July 1 Is Here: An Honest Look at the NDIS, Allied Health and What Comes Next

What these changes mean, how the sector is being perceived and where we go from here.

This has been a big few weeks in Allied Health. The APR was released on 11 June, and the PAPL followed just days later on 16 June. We’re now in a post–July 1 world, and emotions have settled. But the work is far from over.

This is different from my usual content. I generally try to be practical, objective and impartial. I’ve written and rewritten this blog in multiple formats over the past few weeks, and I’ve hesitated more than once about sharing it at all. Not because I think it’s perfect, or that I have all the answers — but because I don’t want to offend anyone or downplay the advocacy efforts people have made.

Still, I’ve decided to post it. Because the changes are here, and we need to think about what comes next.

For context, I’m not a provider anymore. I stepped away from my Allied Health business in February and now work as a consultant with over 30 AH businesses (and growing). These changes don’t directly affect me, but they absolutely affect the people I support and care about.

I’m a Physio by background, but I spent the last six years growing a team of OTs, Speechies, Psychs, BSPs and more. We had 10 different Allied Health disciplines — with Physio being our fifth largest in terms of volume.

As such, I consider myself an Allied Health all-rounder and want the best for all AH professions (and I include Behaviour Support in that too).

Acknowledge the advocacy

The advocacy efforts over the past few weeks have been phenomenal.

I’ve been in meetings with 30+ “competitors” from large AH organisations across Australia, all wanting to work together. I’ve never seen businesses or individuals in our community work together like this.

The stories clinicians and providers have shared on social media (particularly about the impact on participants) have been powerful and heartbreaking. There are too many to acknowledge individually, but it’s been moving to see our professions stand up for the people we support.

It’s also been great to see the professional bodies working together. I hope that continues.

I also want to acknowledge that many people have been advocating for Allied Health in NDIS long before this APR was released. Often that advocacy has fallen on deaf ears, but it still matters. Thank you.

Where the NDIS is heading

If you haven’t already, please read the IPC report.

You may not agree with everything in it. But it gives you a good sense of where things are heading. And if we want to shape a better NDIS, we need to understand the direction the Agency is being pushed.

Some of the things we’ve been advocating for (like simply reversing the pricing changes or increasing rates across the board) are things the IPC explicitly advise against. They describe them as “quick fixes” that delay the structural reform the Scheme needs.

The NDIS needs reform

Most of us can agree that the NDIS needs to change. It has achieved amazing things, but the current system is too expensive and unsustainable.

We all want to see clinicians paid more. I want to see all Allied Health professionals across every funding stream get increases. We’re underpaid and overworked. But that’s not going to happen as a blanket fix.

Instead of asking for across-the-board increases, we should be asking for smart, targeted changes that align with the IPC’s recommendations and broader reform goals:

• Higher prices for higher-value or more complex services

• More viable pricing for groups

• Commissioned services in rural and remote areas

• Fixed-cost pricing for FCAs, home mods, AT, and Behaviour Support

• Increased travel support for regional participants

• Better incentives for providers to stay registered and operate ethically

If we resist all change, we let others shape the system without us.

Perception, PR and public trust

The past few weeks have been a powerful display of just how passionate and community-driven the Allied Health sector is. The stories shared were raw, emotional and deeply human. The advocacy has been tireless.

But if we want to influence long-term policy, we need to move from emotion to strategy.

The general public (ie. voters) and most politicians don’t see what we see. Outside our echo chamber, the perception of the NDIS is one of excess, waste and rorting. Voters see headlines, not context. They see an “hourly rate” of $193.99 and think it’s excessive, not clinical complexity or fair pay.

Even participants and families can get frustrated. They’re tired of turnover, they get frustrated with long reports they didn’t ask for and they often resent travel charges. That doesn’t make those practices unethical, but it does shape how our sector is viewed.

System changes are often designed to fix the worst behaviour. Unfortunately, the ethical majority gets caught in the fallout.

That’s why our next phase of advocacy needs to be more tactical. Less reactive. With clearer asks, stronger PR, better data and practical solutions. We need to show the value we add, not just express the pain we feel. Because when we step outside our own networks, we’ll realise that many people (including voters and policymakers) think we’re already doing pretty well.

If we want their trust, we need to show them why we deserve it.

Consider the wider Allied Health landscape

It’s worth stepping back to reflect on how the NDIS compares to other areas of Allied Health.

This isn’t about saying “NDIS clinicians have it easy.” It’s about recognising that the way we work under the NDIS isn’t universal, and that may help explain why some of the recent reactions haven’t landed the same way across the broader sector.

