What Occupational Therapists Need to Know About the 2026–27 NDIS Pricing Update

The 2026–27 NDIS Pricing Schedule and Annual Pricing Review have now been released.

For Occupational Therapists, the immediate headline is relatively positive. OT rates remain unchanged, avoiding the cuts seen across several other allied health professions.

However, while pricing may appear stable on the surface, the update raises important questions around billing, travel and the long-term sustainability of OT services.

OT pricing remains unchanged

The maximum hourly rate for Occupational Therapists remains unchanged at $193.99 per hour, with provider travel remaining at $97 per hour.

Given concerns about possible pricing cuts, many OT providers will see this as a positive outcome. While there has been no increase to reflect rising wages and operating costs, there has also been no reduction.

For many practices, this was likely the best realistic outcome.

The biggest issue is missing guidance

The biggest challenge is not the pricing itself, but the lack of guidance.

Unlike previous years, the Pricing Schedule currently provides rates and line items without the detailed billing guidance providers usually rely on.

This means there is still uncertainty around travel claiming rules, billing caps, support definitions and claiming requirements.

Right now, OTs know the rates, but not exactly how some of those supports can be claimed in practice.

Travel remains unclear

Travel is one of the biggest unresolved issues.

Although provider travel remains listed at $97 per hour, there is no clear guidance confirming whether existing travel caps still apply.

There is still uncertainty around whether the 30-minute metro cap remains, whether the 60-minute regional cap still applies, or whether travel rules have changed more broadly.

This is particularly important for mobile OT services and regional providers.

New billing line items mean immediate updates

One of the biggest practical changes is the introduction of new billing line items.

The updated structure separates direct service, cancellation, non-face-to-face work, provider travel, telehealth and NDIA requested reports into separate billing categories.

This creates greater billing clarity, but also means many practices will need to urgently update billing systems, CRMs, invoicing templates and internal workflows.

Non-face-to-face billing is becoming clearer

One positive change is the clearer distinction between standard non-face-to-face work and NDIA requested reports.

General non-face-to-face tasks appear to include preparation, documentation, case notes and standard reporting such as functional capacity assessments.

NDIA requested reports generally refer to reports used to support funding decisions, such as assistive technology, home modifications and home and living reports.

This distinction will be important for compliant billing moving forward.

Pricing decisions are shifting

One of the most important long-term changes is how future pricing decisions are being made.

This year, the NDIA used more than 16 million therapy transactions to benchmark therapy pricing against Medicare, private health and comparable government schemes.

This reflects a clear shift toward external market benchmarking and less emphasis on provider operating realities such as wage pressures, overheads and workforce challenges.

This has significant implications for private OT practice sustainability.

Demand is rising while providers are falling

Another major theme is the changing therapy market.

Therapy supports now account for approximately 10% of total NDIS expenditure, while demand for therapy continues to grow.

At the same time, active therapy providers have declined by 3.9%, with unregistered provider numbers declining by 4.9%.

Demand is rising while provider numbers are shrinking, increasing pressure on service access, waitlists and workforce sustainability.

What this means for Occupational Therapists

At a high level, this year’s pricing update feels relatively stable for Occupational Therapists.

There are positives. OT rates remain protected, there have been no immediate pricing cuts and billing categories may be becoming clearer.

But there are also challenges. Practices need to prepare for immediate billing updates, key guidance remains missing and uncertainty around future pricing remains.

For Occupational Therapists, this update feels like short-term relief.

But beneath that stability, there are meaningful shifts in pricing, billing and market dynamics that every OT should be paying attention to.

Key takeaways for OTs

• OT rates remain unchanged at $193.99 per hour, with travel remaining at $97 per hour.
• The biggest concern is missing guidance around billing and claiming rules.
• Travel remains one of the biggest unresolved issues.
• New billing line items will require urgent system updates.
• Non-face-to-face billing appears more clearly separated from NDIA requested reports.
• Future pricing decisions are increasingly based on external benchmarking.
• Demand for therapy is rising while provider numbers are declining.
• The update provides short-term stability, but long-term uncertainty remains.

Occupational Therapists are frequently asked to provide ‘robust evidence’ for NDIS funding decisions, but what does that really mean? Explore why observation, clinical reasoning and context matter when assessing functional capacity.

When Occupational Therapists write reports for the NDIS, one phrase appears repeatedly: robust evidence. Whether it’s a funding review, access request, assistive technology application or change in support needs, Therapists are often asked to provide stronger justification and more comprehensive evidence.

The challenge is that there is no clear definition of what robust evidence actually looks like. As a result, many OTs are left wondering how much evidence is enough and what information carries the greatest weight.

The answer often lies in moving beyond self-report and gathering information from multiple sources to build a complete picture of a person’s functional capacity.

Why self-report is only part of the story

Most assessments begin with conversation. We ask people about their daily routines, the tasks they complete independently and the areas where they need support. These discussions provide valuable information, but they are only one piece of the puzzle.

People naturally interpret their abilities through their own experiences and expectations. Some individuals may overestimate their independence, while others may underestimate what they can do. This is why Occupational Therapists are trained to look beyond verbal responses and consider how a person actually performs tasks in real-world situations.

The value of observation in functional assessments

Observation remains one of the most powerful assessment tools available to OTs.

A person may report that they independently manage meal preparation, household tasks or personal care. However, observing the environment can reveal important details that provide additional context.

A walk through the home may identify signs that tasks are not being completed consistently. Alternatively, it may demonstrate a level of independence that exceeds what was initially reported. Both outcomes are clinically important.

Environmental observations, task completion and functional demonstrations help Therapists validate information, identify barriers and understand how a person’s abilities translate into everyday life. This observational evidence often strengthens the overall assessment and contributes to more robust clinical reasoning.

Understanding function within context

One of the most important principles of occupational therapy is that function does not occur in isolation.

Performance can vary significantly depending on the environment, available supports and expectations placed on the individual. A person may demonstrate greater independence in one setting and require substantial assistance in another.

For example, some individuals may perform tasks independently in structured environments such as school, work or day programs, while requiring significantly more support at home. In other situations, highly supportive family members may unintentionally complete tasks on behalf of the person, masking their true abilities.

