Update – since October 2024, there have been a lot of changes within the NDIS. Each of these has meant a ‘settling in’ period where the NDIS has published confusing, contradictory or incomplete information around how these changes are meant to be adminstered by plan managers.
At OnTime, we go to great lengths to ensure we are as up to date on NDIS rules and guidelines as we can be. Where there is any doubt, or where claims do not appear to be in accordance with a plan, we need the NDIS to advise whether claims are able to be made.
We have updated this post several times, based on the latest information we have received. It appears the NDIA has been moving to a more restrictive view as to whether back claiming is allowed.
What are Funding Periods?
All new NDIS plans from May 2025 have funding periods, which regulate how much funding can be spent over a stated time. Funding periods can apply to:
- The entire NDIS plan – money funded for the length of the plan.
- Funding Components – previously called Category Budgets (Core, Capacity Building and Capital supports). Each Component / Category will have its own funding period (often more than one).
The NDIS works out how long each funding period is and how much funding they will release in each period.
- Some will be for one month (like Choice & Control, SIL or SDA).
- Most supports are quarterly (like Capacity Building and most Core supports).
- Some funds might be released up front (like AT).
Details for funding periods will be shown in a participant’s plan, on the plan manager’s portal, and the NDIS portal. Providers without NDIA portal access will need to ask participants to advise them of funding period details.
What about unused funds?
Unused funds from one period will ‘roll over’ to the following funding period/s.
When a plan ends, unused funds do not ‘roll over’ to a new plan – this has not changed.
Jane’s plan has monthly funding periods for her SIL supports. Each month is funded for $10,000. Her first funding period started on 14/7/25 and finished on 13/8/25. She has $1,000 remaining unspent from that period. This $1,000 rolled over to the next funding period starting on 14/8/25. She now has $11,000 to use during 14/8/25 – 13/9/25.
What if funds run out in a funding period?
Funds cannot be ‘borrowed’ from future funding periods without NDIS permission. If funding periods do not address the needs of the participant, they need to request a change to their NDIS plan. Usually, this means lodging a review request.
The NDIS has advised the following:
Once a participant’s funding period is exhausted, no further payments can be made for supports delivered in that period. Claims must be made against the funding period in which the support was delivered and when funding was available. Outstanding invoices cannot be claimed against a future funding period.
All NDIS funds must be used in line with the participant’s plan, including any funding amounts and funding periods. There are very limited circumstances where a payment may be considered above the available funding period. In these situations, a payment enquiry must be submitted for review. Each request is assessed on a case-by-case basis and does not guarantee payment.
Circumstances under which the NDIA may consider allowing back claiming are:
- s45(5) (a) Participant has experienced fraud or financial exploitation.
- s45(5) (b) Participant faces an imminent threat to their life, health or safety and the payment is necessary to prevent or lessen it.
- s45(5) (c) Participant was unable to request a change to their plan.
- s45(5) (d) Participant has requested a variation for crisis or emergency funding due to significant change in their support needs, but the Agency has not yet made a decision.
Once funds are exhausted in a funding period, no further invoices can be paid. Our process at OnTime Plan Services for this is:
- We will make partial payments where funds are still available.
- We notify the participant and provider that funds are exhausted, and we cannot pay any more invoices for services during the relevant funding period.
- Providers will need to liaise with the participant / nominee as to payment of the invoice.
- Participants will need to discuss any plan changes or concerns with the NDIS directly.
- If participants wish us to lodge a payment enquiry with the NDIA, they need to notify us of this.
Requesting permission to back claim
When lodging a payment enquiry with the NDIS to request permission for back claiming, we also need to submit supporting documentation. This needs to provide evidence as to which of the above four circumstances apply in this case.
Providers may need to work with support coordinators and / or the participant or nominee to put this information together. Without this evidence, the NDIA will not allow the claim.
What does this mean for providers?
What is providers’ responsibility when delivering supports?
Providers are responsible for delivering supports in line with the participant's plan. This includes confirming the participant’s plan has sufficient funding within each funding period and support category to meet their needs.
How should providers schedule and claim for supports?Providers should schedule and claim for supports within the participant’s available budget and funding periods. Claims submitted within a funding period where funds have been exhausted will be rejected.
Providers enter into agreements with participants to provide them with services. Participants can choose to use their NDIS funding to pay for these services. If NDIS funds are exhausted, the provider will need to ask the participant to pay outstanding amounts via other means.
Before starting services, providers should discuss with the participant:
- Whether the participant’s plan has funding periods, and if so, what these are.
- How much funding the participant agrees to spend in each funding period, and if this fits with what was funded. It also needs to fit with other providers’ supports from the same category.
- How outstanding invoices will be paid if the supports requested exceed the available funding.
Why is it important for providers to avoid over servicing?
Over servicing occurs when services are delivered beyond the allocated budget for a given funding period, with the expectation that the claim will be paid using the next funding period’s allocation. While this may seem convenient, it creates risk. If a provider delivers more services than funded in a period, there may not be sufficient funding to cover the participant’s support requirements for the duration of their plan. Under NDIS legislation, claims exceeding the available funding in a support category in the current funding period cannot be paid. To ensure both providers and participants are protected, it is essential to deliver services within the participant’s budget and funding periods. Avoiding over-servicing, especially if funding is nearing its limit, ensures continuity of supports and prevents financial risks for participants and providers.
Service Agreements
Provider’s service agreements for participants with funding periods need to take into account:
- That the requested service is in line with the participant’s plan.
- Overall funding available in the plan for request supports.
- Funding available in each funding period.
The service agreement should state how much funding is requested in each funding period. This helps the participant to budget their funding better. Providers should also consider how to re-allocate funds, if supports provided did not match expected allocations.
Copies of each service agreement should be sent to the participant, support coordinator where applicable, and plan manager.
Suggestions from us
- We recommend that providers invoice in a timely manner to help participants budget their funds more easily.
- Providers need to monitor funds they’ve claimed during each funding period, to ensure they stay within the agreed limits. For any additional supports requested, it should be confirmed that funding is available.
- If providers need to suspend services due to insufficient funds, they should discuss this with the participant in advance. This article from DSC might be helpful.
- Participants who do not have support coordinators may need help to budget their funding. The NDIS provides a Budget Calculator or Support Organiser tool that can be used to help with this: https://www.ndis.gov.au/participants/plan-implementation-directory/budget-calculators