Is my therapy a stated support in my PACE plan?
(and what is a stated support?)
If you have a specific therapy/therapies named in your NDIS PACE plan, you can ONLY spend your therapy funding on that type of therapy.
We call this a STATED support.
Here is an example of a STATED therapy support:
This PACE plan has physiotherapy and occupational therapy specifically named.
This means this Participant can ONLY spend their therapy funding on a Physio and OT.
They cannot decide they would rather use psychology, even if it would help them achieve their goals.
So when is my therapy funding flexible?
Sometimes the NDIS DOES NOT mention specific therapies in an NDIS PACE plan.
We call this type of therapy a FLEXIBLE supprt.
Here is an example where the NDIS PACE plan has its ‘generic’ NDIS blurb and no mention of specific therapies.
This person can spend their therapy funding on ANY therapy the NDIS will fund that will help them achieve their goals.
BTW: Did you see the note on Therapy Reports?
It’s important to note that both plans show the need for a report 6 weeks before the end of the plan.
TIP: Make sure your therapist puts aside funding hours for this when they start your therapy.
What happens if I have stated therapy and I spend on a different therapy?
Plan Managed Participants
If your NDIS PACE plan has stated therapy supports, your Plan Manager cannot pay for any other therapy. There are no exceptions, even when it seems like the NDIS has made an error!!
If your NDIS plan has specific therapy named in it, your Plan Manager can only pay for that therapy. Even if it feels like the NDIS has made a mistake!
You will be out of pocket and have to pay for the therapy yourself.
Self Managed Participants
If your NDIS PACE plan has stated therapy supports and you claim for it, the NDIS could:
- Make you pay back the amount AND
- change your plan to being Plan Managed with no warning (we have seen this happed).
Agency Managed Participants
If your NDIS PACE plan has stated therapy supports and you engage a provider to deliver a different therapy, the NDIS WILL NOT pay the therapy provider.
The therapy provider will look to you to settle their fees.
Important Tip
So that you don’t receive therapy you can’t pay for, make sure you:
- read your plan carefully
- share your plan with your therapist
Again, if you DON’T have any therapies mentioned, you can pay for any therapy that the NDIS will fund, provided its delivered by the appropriate professional.
What happens if you need to change the stated therapy funding you have?
You will need to contact the NDIS and request a plan reassessment or change of circumstances. You will need to provide evidence as to why you need different therapy and it will take ages to change if the NDIS agrees.
