The Private Practice Success Podcast

45. The NDIS Debacle: My Take & Your Next Steps

• Gerda Muller • Episode 45

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In episode 45, Gerda shares a candid, practical take on the current NDIS landscape as well as her take as to the right next steps to future proof your practice.

From inconsistent pricing and slashed travel allowances to the newly announced Thriving Kids Program, Gerda unpacks what’s changing, why so many providers feel exhausted and disillusioned, and how to make grounded decisions that protect your team, clients, and business.

Drawing on years of working with NDIS and non-NDIS practices, Gerda offers a clear-eyed path forward allowing practice owners to reduce their over-reliance on third-party payers, and reframe their business model for sustainability.

In this Episode, you will learn (among others):

  • What the latest NDIS pricing changes and the Thriving Kids announcement mean for paediatric practices.
  • Why over-reliance on third-party payers amplifies risk and how to rebalance toward sustainable private revenue.
  • Practical steps to start diversifying now (even if you feel overwhelmed), including targets and market shifts that work.

Who this Episode is for:

  • Allied health practice owners (especially paediatric and NDIS-heavy practices) seeking clarity and a practical plan.
  • Leaders ready to future-proof their business, reduce risk, and protect margins without burning out their team.
  • Owners who want to balance impact and freedom with serving their community, whilst building a resilient, values-driven practice.

Special Resource:

Download the FREE How to Set your Fees in Private Practice Calculator HERE.

Tune in for a grounded reality check and actionable next steps to help you navigate the NDIS changes as you build a practice you can’t stop smiling about.

Want Gerda's Help with your Business?

Gerda helps allied health group practice owners go from overwhelmed, overworked, and underpaid to fully empowered and financially thriving. If this is you, then make today the day you reach out. Complete this super short Triage Form here bit.ly/triageformpps and Gerda will personally reach out to you. 

Here to help you build a practice you can't stop smiling about :)

Connect with Private Practice Success & Gerda here:

 Well, hello there spectacular private practice owner. My name is Gerda Muller, and you are listening to the Private Practice Success Podcast, and this is episode number 45.

The topic for today's episode is: The NDIS Debacle. 

Now you might be thinking debacle? That is a really strong word to use Gerda. And I know it is. I actually really thought to myself, is that the right word? I think it is. I also suspect that if you are an allied health practice owner currently being impacted by the changes within the NDIS, then you will be the first to wholeheartedly agree that it is 100% a debacle. You might even use some stronger, and even some, you know, what's referred to as choice words when referring to the NDIS. But we are going to talk about it today.

I'm going to preface this by saying that I do not consider myself to be an expert in all things NDIS. I'm pretty sure that there's lots of people out there that know way more about the NDIS than I do. But what I do know about is based upon my own practice providing NDIS services, albeit being non-registered, also referred to as an unregistered provider.  So we do a lot of NDIS work within my practice. 

I also mentor, coach and support Allied Health group practice owners that do a lot of NDIS work, both as unregistered providers, but also as registered providers. So I am most certainly 100% across the frustrations and the disappointment and the panic and all of the emotions that accompany the proposed changes that have already happened within the NDIS, particularly during the course of the last 12 months.

So I do get it. I most certainly get it, but again, I don't call myself an NDIS expert. I am an allied health private practice expert. I'm also not an expert in the field of disability, right? Yes, we work with a lot of clients that have a disability with my practice who are part of the NDIS. But me, myself, I'm a trauma psychologist. 

Though again, we've got clients within my practice and these clients of my business consulting clients that work within that space. But again, I'm not an expert in it. But I'm going to share with you my take, my thoughts and my opinion on the NDIS debacle as somebody that has a group private practice that has skin in the game, that has had to deal with the NDIS for many, many years now. And who every day, week, month, are supporting group practice owners working in that space.

