How Does the NDIS Fund Occupational Therapy in 2025–26?

Reading time: 10 minutes  |  Updated: April 2026  |  Written by: TEAH Allied Health Team

If you have an NDIS plan — or you are helping someone navigate one — understanding how the NDIS funds occupational therapy is essential. OT is one of the most widely used and most impactful supports in the scheme, but it is also one of the most misunderstood when it comes to which budget line pays for what, how to check if you have enough funding, and what to do if you need more.

This guide covers everything you need to know about NDIS OT funding in 2025–26: the relevant budget categories, the current pricing, what is and is not funded, how to access OT with different plan management types, and what to do if your current plan does not include enough to meet your needs.

Which NDIS Budget Funds OT?

Your NDIS plan is divided into three broad budget categories: Core Supports, Capital Supports, and Capacity Building Supports. Occupational therapy sits primarily within Capacity Building — specifically the Improved Daily Living subcategory. However, OT-related activity also appears in Capital Supports when it involves assistive technology or home modifications.

Understanding which budget is which matters because the NDIS treats them differently. Core Supports are flexible and can be moved between subcategories. Capital Supports are earmarked for specific items. Capacity Building funds are allocated by subcategory — you cannot generally shift Improved Daily Living funding across to other Capacity Building subcategories.

Capacity Building — Improved Daily Living Explained

The Capacity Building — Improved Daily Living subcategory (support purpose code 15) is the primary mechanism through which the NDIS funds occupational therapy. Its stated purpose is to fund assessment, training, or therapy that helps a participant build skills, increase independence, and participate more fully in their daily life and community.

This broad mandate covers a wide range of OT activity — from a single functional assessment to an ongoing therapy program spanning many months. The NDIA’s expectation is that Capacity Building supports are an investment in the participant’s future independence, not simply an ongoing service. In practice, however, many NDIS participants receive both short-term, goal-directed therapy and ongoing maintenance support through this budget.

What Improved Daily Living funds for OT

*Provider travel was subject to NDIS pricing changes in 2025. Confirm current travel claim rules with your OT provider. Travel may be billed at 50% of the applicable hourly rate per kilometre beyond a threshold distance.

Capital Supports — When OT Connects to Equipment and Home Mods

While the OT’s professional time is funded through Capacity Building — Improved Daily Living, the equipment and building works the OT recommends are funded from a completely different part of the plan: Capital Supports.

Capital Supports has two subcategories relevant to OT:

• Capital — Assistive Technology: Funds the physical equipment — wheelchairs, hoists, communication devices, adjustable beds, smart home systems. The OT writes the prescription; the AT budget pays for the item.
• Capital — Home Modifications: Funds the structural building works — ramps, widened doorways, roll-in showers, ceiling hoist tracks. The OT writes the report and specifications; the home modification budget pays for the builder.

NDIS OT Pricing in 2025–26

The NDIA publishes a Pricing Arrangements and Price Limits (PAPL) document each financial year that sets the maximum rates providers can charge for all NDIS-funded supports. Providers may charge at or below these limits — they cannot exceed them for registered NDIS services.

For occupational therapy in 2025–26, the key rates are:

What these rates mean in practice

To give you a sense of how quickly OT funding is used, here are typical cost estimates for common OT engagements at 2025–26 rates:

What OT Services Does the NDIS Fund?

The NDIS can fund a broad range of OT services — but only where they are related to your disability, represent reasonable and necessary supports, and are aligned with your NDIS goals. Here is a practical overview:

Assessments

All forms of OT assessment are fundable under Improved Daily Living, including Functional Capacity Assessments, home modification assessments, assistive technology assessments, SIL and SDA assessments, cognitive assessments, sensory processing assessments, and driving assessments (where relevant).

Therapy

Goal-directed OT therapy programs are fundable — for example, fine motor skill development for a child with cerebral palsy, daily living skill training for someone transitioning to independent living, cognitive rehabilitation following a brain injury, or sensory processing intervention for a participant with ASD. Therapy must be linked to specific NDIS goals and demonstrate capacity-building intent rather than simple maintenance.

Report writing and non-face-to-face work

The NDIA allows providers to claim for report writing, case coordination, clinical documentation, and communication with other providers — within reason. This is significant because OT reports are often substantial documents, and the time required to write them is a legitimate clinical cost. Your OT should itemise non-face-to-face time transparently on their invoices.

Training of support workers and carers

An OT can be funded to train your support workers or family members in manual handling, safe use of assistive equipment, sensory strategies, communication approaches, or other techniques relevant to your care. This is a valuable and underused part of the funding framework.

