinforces this misalignment, with the 70th percentile session fee equating to $236.50 per hour, significantly above the NDIA’s proposed price limit.
  • The restriction of travel funding makes outreach services unviable, breaching the Scheme’s own standards, penalising best practice and limiting access to necessary services.
  • The removal of higher regional price loadings in WA, SA, NT and Tasmania has disproportionately affected physiotherapists in these regions.

Many of the concerns identified in the Nous review remain unresolved following the 2026–27 Annual Pricing Review. The report continues to provide a critical evidence base for the APA's advocacy, demonstrating the need for pricing decisions that are informed by comprehensive and representative data, and that accurately reflect the cost of delivering physiotherapy services under the NDIS.

Stay informed and get involved

APA members, please log into PhysioHub regularly, as the advocacy team posts the latest updates there. Be sure to check back often as the APA continues to push for fair and sustainable NDIS pricing.

Have insights to share or questions about our advocacy?
Email the APA Policy & Government Relations team at policy@australian.physio.

Share your story – Your voices continue to drive this work. 
Email the APA Media and PR team at media@australian.physio.

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