Now if you are one of my listeners that are within Allied Health private practice, and you don't do any NDIS work - and I'm sure there are probably many of you - I'm going to give you a very, very short, sharp, quick synopsis of the main pain points of late. I would say the biggest pain points during the course of 2025 was the pricing review that was released somewhere mid year, like June, I think it was like before the start of the financial year. And as part of those changes, there were a number of things that happened.

Brief Background on the NDIS Pricing Review

So in a nutshell, the pricing guidelines that were released and that took effect in July, 2025, had the following biggest impacts. The majority of disciplines had no increase to the dollar amount that they could charge per billable client hour. Which is fairly ridiculous, right? Because the cost of business goes up every year.

If you think the super that has gone up - you know, overheads, wage costs, the Allied Health and Support Services award - there have been award increases - significant this year, particularly not just the normal CPI. Like the cost of doing business goes up every year, but the NDIS has gone, No, even though your cost goes up as a business, we don't care. We are still just paying X amount of dollars. And that was across the majority of the disciplines.  And then, when I speak of disciplines, I mean Allied Health. Then there were certain disciplines in certain states that had their rates go down, and then there were certain disciplines that had their rates go up. So it was really a bit of a mix bag. 

However, one of the major changes was the change in what providers can charge for travel. So that was basically slashed in half. And as a result, that will obviously have a huge impact for the many, many providers that provide mobile services, which will obviously therefore have a big impact in access to services, because I'm going to assume that a lot of people are just not going to be able to provide those services, right?

There's only so much margin in the work that we do within Allied Health, and when the rates don't increase, the margins just get smaller and smaller and smaller, until there's nothing left. And when there's nothing left, a business needs to close their doors. 

Now, these pricing guidelines obviously have the biggest impact on you if you are an NDIS registered service provider. Which basically means that what you charge, a self-funded client, what you charge a plan managed, or NDIA managed client, is now set by the NDIS or the government, right? So they tell you you can only charge X amount of dollars, and you can stand on your head, you can do whatever you want - you can't charge anymore. 

Now if you are not a registered provider, you do not have to stick to that pricing amount. Okay? You can actually charge more. You can charge your private rates. But I'm not going to go into the details about that - how you make that work and that stuff today because that's not what I'm here to talk about. What I'm here to talk about is what you need to do when stuff like this is impacting your business.

The Thriving Kids Announcement

It's also important to mention the Thriving Kids Announcement. Now, this announcement was made very recently, actually on the 20th of August, 2025. The minister announced that as of July 2026,  kids that are eight years and under, and who have a diagnosis of mild to moderate, and I'm using the minister and the government's words here that have mild to moderate developmental delay or autism - those kiddies will no longer be looked after within the NDIS. Instead, they will become part of what will be called the Thriving Kids Program.  Now, this program will be run off the back of existing services such as within schools, community hubs, GPs, all of those types of services that are already within the community.

Now you can imagine, and I want you to imagine if you are a paediatric group practice owner - and the emphasis is on paediatric - where you actually support kids within that age range, and majority of your work is in the NDIS - just imagine hearing that on that day. Just imagine. That is a big blow potentially. Because we actually don't know how thriving kids are going to work. We actually don't know how kids are going to get there. We don't know what the funding's going to look like. Is it going to be like Medicare potentially where there's a contribution from the government, but there's a big gap fee? We don't know, okay. 

And when we don't know, and there is uncertainty, that causes a lot of angst. Because how do you solve this problem, when you don't know what's going to happen? And the thing is, you cannot wait until next year until the government decides to tell us how this is going to work - you need to do something now already.

So this is a really important time for practice owners when it comes to making decisions around where to go from here. I'm in a lot of Facebook groups and I read a lot of posts, I read a lot of comments, and it's saddening that people are experiencing this level of disillusionment with the system - particularly the NDIS and with, particularly within the disability sector - there's a lot of disillusionment.

