What’s NOT in the Price Guide That You Still Need to Know

Will, EnableUs Community

Alright, welcome back to NDIS Pricing & Budgeting! I’m Will, and as always, I’m joined by Winter. Today, we’re digging into what’s not in the Price Guide—but you still really need to know. Winter, you ready for this one?

Winter, EnableUs Community

Absolutely, Will. This is one of those topics that comes up all the time. People think if they’ve read the Pricing Arrangements cover to cover, they’ve got it all sorted. But honestly, there’s so much that’s just not in there.

Will, EnableUs Community

Yeah, exactly. The Pricing Arrangements—so, the old Price Guide—does a great job of laying out the rules and limits. You’ve got your price caps for each support item, the rules for claiming things like travel, cancellations, non-face-to-face work, and all those definitions for support categories. And don’t forget the loadings for remote areas or public holidays. But, it’s really just the foundation, right?

Winter, EnableUs Community

Right. It’s the framework, but it’s not the full roadmap. Like, it’ll tell you what the maximum price is for, say, community participation, but it won’t help you figure out which line item to actually use for a specific service. Or how to structure a service agreement that’s actually clear for participants.

Will, EnableUs Community

Yeah, and I’ve seen that trip people up. I remember this provider—let’s call her Jess—she thought she was following the travel claim rules to the letter. But she didn’t realise the guide doesn’t actually tell you how to document those claims for an audit. She ended up with a bunch of travel charges that got flagged, and she had to scramble to justify them. It was a mess. She was like, “But I followed the Price Guide!” And I had to say, “Yeah, but you also need your own processes for evidence.”

Winter, EnableUs Community

That’s such a common story. The guide doesn’t tell you how to pick the right line item, or how to help participants track their budgets, or even how to write a service agreement that’s actually participant-friendly. It’s all on you to fill in those gaps.

Will, EnableUs Community

Exactly. And if you just rely on the guide, you’re missing half the picture. It’s like having the rules for a game, but no idea how to actually play it well.

Winter, EnableUs Community

And that’s where the real risks come in. If you’re only following the Pricing Arrangements and not thinking about what’s missing, you can end up underbilling, or worse, being non-compliant. I mean, we’ve seen providers leave money on the table just because they didn’t know how to claim for non-face-to-face work, or they picked the wrong line item and got knocked back in an audit.

Will, EnableUs Community

Yeah, and it’s not just about the money. If you’re not clear with participants about what they’re being charged for, or you don’t have proper documentation, you can end up with unhappy clients—or even lose them. And, like, the audit risk is real. If you can’t justify why you charged for high-intensity supports, or you don’t have evidence for your travel claims, you’re in trouble.

Winter, EnableUs Community

Exactly. And providers need to be asking themselves the right questions. Like, “Do I have file notes for every high-intensity support I claim?” or “Can I show evidence for every travel charge?” If you can’t answer those, you’re at risk. I actually worked with a provider—let’s call him Sam—who was great with participants, but he just relied on the guide for everything. He didn’t track budgets properly, so he’d deliver supports, then find out the participant’s funding had run out. He ended up with a bunch of unpaid invoices and some very awkward conversations.

Will, EnableUs Community

Oof, yeah, that’s rough. And it’s not just a one-off, either. We’ve talked about this before—like in our episode on stretching budgets for the whole year—if you’re not monitoring funding and communicating with participants, you’re setting yourself up for problems. The guide won’t save you there.

Winter, EnableUs Community

No, it really won’t. And honestly, participant dissatisfaction is a big one. If your service agreement isn’t clear, or you’re not transparent about fees, people lose trust. And then you’re not just dealing with compliance issues, you’re dealing with reputation damage.

Will, EnableUs Community

So, what do you actually do about it? I mean, the answer is you’ve gotta treat the Price Guide as a starting point, not the whole manual. You need your own internal policies—like, how are you going to handle travel claims, or cancellations, or non-face-to-face billing? And you’ve gotta train your staff, not just hand them the guide and hope for the best.

Winter, EnableUs Community

Yeah, and proactive budgeting is huge. Don’t wait for participants to tell you they’re running out of funds. Work with plan managers, use spreadsheets or software, and keep an eye on budgets so you can forecast if someone’s going to under- or overspend. And service agreements—make them clear, make them flexible, and actually explain what’s included. That’s what builds trust.

Will, EnableUs Community

And don’t forget about invoicing systems. The guide doesn’t tell you how to set those up, but if you don’t have a good system, you’ll end up with errors or missed claims. I helped a new provider once—she was so focused on sticking to the price caps, she didn’t realise she could actually set her prices a bit below the cap to be more competitive. We worked through her pricing policy, set up some templates, and she started winning more business because she was transparent and just a bit more affordable. Sometimes, charging less than the cap is actually the smart move.

Winter, EnableUs Community

That’s such a good point. And staff training is everything. You can have the best policies in the world, but if your team doesn’t know how to apply them, it all falls apart. Real-world training, not just reading the guide, is what makes the difference.

Will, EnableUs Community

Yeah, and honestly, it’s about building your own roadmap. The Price Guide is just the foundation. If you want to be compliant, sustainable, and actually deliver great outcomes for participants, you’ve gotta fill in the gaps yourself.

Winter, EnableUs Community

Couldn’t agree more. And if you’re listening and feeling a bit overwhelmed, just remember—no one gets it perfect from day one. Keep learning, keep improving your systems, and don’t be afraid to ask for help. That’s how you build a business that lasts.

Will, EnableUs Community

Alright, that’s a wrap for today. Thanks for tuning in, everyone. We’ll be back soon with more on making the NDIS work for you and your participants. Winter, always a pleasure.

Winter, EnableUs Community

Thanks, Will. See you next time—and thanks to everyone for listening. Take care!