This week, the National Disability Insurance Agency released its 2024–25 Annual Pricing Review. From July 1, 2025, the NDIS will introduce sweeping pricing reforms: slashing fees for psychologists in four states and territories, cutting hourly rates for other allied health providers, and halving travel reimbursements for all therapy services.
The changes have been framed as a rebalancing effort based on market benchmarking. But for those of us on the front line, especially in regional areas, the result is a system that’s becoming financially unsustainable, ethically compromised, and increasingly inaccessible.
The new pricing arrangements propose a flat national rate for psychology services: $232.99 per hour. For providers in some states, this represents a modest increase. But in states facing chronic workforce shortages including Tasmania, South Australia, Western Australia, and the Northern Territory, this results in a cut of $11.23 per hour. Meanwhile physiotherapists have been hit with a $40 price cut. The pricing review has targeted allied health professionals across the board, including dietetics, occupational therapy and podiatry.
There have also been cuts to travel claiming. Until now, therapy providers could claim travel time at the same rate as service delivery. Under the new cuts providers will only be able to claim half the hourly rate for travel. For many therapists, especially those in regional areas, this effectively wipes out the viability of home visits, community outreach, and mobile care.
The NDIA insists these changes reflect market realities. But those of us actually working in private practice know that psychology fees in the open market vary widely, with the highest rates charged in metropolitan areas. The Australian Psychological Society (APS) suggests the recommended fee for psychologists of $311 per session for 2024-2025, calculated to cover registration, insurances, continuing professional development and the costs of running a clinic. The new NDIS capped rate of $232.99 is not a reflection of reality.
The NDIA’s decision to halve travel reimbursements is particularly harmful to clients with complex needs—especially women with disability who experience poverty, trauma, or restricted mobility. In practice, this change means that therapists will no longer be paid fairly to visit clients in their homes or communities.
For those in regional or remote areas, these changes risk erasing participants’ only point of access to appropriate care. For others, such as women fleeing violence, living with mental illness, or parenting with a disability, clinic attendance is simply not an option.
Here are some reasons these cuts disproportionately impact women:
- Women with disability experience more trauma. The Australian Bureau of Statistics found that women with disability were more likely to experience violence by a cohabiting partner as women without disability. Many require trauma-informed, long-term therapeutic care: precisely the kind of services these pricing changes threaten.
- Women are not receiving equitable treatment under NDIS. Commonly reported gendered barriers to women being able to access supports for their disability involve confidence, negotiation and self-advocacy, gendered discrimination in diagnosis and the medical system, and support for caring roles.
- Women with disability face greater socio-economic disadvantage. The Australian Bureau of Statistics reports that women are less likely to be employed, more likely to live in poverty, and more likely to be carers themselves. These factors make them particularly dependent on outreach and community-based care.
The majority of the allied health workforce is female. According to the Psychology Board of Australia, over 80 per cent of registered psychologists are women. Similar gender splits are seen in occupational therapy, speech pathology, dietetics, and physiotherapy.
These women are not just clinicians. They’re often small business owners juggling unpaid care work and covering huge geographical footprints in under-serviced areas. Slashing fees and travel funding doesn’t just affect their incomes: it undermines the viability of businesses—many of which are already on the brink. Working in Tasmania, I’ve seen the warning signs. Waitlists are expanding. Clients are losing access to support. And providers are quietly exiting the Scheme.
Cutting therapy rates and travel reimbursements may save the NDIA money in the short term. But the long-term cost will be devastating. Without access to early, consistent therapy, people with disability are more likely to experience functional decline, hospitalisation, or disengagement. Informal carers will be pushed to breaking point.
Despite claiming to have consulted widely, the NDIA has failed to meaningfully engage frontline providers in designing these reforms. Many allied health professionals learned about the changes through media outlets rather than direct dialogue.
If the agency wants to build a future-ready, sustainable system, it must begin with co-design. That means listening to allied health professionals and people with disability.
These changes must not proceed unchecked. We need urgent intervention on three fronts:
- Reverse regional allied health fee cuts and raise therapy rates to reflect actual service delivery costs.
- Pause the travel reimbursement overhaul and co-design a model that protects outreach, rural care, and participant choice.
- Ensure transparent, inclusive consultation in pricing schedules.
I believe in reform. I believe in making the NDIS more effective, more efficient, and more responsive to participant needs. But you cannot build a sustainable system by driving out the very providers who hold it up. You stand for “choice and control” while cutting off access to people who cannot leave their homes. You cannot ask women with disability to wait patiently while their care disappears and call it progress.
Reform without equity is not reform. It is harm hidden behind spreadsheets.
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