People that work in the NDIS and that work in disability, they are fighters, right? They are advocates. They will, they will do anything they can for their clients, for their community. But when you have to fight day after day, week after week, month after month, year after year - and it feels like you're fighting this huge giant that is the government, there's a point where you just burn out, where you just can't anymore.

And I'm not saying give up. That's not who I am. I am not somebody that gives up. The worst thing you can tell me to do is to give up, to just close the practice doors. That's the last thing I would ever do. And I know people are doing that. I mean, big organisations are closing their doors. I'm not talking about a little group private practice down the road. I'm talking about huge organisations - NGOs as well that get funding. They are closing their doors to NDIS and specific client work because there's no margin like even NGOs did. 

You know, even an NGO needs to run a business that at the very least breaks even. They cannot run a business at a loss. That's not how an NGO was run. An NGO has a board that ensures that it runs at a profit, because otherwise they really need to fire the entire freaking board, because they shouldn't be making a loss. And they are just going, well, the numbers are saying that we can't do this, so we are getting the hell out of here.

So what is left for you as a small to medium sized group private practice to do? If the big guns can't do it?  My biggest fear really is for solar practitioners because what do they do? They just eat it. They just absorb. And what happens? They're the ones that are going to burn out the fastest. Because that's just what they do because they've got good hearts, right? But you can't run a business on a good heart. Doesn't matter how passionate you are about something. Doesn't matter how big of an advocate you are. It's like you can't do business out of nothing.

 Money is a resource. It has to pay for your room, for the fuel in your car if you're doing home visits, okay? For the wear and tear on your car, for your professional indemnity insurance that you can actually work for your professional registrations -  you can actually work that. That shit ain’t free. Okay? And as a group practice owner. We need to pay our team. Well, we've got a responsibility to look after them. We need to pay our bills. We need to keep the doors open. Okay? And unfortunately, the NDIS are making it almost impossible to do. And I want to be really clear, I wouldn't recommend closing your doors because I do not want the industry to lose any more providers, okay? Please remember that that is just one option.

But I also understand that when you are freaking tired, overwhelmed, exhausted, and over fighting the system, then sometimes that is, or seems like the best, the only, or maybe the easiest way out of it - because all you want is relief. You want relief from all the worry, the panic, the concern, the not knowing, the frustration, the anger, and all of the other emotions that come with it.

So I totally get it, but I want you to know that there are other options.

Diversifying your Revenue Streams

The option is simple. You need to diversify the revenue streams coming into your business. Now, I know when I say that -  because you've got all those emotions that I've just mentioned - you're probably just shutting down when you hear that, you're probably thinking, oh, that's all too hard, or, I can't do that, or I don't have the spoons to try that. I don't even know where to start. 

But the thing is that you have to start, because when you have all your eggs in one basket, it becomes really hard to run a future-proofed business. And this is your job, it's your job to future proof your business. Now, you might be thinking, well, Gerda It's easy for you to say you are not an NDIS registered provider. You don't have this problem. And no, I don't. Although we do NDIS work. NDIS is probably 15% of the revenue coming into my group prior practice. But I've been in a very similar situation to where you are, and I'll tell you about this. 

So this is probably what year is it now? It's 2025. Probably 10 years ago. I'm so bad with timelines, right? It's why I never took history at school because I couldn't remember all those freaking dates that you need to remember in, if you take history as a subject, of course, I took it back in South Africa, but it was all the dates. You had to know all these dates, and I was, I'm just shit with dates. So I don't want to lie to you, but it feels like many years ago. 

At that time at my group practice, we did a lot of funded work under what was then called the Better Outcomes Program. So, if you've been in private practice for as long as I've been, you would probably know about the Better Outcomes in mental health program.

So the Medicare funding is called Better Access under mental health, this was the better outcome under mental health, and that funding is still there today. It's just called something different, and it was administered by what is today called Primary Healthcare Networks. Back then they were called something else, don't ask me what it was, I can't remember. They've actually been through quite a number of name changes, at least two or three. Over the years, they're now called Primary Healthcare Networks. I know in my neck of the woods down in Brisbane, the funding is now not referred to as Better Outcomes. It's referred to as Psychological Therapies. Here where we are now in Agnes Water, the funding is called Healthy Minds, for example, and every primary healthcare network calls it something different. 

