Sometimes we need to contact a provider to confirm or correct a line item before we can process a claim.
This page explains why we may request a correction and what you need to do to help us process your claim as quickly as possible.
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Disability-Related Health Supports (DRHS).
If the line item on your invoice is a Disability-Related Health Support, we’ll need either:
- Confirmation that the line item is correct
- A reissued invoice with the correct line item.
Using the correct line item helps protect a Member’s NDIS Plan funding and ensures claims meet NDIS requirements.
If you’re unsure whether a support is considered a Disability-Related Health Support, we recommend checking the NDIS guidance before submitting your claim.
When should DRHS line items be used?
Core Disability-Related Health Supports line items were introduced to provide additional flexibility for eligible health supports that are directly related to a person’s disability.
These line items:
- Are not a replacement for Capacity Building – Improved Daily Living funding
Should not be used for standard therapy or allied - health appointments
- Can only be used where the support meets the NDIS criteria for a Disability-Related Health Support.
They aren’t intended to replace exhausted Capacity Building budgets or fund general therapy supports.
What is a Disability-Related Health Support?
A Disability-Related Health Support is a support that:
- Directly relates to a Member’s functional impairment because of their disability
- Helps the Member work towards their goals and participate in everyday life
- Usually is the responsibility of the health system if the person didn’t have disability, but also meets the NDIS reasonable and necessary criteria.
Examples may include:
- Dysphagia management
- Diabetes support
- Respiratory therapy
- Stoma care
- Complex wound management
- Continence support.
Before you submit a claim.
Please make sure:
- The DRHS line item is appropriate for the support delivered
- General therapy and Capacity Building supports aren’t claimed using Core DRHS line items
- Your service agreement reflects the support being provided
- DRHS line items aren’t used simply because a Member’s Capacity Building budget has been exhausted.
Transport.
If we’ve contacted you about a transport line item, it means the line item on your invoice doesn’t match the service provided.
Tips for claiming transport correctly.
Before submitting your claim, please ensure you:
- Use the non-labour travel line item that matches the registration group and support delivered
- Have a service agreement that includes any approved travel costs, including labour and non-labour travel where applicable
- Only use Transport line item 02_051_0108_1_1 when claiming against a Member’s Transport funding for General transport.
1. Provider travel – labour.
Use this when claiming for the time a worker or therapist spends travelling to or from a face-to-face support.
Claims are made using:
- The same line item as the primary support, or for Allied Health providers, the primary support line with the “PT” suffix
- The Provider Travel claim type.
Travel time limits apply under the NDIS Pricing Schedule. Refer to the current guide for full eligibility requirements.
2. Provider travel – non-labour.
Use this for vehicle running costs such as:
- Kilometres travelled
- Tolls
- Parking.
Claim these costs using the provider travel – non-labour line item that matches the registration group of the support provided.
For example, community access supports use line item 04_799_0125_6_1 for individual supports with the registration group 0125 – ‘Participation In Community, Social And Civic Activities’.
Different support types use different line items, so it’s important to check the correct registration group before claiming. You can find the different registration groups on the Pricing Schedule under ‘Registration Groups’.
3. Activity-based transport.
Use activity-based transport when transporting or accompanying a Member is part of delivering the support.
Claim:
- The worker’s time using the primary support item
- Vehicle costs using the relevant activity-based transport line item.
Standard provider travel line items shouldn’t be used for activity-based transport claims.
4. General Transport funding.
Line item: 02_051_0108_1_1
This line item is used when claiming against a Member’s Transport budget for regular transport assistance, such as travel to work, appointments or community activities.
This funding is separate from provider travel and doesn’t require the provider to accompany the Member as part of delivering a support. This could be where the transport is provided, but the service or support may be provided by somebody else (such as driving a participant to a Dr’s appointment).
Need more information?
This information is based on the current NDIS Pricing Schedule and related guidance. As NDIS rules and pricing may change, always refer to the latest information on the NDIS website.
If you have questions about your invoice or a requested correction, please contact the Leap in! team at [email protected] or call us on 1300 05 78 78.