NDIS Price Freeze – Why Your OT May Be Getting Harder to Access

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

If you have noticed that finding an NDIS occupational therapist is harder than it used to be, that wait times are longer, that some providers have stopped taking new clients, that your previous OT has left the sector, or that a provider you relied on has closed, you are not imagining it. Something structural has changed, and it has a clear cause.

The NDIS price freeze. Seven years without an increase to the hourly rate that occupational therapists can charge NDIS participants. Seven years in which the cost of running an OT practice has risen by more than 25%. Seven years of the most significant social insurance scheme in Australian history underpricing the allied health profession that is central to its clinical credibility.

This article explains what the price freeze is, how it works, why it is causing an OT shortage that affects your access to care, and what you can do practically to protect your access to the OT services your plan is meant to fund.

What Is the NDIS Price Freeze?

Every year, the NDIA publishes the Pricing Arrangements and Price Limits (PAPL) the document that sets the maximum hourly rates that NDIS-registered providers can charge for each support category. For occupational therapy, the PAPL rate determines what any registered OT can bill an agency-managed participant: they cannot charge more, and they cannot negotiate a premium regardless of their qualifications, experience, or the complexity of the work.

For 2025–26, that rate is $193.99 per hour on weekdays. That is exactly the same figure it was in 2019 – 20. In six consecutive annual pricing decisions through a period that included two significant inflation spikes, a global pandemic, rising wages, escalating rent, and compounding operational costs the NDIA did not raise the OT therapy supports rate by a single cent.

Occupational Therapy Australia’s peak body describes this as a seven-year effective price reduction, because every year of flat rates against rising costs is a year in which the real value of each OT hour billed declines. By 2026, with cumulative CPI growth exceeding 25% since 2019, an OT billing $193.99 per hour is recovering roughly what $154 would have bought them in 2019.

The Numbers – What Has Actually Happened to OT Rates

To understand why the price freeze is producing an access crisis, you need to understand what a flat rate means in the context of real-world practice costs.

The consequence is straightforward arithmetic: an OT practice billing exclusively at NDIS rates in 2025 – 26 is recovering significantly less per clinical hour in real terms than the same practice was in 2019. Every year the rate stays flat and costs rise, the margin between revenue and operating expense narrows. When that margin disappears, the business is no longer viable. And when the business is no longer viable, the OT leaves the NDIS market.

This is not speculation. OTA’s 2025 provider survey of more than 600 NDIS OT businesses found:

• 55% failed to make a profit in the 2024–25 financial year
• 14% were already planning to close
• 50% were actively considering exiting the NDIS within three years
• 92% had already cut back on travel and outreach to regional and remote participants

Why Providers Are Leaving – The Business Case Explained

To understand why the price freeze produces provider exits rather than just squeezed margins, it helps to understand how OT practice economics actually work.

Not all hours are billable

An OT working a 38-hour week does not bill 38 hours to NDIS clients. Typically, a highly efficient OT can bill 25–28 hours per week — the rest is taken up by non-billable administration (NDIS paperwork, AHPRA compliance, NDIS registration audits, email, scheduling), travel time between clients (now compensated at only 50% of the hourly rate), report writing beyond what the PAPL non-face-to-face billing allows, and continuing professional development.

At $193.99 per hour for 26 billable hours per week, an OT generates approximately $260,800 per year in gross revenue. Against this, a practice must fund the OT’s salary (typically $80,000–$110,000 for an experienced NDIS OT), payroll tax, superannuation, leave entitlements, professional insurance, NDIS registration audit costs, administrative support, software, clinical supplies, and commercial rent or vehicle costs.

The margins were workable in 2019. By 2026, after 25%+ cost inflation against a flat revenue line, many practices are breaking even at best and losing money at worst.

Specialist and mobile work is hardest hit

Not all OT work is equally affected. Clinic-based work – where the OT sees multiple clients in a fixed location and travel costs are minimal – is more sustainable at the frozen rate than mobile work. An OT who drives to five different homes across a metropolitan area in a single day, or who flies to a remote community for assessment visits, has far more non-billable overhead per clinical hour than one who sees clients at a fixed clinic.