But anyway, back then, that was 50% of the revenue that came into my group private practice was these Better Outcomes funding. Because one of my practices has always traditionally been in the lower socioeconomic area, so we had a lot of people that met criteria for that funding. So because it was basically earmarked for people with significant financial difficulties to allow them to access free sessions, right? 

And we were called into a meeting at their offices, not just us, all the providers at that time. So I attended the meeting and I went with my then principal psychologist, and at this meeting, where we were and everybody else working underneath that program as providers was when they announced that the way that they assign the funding would be changing.

So at that time, what would happen if you wanted to receive Better Outcomes referrals, all you would do is just register with them and tell them where you're located. And if there were clients in that location, they would send them to you. And then they said going forward this would be a tender process. The tender will be won - by probably a large NGO  - and it'll be up to that organisation to then get their own contractors or their own employees, and they would now be in charge of allocating who gets the funding and AKA, the clients.

And I remember Frankie and me walking out, and we were standing in the parking lot leaning on the car, looking at one another, and I just went, ‘Holy shit, Frankie, we are fucked’. Because that was half our business. Half our business. And I clearly remember what that moment felt like. That wave of just panic of: What does this mean, and what do I need to do to fix this?

But it was also a moment where I made a decision that I'm never going to be here ever freaking again. This is the first, and this is the freaking last time that I am in one of these - holy shit, we are fucked moments - and I never went there again. And that was only 50% of my revenue. 

So I can only imagine what it must feel like for group practice owners who have 80, 90, 100% of their revenue coming from the NDIS right now, and all they're seeing is their margins thinning and thinning and thinning. And if you are in the paediatric space and this Thriving Kids thing has been announced - again, I can't imagine how it must feel when you know that 80% of your revenue could potentially just vanish come the 1st of July, 2026. 

But the message I have for you today is I'm still here. My business is still here. We survived it and so can you. And it starts by taking the first steps towards diversifying your revenue streams within your business. And I know it can be done, because I do that with clients already.

From 100% NDIS to 50% Diversified 

I want to share with you just a quick snippet of a client that I have in my PPS Academy. They have a paediatric practice in the state of Victoria, and they do NDIS work, and they approached me 18 months ago? They approached me and they work 100% in the disability space. It's a psychology practice, I will tell you that they do a lot of positive behaviour support, they do a lot of early intervention, and this practice owner approached me, we had a chat about them joining The Academy. The first thing they said, the first thing they wanted to address, they shared with me was wanting to move away from being 100% reliant on the NDIS, and I need to give them props and credit for making that decision then already. 

Because they were 100% just doing NDIS work and they are an NDIS registered provider. Over the last 12 to 18 months, we've been able to change that to 50% NDIS, 50% private Medicare, and other types of referrals. And that was no freaking mean feat, because if you work in a child in adolescent practice, especially within the NDIS, you would know that kids stay on your caseload for a very long time - often years. So there's not a lot of turnover of clients. But we did it. It was slow and steady, and it took 18 months to get there, but it's possible. 

Now you might think, well Gerda, I don't have 18 months. Okay? But you might have eight months. And you need to start now. You need to start thinking, What do I need to do to tap into a different market? Because I can tell you that the practice owner is sleeping so much better. When the Thriving Kids announcement came out, it didn't rattle them. It's still a concern, because they see that client group - they've got a lot of kids, they work with the really young ones. And a lot of their clients that's still in that 50% is going to be impacted. But they didn't freak out. They went, Okay, now we need to make a plan for this. And we are making a plan together. Right? 