If you’ve worked outside the NDIS, you’ll know that many roles in other funding streams involve lower pay, higher KPIs and less flexibility. A few examples:

Aged Care: Clinicians are almost always paid significantly less. Since AN-ACC was introduced, Allied Health roles in residential aged care have declined sharply. In community aged care, the new Support at Home model introduces all-inclusive pricing, meaning there’s no separate billing for travel, admin or prep time.

Occupational Rehabilitation: Occ Rehab clinicians often work under intense performance pressure. KPIs are high, caseloads are demanding and pay is generally lower. Most face targets and expectations far beyond what’s common in the NDIS.

Private Practice Physio: Many physios in private clinics see 30+ clients per week, often including evenings and weekends. A (for example) $120 session might sound high, but that fee covers rent, admin, notes, systems and rent. There’s no separate charge for travel or documentation.

Hospitals: Public hospital Allied Health staff are usually on award wages well below NDIS earning potential. Overtime is common but often unpaid, and flexibility is limited.

DVA and other funding streams: Many operate under low, fixed rates that haven’t been updated for years.

Of course, there are exceptions. Not every NDIS job is high-paying or flexible, and not every hospital role is under strain. But the broader context still matters.

Because even within Allied Health, we don’t all see the NDIS changes through the same lens. For someone in a lower-paid, higher-pressure role, it may be hard to relate to the backlash, even if they support the broader push for fairness and reform.

This isn’t about minimising concerns. It’s about understanding that Allied Health operates across diverse funding streams, and that context is essential as we talk about what needs to change.

Sole traders and unregistered providers

One of the biggest systemic issues we need to talk about is the way the current pricing model incentivises clinicians to become sole traders, and providers to remain unregistered.

It’s easy to see why. As a sole trader, all you need is a laptop, an ABN and a car — and you’re in business. You can charge $193.99 per hour (or equivalent), with no team, no office, no compliance systems and no audit requirements. Why work for someone else?

But that’s a risk to the sector. We’re seeing more early-career clinicians go out on their own without supervision, support, or structure. No clinical governance. No oversight. No checks or balances. And that’s not good for long-term quality or sustainability.

I acknowledge the hypocrisy here — I work with sole traders and I support them to set up properly. But we still need to ask whether the current setup is healthy for the system overall.

The incentives for unregistered providers are also skewed. Registration is costly and time-consuming. And for what? To serve a shrinking pool of NDIA-managed participants, while unregistered providers can serve Self- and Plan-Managed participants and even charge a gap fee? It doesn’t add up.

The IPC has suggested introducing “pre-qualification” for higher rates. That could be part of the solution. If you want to charge more, you should be able to demonstrate experience, quality systems and appropriate governance. It’s these kinds of safeguards that could help shift the incentives and support ethical, sustainable, high-quality service delivery.

Gap fees

Gap fees are a tricky topic.

I understand why some providers are considering them — especially if they offer their services privately at a higher rate. I also get that margins are tight and I never want to begrudge any clinician getting paid more.

But I don’t think charging a gap fee is a good move for Allied Health. Even if it’s allowed under the current rules (which to be honest is a grey area), I don’t think it’s a good look.

We already have a reputation problem. The public thinks NDIS providers are rorting the system. Charging participants extra out-of-pocket costs is only going to reinforce that narrative.

We should be careful not to damage trust further, especially when we’re also asking for more funding and public sympathy.

Travel should be cut (or at least restructured)

This is controversial, but I believe travel should be cut. Or at the very least, restructured.

Before you stop reading, hear me out.

Participants hate paying for travel. That is a big reason why many providers have historically undercharged for it. It burns through budgets quickly and participants often question its value.

Let’s walk through a simple example of what some providers were already billing (with pre July 1 prices):

• 30 minutes travel each way = $193.99

• 50-minute session plus 10 minutes for notes = $193.99

• 15 minutes for setup or prep = $48.50

• 25km round trip charged at $0.99 per kilometre = $24.75

That adds up to $461.23 for a single 50-minute face-to-face session. That does not pass the pub test.

By comparison, a private clinic might charge $120 for a 30-minute session. But that is an all-inclusive rate. There is no separate charge for notes, travel or setup. That fee covers rent, reception, admin support, systems and overheads. (Note that Aged Care is moving towards all inclusive pricing with Support at Home too.)

The NDIA has made the point that clinic-based therapy includes business overheads that travel time does not necessarily attract. And to be honest, I agree. Sitting in a car costs time, but it doesn’t incur rent, clinical governance costs, or admin wages in the same way direct therapy delivery does.

