NDIS Pricing Arrangements 2025-26 for allied health locums
How Sessional enforces the per-profession hourly cap, the 50% travel rule, and the MMM travel-minute caps line by line. Guidance, not advice.
Important
Per-profession hourly caps, 2025-26
The NDIS publishes a single hourly cap per profession that applies nationally. State variations went in 2021. The 2025-26 caps are:
- Psychologist: $232.99 per hour (single national rate, no clinical/general split)
- Physiotherapist: $183.99 per hour
- Occupational Therapist: $193.99 per hour
- Speech Pathologist: $193.99 per hour
- Support Coordination (Level 2): $100.14 per hour
Sessional enforces the cap by profession. When you build an NDIS Clinical line, the tool looks up your profile profession, matches it to the 2025-26 schedule, and blocks the line from sending if the rate exceeds the cap.
Those hourly figures are the national price limits. In MMM 6 (remote) and MMM 7 (very remote) areas the NDIS lifts the limit: a 40 per cent loading in MMM 6 and a 50 per cent loading in MMM 7. Sessional applies the matching loading to the cap from the workplace postcode, so a legitimate remote-area rate is not falsely flagged as over-cap.
The 50% travel rule
Travel time billed to an NDIS participant is capped at 50 per cent of the clinical cap for the same profession. A physiotherapist can bill clinical time at $183.99 per hour and travel time at $91.99 per hour (50 per cent). Anything above that triggers the travel_rate_over_cap warning on the invoice line.
This applies to door-to-door travel time while on the way to deliver a support, not to the clinical session itself. Sessional treats NDIS Travel as a distinct line type you tag at create time; the 50 per cent rule fires automatically.
The MMM travel-minute caps
On top of the 50 per cent rate rule, the NDIS applies a one-way travel-minute cap based on the workplace postcode:
- MMM 1-3 (metro and inner regional): 30 minutes one-way
- MMM 4-5 (outer regional): 60 minutes one-way
- MMM 6-7 (very remote): no simple cap; priced by arrangement
Sessional looks up the workplace postcode in the bundled AU postcode dataset, pulls the Modified Monash Model 2023 classification (the NDIS moved to MMM 2023 effective 24 November 2025), and applies the correct minute cap. If a line claims 45 minutes travel at an MMM 2 postcode, Sessional flags travel_minutes_over_cap and asks you to either split the trip or lower the claim.
For very remote work (MMM 6-7), Sessional prompts a manual-review warning rather than silently accepting unlimited travel. This is because Pricing Arrangements 2025-26 does not publish a single figure for remote catchments; claims are priced by exception and supported by documentation.
Classifying lines on a mixed invoice
An NDIS invoice can legally include non-NDIS lines, as long as the header makes it clear which participant the NDIS lines belong to. Sessional asks you to tag each line as NDIS Clinical, NDIS Travel, or Non-NDIS at build time. The PDF separates them under clear headings; the CSV export keeps them as separate rows.
Non-NDIS lines (private pay, EAP, Medicare rebate sessions, workers compensation) bypass the NDIS caps. The tool still applies GST classification per s38-7 medical services for those lines, so your BAS is correct regardless of billing source.
Plan-managed vs self-managed vs agency-managed
Who you address the invoice to depends on the participant's plan management style. Sessional asks you to set this on the participant record once; the invoice header, payment reference format, and default payment terms adjust per invoice.
- Plan-managed: invoice goes to the plan manager with participant reference. Payment terms default to 14 days.
- Self-managed: invoice goes directly to the participant with NDIS plan number. Payment terms default to 7 days.
- Agency-managed: service booking submitted to NDIS with the service booking reference; no participant-facing invoice.
Annual update cadence
The NDIA publishes Pricing Arrangements and Price Limits each July. Caps, travel rules, and MMM minute caps can all shift. Sessional loads the new schedule within the first week of July and emails Pro-tier users when the update lands. Older invoices keep the caps that applied at the time they were issued; new invoices use the current schedule.
Common questions
What are the NDIS price caps for 2025-26?
Psychologist: $232.99 per hour (single national rate, no clinical/general split). Physiotherapist: $183.99 per hour. Occupational Therapist: $193.99 per hour. Speech Pathologist: $193.99 per hour. Caps update each July; Sessional pulls the published NDIS Pricing Arrangements and Price Limits and applies the correct cap per profession + state + year.
How does the 50% travel rule work?
Travel time billed to a participant is capped at 50 per cent of the relevant clinical hourly cap. A psychologist can bill travel at up to $116.50 per hour (50 per cent of the $232.99 cap). Sessional flags any travel line priced above 50 per cent of the matching clinical cap automatically.
What are the MMM travel-minute caps?
The NDIS limits billable one-way travel: 30 minutes per visit in MMM 1-3 (metro and inner regional), 60 minutes per visit in MMM 4-5 (outer regional and remote), and no simple cap in MMM 6-7 (very remote). Sessional looks up the workplace postcode MMM from the bundled AU postcode dataset and applies the right cap per line.
How does Sessional enforce caps on the invoice?
At invoice build time, each line is classified as NDIS Clinical, NDIS Travel, or Non-NDIS. Clinical lines compare the hourly rate to the 2025-26 cap for that profession. Travel lines compare against 50 per cent of the cap, and against the MMM minute cap from the workplace postcode. Any line outside cap is blocked from send with a clear explanation, or flagged to the participant plan manager if the participant has approved higher-than-cap pricing through a plan variation.
What about non-NDIS lines on the same invoice?
Lines tagged Non-NDIS bypass the NDIS checks. This is the right treatment for private-fee work, EAP, Medicare rebate consults, or workers-compensation sessions. Sessional lets you mix NDIS and non-NDIS lines on the same invoice as long as the participant and plan manager accept it; the PDF clearly separates them.
Does Sessional handle plan-managed vs self-managed vs agency-managed billing?
Yes. For plan-managed participants, Sessional addresses the invoice to the plan manager with the participant reference. For self-managed participants, it goes direct to the participant with NDIS plan details. Agency-managed participants go direct to NDIS with the service booking reference. The PDF header, payment reference, and due date auto-adjust per billing mode.
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