The latest pricing agreements specify a date for removing the duplication of therapeutic disability-related health support from the core.
In this article, we will clarify Disability-Related Health Supports, outline the upcoming changes, and provide guidance on preparing for them.
The Pricing Arrangements and Price Limits (PAPL) for 2024-25 include a plan to gradually eliminate the Disability-Related Health Supports (DRHS) line items from the Core. While these items have been included in both Capacity Building and Core categories for a number of years, as of June 30, 2025, they will exclusively be found in Capacity Building. This adjustment will bring about notable consequences for both providers and participants.
We will discuss the definition of DRHSs and the implications of this change.
What are Disability-Related Health Supports?
Disability-related health supports (DRHSs) are funded by the NDIS to help individuals with disabilities manage their health conditions. The NDIA oversees eight key areas of DRHS.
• Continence
• Diabetes Management
• Dysphagia
• Epilepsy
• Nutrition
• Podiatry and Foot Care
• Wound and Pressure Care
• Respiratory Supports
The NDIA has indicated that they will evaluate funding assistance for addressing extra health conditions on a case-by-case basis. However, there have been limited occurrences of including support for additional health conditions in DRHS benefits.
The updated transitional Rules for determining NDIS assistance now encompass the following as DRHS:
Support is provided to individuals with complex communication needs or behaviours who are seeking healthcare or mental health services, such as in hospitals and residential facilities.
Specialized allied health services and support that enhance functioning and community reintegration for individuals with newly acquired severe conditions, including spinal cord injuries and severe acquired brain injuries.
Currently, the operational guidelines for DRHS have not been updated to include these changes.
Financial assistance may cover disability-related health aids for:
Hiring a support worker to provide your disability-related health aids
Training for your support workers or other individuals aiding you, such as family or friends, as needed
Essential supplies, including items used to manage your condition. It may also include continence products, dressings, and nutritional products for your PEG tube.
What isn’t a Disability-Related Health Support?
The guidelines for determining NDIS support and the NDIA’s Operational Guidelines for DRHS specify that other service systems are still accountable for the following responsibilities:
Enhancing health outcomes for all Australians
Diagnosing health conditions, including chronic health conditions
Delivering acute and emergency health services
Providing health services after an incident, such as an accident or injury
Supplying medication for health requirements, such as antibiotics
Offering general hearing and vision services not directly related to the individual's disability.
Health support does not automatically fall under the highly precise category of Disability-Related Health Services (DRHS). However, DRHS could fall under the mainstream health system's obligation to assist individuals with disabilities under the Universal Principle.
What is changing with Disability-Related Health Support?
Starting in 2019, individuals have been able to request Disability-related Health Support (DRHS) from both Core and Capacity Building. This temporary duplication was implemented to ensure that participants could access essential support from Core immediately without needing to wait for a plan review to access funds from Capacity Building.
After five years, it's evident that these replicated line items were not as temporary as initially thought. They have become crucial for many providers and participants, particularly in cases where therapy budgets were inadequate. Nonetheless, the most recent PAPL update revealed that therapy DRHS line items from Core will be eliminated after June 30, 2025.
Starting July 1, 2025, all therapy supports, such as DRHS, must be invoiced through Improved Daily Living in Capacity Building.
The following information regarding nursing support in DRHS Core is important to note:
Within DRHS Core, separate line items are allocated for therapy support and nursing support. It is crucial to highlight that the only line items slated for removal from Core pertain to Therapeutic Disability-Related Health Supports, encompassing:
- Dietitian
- Occupational Therapist
- Physiotherapist
- Podiatrist
- Psychologist
- Speech Pathologist
- Other Professional
The codes concerning the provision of nursing care for health needs related to disabilities are still located in the Core section.
The following information should also be noted:
While the temporary duplication was mainly used as planned, it was sometimes used to increase the provision of therapy services. More particularly, when there was a shortage of funds in the Capacity Building budget, providers would use DRHS line items from Core to pay for general therapy expenses, deviating from the initial purpose of the temporary duplication (and concealing actual Capacity Building needs). The NDIA acknowledged this problem and opted to end the temporary duplication. Therefore, as of June 30, 2025, all therapy sessions must be financed through Capacity Building, with no billing permitted under Core.
Hence, most providers will need to analyze the existing DRHS services they offer, determine their position, and assess their potential funding under Capacity Building in the upcoming period.
The following also should be noted to help participants prepare for the upcoming changes with DRHS:
Identify which supports offered to participants are disability-related health supports (DRHS) and general therapy supports.
Inform participants about how the changes will affect them and their NDIS plan.
Establish a support continuity plan for therapy services.
Complete the required DRHS assessments promptly and submit them to the NDIA. Providers should ensure that the assessments are carried out by the appropriate professional under the Operational Guidelines.
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