Let’s compare some very simple weekly models to make the contrast clear. These are not perfect, but they illustrate the point:

Mobile clinician (1-hour sessions):

• 3 clients per day = 15 clients per week

• 2 hours of travel daily

Clinic-based clinician (1-hour sessions):

• 5 clients per day = 25 clients per week

• No travel time

Clinic-based clinician (30-minute sessions):

• 10 clients per day = 50 clients per week

• No travel time

Which one do you think requires more clinical support and overheads?

Of course, there are many participants who benefit far more from home-based appointments, and mobile services should absolutely remain part of the NDIS. But we also need to recognise that home visits are often cheaper to deliver from a provider perspective, especially when clinicians are subcontractors or sole traders working from their cars. That’s not inherently bad, but it highlights why the system needs better balance.

That is why I believe we need to rethink how travel is funded. We should be valuing the time clinicians spend delivering meaningful support, not simply driving between appointments.

What should change with travel

The new travel rules are going to hit regional areas hardest. That’s a real concern.

Most clinicians who service regional and rural participants were already completing significant non billable travel. For many, the cuts make an already difficult situation even harder.

If you’re not familiar, travel limits are based on the Modified Monash Model (MMM):

• MM1–3: 30-minute cap (metro, regional centres, large rural towns)

• MM4–5: 60-minute cap (medium and small rural towns)

• MM6–7: uncapped (remote and very remote)

You can check MMM classifications here: Health Workforce Locator

The problem is that these categories don’t align well with how Allied Health services are delivered.

For example, Bendigo and Ballarat (MM2) are grouped under the same cap as metro Melbourne (MM1), and Dubbo (MM3) is treated the same as metro Sydney (MM1). But the availability of clinicians and the level of choice in these locations is completely different.

Clinicians often live in higher socioeconomic status (SES) metro areas, while many participants live in lower SES or more remote suburbs. Even within metro MM1, servicing a participant can involve a long commute if there’s no one else available nearby.

That said, I don’t have as much sympathy for metro-based providers and participants who are frustrated by reduced travel claims. I understand it feels unfair, but the reality is that metro areas have significantly more provider choice than rural or remote regions. It’s not the same level of access issue.

If we want to be strategic, we should be pushing for changes that support areas with genuine access barriers. For example:

• Increasing travel allowances or caps for MM2 and MM3 locations

• Considering SES or local workforce shortages in travel policy design

This kind of targeting is more likely to resonate with policymakers and better support participants who are most at risk of missing out.

Participant outcomes should be the focus

It’s tough to say, but the NDIA doesn’t really care if your business is unviable. That’s not what the scheme was designed to protect. Their focus is on participant outcomes.

That might feel harsh, especially for small businesses doing the right thing. But it’s a reality we need to keep in mind, particularly when it comes to advocacy.

If we want policymakers to take our concerns seriously, we need to centre participants in every message we share. Not just how pricing changes affect us, but how they affect people’s access to essential supports, the quality of care they receive and their overall outcomes and goals.

We also need to bring more than just emotion to the table. Emotion sparked the initial movement, and rightfully so. But to sustain it, we need strategy. We need to back our stories with data, offer practical solutions and speak in terms that matter to decision-makers.

That might look like:

• Mapping access gaps for regional participants based on the new travel rules

• Using plan utilisation data to highlight unmet need in thin markets

• Demonstrating how Allied Health prevents hospital admissions, delays SIL entry and reduces reliance on paid care

• Showing how early Allied Health intervention reduces long-term support needs and overall Scheme costs

And above all, we need to be united. Not just resisting change, but helping to shape it into something that is fair, sustainable and genuinely centred around participant needs.

Conclusion

I’m always open to talking more about these changes and where our sector goes from here. If you’re a provider, peak body, or policymaker thinking through what comes next, I’m happy to be a part of that conversation. The future of Allied Health within the NDIS is at a crossroads, and we all have a role to play in shaping it.

I’m not pretending to have all the answers. But I do hope this piece helps widen the lens through which we’re viewing the pricing changes. Not to downplay how difficult this period has been, but to help us think more strategically about what we ask for next.

Because real reform isn’t just about what we push back on. It’s about what we build in its place. It’s about offering practical solutions, uniting around shared priorities and proving the value we add — not just to participants, but to the broader health system and community.

We’ve shown we can advocate with passion. Now we need to pair that with strategy, data and focus.

And if we want policymakers and the public to back us, we need to give them a reason to.

Let’s get to work.