NDIS and Occupational Therapy: What's Actually Covered

NDIS plans can feel like a maze, and occupational therapy sits inside several parts of it at once. Families regularly arrive unsure which budget pays for OT, whether report writing eats their therapy hours, or whether they're even allowed to see us. This guide answers those questions properly.

At Square One Therapy Hub in Kogarah, we welcome self-managed and plan-managed NDIS participants for occupational therapy. We are not NDIA-registered — more on why that matters below.

Which budget funds OT?

NDIS plans contain three budget types: Core Supports, Capacity Building and Capital Supports. Occupational therapy sits in Capacity Building, almost always under Improved Daily Living (support category 15) — the budget for therapy that builds a participant's ability to do everyday things more independently.

OT can also touch other parts of a plan:

• Improved Relationships — where therapy targets social and emotional skills
• Improved Health and Wellbeing — where the focus is health maintenance or fitness rather than functional capacity
• Assistive Technology (Capital Supports) — for OT-prescribed equipment, following an AT assessment
• Home Modifications (Capital Supports) — for OT-led environmental changes such as rails or bathroom modifications

Your plan document lists which categories are funded; a plan manager or support coordinator can confirm what sits where.

What OT funding actually covers

A common misconception is that the funding only pays for face-to-face session time. Depending on your plan and service agreement, OT funding can cover:

• Initial assessment and the written report
• Ongoing therapy in clinic, at home, at school or via telehealth
• Functional Capacity Assessments to support plan reviews and access requests
• Progress reports and review evidence
• Equipment prescription, trials and follow-up
• Meetings with schools, support coordinators and other professionals
• Home programs and written resources
• Travel time to home or school visits, where the plan includes travel funding

All of it draws from the same Improved Daily Living budget, so agree the expected mix with your provider up front — a Functional Capacity Assessment, for instance, is a substantial piece of work (typically 8–15 hours including the report), and it's much better planned for than discovered on an invoice.

Rates are capped by the NDIS Pricing Arrangements and Price Limits, reviewed by the NDIA each July. No provider can bill an NDIS participant above the published limit.

Self-managed, plan-managed, NDIA-managed

How your plan is managed decides which providers you can use:

• Self-managed — you pay providers and claim back via the myplace portal. Any provider, registered or not. Most flexibility, most admin. We accept self-managed participants.
• Plan-managed — a plan manager pays invoices from your budget. Any provider, registered or not, and the plan management fee comes from its own budget line, so it doesn't reduce therapy hours. We accept plan-managed participants.
• NDIA-managed — the NDIA pays providers directly and only NDIS-registered providers can be used. We are not NDIA-registered, so NDIA-managed plans can't be used with us. If you'd like wider provider choice, switching to plan-managed can be requested at a plan review and is usually straightforward.

Do I need a referral or diagnosis?

No GP referral is needed — the NDIS plan itself is the pathway. And once a plan exists, therapy is driven by goals rather than diagnosis. (A diagnosis or functional evidence is generally needed to access the scheme in the first place, which is one of the main jobs a Functional Capacity Assessment does.)

For children under 9, the NDIS Early Childhood Approach is the usual entry point; we work alongside Early Childhood Partners and can provide the assessments and reports that support access requests.

Making the funding go further

• Write specific goals. "Improve fine motor skills" is hard to evidence at review; "dress independently for school, including buttons" is not.
• Ask for a session forecast. Roughly how many sessions, which reports, and when — so the budget is predictable across the plan period.
• Use the home program. What happens between sessions drives most of the change and stretches every funded hour further.
• Match intensity to phase. Skill-building often suits a weekly block; consolidation usually needs far less.
• Collect evidence as you go. Short videos and teacher observations gathered through the year make plan reviews vastly easier.

Getting started with us

1. Contact us with your plan details and priorities
2. We book an initial assessment (60–90 minutes)
3. You receive a written plan of recommended sessions and goals
4. We invoice your plan manager, or you directly if self-managed

You may also find our NDIS funding page useful, along with our guides to OT for autistic children and what a paediatric OT does. Official guidance on using your plan is on the NDIS website.

We're at 4 Short Street, Kogarah, supporting participants across the St George area and Sutherland Shire — clinic, home, school and telehealth. Book online or get in touch with a question first.