OT Unplugged is a space for you to connect, reflect and stay up to date on OT practice and the evolving world of the NDIS.
OT Unplugged: Community of Practice Insights
Claim This Podcastby Sarah Collison, Nikki Cousins and Alyce Svensk
4.9(49 reviews)
104 episodes
Updated Daily
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OT Unplugged is a space for you to connect, reflect and stay up to date on OT practice and the evolving world of the NDIS.
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🇺🇲
Publishing Since
2/15/2024
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Recent Episodes
June 22, 2026
S09E10 - NDIS Price Guide - What OTs really need to know
<p><strong>What Occupational Therapists Need to Know About the 2026–27 NDIS Pricing Update</strong></p> <p>The 2026–27 NDIS Pricing Schedule and Annual Pricing Review have now been released.</p> <p>For Occupational Therapists, the immediate headline is relatively positive. OT rates remain unchanged, avoiding the cuts seen across several other allied health professions.</p> <p>However, while pricing may appear stable on the surface, the update raises important questions around billing, travel and the long-term sustainability of OT services.</p> <p><br><strong>OT pricing remains unchanged</strong></p> <p>The maximum hourly rate for Occupational Therapists remains unchanged at $193.99 per hour, with provider travel remaining at $97 per hour.</p> <p>Given concerns about possible pricing cuts, many OT providers will see this as a positive outcome. While there has been no increase to reflect rising wages and operating costs, there has also been no reduction.</p> <p>For many practices, this was likely the best realistic outcome.</p> <p><br><strong>The biggest issue is missing guidance</strong></p> <p>The biggest challenge is not the pricing itself, but the lack of guidance.</p> <p>Unlike previous years, the Pricing Schedule currently provides rates and line items without the detailed billing guidance providers usually rely on.</p> <p>This means there is still uncertainty around travel claiming rules, billing caps, support definitions and claiming requirements.</p> <p>Right now, OTs know the rates, but not exactly how some of those supports can be claimed in practice.</p> <p><br><strong>Travel remains unclear</strong></p> <p>Travel is one of the biggest unresolved issues.</p> <p>Although provider travel remains listed at $97 per hour, there is no clear guidance confirming whether existing travel caps still apply.</p> <p>There is still uncertainty around whether the 30-minute metro cap remains, whether the 60-minute regional cap still applies, or whether travel rules have changed more broadly.</p> <p>This is particularly important for mobile OT services and regional providers.</p> <p><br><strong>New billing line items mean immediate updates</strong></p> <p>One of the biggest practical changes is the introduction of new billing line items.</p> <p>The updated structure separates direct service, cancellation, non-face-to-face work, provider travel, telehealth and NDIA requested reports into separate billing categories.</p> <p>This creates greater billing clarity, but also means many practices will need to urgently update billing systems, CRMs, invoicing templates and internal workflows.</p> <p><br><strong>Non-face-to-face billing is becoming clearer</strong></p> <p>One positive change is the clearer distinction between standard non-face-to-face work and NDIA requested reports.</p> <p>General non-face-to-face tasks appear to include preparation, documentation, case notes and standard reporting such as functional capacity assessments.</p> <p>NDIA requested reports generally refer to reports used to support funding decisions, such as assistive technology, home modifications and home and living reports.</p> <p>This distinction will be important for compliant billing moving forward.</p> <p><br><strong>Pricing decisions are shifting</strong></p> <p>One of the most important long-term changes is how future pricing decisions are being made.</p> <p>This year, the NDIA used more than 16 million therapy transactions to benchmark therapy pricing against Medicare, private health and comparable government schemes.</p> <p>This reflects a clear shift toward external market benchmarking and less emphasis on provider operating realities such as wage pressures, overheads and workforce challenges.</p> <p>This has significant implications for private OT practice sustainability.</p> <p><br><strong>Demand is rising while providers are falling</strong></p> <p>Another major theme is the changing therapy market.</p> <p>Therapy supports now account for approximately 10% of total NDIS expenditure, while demand for therapy continues to grow.</p> <p>At the same time, active therapy providers have declined by 3.9%, with unregistered provider numbers declining by 4.9%.</p> <p>Demand is rising while provider numbers are shrinking, increasing pressure on service access, waitlists and workforce sustainability.</p> <p><br><strong>What this means for Occupational Therapists</strong></p> <p>At a high level, this year’s pricing update feels relatively stable for Occupational Therapists.</p> <p>There are positives. OT rates remain protected, there have been no immediate pricing cuts and billing categories may be becoming clearer.</p> <p>But there are also challenges. Practices need to prepare for immediate billing updates, key guidance remains missing and uncertainty around future pricing remains.</p> <p>For Occupational Therapists, this update feels like short-term relief.</p> <p>But beneath that stability, there are meaningful shifts in pricing, billing and market dynamics that every OT should be paying attention to.</p> <p><br><strong>Key takeaways for OTs</strong></p> <p>• OT rates remain unchanged at $193.99 per hour, with travel remaining at $97 per hour.<br>• The biggest concern is missing guidance around billing and claiming rules.<br>• Travel remains one of the biggest unresolved issues.<br>• New billing line items will require urgent system updates.<br>• Non-face-to-face billing appears more clearly separated from NDIA requested reports.<br>• Future pricing decisions are increasingly based on external benchmarking.<br>• Demand for therapy is rising while provider numbers are declining.<br>• The update provides short-term stability, but long-term uncertainty remains.</p>