Without considering context, Therapists risk drawing incomplete conclusions about a person’s functional capacity.

Why clinical reasoning matters

Robust evidence is not simply about collecting more information. It is about interpreting that information accurately.

Occupational Therapists draw on clinical knowledge, experience and evidence-based practice to identify patterns and understand how a person’s diagnosis may impact their function. This becomes particularly important when working with conditions characterised by fluctuating capacity.

A snapshot assessment conducted on a person’s best day may not accurately reflect the support they require over time. Likewise, a single observation may not capture the impact of fatigue, pain, mental health challenges or episodic symptoms.

Strong clinical reasoning allows Therapists to synthesise multiple sources of information and determine what is most representative of the individual’s everyday experience.

The role of standardised assessments

Standardised assessments can provide valuable objective data when selected appropriately and interpreted correctly.

However, assessment scores alone rarely tell the full story. A percentile rank or functional score only becomes meaningful when the Therapist explains what it represents and how it relates to everyday function.

The most effective reports integrate standardised assessment results with observational findings, collateral information and clinical interpretation. This approach creates a comprehensive picture of a person’s strengths, challenges and support needs.

The challenge of future support needs assessments

As discussions continue around NDIS support needs assessments, many OTs have raised concerns about the potential loss of observation-based assessment.

Functional capacity cannot always be accurately understood through questionnaires or interviews alone. Observation, environmental assessment and task analysis provide critical insights that help Therapists distinguish between reported abilities and actual performance.

Without these opportunities, there is a risk that assessments may overlook important nuances that influence a person’s daily functioning and support requirements.

Building truly robust evidence

When Occupational Therapists talk about robust evidence, they are rarely referring to a single assessment tool or a larger volume of paperwork.

Instead, robust evidence comes from combining multiple sources of information, including self-report, observation, standardised assessments, collateral input and professional clinical reasoning.

It is this synthesis that allows OTs to understand not only what a person says they can do, but what they actually do, how they do it and what support they need to participate meaningfully in everyday life.

Key takeaways for OTs
• Robust evidence involves more than self-report and should include observation wherever possible.
• Functional performance must be interpreted within the context of the person’s environment and supports.
• Clinical reasoning is essential when assessing fluctuating capacity and complex presentations.
• Standardised assessments are valuable when appropriately selected and clearly interpreted.
• Observation and task analysis remain critical components of comprehensive functional assessments.
• Strong reports synthesise multiple sources of information to create an accurate picture of support needs.

Pricing uncertainty continues to affect providers

For many providers, annual pricing updates remain a significant source of uncertainty. Business owners are often required to make decisions about staffing and service delivery without knowing exactly what future funding arrangements will look like.

Combined with rising employment costs and workforce reforms, these changes are placing increasing pressure on provider sustainability, particularly for smaller practices.

The growing loss of experienced therapists

Across Australia, many experienced occupational therapists are reconsidering their future within the NDIS. While financial pressures contribute to this trend, increasing administrative demands, system changes and frustration with decision-making processes are also driving clinicians away from the scheme.

The impact extends beyond individual businesses. Experienced therapists bring years of clinical reasoning, assessment expertise and mentorship to the profession. As these practitioners leave, participants lose access to valuable knowledge and support.

Moral injury and professional frustration

Many therapists report feeling that their professional expertise is being given less weight despite extensive assessment and evidence gathering. When recommendations are repeatedly challenged or dismissed, it can create significant professional frustration and contribute to moral injury.

For a profession built on evidence-based practice and participant-centred care, this can be particularly difficult. Over time, the emotional burden contributes to burnout and influences decisions to leave the sector altogether.

Advocacy and sector response

Recent NDIS consultation processes have demonstrated the strength of engagement across the disability sector. Thousands of submissions were lodged by clinicians, providers, participants and advocacy groups, highlighting widespread concern about proposed reforms.

While the outcome remains uncertain, these submissions reflect a profession determined to contribute its expertise and advocate for meaningful outcomes. Advocacy continues to be a core part of occupational therapy practice, both at an individual and systemic level.

AI in occupational therapy

Artificial intelligence is becoming increasingly common across healthcare, particularly for tasks such as note-taking, report drafting and written communication. Used appropriately, these tools can reduce administrative burden and improve efficiency.

However, AI cannot replace clinical reasoning. Occupational therapy relies on contextual understanding, professional judgement and relationship-based practice. Therapists remain responsible for ensuring documentation is accurate, clinically appropriate and reflective of participant needs.

The use of AI also raises important considerations around consent, privacy and data security. Clear communication with participants and strong governance processes remain essential as technology becomes more integrated into practice.

Looking ahead

The coming months are likely to bring further change across the NDIS landscape. Pricing decisions, legislative reforms and technological developments will continue to shape the way occupational therapists work and how participants access support.

While the challenges are significant, the profession’s ongoing commitment to advocacy, clinical excellence and participant-centred practice remains unchanged. Supporting workforce sustainability and valuing professional expertise will be critical to the future success of both occupational therapy and the NDIS.

Key takeaways for OTs

• Pricing uncertainty continues to create challenges for providers and business planning.
• Experienced occupational therapists are increasingly leaving the NDIS workforce.
• Moral injury is contributing to clinician burnout and workforce attrition.
• Strong engagement in consultation processes highlights the sector’s commitment to advocacy.
• AI can improve efficiency but cannot replace clinical reasoning and professional judgement.
• Participant consent, privacy and data security remain essential when using AI tools.
• Supporting workforce sustainability is critical for the future of participant care.

Award changes are reshaping workforce planning

One of the most significant developments for allied health businesses is the recent review of the Health Professionals and Support Services (HPSS) Award.

Although much of the attention has focused on wage increases, the bigger story may be the changes to classification levels and how occupational therapists are positioned within the award structure. The revised framework places greater emphasis on the responsibilities attached to a role rather than simply years of experience.

For many private practices, the most notable change is the inclusion of supervision responsibilities within the Level 2 classification. Therapists who supervise students, therapy assistants or other clinicians may now fall into a different classification than previously expected.