The result: the work that is most valuable for NDIS participants – in-home assessment, community-based therapy, remote outreach – is the work that is financially least sustainable for providers. This is precisely backwards from what the NDIS is trying to achieve.

What You See as a Participant – Longer Waits, Fewer Choices

The economics described above produce observable consequences for participants that most families experience without knowing the cause:

Wait times have grown significantly

Where FCA wait times in metropolitan areas were typically 6 – 10 weeks two years ago, many providers are now running at 12 – 20 weeks for new referrals. In outer suburbs and regional areas, waits of 4 – 6 months are increasingly common. For participants approaching a plan review with an FCA deadline, this is not an inconvenience it is a plan funding risk.

Fewer providers are taking new NDIS clients

Some practices that previously operated as primarily NDIS providers are now accepting only a limited number of NDIS clients alongside private-pay or other insurance-funded work where rates are not capped by a government pricing schedule. The NDIS clients remaining on their books are retained; new NDIS referrals may be declined or waitlisted indefinitely.

Experienced OTs are moving to private-pay work

Senior OTs with deep NDIS expertise the practitioners most capable of producing the complex FCAs, SIL assessments, and AT prescriptions that drive the best plan outcomes are disproportionately exiting the registered NDIS market. The PAPL cap makes it impossible to charge a premium for specialist expertise, so experienced practitioners who can command higher rates in the private market or with non-NDIS insurance schemes are exercising that option.

Home visiting is being quietly discontinued

Perhaps the most clinically significant consequence: providers are withdrawing from in-home assessment and shifting clients to clinic-based appointments that are more efficient for the practice. Many families are not told why they are simply offered a different appointment format. As covered in our detailed article on in-home vs clinic OT, this shift has direct consequences for the quality of assessments particularly FCAs, home modification assessments, and SIL reports.

Who Is Being Hit Hardest

The OT access reduction from the price freeze is not evenly distributed. Three participant groups are bearing disproportionate impact:

Regional and remote participants

The combination of the price freeze and the 2025 travel reimbursement cut (reducing travel time billing to 50% of the hourly rate) has made regional and remote outreach particularly unviable. OT businesses that were previously willing to absorb the travel overhead as a cost of service delivery can no longer do so profitably. OTA’s 2025 survey found 92% of providers had cut back on travel and outreach. In remote communities particularly across the Top End, the Kimberley, and remote Queensland some communities that had intermittent OT access now have none.

Participants needing complex assessments

SIL assessments, complex AT prescriptions for powered mobility or AAC, and comprehensive FCAs for participants with multiple co-occurring conditions are time-intensive work that requires experienced clinicians. These are the assessments where the PAPL cap is most biting because the time required to do them well exceeds what can be efficiently recovered at $193.99/hr against current business costs. Senior OTs who previously specialised in this work are moving to less constrained markets.

Participants with agency-managed plans

Agency-managed participants are most exposed to the price freeze effects because their plans restrict them to registered providers — precisely the cohort most affected by the freeze, and most likely to exit. Plan-managed participants have access to the broader (registered and unregistered) OT market, which includes practitioners who have chosen not to pursue NDIS registration and are therefore not bound by PAPL rates. See the next section for more on this.

What the Sector Is Doing – OTA’s Campaign

Occupational Therapy Australia has been publicly and consistently campaigning for pricing reform since 2022. In 2025, following the NDIA’s decision to once again freeze rates, OTA launched a national campaign including:

• A petition calling on the Federal Government to immediately increase OT pricing by at least 7%
• An email-your-MP tool directing OTA members and NDIS participants to contact their federal representatives
• Formal submissions to the NDIA pricing review, the Independent Health and Aged Care Pricing Authority (IHACPA), and the Senate Committee on NDIS sustainability
• Public statements from OTA’s Chief Occupational Therapist describing the situation as “market failure” and calling on the NDIA to act before provider exits become irreversible

Deloitte’s economic modelling, commissioned by the Ability Roundtable and provided to the NDIA — found that real provider costs significantly exceeded the current PAPL maximum for the past three consecutive review cycles. This evidence was acknowledged but not acted on in the 2025–26 pricing decision.