June 18, 2026
S09E09 - Beyond Self-Report: Building Stronger Functional Capacity Evidence
<p>Occupational Therapists are frequently asked to provide ‘robust evidence’ for NDIS funding decisions, but what does that really mean? Explore why observation, clinical reasoning and context matter when assessing functional capacity.</p> <p>When Occupational Therapists write reports for the NDIS, one phrase appears repeatedly: robust evidence. Whether it’s a funding review, access request, assistive technology application or change in support needs, Therapists are often asked to provide stronger justification and more comprehensive evidence.</p> <p>The challenge is that there is no clear definition of what robust evidence actually looks like. As a result, many OTs are left wondering how much evidence is enough and what information carries the greatest weight.</p> <p>The answer often lies in moving beyond self-report and gathering information from multiple sources to build a complete picture of a person’s functional capacity.</p> <p><strong><br>Why self-report is only part of the story</strong></p> <p>Most assessments begin with conversation. We ask people about their daily routines, the tasks they complete independently and the areas where they need support. These discussions provide valuable information, but they are only one piece of the puzzle.</p> <p>People naturally interpret their abilities through their own experiences and expectations. Some individuals may overestimate their independence, while others may underestimate what they can do. This is why Occupational Therapists are trained to look beyond verbal responses and consider how a person actually performs tasks in real-world situations.</p> <p><strong><br>The value of observation in functional assessments</strong></p> <p>Observation remains one of the most powerful assessment tools available to OTs.</p> <p>A person may report that they independently manage meal preparation, household tasks or personal care. However, observing the environment can reveal important details that provide additional context.</p> <p>A walk through the home may identify signs that tasks are not being completed consistently. Alternatively, it may demonstrate a level of independence that exceeds what was initially reported. Both outcomes are clinically important.</p> <p>Environmental observations, task completion and functional demonstrations help Therapists validate information, identify barriers and understand how a person’s abilities translate into everyday life. This observational evidence often strengthens the overall assessment and contributes to more robust clinical reasoning.</p> <p><strong><br>Understanding function within context</strong></p> <p>One of the most important principles of occupational therapy is that function does not occur in isolation.</p> <p>Performance can vary significantly depending on the environment, available supports and expectations placed on the individual. A person may demonstrate greater independence in one setting and require substantial assistance in another.</p> <p>For example, some individuals may perform tasks independently in structured environments such as school, work or day programs, while requiring significantly more support at home. In other situations, highly supportive family members may unintentionally complete tasks on behalf of the person, masking their true abilities.</p> <p>Without considering context, Therapists risk drawing incomplete conclusions about a person’s functional capacity.</p> <p><strong><br>Why clinical reasoning matters</strong></p> <p>Robust evidence is not simply about collecting more information. It is about interpreting that information accurately.</p> <p>Occupational Therapists draw on clinical knowledge, experience and evidence-based practice to identify patterns and understand how a person’s diagnosis may impact their function. This becomes particularly important when working with conditions characterised by fluctuating capacity.</p> <p>A snapshot assessment conducted on a person’s best day may not accurately reflect the support they require over time. Likewise, a single observation may not capture the impact of fatigue, pain, mental health challenges or episodic symptoms.</p> <p>Strong clinical reasoning allows Therapists to synthesise multiple sources of information and determine what is most representative of the individual’s everyday experience.</p> <p><strong><br>The role of standardised assessments</strong></p> <p>Standardised assessments can provide valuable objective data when selected appropriately and interpreted correctly.</p> <p>However, assessment scores alone rarely tell the full story. A percentile rank or functional score only becomes meaningful when the Therapist explains what it represents and how it relates to everyday function.</p> <p>The most effective reports integrate standardised assessment results with observational findings, collateral information and clinical interpretation. This approach creates a comprehensive picture of a person’s strengths, challenges and support needs.</p> <p><strong><br>The challenge of future support needs assessments</strong></p> <p>As discussions continue around NDIS support needs assessments, many OTs have raised concerns about the potential loss of observation-based assessment.</p> <p>Functional capacity cannot always be accurately understood through questionnaires or interviews alone. Observation, environmental assessment and task analysis provide critical insights that help Therapists distinguish between reported abilities and actual performance.</p> <p>Without these opportunities, there is a risk that assessments may overlook important nuances that influence a person’s daily functioning and support requirements.