This shift creates important questions for business owners. Student supervision has long been viewed as a professional responsibility and a way of supporting the future workforce. However, if supervision activities influence classification and remuneration, practices may need to reconsider how these responsibilities are allocated and supported.

The changes are expected to commence in October, providing an opportunity for businesses to review role descriptions, employment agreements and career progression pathways before implementation.

Career progression is no longer just about experience

A common misunderstanding within allied health is that clinicians automatically progress through award levels as they accumulate years of experience.

In reality, award classifications are linked to the scope and responsibilities of a role. Leadership responsibilities, supervision duties, advanced clinical expertise and management functions all influence where a clinician sits within the award structure.

This distinction becomes increasingly important as practices grow. Not every experienced clinician will move into a higher classification, just as not every newer therapist will remain in an entry-level role. Progression is tied to responsibilities, not tenure alone.

Clear role descriptions and transparent career pathways can help both employers and clinicians understand what advancement looks like and how different positions align with award expectations.

Rising costs continue to challenge practice sustainability

Award changes are arriving at a time when operating costs are already increasing across the allied health sector.

While salary increases often receive the greatest attention, they represent only one component of the financial pressures facing businesses. Workers compensation premiums, payroll tax, superannuation obligations, insurance costs and administrative expenses all continue to rise.

For occupational therapy practices, particularly those working in paediatrics, overheads can be substantial. Assessment tools, intervention resources, sensory equipment and clinical materials represent ongoing investments that are essential for service delivery but are often overlooked in broader discussions about business viability.

As these costs continue to increase, business owners are being forced to make increasingly careful decisions about staffing structures, leadership roles and growth opportunities.

Why financial awareness matters more than ever

The reality is that many of the most significant costs in running a practice are largely invisible to clinicians.

Insurance premiums, workers compensation, payroll tax and compliance obligations can add tens of thousands of dollars to annual operating expenses. As teams grow, these costs often increase at a rate that outpaces expectations.

This makes financial literacy an increasingly important skill for practice owners. Understanding profit margins, overheads and workforce costs is no longer optional. It is essential for making informed decisions about recruitment, remuneration and long-term sustainability.

With continued uncertainty around future NDIS pricing arrangements, businesses that understand their numbers will be better positioned to adapt to whatever changes emerge.

Preparing for Payday Super

Another important change for employers is the introduction of Payday Super from 1 July.

Although many payroll systems are now equipped to manage the administrative side of these payments, the change will require businesses to think differently about cash flow. Superannuation obligations will become more immediate, reducing the flexibility that previously existed around payment timing.

For practices already managing increasing employment costs, this serves as another reminder of the importance of strong financial planning and forecasting.

NDIS uncertainty remains a significant challenge

Alongside workforce and business pressures, occupational therapists continue to navigate an increasingly complex NDIS environment.

Across Australia, clinicians are reporting inconsistencies in planning decisions, funding outcomes and documentation expectations. Reports are being returned for reasons that often appear contradictory, with different planners applying different interpretations to similar situations.

Questions continue to arise around assessment tools, report formats, assistive technology recommendations and home modification applications. In many cases, therapists are left wondering whether they are seeing a genuine policy change or simply an isolated interpretation from an individual decision-maker.

The lack of consistency can make it difficult for clinicians to determine when they should adapt their practice and when they should challenge a decision.

Looking for patterns rather than reacting to isolated decisions

One of the most effective ways to navigate uncertainty is to avoid overreacting to individual experiences.

A single unusual decision does not necessarily indicate a systemic change. However, when the same issue begins appearing repeatedly across different participants, regions and planners, it may signal a broader trend that warrants attention.

Professional networks and peer communities play a critical role in identifying these patterns. Sharing experiences helps clinicians separate isolated incidents from genuine changes in practice expectations.

Taking a measured approach can reduce unnecessary changes to templates, reports and clinical processes while still allowing therapists to respond appropriately when genuine trends emerge.

Supporting participants through an evolving system

Many clinicians are also becoming more cautious when discussing plan reassessments and funding reviews with participants.

Where there is strong clinical evidence supporting additional funding or supports, recommendations should continue to be made confidently. However, it is equally important that participants understand the potential risks associated with reassessment processes in the current environment.

Open and transparent conversations allow participants to make informed decisions while ensuring recommendations remain grounded in clinical reasoning and functional need.

Looking ahead

Occupational therapists have always adapted to change, but the current environment requires a particularly careful balance between clinical excellence and business sustainability.

The practices most likely to thrive will be those that understand both the operational realities of running a business and the evolving landscape of the NDIS. While uncertainty remains, informed decision-making, financial awareness and strong clinical reasoning will continue to provide the strongest foundation for success.

Key takeaways for OTs

• Review award classifications and role descriptions before the HPSS Award changes commence.
• Ensure supervision responsibilities are clearly defined and aligned with award requirements.
• Understand the true cost of operating a practice, including insurance, payroll tax and compliance obligations.
• Prepare cash flow systems for Payday Super requirements.
• Avoid making significant changes to clinical documentation based on isolated NDIS decisions.
• Look for patterns across multiple cases before adjusting templates or reporting practices.
• Continue making recommendations that are supported by strong clinical evidence.
• Help participants understand both the opportunities and risks associated with plan reviews and reassessments.

P.S. To join the OT Unplugged Podcast dinner, email [email protected] to reserve your spot. It will be held on Tuesday 23 June following the OTX drinks on Day 1 of OT Exchange.

Occupational Therapy careers rarely follow a straight line. Many OTs begin with a clear idea of where they’re heading, only to find themselves moving into completely different spaces years later.

Clinical work evolves, industries shift and new opportunities emerge. Alongside this, many therapists are recognising the growing importance of connection, mentorship and sustainable ways of working.

The OT career you imagine may not be the one you build

Many OTs enter the profession expecting to work in hospitals, paediatrics or traditional clinical roles long term. Yet careers often evolve into leadership, mentoring, supervision, education, business ownership or advocacy.

For newer therapists, particularly those entering during the NDIS era, private practice can sometimes feel like the default pathway. In reality, occupational therapy offers far more diversity.

