New NDIS laws: what they mean for smaller providers

Visualcare Care Sector Benchmark reports are released quarterly, with the aim of giving home care leadership teams reference points based on real data.

The first edition, covering the September quarter 2026, draws on information from hundreds of NDIS and Support at Home provider organisations that use the Visualcare platform. Every figure is anonymised and reported only in aggregate.

One of the four findings in this edition stood out for what it might mean in light of the new NDIS laws.

In short:

• The annualised median charge per NDIS participant is $62,460, and $22,056 for Support at Home, according to Visualcare's first Care Sector Benchmark Report.
• Larger NDIS providers (100+ participants) charge about half as much per participant as smaller ones (20 to 49 participants): around $37,000 a year against $72,600.
• Smaller providers may attract higher-needs participants who need more specialised care.
• Updated NDIS laws will reduce budgets for community participation and daily living skills from October 2026.
• Larger providers may move into the higher-needs segment to replace lost revenue, which could mean more competition for specialist providers.

NDIS participant median value in Australia

Visualcare's latest research showed that the annualised median charge per NDIS participant was $62,460. For Support at Home, it was $22,056. In both schemes, that figure is set by the participant's funding, not by the provider.

What's interesting is there is a sharp split by provider size. Looking at NDIS median monthly charge per participant:

• Providers with 20 to 49 participants: $6,054 (about $72,600 per year)
• Providers with 100 or more participants: $3,086 (about $37,000 per year)

Based on the numbers above, larger providers charge about half as much per participant. Support at Home follows the same direction, though the gap is much narrower: $1,962 against $1,794, or 9% lower.

Learn more: NDIS management software for providers

Why the gap? Our view

The data we gathered doesn't share what type of support each provider delivers, so this part is interpretation. Our assumption is that larger organisations are serving participants with lower support needs at volume, while participants with higher support needs are drawn to the more specialised care of smaller providers.

The scale of funding for higher-needs participants supports that reading. NDIA figures show participants in Supported Independent Living average $447,100 in annualised committed supports, against $85,100 across all participants.

There are other possible explanations. Larger providers may deliver more short visits or coordination-type services, which would also lower their charge per participant. Either way, the pattern is clear, and it matters more now than it did a few months ago.

Read more: Five biggest profit destroyers for care providers

Amended NDIS laws change the direction of the scheme

On 19 August 2026, Parliament passed the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.

The changes will roll out over several years, but the direction is consistent: more stringent eligibility assessments, closer scrutiny of funding and stronger controls over how NDIS supports are delivered and claimed.

Some of the changes that are most relevant to provider strategy include:

• From October 2026: Support budgets for social, economic and community participation, and for improved daily living skills, will be reduced as plans are reassessed or new plans approved. From February 2027, the reductions also apply when plans are renewed.
• Protected categories: Funding for help with eating and drinking, education, employment and disability-related health supports is not affected. A new plan variation pathway will be created for high support needs participants who require 24-hour disability support.
• From December 2026: Claims must be submitted within 90 days of delivering a support.
• From July 2027: Mandatory registration expands to providers delivering personal care and daily living supports, and supports in closed settings.
• From January 2028: Access changes begin for new applicants, with eligibility based on a new standardised assessment of functional capacity. Existing participants will be reassessed over three years.
• Ongoing consultation: A commissioning approach for SIL participants who need 24/7 support is being designed, in part to address provider viability.

Providers must also keep records for seven years, and the Minister now has the power to set maximum prices through a pricing determination.

Where the pressure lands

The budget reductions resulting from the NDIS amendment put pressure on the kinds of supports that are often delivered at volume: community participation, capacity building and daily living skills. If our reading of the benchmark is right, that's where many larger providers have built their participant base.

The changes create uncertainty around participant budgets, with a possible outcome being that larger providers focus their attention on higher-needs clients.

Two sides for smaller providers

If you're a smaller provider specialising in higher-needs participants, our reading of the benchmark suggests you're in one of the safest positions in the sector.

That's also what makes your segment attractive. Larger providers with the scale to invest in specialist teams, registration and compliance may see the same opportunity, and you could see more of them entering your market over the next two years.

Registration changes add another layer. Expanded mandatory registration from July 2027 brings audit and compliance costs, which larger organisations can spread across a bigger base.

How to prepare for amended NDIS laws

Business sustainability comes from higher-value clients, and for the NDIS, that can include a higher monthly charge per participant.

In light of our care provider benchmark reports and the upcoming changes to the NDIS, areas to explore include:

• Participant mix: How much of your revenue sits in support categories facing reductions, and how much in 'protected' ones?
• Plan renewal: Map which participants are approaching reassessment or renewal over the next 12 months.
• Registration: If you deliver personal care or daily living supports, start preparing for July 2027 registration changes now.
• What sets you apart? Continuity of care, the right staff matched to the right participant, and experience with complex needs are hard for a competitor to replicate quickly.
• Do you know your cost to serve? High-intensity rosters are expensive to get wrong. When competition increases, margin will depend on how well you roster, not on what you charge.

See how Visualcare supports NDIS providers through the changes. Book a demonstration.