01_049_0107_1_1
Establishment Fee For Personal Care/Participation - Daily Personal Activities

Line Item Description

This line item allows providers to claim a one-off fee to cover the administrative costs associated with establishing service arrangements for new participants requiring significant levels of personal care or community participation support.

Purpose of the Fee
The Establishment Fee is designed to recognise the non-claimable costs that providers incur when setting up new, ongoing service arrangements with a participant. It is claimable by providers who are contracted to deliver substantial support over an extended period.

Conditions for Claiming
A provider can claim this Establishment Fee only when they have an agreement with the participant to supply a minimum of 20 hours per month for three or more consecutive months. The qualifying supports fall under two main categories:

Personal Care Supports: This includes supports from the 'Activities of Daily Living' category, delivered by providers registered for 'Daily Personal Activities' (0107).

Participation Supports: This includes supports from the 'Social, Economic and Community Participation' category.

Key Claiming Rules

One Fee Per Participant: A provider can only claim this fee once in respect of a particular participant, across all of their NDIS plans.

Multiple Providers: It is possible for more than one provider to claim an Establishment Fee for the same participant, provided that each provider independently meets the eligibility criteria (e.g., 20+ hours of support per month for 3+ months).

Single Claim Per Provider: If a provider delivers multiple types of qualifying supports (e.g., both personal care and participation supports), they can still only claim one Establishment Fee for that participant.