Some therapists thrive in specialist clinical roles. Others are drawn to leadership, systems work or education. Neither pathway is better – careers simply change over time.

Why early career OTs don’t need all the answers

Students and new graduates are entering the profession during significant reform and uncertainty. With constant NDIS updates and workforce pressures, it can feel like there’s an endless amount to learn.

But early career therapists do not need to master everything immediately.

Strong clinical foundations still matter most. Confidence, professional identity and career direction develop gradually through experience.

Many experienced OTs working in leadership or education today never imagined those roles when they first graduated.

The hidden opportunities within occupational therapy

Occupational therapy careers are now broader than many therapists originally expected.

Mentoring, supervision, consultancy, training, digital education and professional development businesses have become increasingly visible career pathways. Many clinicians are building portfolio careers that combine clinical practice with leadership or education.

There is no single version of success within OT.

Some therapists prioritise flexibility, others value autonomy and some simply want to become exceptional clinicians. The profession is broad enough to support all of these goals.

Balancing clinical work and sustainability

One of the biggest challenges for experienced OTs is balancing clinical work with growing non-clinical responsibilities.

Supervision, presentations, training development, business administration and leadership all require significant time and energy. For therapists who genuinely love clinical work, reducing caseloads can also feel difficult.

As a result, many OTs are becoming more intentional about workload management, time blocking and protecting non-clinical work time.

There is also growing recognition that sustainable careers matter more than constantly operating at full capacity.

Why connection matters more than ever

Across disability, aged care and healthcare systems more broadly, many OTs are feeling the pressure of constant reform and change.

In response, therapists are increasingly prioritising genuine professional connection over hard-sell marketing or rapid business growth. OTs want spaces where they feel informed, supported and understood.

Community matters because not everyone learns best through policy documents and lengthy written updates. Shared conversations and practical discussions often make complex industry changes feel far more manageable.

This has become especially important throughout ongoing NDIS reform, where therapists are looking for reliable and accessible ways to stay informed.

The value of community during industry change

Conferences, networking events, mentorship spaces and online OT communities are becoming increasingly valuable.

They provide reassurance that therapists are not navigating these challenges alone while also exposing OTs to the incredible diversity within the profession.

At a time of rapid change, professional community is helping many therapists feel more connected, informed and hopeful about the future of OT.

Occupational therapy careers are no longer one-dimensional

The modern OT career is far more flexible than many therapists initially expect.

An OT may begin in hospital work before moving into private practice, supervision, leadership or education. Others may remain deeply clinical throughout their entire careers.

Most therapists will experience multiple versions of their career over time – and that flexibility is one of the profession’s greatest strengths.

Supporting sustainable OT careers moving forward

Sustainable OT careers are not built solely on productivity or growth.

They are built on meaningful work, professional connection, adaptability and the ability to evolve over time.

There is no single ‘correct’ OT career pathway. The profession continues to change – and so do the people within it.

Key takeaways for OTs
• OT careers often evolve in unexpected ways over time
• Professional connection and community are becoming increasingly important across the profession
• Early career OTs do not need to have every aspect of their future career mapped out immediately
• Sustainable careers require balancing clinical work with wellbeing and professional growth
• Occupational therapy offers diverse pathways including leadership, mentoring, education and business development
• Different seasons of life may require different approaches to work and career planning
• Building strong clinical foundations remains valuable even as the profession changes
• Flexibility and adaptability are becoming essential long-term career skills for OTs

A significant period of change
The disability sector is facing another major round of NDIS reform. The proposed legislation has sparked widespread discussion among Occupational Therapists, participants and advocacy groups, with many working to understand what the changes could mean in practice.

Importantly, the reforms are not yet law. The legislation must still progress through consultation and parliamentary processes, creating an opportunity for the disability community to provide feedback and advocate for change.

A shift towards standardisation
Many of the proposed reforms introduce more standardised approaches to eligibility, funding and decision-making. While consistency may improve administrative efficiency, disability support often relies on understanding individual circumstances, environments and goals.

For Occupational Therapists, this tension between standardisation and individualisation sits at the heart of many concerns. The proposed changes raise questions about how effectively future systems will reflect the complexity of people’s lives and support needs.

Changes to NDIS access and eligibility
Several proposed reforms focus on how people access the NDIS and demonstrate eligibility. These include changes to functional capacity assessments and stronger expectations around treatment history before support can be approved. Together, these measures could reshape how disability-related needs are assessed and understood.

A new approach to functional capacity
The draft legislation proposes assessing functional capacity without considering assistive technology or support from others.

For Occupational Therapists, this represents a significant departure from established practice. Functional capacity is rarely understood in isolation. Environmental barriers, informal supports and assistive technology all influence how a person participates in daily life. Removing these factors risks creating an incomplete picture of disability and support needs.

The challenges may be even greater for people with complex, overlapping or fluctuating disabilities, where function can vary significantly depending on context and available supports.

Treatment requirements and access barriers
The proposed legislation would also strengthen requirements for participants to demonstrate they have explored available treatments before accessing the NDIS.

While intended to clarify eligibility, concerns have been raised about how this would work in practice. Access to treatment can be limited by geography, cost or service availability, and some people may reasonably choose not to pursue interventions that carry significant risks or side effects. Questions also remain about how treatment, rehabilitation and capacity-building supports will be distinguished, particularly for people with complex or long-term conditions.

Funding and support decisions
Beyond eligibility, the proposed reforms could influence how supports are funded and which interventions participants can access.

One of the most discussed changes is the introduction of powers that could allow funding limits to be applied across categories of NDIS supports. While current discussion has focused on therapy funding, the proposed mechanism could potentially be used more broadly. This raises concerns about whether future funding decisions will continue to reflect individual circumstances and goals.

The legislation would also provide the NDIA with greater authority to determine which interventions are considered evidence-based. Although evidence-informed practice is essential, research often takes time to catch up with emerging interventions and assistive technology. A lack of extensive evidence does not necessarily mean a support is ineffective, particularly when strong clinical outcomes are being achieved.