As of April 2026, no rate increase has been implemented. The campaign continues. Participants and families who want to add their voice can do so through OTA’s advocacy resources at otaus.com.au.

What You Can Do as a Participant or Support Coordinator

The price freeze is a systemic policy problem not something individual participants can fix. But there are practical steps you can take right now to protect your access to OT in a market that is getting harder to navigate.

1. Refer earlier than ever

The single most effective action is simply acting sooner. Refer for your OT assessment at least 4–5 months before your plan review date — not 8 weeks. In the current market, 8 weeks will frequently not be enough time to secure an appointment, complete the assessment, and have the report in hand for your planning meeting.

2. Do not wait for your plan review to be imminent

If you know your plan review is in the second half of 2026, refer in the first quarter of 2026. If you already have an NDIS plan and Capacity Building — Improved Daily Living funding, you do not need to wait for a plan review trigger to commission an OT assessment. An FCA can be commissioned at any time within a plan year — its findings can be held in readiness for when the review is scheduled.

3. Consider requesting plan management

Agency-managed participants are most constrained by the price freeze — because they can only access NDIS-registered providers, who are exactly the cohort most affected by the freeze. Moving to plan management opens access to unregistered OT providers who are not bound by PAPL rates and who may have more availability. Plan management is funded separately by the NDIA and does not reduce your support budget. See the next section for more detail.

4. Ask directly about availability before committing

Before committing to an OT provider, ask directly: “What is your current wait time for a new FCA? Can you confirm that the report will be ready by [specific date]?” A provider who cannot confirm their capacity to meet your timeline before you sign a service agreement is a provider you may want to reconsider in favour of one who can give you a clear commitment.

5. Build the OT relationship before you urgently need it

Participants who have an ongoing OT relationship — even a light-touch one involving occasional therapy sessions or check-ins — are better positioned when a plan review or SIL assessment becomes urgent. A provider who already knows your participant’s situation can move to assessment mode more quickly than one starting from scratch with a new client. If your participant is currently between assessments, consider maintaining a light OT engagement so you are not starting cold when the next review approaches.

The Plan Management Advantage – Accessing the Unregistered Market

One of the most practical and underutilised responses to the OT access squeeze is plan management. Here is why it matters specifically in the context of the price freeze.

NDIS-registered OT providers are bound by the PAPL rate ceiling. As that ceiling has failed to keep pace with costs, many excellent OTs have made the deliberate decision not to pursue or renew NDIS registration — allowing them to charge above-PAPL rates and therefore to maintain sustainable practices. These OTs are effectively invisible to agency-managed participants, who cannot use unregistered providers regardless of quality.

Plan-managed and self-managed participants can access both registered and unregistered OT providers. This means they have access to a substantially larger pool of available OTs — including experienced specialist practitioners who have exited the registered market but are still practising in the NDIS context for plan-managed clients.

Plan management is funded by the NDIA as a separate budget line — it does not reduce your Capacity Building or Core Supports allocation. For agency-managed participants who are struggling to find available registered OTs, requesting a move to plan management is a fast, free way to significantly expand your provider options.

To change from agency management to plan management mid-plan, contact the NDIA directly (1800 800 110) or raise it with your support coordinator. You do not need to wait for your plan review — this change can be made at any time.

Frequently Asked Questions

Summary

The difficulty many NDIS participants and families are experiencing in finding occupational therapy is not random or temporary — it is the predictable, documented consequence of seven years of frozen pricing against rising costs. The NDIS price freeze has reduced the financial viability of OT practice, driven provider exits, lengthened wait times, withdrawn home visiting from many areas, and hit regional and remote communities hardest of all.

The systemic solution is a rate increase — which OTA is actively campaigning for and which the evidence strongly supports. The individual response in the meantime is practical: refer earlier, consider plan management to access the broader OT market, do not accept a clinic-based appointment where an in-home assessment is clinically indicated, and choose providers who have maintained quality standards under the financial pressure rather than responding by cutting corners on report quality.

TEAH continues to operate across Darwin, Perth, Brisbane, and Victoria — with in-home delivery, below-average wait times, and the clinical standards that the NDIS framework requires.