But you have to start. We need to go - it is my responsibility as the practice owner to future proof my business. And I know it's frustrating because it's like, why is the government doing this? The system is broken. But the thing is this: we only have so much impact on the government, and I have seen such great advocacy happening within the Allied health community around all of these changes and all of that stuff.

But at the end of the day, the impact of that advocacy takes years. I hate to say it, but it doesn't impact just in a day, in a week, or even in a month. It can take years for that to have an impact. And I'm not saying stop advocating. I'm not saying stop holding the government to account - we need to do all of those things.

But in the meantime, back at the ranch, it's your job as the practice owner to future proof your business to go, “Okay, this is the NDIS market. I now need to start tapping into different markets,” right? Many years ago, people in the psychology field were bulk billing, because it was easy work. It's easy for people to say, yes, I'm going to come for a session because they're being bulk billed.

And then they realised the freaking bulk bill rate was frozen for many years. And when it does increase - like increases 30 cents - what the hell is that? Whereas cost of living, cost of running a business keeps on going up. And just like practices that marketed themselves as bulk billing practices had to go, “Okay, well, I guess the time has come that I either have to close the doors because I can't pay the bills and I will be trading whilst insolvent, and I don't want to do that  - or I need to tap into a different market, a market that is willing and able to pay for my services. And you don't just kick your bulk bill clients off your caseload, and you don't just kick your NDIS clients off your caseload. But you go, okay, let's hit some targets for myself.

Because there will always be people that have money to pay for your services. Because don't forget, you're a private practice, you're a private provider; you're not an NGO. And when you go to a private business, you need to take out your wallet and pay for that service. People know they need to pay for it.

You can't get your nails done without paying. You can't see a lawyer without paying, unless of course you go to legal aid. Okay? But that's a different market. You can't see a heart specialist without paying, unless you are willing to go sit on a wait list and be seen when it suits them through the public system.

So there is always a market that you can tap into. But you need to go, that's what I'm going to do. You need to make that decision. And it's hard because this is change, and nobody likes change. And I can tell you helping professionals are very change resistant, particularly psychologists, I can tell you that.

But generally, we as humans don't like to change, and this is what's required here. When we've been doing something for so long and now we need to do it differently. And when your values, your vision for your business was aligned to helping people within the disability space, those people that are on the NDIS, and now somebody like me is telling you, no, you need to tap into a different market - I know that's not nice to hear. Okay. 

And I'm not saying again, drop your NDIS clients, that's not what I'm saying. What I'm saying is instead of being a hundred percent reliant on that one referral source, let's get that two 90% and let's work on changing 10% of the caseload of every clinician in my practice to maybe also include Medicare clients, private paying clients, okay? And start thinking there's lots of different referral streams that you can access. I can tell you, you can find 10%, enough clients who pay you privately to full 10%. And then you will slowly start building that snowball. But obviously, you need to get your marketing message right.

More generally, what I want to share with you is the way that I look within my own business at the distribution of revenue streams. So when we do third party work - and there's quite a lot of third-party work that we do as psychology group practice owners - I want third party referrals not to be more than 30% of our revenue.

So, some examples of third-party work within the psychology part of Allied Health private practice would be: obviously NDIS work, but also Work Cover, Department of Veterans Affairs Victims Assist, you might be doing employee assistance program contracting as well as third party insurance, like CTP insurance, for example.

So essentially a third-party referral is where the business isn't paid by the client who is receiving the actual clinical health -  allied health in our instance - service. Instead, your business is paid by a third party, hence the name.  And in my humble opinion, you want all your third-party work to be 30% or less. You know why? Because the revenue coming into your business from that work - as I said, it doesn't come from the client -  and often when it's that third party that is paying, they are the ones that are setting the rate.

So work cover will tell you - we are paying X, take it or leave it. DVA will tell you - we pay Y,  take it or leave it. And very similar to the NDIS, particularly if you are an NDIS registered provider. For us as non-registered providers, that's okay right, because we actually charge our NDIS clients our private fee because we are unregistered, hence, we don't have to stick to the NDIS amount that they say we can charge for the work that we do. And I can tell you for sure that our private rate is way more than what the NDIS will pay for a similar service.