There are concerns that stricter interpretations of evidence could reduce participant choice and limit access to supports that are currently delivering meaningful benefits.

The growing role of automation
The legislation also expands the use of automated decision-making processes within the NDIS.

While automation may improve efficiency, disability support decisions often require nuanced understanding of individual circumstances. Maintaining appropriate human oversight will be critical to ensure decisions remain fair, transparent and responsive to participant needs.

Why Occupational Therapist engagement matters
Occupational Therapists bring valuable expertise to conversations about disability, function and participation. Their day-to-day experience provides important insight into how legislative changes may affect people in real-world settings.

As consultation continues, feedback from practitioners can help highlight practical implications and ensure participant experiences remain central to policy discussions. Organisations such as the OT Society for Hidden and Invisible Disabilities (OTSI) and Occupational Therapy Australia are actively supporting advocacy efforts and providing resources to help clinicians understand the proposed reforms.

Looking ahead
The proposed NDIS reforms have the potential to reshape eligibility, funding and service delivery across the disability sector. While many questions remain unanswered, the consultation process offers an important opportunity for Occupational Therapists and participants to contribute to the conversation.

Understanding the proposed changes now will help practitioners, providers and participants prepare for whatever comes next. The decisions made in the coming months may influence disability support and Occupational Therapy practice for years to come.

Key takeaways for OTs
• The proposed NDIS legislation is still under consultation and has not yet become law.
• Many of the reforms reflect a broader shift towards more standardised decision-making.
• Proposed functional capacity assessments may place less emphasis on environmental factors and supports.
• Stronger treatment requirements could create barriers for some participants seeking access.
• Changes to funding powers and evidence requirements may affect participant choice and support flexibility.
• Increased automation highlights the need for ongoing human oversight in decision-making.
• Occupational Therapist perspectives remain critical in shaping the future direction of disability policy.

Links
🖥️ FREE NDIS Insights: Unpacking the Proposed NDIS Bill and Impact to OTs & Participants: https://www.verveotlearning.com.au/free-ndis-insights-unpacking-the-proposed-ndis-bill-impact-to-ots

🔗 Securing the NDIS for Future Generations Bill: https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22legislation%2Fbills%2Fr7487_first-reps%2F0000%22;rec=0

🔗 Explanatory Memorandum: https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22legislation%2Fems%2Fr7487_ems_35e6531f-c440-4faf-98d6-7c7ddd8bd539%22

🔗 Make a Submission: https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/NDISFutureGenBill

A major shift in early childhood supports

The long-anticipated Thriving Kids rollout is beginning to take shape in New South Wales, offering the clearest indication yet of how early childhood supports may operate from October 2026.

Children already on the NDIS are not expected to be removed immediately. However, children aged eight and under who may previously have entered the NDIS under mild to moderate autism categories are expected to be redirected into Thriving Kids instead.

This marks a significant shift for OTs, families and private providers.

While the program includes many evidence-based early intervention ideas, it is also arriving alongside tighter NDIS eligibility. For many clinicians, the concern is not the existence of Thriving Kids itself, but what families may lose access to in the process.

What the Thriving Kids model includes

The current draft specifications outline a system focused on short-term, early intervention supports for children, families and carers.

Proposed services include supported playgroups, parenting programs, peer support and allied health intervention delivered individually or in groups. There is also a strong focus on family navigation and coordination.

Importantly, the model appears focused on functional support rather than diagnosis.

General supports and early intervention

The general supports stream includes playgroups, parenting programs, peer support and referral services.

The draft also includes allied health “in-reach” within these programs, allowing clinicians to observe children in play-based settings, provide developmental guidance and support referrals into targeted services.

For many OTs, this resembles community outreach models already operating within some health services.

Targeted allied health supports

The targeted support stream includes time-limited, goal-focused allied health intervention.

Services may be delivered individually, in groups or through multidisciplinary collaboration across clinics, homes and community settings.

Although exact limits have not yet been released, the wording strongly suggests therapy caps around intensity and duration.

Group intervention also appears likely to play a larger role. While groups can work well for some children, clinicians are concerned they may become the primary pathway for children who require more individualised support.

Why providers are concerned

One of the biggest challenges for providers is the proposed commissioning structure.

The New South Wales expression of interest documentation strongly prioritises not-for-profit organisations as preferred providers. This has created widespread concern across private practice, particularly for regional and rural clinicians who are already filling workforce gaps.

However, the draft specifications also reference a pre-qualified allied health panel that may allow private practitioners, sole traders and small businesses to deliver fee-for-service supports where service gaps exist.

This pathway appears especially relevant in thin-market and regional locations where NGOs or public services may not have enough workforce capacity.

The practical reality in regional areas

For many regional communities, private practitioners are already the only available providers.

Long waitlists, recruitment difficulties and workforce shortages remain significant issues. As a result, practices operating in these locations may have stronger opportunities to demonstrate why private allied health involvement remains essential.

The expression of interest process allows providers to outline:

There is also a strong emphasis on collaboration between providers, including partnerships with Aboriginal community-controlled organisations and allied health services.

For some smaller practices, consortium-style partnerships may become an important pathway moving forward.

The return of capped intervention models

Many clinicians recognise similarities between Thriving Kids and pre-NDIS systems where intervention was often short-term and group-based.

The concern is not necessarily that group programs exist, but whether children who need ongoing support will still have access to consistent therapy.

Families of children with ADHD, anxiety and developmental concerns have already struggled to access support under the current system. Many providers worry more children may now fall into those same gaps.

At the same time, parts of the model are genuinely promising.

The focus on peer support, family navigation, early touchpoints and community-based intervention aligns strongly with best-practice early childhood approaches. If these services were being introduced alongside existing NDIS access, many clinicians would likely welcome the program enthusiastically.

Questions around assistive technology and coordination

The draft specifications also include low-cost assistive technology funding for communication, mobility, sensory regulation and daily functioning.

However, clinicians have raised concerns about how equipment provision will work in practice.

Mobility and sensory supports rarely succeed through equipment alone. Effective implementation usually requires assessment, training and follow-up support. There is still little detail about funding caps, approved product pathways or how therapy input will integrate alongside equipment provision.

