Published by SESI Care Services · Updated August 2026 · 2-minute summary
Quick answer: In Victoria, occupational therapy (OT) and physiotherapy at home are paid for by one of two systems, and age decides which. Under 65, the NDIS pays from Capacity Building – Improved Daily Living, up to $193.99 per hour for OT and $183.99 for physio in 2026–27. At 65 or over, Support at Home funds therapy as clinical care with no participant contribution, after a My Aged Care assessment.
Key takeaways
- Age at application decides the system. You must be under 65 to apply for the NDIS. From 65, in-home therapy comes through Support at Home.
- NDIS participants who turn 65 can choose to stay on the NDIS or move to aged care, but cannot use both at once.
- NDIS therapy comes from Improved Daily Living, claimed at price limits of $193.99 (OT) and $183.99 (physio) per hour. Core cannot be moved across.
- Support at Home therapy is clinical care, which carries no participant contribution, whatever your income or assets.
- Starting is different. NDIS: contact a provider directly, no GP referral. Support at Home: My Aged Care assessment first.
- Equipment has its own route in each system: NDIS Capital after an OT report; the Support at Home Assistive Technology and Home Modifications (AT-HM) scheme.
- You can pay privately while you wait for either system, and the report can support the funding application.
Which system am I in: NDIS or Support at Home?
Your age on the day you apply decides it. The NDIS is for people who apply before they turn 65. Support at Home is the aged care program for people 65 and over.
The National Disability Insurance Agency (NDIA) sets out the NDIS age requirements plainly: anyone who applies must be younger than 65 on the day they apply. At 65 or over and not already a participant, you cannot apply, and aged care is the path.
Support at Home started on 1 November 2025, replacing Home Care Packages and Short-Term Restorative Care. It has 8 classifications for ongoing services and 3 short-term pathways, one of which is built around intensive allied health.
Turning 65 while on the NDIS. If you are already a participant at 65, you choose: keep your NDIS supports, or move to aged care. You cannot use both at once. Our guide to in-home allied health under the NDIS covers the NDIS side in depth; this article compares the two.
NDIS vs Support at Home for in-home OT and physio: side by side
Both systems pay the same therapists to do the same work in your home, but the budget line, the cost to you and the way in differ.
| NDIS (under 65 at application) | Support at Home (65+) | |
|---|---|---|
| Who runs it | National Disability Insurance Agency (NDIA) | Department of Health, Disability and Ageing, via My Aged Care |
| Budget line for OT and physio | Capacity Building – Improved Daily Living | Clinical care (part of your quarterly budget), or the Restorative Care Pathway |
| What it costs you | Nothing out of pocket while funding lasts. Provider claims up to the price limit: OT $193.99/hr, physio $183.99/hr (2026–27) | No participant contribution for clinical care, regardless of income or assets |
| How you start | Contact a provider directly. No GP referral. Sign a service agreement | Apply to My Aged Care (1800 200 422) for an assessment, then choose a provider |
| Who decides how much therapy | Your plan (funding periods, often 3-monthly) | Your assessed classification and support plan |
| Equipment and home changes | Capital – Assistive Technology or Home Modifications, after an OT report | AT-HM scheme, with a prescription from a health professional |
| Short, intensive block | Not separate; built into Improved Daily Living | Restorative Care Pathway: around $6,000 for up to 16 weeks |
| Telehealth | Yes, when agreed and clinically appropriate; shown as its own invoice line | Ask your provider |
| While you wait | Private pay | Private pay; no assessment needed for privately funded care |
Sources: NDIS pricing arrangements (schedule effective 1 July 2026), Support at Home participant contributions, Restorative Care Pathway and AT-HM scheme, current at September 2026.
Which budget line pays for therapy in each system?
In the NDIS it is Capacity Building – Improved Daily Living; in Support at Home it is clinical care, with the Restorative Care Pathway as a short-term extra.
NDIS. Improved Daily Living is the Capacity Building category for assessments, therapy and training. It is a stated budget: Core cannot be moved into it. If your plan has no Improved Daily Living line, the route is a plan variation or reassessment with functional evidence. From 1 October 2026 the NDIA is tightening some Capacity Building budgets, including Improved Daily Living, as set out in our 2026 NDIS changes guide.
Support at Home. Services are grouped into clinical care (nursing and allied health), independence (personal care, social support, transport) and everyday living (cleaning, gardening, meals). OT and physio sit in clinical care. Your quarterly budget depends on your classification.