Telehealth OT

Telehealth OT — delivered via video call — is fundable under Improved Daily Living at the same rates as in-person therapy for eligible service types. Not all OT services can be delivered effectively via telehealth (in-home assessments and equipment trials, for example, require physical presence), but therapy sessions, goal-setting consultations, and some cognitive assessments can be delivered remotely.

What the NDIS Does Not Fund

Understanding the boundaries of OT funding prevents surprises and helps you plan your budget realistically. The NDIS does not fund:

• OT services unrelated to your disability. If your condition is age-related, managed through another health system (such as a chronic disease managed through Medicare), or not listed as an NDIS disability, those services are not fundable through the scheme.
• General health and wellbeing OT. Exercise programs, wellness coaching, and general fitness support are not fundable unless directly linked to a specific disability-related functional goal.
• Day-to-day activities that anyone would need to do. The NDIS does not fund support for ordinary living costs — even if your OT frames them as therapeutic. Cooking a meal is not an NDIS-fundable activity unless you are building a specific, measurable capacity that is genuinely impaired by your disability.
• Private health extras claims. You cannot double-dip — if a service is funded through your NDIS plan, it cannot also be claimed through private health insurance for the same service.
• Support beyond reasonable and necessary. The NDIA assesses every support claim against whether it is reasonable and necessary. Excessive frequency, duration, or scope of OT services relative to identified clinical need can result in claims being disallowed or funding being reduced at plan review.

Agency, Plan-Managed, and Self-Managed – How Your Plan Type Affects OT Access

Your plan management type significantly affects which OT providers you can use and how the funding flow works. Here is a clear breakdown:

How to Check If You Have OT Funding in Your Plan

Before making a referral for OT, it is worth confirming that your NDIS plan includes funding under Capacity Building — Improved Daily Living, and that there is sufficient budget remaining for the type of OT service you need. Here is how:

If you are agency managed

1. Log in to the myNDIS participant portal at my.ndis.gov.au
2. Navigate to My Plan and select the current plan
3. Look for Capacity Building Supports and expand the subcategories
4. Find Improved Daily Living – this shows your total allocation and remaining balance

If you are plan managed

Contact your plan manager directly and ask for the current balance in your Capacity Building – Improved Daily Living budget. Your plan manager has real-time visibility of your spending and can tell you exactly how much is available for OT.

If you are self managed

Check your plan document for the total Capacity Building – Improved Daily Living allocation, then subtract any invoices you have already paid from that budget. You are responsible for tracking your own spending.

What to check before your first OT appointment

• Is Improved Daily Living funding present in your plan?
• Is the balance sufficient for the type of OT service you need? (See our cost estimates above.)
• If you need AT or home modifications – is Capital Supports funding also present?
• When does your current plan expire? OT services started close to a plan expiry may not be completeable before funding rolls over.

What If You Don’t Have Enough OT Funding?

It is common for participants to find that their current plan does not include sufficient Improved Daily Living funding – particularly if their OT needs were not comprehensively documented at their last plan review, or if their disability or circumstances have changed since then.

If this is your situation, you have several options:

Option 1: Request a plan variation

A plan variation is an amendment to your current plan without a full review. You can request a variation if there has been a significant change in your circumstances — such as a new diagnosis, a deterioration in function, a change in living situation, or a clearly identified need that was not anticipated in the current plan. Your support coordinator can help you prepare the request and the supporting evidence.

Option 2: Raise it at your next plan review

If your OT need is not urgent, the most common path is to document it clearly in preparation for your next scheduled plan review. Bring an OT referral or, ideally, a completed OT report as supporting evidence. The more specific and clinically grounded the evidence, the more likely the NDIA is to include adequate Improved Daily Living funding in your new plan.

Option 3: Seek an unregistered OT and self-fund the gap

If you are self-managed or plan-managed and your funding is insufficient, you may choose to pay for some OT services privately to supplement your NDIS funding. This is less common and generally not recommended as a primary strategy — but it is an option where urgent clinical need exists.

Option 4: Ask your support coordinator to help

A skilled support coordinator will know how to navigate the NDIS planning process to advocate effectively for OT funding. If you don’t have a support coordinator but believe you need one, this is worth raising with the NDIA at your next contact.

Frequently Asked Questions

Summary

NDIS OT funding is primarily accessed through Capacity Building — Improved Daily Living, at the 2025–26 rate of $193.99 per hour on weekdays. This budget covers the full range of OT services — assessments, therapy, reports, training, and non-face-to-face work. Equipment and building works recommended by the OT are funded separately through Capital Supports.

Understanding which budget pays for what, how your plan management type affects provider choice, and what to do when your current plan falls short gives you the confidence to navigate the system — and get the OT services your participant or yourself genuinely needs.

At TEAH, we make the funding conversation straightforward. Our intake team will check your plan before your first appointment, identify the right budget lines, and match you with the most appropriate OT for your needs.