The program also introduces a family support coordination role designed to help families navigate services and systems.

Rather than a traditional NDIS key worker model, this role appears more focused on care coordination and oversight. For families navigating multiple systems, this could become an important source of continuity.

Preparing your practice for what comes next

Despite ongoing uncertainty, one message is becoming increasingly clear.

Private practices will need to think strategically about diversification.

Many providers are already exploring private fee-paying pathways, school-based supports, community partnerships and collaborative service models. Others are considering consortium arrangements to strengthen future tender opportunities.

There is still substantial uncertainty around pricing, therapy caps and implementation. However, waiting for complete clarity may leave practices unprepared.

For OTs, this is likely to be a period of recalibration rather than business as usual.

Key takeaways for OTs

• Thriving Kids is expected to begin in New South Wales from October 2026.
• Children already on the NDIS are not expected to lose access immediately, but new children may enter Thriving Kids instead.
• The model appears focused on short-term, goal-based and group-oriented intervention.
• Current documentation strongly favours NGO-led delivery.
• Regional and rural providers may still play a significant role where workforce shortages exist.
• Collaboration and partnership models are likely to become increasingly important.
• Practices should begin considering diversification strategies now.
• Significant uncertainty remains around funding, therapy caps and implementation.

Links

Communities and Justice: Thriving Kids
https://dcj.nsw.gov.au/community-inclusion/disability-and-inclusion/thriving-kids.html

OT Unplugged - Brisbane Friends of the Podcast Event - 20 May 2026: https://www.trybooking.com/events/landing/1576072

Balmoral Burn Fundraiser Event - Support Sarah here: https://raceroster.com/events/2026/109219/humpty-dumpty-balmoral-burn/pledge/participant/46083634

The Occupational Therapy sector is moving through another period of uncertainty, with ongoing discussions around NDIS pricing, registration and funding changes continuing to dominate conversations across the profession. At the same time, conference and expo season is underway, giving OTs a valuable opportunity to reconnect, learn from one another and strengthen professional networks.

In recent conversations across the OT community, one thing has become increasingly clear – while there is still a lot we don’t know about upcoming NDIS changes, there is enormous value in staying informed, avoiding misinformation and leaning into community support.


Understanding the current NDIS funding discussion

One of the biggest concerns circulating at the moment is the discussion around NDIS plan reductions. There has been widespread confusion, with some providers and coordinators hearing claims that all plans will be reduced to a fixed amount.

What has actually been communicated so far is that the government intends to gradually reduce overall plan spending back toward average funding levels seen around 2023. Reports suggest this may involve reductions somewhere in the range of approximately 22% to 30% overall, but the exact implementation process remains unclear.

Importantly, this does not mean every participant will suddenly receive the same funding amount. The details of how any reductions may occur have not yet been released, and there is still uncertainty around whether changes will happen during scheduled plan reviews or through broader administrative adjustments.

For OTs supporting participants through this period, caution around misinformation is critical. Many conversations currently happening online and within services are based on speculation rather than confirmed policy.


Why the annual pricing review matters

A key document many providers are waiting for is the annual pricing review report. This report is expected to provide further clarity around pricing recommendations, registration pathways and possible future pricing structures.

The annual pricing review is separate from the final NDIS price guide. The review outlines recommendations and findings gathered through consultation, while the price guide confirms the actual operational changes providers will need to follow.

This distinction matters because many OTs are currently feeling pressure to begin registration processes immediately, despite not yet knowing what future registration requirements or pricing models may look like.

For many providers, particularly sole traders and small practices, the most practical approach right now may simply be to stay informed, monitor updates closely and avoid making rushed decisions before the full details are released.


NDIS worker screening checks for unregistered providers

Another area creating confusion for many therapists is the NDIS worker screening check process for sole traders and unregistered providers.

While requirements vary slightly between states, the process generally involves applying through the relevant state authority before linking the screening clearance through the NDIS Commission’s unregistered provider portal.

For sole traders, this can feel unnecessarily complicated because providers are often required to effectively link themselves to their own unregistered provider account.

The worker screening process itself is relatively straightforward once the systems are set up correctly. Most therapists will need to provide identification documents such as a Medicare card, passport and driver’s licence, complete an online application and attend an in-person identity check.

One positive development is that NDIS worker screening checks are now increasingly being recognised within aged care settings, reducing the need for duplicate police checks in some circumstances.

For OTs considering future registration, obtaining a worker screening check may be one practical step worth completing early while waiting for further policy announcements.


Conference season brings connection and perspective

Alongside all the uncertainty, conference and expo season has arrived, bringing much-needed opportunities for connection within the OT profession.

Large events such as ATSA and OTX require significant preparation from exhibitors, educators and providers. Behind every stand is a huge amount of planning, logistics, freight coordination and setup work that many attendees never see.

For therapists attending these events, expos can provide far more than just product displays or CPD opportunities. They create space for relationship building, idea sharing and genuine community connection at a time when many clinicians are feeling professionally isolated or overwhelmed.


Why networking matters for OTs

Professional networking is often misunderstood as formal or transactional, but for many OTs, it becomes one of the most valuable long-term career investments.

Strong professional networks help therapists build referral pathways, identify trusted service providers and create collaborative support systems that ultimately benefit clients.

For clinicians running private practices, these relationships can become particularly important during periods of transition or uncertainty. Having established connections with other providers makes it easier to coordinate care, refer appropriately and support participants when service needs change.

Networking also creates emotional support within a profession that can sometimes feel isolating. Simply being around other OTs who understand the pressures of clinical work, business ownership and the evolving NDIS landscape can make a significant difference.

Importantly, networking does not need to feel forced or performative. Often, the most meaningful professional relationships begin through simple conversations over coffee, shared experiences at conferences or casual introductions at industry events.


Making the most of conferences and expos

Many OTs feel intimidated by networking events or unsure how to approach large exhibitions. The reality is that there is no single right way to participate.

Some clinicians enjoy speaking to every exhibitor they encounter, while others prefer to quietly explore before choosing who they want to engage with more deeply. Both approaches are completely valid.