Restorative Care Pathway. A short-term pathway inside Support at Home, separate from any ongoing budget. The Department’s page describes each episode as around $6,000 for up to 16 weeks of intensive allied health and/or nursing. Eligible participants may get a further unit, up to $12,000 in total. It suits someone recovering from a fall or hospital stay.
What does in-home therapy actually cost the person?
Under the NDIS, nothing out of pocket while your funding lasts; under Support at Home, clinical care has no participant contribution at all.
NDIS. The 2026–27 price limits are the most a provider can claim from your plan: $193.99 per hour for OT and $183.99 for physiotherapy. They are not a bill. Since 1 July 2026, invoices show therapy time, therapist travel (capped and agreed in advance) and report writing as separate lines. Our 2026–27 price changes guide walks through the numbers.
Support at Home. Contributions depend on the service type, not just your income and assets. The participant contributions page states that participants make no contribution for clinical support services such as nursing and physiotherapy, moderate contributions for independence services, and the highest for everyday living. So an OT or physio visit is fully funded, while the cleaner who comes the same week is not. The same page notes that from 1 October 2026 the government will fully fund personal care too. Contributions for everyday living still matter for the turning-65 choice if you rely heavily on cleaning, gardening or meals.
How do I start in each system?
NDIS: ring a provider. Support at Home: ring My Aged Care first.
NDIS (days, not months). If your plan has Improved Daily Living funding, there is no NDIA approval step. You, a family member or your support coordinator contacts a provider, signs a service agreement, and the first visit is an assessment at home. We explain that first hour in your first in-home allied health visit. SESI delivers occupational therapy and physiotherapy in homes across Victoria.
Support at Home (assessment first). My Aged Care is the entry point. Apply online, by phone on 1800 200 422, or face to face at a Services Australia centre. An assessor works out your classification, then you choose a provider. SESI provides Support at Home services across Victoria, and our community nursing guide goes into more Support at Home detail.
How is equipment funded in each system?
Both systems fund equipment separately from the therapy, and both expect a therapist’s report first.
NDIS. Assistive technology and home modifications come from the Capital budget, which is stated and one-off. The NDIA expects an assistive technology assessor working under a registration body such as Ahpra. Its home modifications page separates minor modifications (non-structural, generally under $25,000, such as rails and simple ramps) from complex ones (structural, generally over $25,000, needing approvals). Low-cost items can sometimes come from Core consumables.
Support at Home. The AT-HM scheme is a separate short-term pathway with its own tiers. They are low (under $500), medium (up to $2,000) and high (up to $15,000, or more for assistive technology if needed). Items that need a prescription must have one from a suitably qualified health professional.
Can I pay privately while I wait?
Yes, in both systems, and the assessment report you pay for is still useful once funding comes through.
On the NDIS side the wait is usually for a plan variation or reassessment. On the aged care side it is the gap between applying to My Aged Care and receiving a classification. Privately funded care needs no assessment. If you go private, ask for a written functional assessment: what the person cannot do, how often, and what help they need. That is the evidence both the NDIA and a My Aged Care assessor work from. Ask for the private rate up front.
Frequently asked questions
Can I have NDIS and Support at Home at the same time?
No. The NDIA states that participants cannot use NDIS and aged care supports at the same time. A participant who turns 65 chooses one or the other, and nothing changes if they stay on the NDIS.
Is physiotherapy free under Support at Home?
There is no participant contribution for clinical care, which includes nursing and physiotherapy, so you do not pay towards the visit. Contributions apply to other independence services and to everyday living services such as cleaning, and personal care becomes fully funded from 1 October 2026.
Do I need a GP referral for NDIS therapy or Support at Home therapy?
The NDIS needs no referral: anyone can contact a provider directly if the plan has Improved Daily Living funding. Support at Home needs a My Aged Care assessment first, not a GP referral, though a GP letter can help the assessor understand your needs.
I am 64 and have never applied for the NDIS. Which way should I go?
If you have a permanent and significant disability, apply to the NDIS before you turn 65, because you cannot apply after that birthday. The NDIA decides within 21 days of a complete access request. If your needs are mainly age-related, or the NDIS says no, My Aged Care is the path.
Talk to SESI
Whether the person you care for is on the NDIS or coming through My Aged Care, tell us what is going on. We will call you back to talk through which pathway pays for therapy at home.
Tell us what’s going on: sesi.com.au/referral · Call: 1800 017 374
This guide is general information based on the NDIS pricing schedule effective 1 July 2026 and NDIA eligibility and assistive technology guidance. The Support at Home detail comes from the Department of Health, Disability and Ageing, current at September 2026. It is not advice about your individual plan. For help with your own situation, contact the NDIA on 1800 800 110 or My Aged Care on 1800 200 422.
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