Recent NDIS updates are reshaping how therapy supports and respite services are delivered and justified. Two new documents – the Therapy Support Guideline and the Short-Term Respite Guideline – mark a significant shift in expectations for evidence-based practice, outcome measurement and funding accountability.

For OTs, these changes mean reviewing how group programs, therapy assistant hours and respite recommendations are structured, documented and billed. While the intent is greater consistency and transparency, the practical implications will be felt across paediatric, community and functional assessment work.

New expectations for evidence-based therapy

The Therapy Support Guideline places strong emphasis on therapy being explicitly evidence based, outcome driven and capacity building in nature. It also highlights that therapy must demonstrate measurable improvement in functional capacity, not simply maintenance or general participation.

For many OTs, particularly those in paediatrics, this signals a need to clearly link every intervention to research evidence or documented clinical reasoning. Interventions such as Lego-based social skills groups or animal-assisted therapy can still be justified, but only when delivered as occupational therapy interventions supported by measurable outcomes.

Clinicians running group programs will now need to show the functional gains achieved during participation, gather baseline data before and after sessions and demonstrate how the group supports capacity building rather than maintenance. This represents a move away from broad social or recreational groups toward structured, evidence-backed interventions.

Clarifying qualifications and the role of therapy assistants

The guideline also tightens requirements around professional qualifications. For example, speech pathologists must be certified practicing members of Speech Pathology Australia to provide NDIS-funded therapy. Similar expectations apply across all allied health disciplines, reinforcing that services must be delivered by appropriately accredited practitioners.

It also clarifies how therapy assistants can be used. While assistants remain an important part of therapy delivery, OTs cannot bill for student-led sessions or any time when the supervising clinician is not present. However, supervision time within the participant’s session can still be billed if the OT is directing the work in real time.

These updates underline the NDIA’s focus on value for money and accountability, ensuring that therapy hours funded under plans directly reflect qualified professional input.

Group programs and reporting requirements

Group-based interventions remain permissible but must now show clear evidence of effectiveness and link to functional outcomes. Invoices and program descriptions should reflect that the service is an occupational therapy group, not a “social skills” or “Lego group”, as these labels risk being flagged for non-compliance.

Clinicians are advised to document outcomes in progress reports that are concise but evidence informed. The NDIA’s new reporting preference is for short, factual summaries that show where the participant started, what interventions were delivered, what measurable change was achieved and what recommendations follow.

This shift will require services to collect clearer baseline data, reference clinical evidence where relevant and maintain defensible reasoning behind every intervention.

Capacity building versus maintenance therapy

The distinction between capacity building and maintenance therapy has reappeared after several years of absence from NDIS language. OTs are now expected to define which type of therapy is being delivered, how long it will be required and what measurable change is anticipated.

While maintenance therapy remains fundable in certain contexts, it will require robust justification and alignment with the participant’s goals. Progress reports will need to demonstrate that services continue to add value beyond routine care.

Short-term accommodation becomes short-term respite

The second major update redefines Short-Term Accommodation (STA) as Short-Term Respite (STR). This change signals a clearer intent: funding is now strictly for sustaining informal supports rather than providing holidays or capacity-building experiences.

Respite is now expected to occur within the participant’s own state or territory, unless interstate travel is more cost effective. Participants can stay in hotels or short-stay rentals if clinically appropriate, but the focus must remain on maintaining carer relationships and wellbeing, not leisure.

Under the new model, funding is based on the actual level of support required rather than a daily flat rate. For example, if a participant usually receives 12 hours of support per day, respite will be funded at that level, not for 24-hour coverage. Participants already receiving more than 18 hours of paid support daily are generally not eligible for additional respite funding.

Clarifying purpose and eligibility

Short-term respite is now explicitly for sustaining informal carers and ensuring participants continue accessing their usual daily activities. It cannot be used for capacity building or skill development, even though this was common practice previously.

Eligibility will now depend on factors such as the intensity of supports required, the presence of complex behaviour or high-intensity needs, the risk of carer burnout and whether informal supports have additional caring responsibilities, such as other children or family members with disability.

In the paediatric space, this last factor will be particularly important. Reports recommending respite should clearly evidence how it sustains carers and why this is necessary for family functioning.

Funding and compliance implications

Meals and activities are no longer automatically included unless respite occurs in a group residence or SIL-style setting. For hotel-based respite, only accommodation and support hours can be claimed.

For many providers, this means revising quotes and cost structures. Respite must now align with the NDIS pricing arrangements and cannot be billed using generic daily rate line items unless explicitly approved.

The guideline also notes that respite will appear as flexible funding within the core budget rather than as a stated support. Participants and plan managers should still ensure that all spending aligns with plan goals and eligibility requirements.

Implications for paediatric and community OTs

For paediatric therapists, the therapy guideline reinforces the need to back interventions with evidence, measurable outcomes and clear rationale. Services that rely heavily on group programs or alternate therapy models will need to tighten documentation and ensure invoices clearly indicate professional oversight.

For community and fucctional assessment OTs, the respite guideline will require more detailed justification for carer relief. Reports must now explicitly link respite recommendations to maintaining informal support capacity rather than participant skill development.

Both updates highlight the NDIA’s continued focus on evidence, accountability and cost containment, reinforcing that high-quality, transparent clinical reasoning remains an OT’s strongest asset.

Key takeaways for OTs