In June 2025, the National Disability Insurance Agency (NDIA) implemented a new pricing structure for therapy and support services under the National Disability Insurance Scheme (NDIS). The changes were positioned as part of a broader reform agenda to streamline service delivery and improve scheme sustainability. However, for many allied health providers, these changes to NDIS funding are threatening the viability of their businesses, and more importantly, the stability of care for thousands of participants across the country.

The new price guide includes significant cuts to the hourly rates for key therapy services such as physiotherapy, occupational therapy, psychology, and speech therapy. Remote and non-face-to-face work, like travel, preparation, and case notes, has also seen restrictions on claimable time, despite its essential role in delivering holistic care. For the disability sector, these changes are not just administrative adjustments. They represent a fundamental shift in how care is delivered, accessed, and sustained.

What Changed in the 2025-26 NDIS Pricing Review

The National Disability Insurance Agency (NDIA) has implemented sweeping changes to NDIS funding that directly impact how allied health providers operate and deliver services. Hourly therapy rates have been slashed by 5-15% depending on the discipline, while telehealth services now receive significantly lower compensation compared to in-person therapy. Perhaps most concerning for rural and remote communities, regional and remote loading has been removed in several areas, making it financially unviable for many providers to continue servicing these regions.

The changes extend beyond simple rate reductions to include new restrictions on billable non-face-to-face time, severely limiting compensation for essential activities such as travel time, report writing, and care coordination. The NDIA has framed these modifications as necessary for cost containment, improved "efficiency," and long-term scheme sustainability. However, the sector argues that these changes fail to recognise the complexity of disability support work and the genuine costs of providing high-quality, person-centred care.

How These Changes Are Affecting Allied Health Providers

Financial and Operational Pressure

Many NDIS allied health providers, especially small practices and sole traders are under growing financial and operational stress due to the revised rates. These changes are having wide-reaching effects on the sector, particularly for those offering mobile or community-based care.

Key Challenges:

• Reduced financial viability: Providers working with already tight margins, especially those delivering mobile or in-home services, face higher costs without adequate compensation.
• Threat to service delivery: Personalised therapy crucial for participant independence is at risk due to cost pressures.
• Impact on small businesses: The entrepreneurial backbone of the sector, small, community-focused providers is being undermined.
• Possible provider withdrawal: Many are reconsidering their involvement in the NDIS due to unsustainable rates, potentially reducing access to care.
• Increased strain on remaining providers: As others exit, remaining businesses must meet growing demand without additional financial support.
• Disruption to community-based care models: Providers who have built their services around local, relationship-driven care are especially affected.

Workforce Impact and Exit Risks

Beyond the business impact, there are major implications for workforce morale and retention. Allied health professionals are already under significant stress. The profession involves emotionally demanding work, complex care planning, and long hours. With fewer billable hours and lower pay for the same work, the pricing changes risk accelerating burnout across the sector.

Experienced clinicians, particularly in regional areas, are questioning whether continued NDIS involvement is sustainable. Some are transitioning to hospital settings, private clinics, or leaving the profession entirely. As seasoned professionals exit, the capacity to train and supervise the next generation of allied health workers diminishes. The sector could soon face a skills gap that compromises care quality across the board.

Compromised Quality of Care

One of the most worrying impacts of the changes to NDIS funding is the indirect decline in the quality of care.

Many of the services affected by the pricing changes include essential, non-face-to-face work. This includes writing clinical reports, coordinating with schools and GPs, preparing therapy plans, and liaising with support coordinators or family members. Under the new model, much of this work is now unpaid or must be squeezed into tighter windows.

This results in shorter, more rushed sessions. Therapists have less time to plan and adjust interventions to suit each individual’s needs. Participants may notice reduced engagement, lack of consistency, and a shift toward more transactional models of care.

This is not what the NDIS was designed for. The scheme was intended to deliver person-centred support that empowers individuals, not factory-line service delivery that prioritises billable units over outcomes.

The Consequences for NDIS Participants

Reduced Access to Essential Therapies

NDIS participants are experiencing significant delays in accessing essential therapies as the provider network shrinks and remaining services become increasingly stretched. The discontinuation of in-home and community-based support has forced many participants to travel greater distances for care, creating additional barriers for those with mobility limitations or transport challenges. Rural, remote, and outer-suburban participants face particularly acute access issues as providers withdraw from these areas due to financial constraints.

The reduction in available appointments has created waiting lists for essential services, with some participants reporting delays of several months for initial assessments and ongoing therapy. This is particularly problematic for children with developmental delays, where early intervention is crucial for optimal outcomes. The cumulative effect of these delays is a systematic erosion of the timely, accessible care that the NDIS was designed to provide.

Widening Inequities

A significant concern arising from these pricing changes is the growing inequity in service access. Participants from marginalised backgrounds, such as Indigenous Australians, culturally and linguistically diverse (CALD) communities, and people with low digital literacy, already face barriers in navigating the NDIS.

Now, with fewer providers willing to take on high-complexity or high-travel clients, these groups may be pushed even further to the margins. Carers, too, are reporting increased burdens as they step in to fill gaps in service coordination and support.

If not addressed, these changes risk widening existing disparities in health and wellbeing outcomes, undermining the NDIS’s core promise of fairness and inclusivity.

Broader Economic and Health System Impacts

The ripple effect of reduced allied health access doesn’t stop at the NDIS. Delays in therapy lead to increased demand on public health services, emergency departments, and mental health providers. Children who miss early intervention milestones may require lifelong support. Adults who lose mobility or independence may become more reliant on carers and housing supports.

There are also economic consequences. Allied health is one of the fastest-growing employment sectors in Australia. It supports not only therapists, but admin staff, trainers, students, and community-based roles. Shrinking this workforce undermines regional job creation and weakens the local economy, particularly in health-driven areas like aged care, mental health, and disability services.

Voices from the Sector

Allied health professionals across Australia have voiced serious concerns about the impact of funding changes on their ability to provide quality care. Regional occupational therapists report being forced to make difficult decisions about service delivery, with one noting, "We'll have to reduce session time or cut staff hours to remain viable under the new rates." These sentiments are echoed across disciplines, with physiotherapists, speech pathologists, and other professionals expressing similar concerns about the sustainability of their services.

Peak bodies representing allied health providers have documented the sector's response to these changes, with recent surveys indicating that 58% of providers anticipate implementing service cuts or significant changes within six months. The Cerebral Palsy Alliance and other advocacy organisations have highlighted the disconnect between the NDIA's efficiency rhetoric and the reality of providing complex disability support. These voices represent not just business concerns, but genuine fears about the future of disability care in Australia.

Cutting Costs, But at What Cost?

The recent changes to NDIS funding mark an important turning point for Australia’s disability support system. While the NDIA frames these modifications as necessary efficiency measures, the evidence suggests they risk undermining the very foundations of quality disability care. Without sustainable pricing that recognises the true cost of providing person-centred support, allied health services cannot survive, and the promise of the NDIS cannot be fulfilled.

Providers, participants, and families are united in their concern. What’s needed now is not just consultation, but genuine partnership in designing a model that values the role of allied health professionals and upholds the vision of the NDIS.

The future of disability support in Australia depends on it.