Claiming Therapy Supports from the Core Budget

Participants often ask us if they can use their Core budget to pay for their therapists. As with most things NDIS, the answer is 'it depends'.

What does the NDIS say?

The Pricing Arrangements and Price Limits Guide (the Guide) lists NDIS support item codes. There are codes for therapists in both the Core and Capacity Building sections. This can often be confusing, as they are for different purposes. The codes in Core:

are for Disability-Related Health Supports – see below for more information. Therapists listed in Capacity Building are for ‘therapeutic supports’, not disability-related health supports.
were meant to end on 30/6/25 but there is currently no end date.

What is a Disability-Related Health Support?

The Guide explains what a disability related health support is, and when the NDIS will fund it. The list of NDIS supports also provides further information. The NDIS has several operational guidelines with more information on disability-related health supports. These are different to therapeutic supports, which are usually in your Improved Daily Living budget.

As a basic overview, disability-related health supports:

need to directly relate to a functional impairment of your disability. For example, you might have an intellectual disability and can’t manage your diabetes. The NDIS could then fund someone to help you with your insulin shots.
can help you access health services, if you have complex communication needs or behaviours. For example, if you use an app to communicate, your support worker might show hospital staff how to use the app.
don’t help you with acute needs. These have to be provided by the health system. For example, nursing supports at home if you’re recovering from an operation.
could include: continence, respiratory, diabetes, wound care, dysphagia and podiatry. Also Specialist services if you have a recently acquired condition (like acquired brain injury).

You can ask yourself, ‘If I didn’t have my disability, would I need this health support?’ If the answer is ‘No’, then it’s probably disability related. If the answer is ‘Yes, I would need this even if I didn’t have a disability’, then it’s unlikely to be disability related.

NDIS Guideline on Disability-related health supports

Can I claim it?

Supports are only claimable if they are ‘in accordance with your NDIS plan’. If the NDIS funds you for disability-related health supports, they will show this in your plan.

You can claim supports under the disability related health codes in Core if:

the specific items have been written into your plan; or
you have written permission from an NDIS delegate for these items.

We know that this is a very confusing area for many people, including us as your plan manager. We consulted Disability Intermediaries Australia (DIA) for help as well. They are the peak body for plan managers and support coordinators. You can read what they had to say about this in their Practice Guidance.

How do I get permission?

Only the NDIS can decide if a support is reasonable and necessary for you. You can request written confirmation that your plan covers disability related health supports by:

Getting in touch with your “My NDIS Contact” as listed on your plan. This may be a planner or LAC.
Lodging an online enquiry via the NDIS website or through your NDIS portal.
Asking the NDIS via email, calling 1800 800 110 or doing a webchat to request your LAC or a planner consider your request.

Once you have written permission, you can send this through to us along with an invoice or receipt. We can then organise payment.

Some suggestions from us

Read through the Operational Guideline on Disability-related health supports. It goes into a lot of detail about what supports might qualify, and what evidence you might need to show.

If your supports are therapeutic supports, you usually can’t claim therapy from Core. If you need to claim therapy from Core but haven’t got permission, you will need to apply for a plan review.