Navigating provider travel costs within the NDIS can often confuse participants and providers. Providers are permitted to charge for transport costs directly linked to the delivery of approved NDIS services. This may include time spent travelling to provide face-to-face support at home, commuting with you to activities, and additional expenses such as parking or toll fees.
Key Points on Provider Transport Costs Under the NDIS
Transport costs are billed separately from the support services.
Charges can include support worker travel time and other related transportation expenses.
Participants must agree to these costs beforehand.
If travel expenses are for services provided to multiple participants simultaneously, these costs should be divided accordingly.
Conditions for Provider Travel Cost Billing
Providers can bill travel expenses if all the following conditions are met:
The participant has given prior consent.
The NDIS Pricing Arrangements and Price Limits authorise travel cost billing for the service, and the claim complies with these limits.
The service involves direct, face-to-face disability support.
A clear explanation has been provided on how these travel costs represent a sensible use of NDIS funds.
Travel claims may include compensation for the provider’s time or business expenses if they operate as a sole trader.
Zone-Based Travel Allowances
The NDIS categorises areas into seven zones, impacting the pricing of services based on geographic location:
Zones 1-3: Up to 30 minutes of travel per session.
Zones 4-5: Up to 60 minutes.
Zones 6-7: Travel time as negotiated, up to the hourly support rate.
Providers can also claim for travel from the last participant's location back to their usual workplace, with maximum allowable times mirroring the above zone distinctions.
Additional Non-Labor Travel Costs: Providers might incur other costs while delivering face-to-face support, including parking, tolls, and vehicle operational costs. These are claimable only if the service agreement allows for travel time billing, and participants may be asked to contribute reasonably to these expenses, such as:
$0.97 per km for a provider-owned vehicle.
Activity-Based Transport Costs
Providers can claim both the time spent transporting participants and associated travel expenses for activities like community participation under a participant's NDIS plan. Conditions include prior agreement and clear delineation in the service contract. Not all support categories are eligible for these claims, but they typically include supports related to employment, education, living arrangements, and community participation.
Billing for Activity-Based Transport
Claims must be filed under the appropriate transport support item.
Costs are deducted from the participant’s core budget.
Providers should itemise support and travel costs separately on invoices.
If transporting multiple participants, costs should be apportioned based on prior agreements.
Detailed Examples of NDIS Provider Travel Costs
In the NDIS framework, travel costs are categorised and billed differently depending on whether the support is provided in-home or outside and whether the provider or participant is travelling. Here’s how you can understand and use the item codes for managing travel costs effectively:
1. In-Home vs. Out-of-Home Support:
01 - In-Home Support: This code is used when supports are delivered directly at the participant’s home.
04 - Out-of-Home Support: This is used for supports provided outside the participant's home.
2. Specific Item Codes for Travel Costs:
04_104: Represents support hours for out-of-home services. When supports are delivered outside the participant's home, the provider logs these hours under this item code.
04_590: Should be explicitly used for mileage when the provider is travelling with the client in the car during out-of-home support. This item code ensures that travel costs are billed correctly for the mileage covered with the participant.
3. Provider Travel Without the Participant:
Item Codes with 799: Such as 01_799, 04_799, 07_799, and 15_799 indicate provider travel without the participant in the vehicle. This is strictly for mileage claims when providers travel alone to prepare for or follow up on participant support.
Example: If a provider needs to travel to gather resources for an in-home support session or return to their office after an out-of-home session without the participant, these travels are billed under these codes, categorising the costs as provider-only travel.
4. Charging for Travel Time (With No Client in the Car):
Providers use the same item code as the supporting hours (e.g., 04_104), but in the billing system, they must select "provider travel" from the drop-down options. This differentiation ensures clarity in billing when the provider is travelling alone to or from a location of support.
5. Special Considerations for Support Coordination:
Support Coordination Travel: Often begins with item code 07. In cases where 07_799 is not applicable, providers might use 01_799 for mileage claims related to support coordination activities.
Alternative Billing Options: If mileage billing is problematic, providers may discuss with the support coordinator the possibility of using the support hour item code and billing for time instead of mileage. This allows flexibility in how travel costs are managed and billed, depending on specific support activities and agreements with the participant.
Support Categories | Mileage, charge by KM (Provider Travel) | Time Travelled (NO Client in the car) | Mileage (With CLIENT in the car) | Comment |
01 Code - In-Home Support | 01_799_0102_1_1 | 01_011_0107_1_1 (use different code for weekends and nights, etc) | NO MILEAGE should be charged as it is for IN-HOME support. | Generally, don't charge for provider travel unless it's for cleaning, gardening, etc. |
04 Code - Out of Home Support | 04_799_0104_6_1 | 04_104_0125_6_1 (use different codes for weekends, nights, etc, same as support codes) | 04_590_0125_6_1 | Generally, don't charge for provider travel.If the 04 Support code is NOT charged, we cannot charge for 04_590! |
07 Code - Support Coordination | 07_799_0106_6_3 (if SC isn't stated)If stated, use 01_799_0102_1_1 if agreed by the client | 07_002_0106_8_3 (depending on the level of SC support, same SC code. If SC is stated, advise SC to charge for TIME TRAVEL instead of Mileage. | NA | SC should only charge either time or mileage and should not be charged BOTH. |
09 Code - Capacity Building Supports Social | 09_799_0106_6_3 | Same as the support code | 09_590_0106_6_3 |
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11 Code - Improved Relationship | 11_799_0110_7_3 (if it isn't stated) If stated, USE 01_799_0102_1_1 if agreed by the client | Same as support code 11_022_0110_7_3 & 11_023_0110_7_3 (maximum 30mins) | NA | |
15 Code - Capacity Building Supports Daily | 15_799_0106_1_3 | Same as the Therapy support code (maximum 30mins) | NA |
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Practical Scenario
A provider delivering assistance with social and community participation services might need to transport a participant to an activity outside the home. If the travel involves the participant, item code 04_590 would be used to bill the mileage. Conversely, if the provider travels alone to set up the activity beforehand, item code 04_799 would be appropriate for the mileage incurred without the participant.
This structure ensures that all travel-related costs are transparently and appropriately charged, aligning with NDIS guidelines and ensuring participants are only billed for the travel costs they have agreed upon. For further clarification, refer to the most recent NDIS Pricing Arrangements and Price Limits guide or contact Simplified Plan Management for personalised advice.
If you want to learn more about plan management and how it can benefit you, contact Simplified Plan Management. Our expert team is here to assist you with managing your NDIS plan, ensuring you can focus on achieving your goals while we handle the administrative tasks. Reach us at 0491 090 747 or email us at info@simplifiedpm.com.au.