NDIS plan-managed vs self-managed invoices: who you bill

Two NDIS participants book the same 60-minute session on the same day. One invoice goes to a plan manager, the other to the participant's mother, and if either is addressed to the wrong party the payment stalls. The difference is how each participant's plan is managed, and it changes who you bill, who pays, what they need from you and how long the money takes to arrive.

The three ways a plan can be managed

• Plan-managed. A plan manager, funded from the participant's plan, pays providers on the participant's behalf. You invoice the plan manager.
• Self-managed. The participant, or their nominee, manages the funding themselves. You invoice the participant, who either pays you and then claims from their NDIS funds, or claims first and then pays you.
• Agency-managed, also called NDIA-managed. The NDIA pays providers directly. Only registered providers can be paid this way, and you claim through the NDIS provider portal.

A plan can also be mixed, with some budgets plan-managed and others self-managed. Check which part of the plan your service is funded from, not just how the participant describes their plan overall.

Plan-managed: bill the plan manager, name the participant

The invoice is addressed to the plan manager, but the participant is still the person treated, and both need to be clear on the page. A plan manager is paying out of someone else's funding and has to match your invoice to a participant, a plan, a support item and a date. Our post on what NDIS plan managers actually need on an invoice covers those fields in detail.

• Addressee: the plan manager's business name and accounts email.
• Patient: the participant's name and NDIS number.
• Lines: support item number, date of service, quantity and price.
• Price: within the maximum price in the current NDIS pricing schedule, which applies to plan-managed supports.

Plan managers pay on their own processing cycle. Send invoices promptly after the service, and let the participant or their support coordinator know if something has been outstanding for a while.

Self-managed: bill the participant, and help them claim

For a self-managed participant, you invoice the participant or their nominee. They pay you and claim from their NDIS funds, so your invoice has to work as evidence for their claim, not just as a request for payment.

• Address the invoice to the participant or nominee, as your service agreement says.
• Include the same detail a plan manager would want: participant name and NDIS number, support item, date of service, quantity and price.
• Issue a receipt once they have paid. Self-managed participants need to keep records of what they paid for, in case the NDIA asks.
• Agree the price in your service agreement. The NDIA says the maximum prices in its pricing schedule apply to agency- and plan-managed participants, not self-managed ones, but pricing rules are under reform, so check the NDIA's current pricing documents before you agree a price above the schedule.

Payment from a self-managed participant can take longer if they claim before paying you, so be clear in the agreement about when payment is due.

Agency-managed: claim from the NDIA

For agency-managed participants there is no invoice to a third party in the usual sense. A registered provider claims through the NDIS provider portal, one claim at a time or as a bulk upload file. What has to be in place before you can claim has changed as the NDIA has moved to newer systems, so check the current portal guidance before your first claim for each participant. The service agreement applies just the same, and your notes still need to support every claim.

Timing and the participant on the page

Whatever the management type, a few habits keep payment moving:

1. Invoice for services that have been delivered, showing the date of service, not just the date you invoice.
2. Check that the service falls within the participant's current plan dates.
3. Keep the participant visible on every invoice, even when someone else pays.
4. Use one invoice per payer. Do not mix plan-managed and self-managed services on one document.
5. When a plan manager is late, follow up with the plan manager, not the participant.

Our guide to NDIS invoicing requirements for allied health has the full list of fields for each type of invoice.

How AspireOS sends each invoice to the right payer

In AspireOS, the funding card on a participant's file records whether their NDIS plan is plan-, self- or agency-managed, and the plan manager sits on the file as a contact. Plan- and self-managed invoices go to the right payer as a branded PDF tax invoice carrying the NDIS number and plan manager, and you can see whether each email was delivered or bounced. For agency-managed participants, the NDIS upload tab in Finances builds the bulk payment file, flagging problems first, for you to upload yourself in the NDIS portal; AspireOS does not lodge the claim. Participants can see their invoices and receipts in the patient portal, and receipts are emailed when you record a payment. There is more on our page for NDIS providers.

You can start free, set up your NDIS participants with the right management type, and send your next batch of invoices to the right people.