A newly released independent review from the Nous Group provides compelling evidence the National Disability Insurance Agency (NDIA) used flawed methodology in setting current National Disability Insurance Scheme (NDIS) price limits which has already impacted access to critical services for people living with disability.   

The review was commissioned by the Australia Physiotherapy Association (APA) in the wake of the NDIA’s June decision to cut price limits for physiotherapists working within the Scheme.  

The Nous Group’s analysis determined the NDIA’s methodology utilised limited data sources, made flawed modelling assumptions and failed to account for the complexity of delivery high-quality care to people with disability in setting prices which fall well below sustainable hourly rates.  

The review assessed that the NDIA’s national price limit for physiotherapy in 2025–26 is set at $183.99 per hour—a 5.2 percent reduction from the previous year and off the back of a five-year price freeze. In contrast, market analysis places the 75th percentile rate between $215 and $259 per hour. These figures are consistent with the findings of a separate independent analysis undertaken by Nous commissioned by the APA in 2025 on a sustainable hourly rate for the provision of physiotherapy services. 

This hourly rate is not the take home pay for physiotherapists working within the scheme. The vast majority of this hourly rate supports the overhead costs involved in providing care to NDIS participants, who often present with complex, chronic and multi-faceted needs, and continue to rise rapidly year on year. 

The APA has received private health insurance data covering approximately 25 percent of the national market, which shows a 70th percentile session fee equivalent to $236.50 per hour. These figures demonstrate that the NDIA price cap falls well below what is required to sustain high-quality, participant-centred care. 

The review raises questions over the NDIA’s use of regression modelling which overestimates session durations, leading to artificially low hourly rates. Furthermore, the data sources used by the NDIA in their pricing review— the Medicare Benefits Schedule, a single private health insurance dataset and public websites—were determined to be limited, unrepresentative and failed to reflect the complexity of delivering disability supports.  

APA CEO Rob LoPresti said that, while not surprising, the findings of the Nous Group review validate the APA’s ongoing campaign to reverse this decision, raise questions about NDIA’s current decision-making processes and emphasise the need for broader reform.   

‘This review confirms the concerns we’ve had all along, which is that the NDIA’s pricing approach for physiotherapy is significantly flawed,’ LoPresti said. ‘These issues point to deeper flaws in how services are funded. Pricing does not reflect the real cost of care, including essential components like travel, it limits access, weakens plan integrity and puts provider viability at risk.’ 

‘The result is a significant gap between the set NDIA hourly price limit and the prevailing market costs of delivering care, making the financial viability of providing care within the Scheme increasingly untenable.’ LoPresti said. 

‘We are already seeing service curtailment and withdrawal, leaving participants, who rely on physiotherapists to provide the unique, complex care they need to move, participate and build capacity, to suffer the consequences.’ 

‘It’s important to note that the changes to travel are also a big concern,’ LoPresti said. ‘Changes to travel funding are significantly impacting practitioners traveling to clients, making it extremely difficult to see them in their natural environment which is a fundamental tenant of the Scheme.’ 

‘The evidence is clear,’ LoPresti said. ‘The pricing decision must be reversed, and the NDIA must seize the opportunity to strengthen their pricing approach to more accurately reflect a true market rate which support sustainable, high-quality care for NDIS participants.’ 

Read the full Nous Group report here.