The most valuable conference experiences often come from approaching events with intention. Rather than collecting endless flyers or free merchandise, it can help to think ahead about what you actually want to gain from the experience.

For some therapists, this may mean exploring referral pathways or learning more about local services. For others, it may involve discovering new equipment, asking questions about complex clinical areas or connecting with peers facing similar challenges.

Students can particularly benefit from attending expos when they approach them with curiosity. Asking thoughtful questions about workplace culture, career pathways, client groups and clinical roles often leads to far more meaningful conversations than simply collecting brochures or promotional material.

Approaching conferences with a clear sense of purpose can help therapists feel less overwhelmed and more confident engaging with exhibitors, educators and peers.


Balancing innovation with practicality at expos

Exhibitors are increasingly looking for creative ways to stand out at conferences, but there is growing awareness that practical value matters more than novelty.

Many attendees no longer want to carry large amounts of printed material home from events, leading providers to experiment with QR codes, digital resources and more streamlined information sharing.

At the same time, there is still value in creating memorable experiences that reflect a brand’s personality and values. The challenge for exhibitors is finding the balance between engaging attendees and ensuring resources remain genuinely useful.

For OTs considering future exhibiting opportunities, clear planning around goals, budget and intended outcomes can make a significant difference. Understanding whether the focus is on education, visibility, networking or referral growth helps shape a far more effective conference strategy.


Building community during uncertain times

The OT profession is currently navigating significant change, and uncertainty within the NDIS space continues to create understandable stress for providers and participants alike.

But amid the complexity, one thing remains incredibly valuable – connection.

Whether through conferences, networking events, online communities or informal peer support, staying connected with other therapists creates opportunities for shared learning, collaboration and reassurance.

At a time when many OTs are searching for clarity, community may be one of the most important professional resources we have.


Key takeaways for OTs

• Current NDIS funding discussions do not mean every participant’s plan will be reduced to the same amount.
• The annual pricing review and upcoming price guide are expected to provide further clarity on registration and pricing changes.
• Sole traders and unregistered providers may still complete NDIS worker screening checks through the unregistered provider portal.
• Conference season offers valuable opportunities for networking, learning and professional connection.
• Attending expos with clear goals can make the experience far more meaningful and manageable.
• Strong professional networks support referral pathways, collaboration and long-term career resilience.
• Community connection remains essential during periods of industry uncertainty.

Sydney Friends of the Podcast: Wednesday 13 May 2026 @ 5:30pm
https://www.trybooking.com/events/landing/1560836

Brisbane Friends of the Podcast: Wednesday 20 May 2026 @ 5:30pm
https://www.trybooking.com/events/landing/1576072

The current NDIS landscape is shifting quickly, and many Occupational Therapists are being asked to make decisions without having all the information. Between proposed funding changes, evolving reporting expectations and ongoing uncertainty around registration, it’s easy to feel overwhelmed.

Rather than trying to predict every outcome, the focus right now is on understanding what’s changing, what it means in practice and how to respond in a way that is both clinically sound and sustainable for your business.

Preparing for changes to social and community participation funding

One of the biggest concerns is the proposed reduction in social and community participation funding. While details are still emerging, early indications suggest a significant cut for many participants.

What’s important to recognise is that this funding is often not just used for social outings. It supports essential daily activities such as attending medical appointments, grocery shopping and accessing community services.

If funding is reduced, the need for support does not disappear. In many cases, it simply shifts. Participants may still require assistance at home, which can increase pressure on families and create new risks if appropriate supports are not in place.

Adapting your reporting approach

These changes highlight the need to be far more explicit in reporting.

Rather than broadly referencing social participation, reports should clearly outline how funding is currently being used, why those supports are essential for daily functioning and what risks may arise if they are reduced.

It is also important to articulate what alternative supports would be required if funding is changed. This ensures that reports reflect the real-world impact on the participant, rather than abstract recommendations.

Clarity, specificity and clinical reasoning are more important than ever.

Functional assessments on file: necessary or not?

There has also been an increase in requests for updated functional assessments “just in case”. While this may feel like a protective strategy, it is not always the best use of funding.

If a participant has had a recent assessment and there have been no meaningful changes, completing another report may not provide additional value. In contrast, if circumstances have changed, eligibility is unclear or documentation is outdated, an updated assessment may be justified.

The key is shared decision-making. Presenting the pros and cons allows participants and their families to make informed choices, rather than defaulting to unnecessary reporting.

Should you register as an NDIS provider?

With all of these changes, it is no surprise that the question of registration is coming up again.

There is ongoing discussion around mandatory registration and potential pricing differences between registered and non-registered providers. However, there is still no clear timeline or confirmed model for what this will look like.

Registration is not a simple decision. It depends on your service type, business structure and financial position. Therapists providing therapeutic supports may access the verification pathway, while those in early childhood or behaviour support may face significantly higher costs through certification.

Adding to the complexity is the likelihood that the system will change again. Investing in registration now may not mean avoiding future requirements.

Understanding the true cost of registration

Registration involves far more than the initial fee.

Beyond upfront costs, there is a significant time investment in preparing documentation, undergoing audits and maintaining compliance. This includes systems for staff checks, professional development, incident management and infection control.

Importantly, it is not enough to have policies in place. You must demonstrate how they are implemented in practice. Audits often include staff interviews and evidence of real-world application.

While these systems become easier to maintain over time, the initial setup can be substantial, particularly for smaller practices.

Making a business decision, not an emotional one

Given the uncertainty, registration decisions need to be grounded in business strategy rather than fear.

This includes considering how long you plan to remain in the NDIS space, whether you have the financial capacity to absorb costs and whether your client base will require registration in the future.

For some areas of practice, particularly paediatrics, the future demand within the NDIS is still unclear. This makes it even more important to carefully weigh the return on investment.

There is no universally correct answer, only what makes sense for your individual context.

Staying grounded in uncertainty

The lack of clear direction is one of the biggest challenges right now. With multiple changes pending, it is easy to feel like every decision carries significant risk.

This is where intentional decision-making becomes critical. Focusing on what you know, what you can control and what aligns with your values will lead to more sustainable outcomes.