So they will tell you how much they're paying. And I don't like that. I do not like that, but I accept it. And that's the acknowledgement, I, as the business owner, when I'm engaging with those third parties, when I say yes to that work, I am accepting the rates that they are offering me. But as a strategic business owner, I'm going to go -  I am happy to accept that for 30%. 

In order for me to run a fiscally responsible business, that can keep the doors open, I need to ensure that at least 70% of our revenue is set at our private rates. Because I've got a very clear formula for calculating what our private fee needs to be in order to pay all our expenses, save money for a rainy day - you should have three to six months of working capital in a separate squirrel account for in case something like freaking COVID happens again - in order to run a business responsibly and sustainably, you need to know what that number is, and that's what your private fee needs to be. 

And because you charge that, that allows you to then go, Yes, let's support, you know, clients that have to go through a third party, because they can't potentially, most likely, afford to pay privately, okay. And I'm happy to do my part in that. I want to do that. Those are great clients and it feels good as a helping professional to do that work. But I also know that the risk is too high as a business owner to have all your work be through any one third party. Too high. It's too high. The risk per parameters just doesn't work.

Calculating your Private Fee

On a side note: If you do not have a clear data driven method for calculating what your recommended private fee should be at your group private practice, then don't worry I've got you covered. And because you've listened all the way to almost to the end of the episode, we're not there yet, but almost, I'm going to share with you a download link for free - so go to the show notes, find the link, and download my Excel calculator where you can literally just pop in a couple of numbers, and it'll help you calculate what your private fee should be at your business. 

And then what I want you to do is really look at, Okay, if it's, let's say A, go and find then B, which is your average session fee - so what is the amount of money that you get paid on average right now per billable client hour - and then identify the gap between those two. And that will be where the work starts. Because you would need to start taking some really practical steps towards moving towards your recommended private fee.

Alrighty, now, I was really hoping that this was going to be a bit of a more optimistic episode, but it didn't turn out that way. And you know, this is a heavy, heavy subject area. I. But the main message that I have for you is that these NDIS changes do not have to be the end of your practice, okay? I work with psychology, and more and more occupational therapy speech and physio practice owners that's coming into my world, to help them slowly but surely move away from being so freaking reliant on the NDIS - and instead create a business that is future-proofed, a business that's going to be sustainable, and allow them to keep their doors open.

And no, I am not advocating for a mass exodus of providers from the NDIS. I'm not doing that - that's not what I'm saying here. But you know what? Unless we clearly show the government that we are going to walk away if you do not change the system, it's not going to change. It's up to us to walk away and to vote with our feet so the government can actually see, ‘Oh okay, this is what's happening’. And I am very willing to help practice owners do that one step at a time. 

Alright, so I'm going to leave that there. I hope I haven't ruffled too many feathers with this. As I said in the start, I'm not an NDIS expert, I'm not a disability expert. I've just shared with you my thoughts as a business consultant, as a fellow group practice owner. And I want the best for you and your business, your team and your clients. And that means that you need to keep your doors open - which means you need to be able to pay your bills, which means that you need to have a margin in your financials. 

It also means that you can't burn out your team. You can't just increase KPIs so that you can prop up the margins - that's also not the answer. And I hate to think that some people might be doing that, hopefully not in Allied Health, because that's not something that I want because that's not sustainable. So if we want to have a sustainable Allied Health private practice industry, we need to run our service like a business.  

So thank you so very much for tuning in, for being open to hearing my thoughts on it. Feel free to flick me an email. Reach out if there's any experiences that you've had with the NDIS that you want to share, or any thoughts or comments that you have on this topic. I always look forward to hearing from any of you. 

Thank you so very much. And as always, remember that I am here to help you build a practice you can't stop smiling about. 😊

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Gerda Muller

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