Changes to the timeframe in submitting claims
Please take the time to make sure you’re aware of recent changes to the timeframe in submitting claims. Please read the below information carefully. We will continue to communicate changes to the NDIS as and when information becomes available.
The Department of Health and Aged Care has recently amended the timeframe for submitting claims to the NDIS. This amended timeframe takes affect from 1 December 2026 and specifies the time period for submitting claims has reduced from 2 years to 90 days from the date of service delivery.
This change could impact a participant whose budget has been exhausted in a funding period and an invoice is held for payment until a new funding period is released. To minimise this risk, we encourage providers to regularly check with participants on their funding balances prior to supports being delivered.
Please continue to submit your invoices via the Payments inbox payments@spspmandsc.com.au
FUTURE expected changes and their potential impact
- Future eligibility for access to the scheme will be more closely assessed. There will be an increased focus on functional capacity rather than just a diagnosis requirement.
- The NDIA will strengthen their focus on what is considered “Reasonable and Necessary” in relation to individual participant plans. This may result in a closer review of funding categories and more structured and considered planning decisions.
- Budgets and funding allocations in areas such as community participation will be more tightly managed.
- The Government has also indicated that there are measures to strengthen the regulations around providers who operate within the scheme. This includes intentions to move towards mandatory NDIS registration for providers who deliver certain supports.
Specialised Plan Services wants to reassure Participants and Providers that we are keeping on top of these reforms and any potential changes and will continue to keep you informed.
Invoice Compliance
We emphasise the importance that all invoices received are NDIA compliant and align with the NDIS operating and pricing guidelines. It is the responsibility of the participant/nominee and providers to ensure you are claiming correctly.
COMPLIANT INVOICES – Important Information
To avoid any processing delay, it is necessary that all invoices are NDIA and ATO compliant.
An invoice must include the following information:
- Participant details – Family name and given name/s
- Participants NDIS number
- Clear details on the services being invoiced for:
- Individualised line items for all support categories, including Date of Service, hours & price per hour.
- NDIS Service provider details (all are mandatory)
- Payee billing address – Bank account details for EFT payments.
- Email contacts details for example where to send the remittance advice.
- Contact phone number.
- Registered ABN
Claims that need further review by the NDIA, will require more detailed information to be provided. The NDIA will not pay the claim until all information has been received. These changes by the NDIA may mean your invoices will take longer to be processed and paid.
Please note: the NDIA price guide can be viewed at Pricing Updates on the NDIA Website.