The Australian Physiotherapy Association (APA) has released its reform agenda for Support at Home Program pricing, calling for changes which ensure the sustainable, high-quality person-centred services for participants that the program was designed to deliver.  

The pricing structure of Support at Home, which was introduced less than a year ago, remains severely misaligned with the real-world costs and challenges of delivering aged care, undermining financial viability for physiotherapists providing essential in-home care to older Australians.

‘The Support at Home Program presents a once-in-a-generation opportunity to modernise aged care and deliver on the promise of flexible, person-centred support,’ said APA National President Dr Rik Dawson.

‘But this can only be achieved if every aspect of the program, from funding and pricing framework to workforce, is aligned, and, right now, that simply isn’t the case.’

‘Pricing guidance on hourly rates and travel costs for physiotherapists and other allied health providers remain well below sustainable levels, putting essential supports at risk.’ 

‘If these structural flaws aren’t remedied, the high-quality care that older Australians rely on is at risk’ said Dr Dawson.

‘This doesn’t have to happen, and we’ve seen that policymakers are willing and able to listen and act to improve the program,’ said Dr Dawson. ‘In the weeks prior to Support at Home’s implementation, the Department of Health engaged with the sector and released updated pricing guidance which included enabling physiotherapists to bill indirect care costs such as documentation, suggesting some recognition of the full scope of clinical work required to deliver safe and effective care in the home.’

‘Now, we’re hoping that policymakers will listen and act again, utilising our reform agenda to align funding, restore viability and uphold aged care standards,’ said Dr Dawson.

‘In the coming months, we look forward engaging with the Department of Health to ensure the Support at Home Program lives up to its potential.’

The APA’s recommended reforms to strengthen physiotherapy under Support at Home and safeguard care quality, access and workforce stability include:

1. Ensure pricing reflects the full cost of physiotherapy service delivery, including indirect labour and administrative overheads.

This includes:

1.1 Clarify how time-based billing applied to allied health, nursing care and other therapeutic services in practice, including indirect activities across different delivery models.

1.2 Review pricing benchmarks and guidance to address cost shifting in brokered service arrangements, where providers often apply additional loadings to physiotherapy service rates to recover administrative and coordination costs arising from capped care management fees and the removal of package management fees.

2. Introduce dedicated funding for travel, parking, hydrotherapy access, and other essential costs tied to in-home and community-based physiotherapy care.
3. Publish the IHACPA pricing report immediately to ensure transparency and enable providers to prepare for the 2026 set price model.
4. Ensure pricing structures and package design support brokered physiotherapy services to maintain access, flexibility, and market stability.

This includes:

4.1 Reinstate adequate package and care management margins to ensure providers can sustainably manage multiple service agreements without absorbing unfunded administrative burden.

4.2 Establish a brokerage viability supplement or pricing adjustment to reflect the additional coordination and compliance costs associated with brokered service delivery.

4.3 Ensure pricing and operational guidance explicitly recognises brokerage as a legitimate and essential delivery model for allied health services, particularly physiotherapy.

5. Enable older Australians to engage directly with multiple providers to reduce administrative burden and expand choice, efficiency, and service sustainability.

Read the APA’s full statement on reforms to the Support at Home program here.