In determining which price limit is applicable to a support, the important consideration is when the support is provided to the participant, not the shift of the worker used to deliver that support as determined by the applicable Industry Award or Enterprise Bargaining Agreement.
For NDIS claiming purposes, the provider must first determine the day of the week on which the support was provided and then the time of the day during which the support was delivered. Weekday means Monday, Tuesday, Wednesday, Thursday, or Friday.
Types of Support by Time and Day
- Night-time Sleepover Support: This is any support to a participant delivered on a weekday, a Saturday, a Sunday, or a Public Holiday that commences before midnight on a day and finishes after midnight on that day; is for a continuous period of eight (8) hours or more; and the worker is allowed to sleep when they are not providing support.
- Public Holiday Support: This support starts at or after midnight on the night prior to a Public Holiday and ends before or at midnight of that Public Holiday (unless it is a Night-time Sleepover Support).
- Saturday Support: This support starts at or after midnight on the night prior to a Saturday and ends before or at midnight of that Saturday (unless it is a Public Holiday or Night-time Sleepover Support).
- Sunday Support: This support starts at or after midnight on the night prior to a Sunday and ends before or at midnight of that Sunday (unless it is a Public Holiday or Night-time Sleepover Support).
- Weekday Support: Any other support.
For disability support workers:
- Weekday Daytime Support: Any support to a participant that starts at or after 6:00 am and ends before or at 8:00 pm on a single weekday (unless it is a Public Holiday or Night-time Sleepover Support).
- Weekday Evening Support: Any support to a participant that starts at or after 8:00 pm and finishes at or before midnight on a single weekday (unless it is a Public Holiday or Night-time Sleepover Support).
- Weekday Night Support: Any support to a participant that commences at or before midnight on a weekday and finishes after midnight on that weekday, or commences before 6:00 am on a weekday and finishes on that weekday (unless it is a Public Holiday, Saturday, Sunday or Night-time Sleepover Support).
For nurses delivering nursing supports:
- Weekday Daytime Support: Any support to a participant that commences before 12.00 noon on a Weekday and finishes on the same day (unless it is a Public Holiday, Weekday Evening, or Weekday Night Support).
- Weekday Evening Support: Any support to a participant that commences not earlier than 12.00 noon on a Weekday and finishes after 6.00 pm on the same day (unless it is a Public Holiday Support).
- Weekday Night Support: Any support to a participant that commences on or after 6.00 pm on a Weekday and finishes before 7.30 am on the following day (unless it is a Public Holiday Support).
If a support to a participant does not meet one of the above criteria, then it needs to be billed as two or more separate supports. An exception to this general rule occurs when a particular support crosses a shift boundary and the same worker delivers the entire support. In this case, the higher of the relevant price limits applies to the entire support and the provider should make the claim against the relevant support item. Providers are required to discuss this billing arrangement with the participant.
Night-Time Sleepover Supports
This support provides a participant with assistance with, or supervision of, personal tasks of daily life where overnight support is needed, but the caregiver can sleep when not required to provide support. This support applies to any day of the week and on public holidays. This support item includes up to two hours of active supports provided to the participant for the duration of the period. Providers may claim for the third or additional hour at Saturday rates on weekdays, or at applicable rates on other days (Saturday, Sunday, or Public Holidays).
Note: There is no night-time sleepover support item for nurses.
Conclusion
At Trusted Care & Support Services, we understand the importance of adhering to the NDIS claiming rules and creating comprehensive Service Agreements. These practices ensure that our participants receive high-quality care, understand their services, and can trust in the transparency and integrity of our billing practices. By following these guidelines, we continue to provide reliable, effective, and compassionate support to those who need it most.
Understanding the various types of supports and their respective claiming rules can be complex, but it is essential for ensuring compliance and providing the best possible care. Whether it’s a night-time sleepover support, public holiday support, or weekday support, knowing the specifics helps in accurate billing and fosters trust between the provider and the participant.
If you have any further questions about our claiming processes or service agreements, please do not hesitate to contact us. Trusted Care & Support Services is here to help you navigate the complexities of the NDIS and ensure you receive the support you need in the most transparent and effective manner.