</p> <p><strong><br>Building truly robust evidence</strong></p> <p>When Occupational Therapists talk about robust evidence, they are rarely referring to a single assessment tool or a larger volume of paperwork.</p> <p>Instead, robust evidence comes from combining multiple sources of information, including self-report, observation, standardised assessments, collateral input and professional clinical reasoning.</p> <p>It is this synthesis that allows OTs to understand not only what a person says they can do, but what they actually do, how they do it and what support they need to participate meaningfully in everyday life.</p> <p><strong><br>Key takeaways for OTs</strong><br>• Robust evidence involves more than self-report and should include observation wherever possible.<br><span>• </span>Functional performance must be interpreted within the context of the person’s environment and supports.<br><span>• </span>Clinical reasoning is essential when assessing fluctuating capacity and complex presentations.<br><span>• </span>Standardised assessments are valuable when appropriately selected and clearly interpreted.<br><span>• </span>Observation and task analysis remain critical components of comprehensive functional assessments.<br><span>• </span>Strong reports synthesise multiple sources of information to create an accurate picture of support needs.</p>
June 11, 2026
S9E08 - The Year of Uncertainty Continues
<p><strong>Pricing uncertainty continues to affect providers</strong></p> <p>For many providers, annual pricing updates remain a significant source of uncertainty. Business owners are often required to make decisions about staffing and service delivery without knowing exactly what future funding arrangements will look like.</p> <p>Combined with rising employment costs and workforce reforms, these changes are placing increasing pressure on provider sustainability, particularly for smaller practices.</p> <p><strong><br>The growing loss of experienced therapists</strong></p> <p>Across Australia, many experienced occupational therapists are reconsidering their future within the NDIS. While financial pressures contribute to this trend, increasing administrative demands, system changes and frustration with decision-making processes are also driving clinicians away from the scheme.</p> <p>The impact extends beyond individual businesses. Experienced therapists bring years of clinical reasoning, assessment expertise and mentorship to the profession. As these practitioners leave, participants lose access to valuable knowledge and support.</p> <p><strong><br>Moral injury and professional frustration</strong></p> <p>Many therapists report feeling that their professional expertise is being given less weight despite extensive assessment and evidence gathering. When recommendations are repeatedly challenged or dismissed, it can create significant professional frustration and contribute to moral injury.</p> <p>For a profession built on evidence-based practice and participant-centred care, this can be particularly difficult. Over time, the emotional burden contributes to burnout and influences decisions to leave the sector altogether.</p> <p><strong><br>Advocacy and sector response</strong></p> <p>Recent NDIS consultation processes have demonstrated the strength of engagement across the disability sector. Thousands of submissions were lodged by clinicians, providers, participants and advocacy groups, highlighting widespread concern about proposed reforms.</p> <p>While the outcome remains uncertain, these submissions reflect a profession determined to contribute its expertise and advocate for meaningful outcomes. Advocacy continues to be a core part of occupational therapy practice, both at an individual and systemic level.</p> <p><strong><br>AI in occupational therapy</strong></p> <p>Artificial intelligence is becoming increasingly common across healthcare, particularly for tasks such as note-taking, report drafting and written communication. Used appropriately, these tools can reduce administrative burden and improve efficiency.</p> <p>However, AI cannot replace clinical reasoning. Occupational therapy relies on contextual understanding, professional judgement and relationship-based practice. Therapists remain responsible for ensuring documentation is accurate, clinically appropriate and reflective of participant needs.</p> <p>The use of AI also raises important considerations around consent, privacy and data security. Clear communication with participants and strong governance processes remain essential as technology becomes more integrated into practice.</p> <p><strong><br>Looking ahead</strong></p> <p>The coming months are likely to bring further change across the NDIS landscape. Pricing decisions, legislative reforms and technological developments will continue to shape the way occupational therapists work and how participants access support.</p> <p>While the challenges are significant, the profession’s ongoing commitment to advocacy, clinical excellence and participant-centred practice remains unchanged. Supporting workforce sustainability and valuing professional expertise will be critical to the future success of both occupational therapy and the NDIS.</p> <p><strong><br>Key takeaways for OTs</strong></p> <p>• Pricing uncertainty continues to create challenges for providers and business planning.<br>• Experienced occupational therapists are increasingly leaving the NDIS workforce.<br>• Moral injury is contributing to clinician burnout and workforce attrition.<br>• Strong engagement in consultation processes highlights the sector’s commitment to advocacy.<br>• AI can improve efficiency but cannot replace clinical reasoning and professional judgement.<br>• Participant consent, privacy and data security remain essential when using AI tools.<br>• Supporting workforce sustainability is critical for the future of participant care.</p>
104 total episodes available
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