Small, considered actions will always be more effective than reactive decisions driven by uncertainty.

Key takeaways for OTs

• Start with what is changing in funding and how it impacts your clients
• Be explicit in reports about how supports are used and why they are essential
• Only complete functional assessments when there is clear clinical value
• Use shared decision-making with participants when considering reports
• Registration is a business decision, not a reactive one
• Consider both upfront and ongoing costs of becoming registered
• Wait for further NDIS updates where possible before committing
• Stay intentional and focus on what is within your control

Links

Life Skills Training for NDIS OTs with Nikki Cousins: https://www.verveotlearning.com.au/Life-Skills-Training-for-NDIS-OT-Providers

A Coregulation Approach to Emotional Regulation in Paediatric OT with Alyce Svensk: https://www.verveotlearning.com.au/Supporting-Children-with-Emotional-Regulation-Challenges

The National Disability Insurance Scheme is entering a major reform phase, with sweeping changes designed to improve long-term sustainability. These updates will reshape how people access the scheme, how funding is allocated and how services are delivered.

While some reforms aim to strengthen consistency and reduce misuse, others introduce significant shifts that will directly impact participants and the clinicians who support them. For Occupational Therapists, understanding the direction of these changes is essential for navigating what comes next.

A system under pressure

The driving force behind this reset is cost growth. The scheme has expanded rapidly, both in participant numbers and overall expenditure, prompting concerns about its long-term viability.

In response, the government has outlined a four-year reform plan focused on reducing fraud, slowing spending, clarifying eligibility and improving service quality. A new legislative package is expected to be introduced and passed quickly to enable these changes.

A fundamental shift to functional capacity

At the centre of the reform is a move away from diagnosis-based access towards functional capacity. Eligibility will increasingly depend on whether a person has substantially reduced functional ability, rather than the presence of a specific condition.

This change will be supported by a new standardised assessment tool, although key details remain unclear, including who will complete these assessments and how they will be implemented in practice.

Over time, this approach is expected to apply not only to new applicants but also to existing participants as their plans are reviewed.

Fewer participants, tighter entry

Alongside changes to eligibility, the government is aiming to significantly reduce the number of people on the scheme compared to current projections.

This will likely occur through stricter access criteria, reassessment of existing participants and a greater reliance on supports outside the NDIS. While funding has been allocated to strengthen these alternative systems, there is limited clarity about how they will function or whether they will meet demand.

Funding changes that will impact daily life

One of the most immediate and tangible changes is the reduction in social and community participation funding. Budgets will be reset to align with earlier averages, resulting in an estimated 30 per cent decrease for many participants.

These reductions are expected to begin from October 2026 and may occur regardless of where a participant is in their plan cycle. This represents a significant departure from previous approaches and may create uncertainty for participants who rely on this funding for everyday activities.

Although a national fund has been proposed to support community-based alternatives, questions remain about whether this will adequately replace individualised supports.

Reduced flexibility in plan management

Changes to plan reassessment processes will also affect how participants respond to changing needs. Stricter criteria for unscheduled reviews are expected to limit access to additional funding within a plan period.

While intended to reduce overspending, this may also reduce responsiveness when circumstances change, placing greater pressure on initial planning accuracy.

Provider reforms and market shifts

The reform package includes several changes that will reshape the provider landscape.

Mandatory registration will apply to providers delivering higher-risk supports, particularly those involving personal care or restrictive practices. In addition, a new system will require basic identification or enrolment for most providers, improving visibility across the sector.

Plan management will also undergo significant restructuring, with a move towards an approved panel system. This is likely to reduce the number of providers and may disproportionately impact smaller businesses.

There are also early indications of differentiated pricing, potentially favouring registered providers, although details are still emerging.

A move towards commissioned supports

A notable structural change is the potential introduction of commissioning for home and living supports. This would involve funding a select group of providers directly, rather than allowing participants to choose freely from the market.

While this approach may improve consistency and cost control, it represents a shift away from participant choice and could reduce the diversity of available options.

Strengthening compliance and oversight

Fraud prevention and compliance remain key priorities within the reform. Planned changes include improved payment systems, increased evidence requirements and expanded regulatory powers.

These measures are designed to protect participants and ensure funds are used appropriately, addressing ongoing concerns about misuse within the scheme.

What this means for Occupational Therapists

Although many of the changes do not directly target allied health, the flow-on effects will be significant.

Occupational Therapists will need to support participants through funding reductions, changing eligibility criteria and increased uncertainty. Clear, functional evidence will become even more important in demonstrating need and justifying supports.

There will also be a growing role in helping participants adapt to reduced flexibility and navigate alternative support systems outside the NDIS.

What to watch next

Many elements of the reform are still evolving, with further detail expected as legislation is introduced and implementation plans are released.

Key areas to monitor include the development of the functional assessment tool, the rollout of support needs assessments from 2027 and updates to pricing and provider regulation.

Staying informed and adaptable will be critical as the scheme continues to shift.

Key takeaways for OTs
• Expect a stronger focus on functional capacity in both access and funding decisions
• Prepare for future changes to assessment processes, including support needs assessments
• Be aware of reductions in social and community participation funding and how this affects clients
• Anticipate tighter rules around plan reassessments and reduced flexibility
• Monitor provider reforms, including registration and pricing changes
• Strengthen reporting to clearly demonstrate functional impact and support needs
• Support participants to navigate both NDIS changes and alternative support pathways

Links
Speech Transcript made by Mark Butler at National Press Club on 22/04/2026: https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/minister-butler-speech-at-the-national-press-club-22-april-2026?language=en&fbclid=IwY2xjawRVYFdleHRuA2FlbQIxMABicmlkETFzVm1kUkFuUVJGMDBvbEN4c3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHsmjiG7yqVQOEl0d_2wkkwEh2weHvl2Xra9wg4zmbTRx95bkZNBb_MJFWhbq_aem_YgrkLacZXUDHpufvM0KOZA

Securing the NDIS for future generations fact sheet: https://www.health.gov.au/sites/default/files/2026-04/securing-the-ndis-for-future-generations_0.pdf