OT Unplugged: Community of Practice Insights

Paid placements for Occupational Therapy students are finally here. But they're only part of the solution

For generations of Occupational Therapists, unpaid placements have simply been accepted as part of the journey into practice. Long days, lost income and months spent balancing study with everyday life were often seen as a rite of passage rather than a problem.

The Australian Government's announcement that eligible Occupational Therapy students will receive financial support through the Commonwealth Prac Payment from July 2027 is a significant step forward. It recognises the financial pressures many students face while completing mandatory clinical placements.

However, while paid placements are welcome, they're only one part of a much bigger conversation about preparing the next generation of Occupational Therapists.

The reality of student placements

Clinical placements are one of the most valuable parts of an Occupational Therapy degree, but they can also be one of the most demanding.

Many students relocate for placements, pay for temporary accommodation, travel long distances or put paid employment on hold for weeks or months at a time. Others juggle family responsibilities, university assessments and research projects while working full-time on placement.

Although many experienced Occupational Therapists fondly recall surviving placements on inexpensive meals, shared accommodation and multiple casual jobs, these stories also highlight how financial hardship became normalised within the profession. Today's students face those same challenges alongside significantly higher living costs, making financial support more important than ever.

Paid placements don't solve the placement shortage

Financial assistance addresses one barrier, but it doesn't solve another growing challenge – there simply aren't enough placement opportunities.

Universities across Australia continue to struggle to source quality placements, with some students delaying graduation because suitable placements aren't available. At the same time, the diversity of placement experiences is changing.

Where many graduates previously completed placements across hospitals, rehabilitation, mental health and community services, today's students are increasingly undertaking placements within private paediatric practice because that's where capacity exists. While these experiences are valuable, broad exposure across different practice settings remains essential for developing well-rounded clinicians and helping students discover where they want to build their careers.

Private practice is becoming a vital training ground

As placement demand continues to grow, private practices are playing an increasingly important role in educating future Occupational Therapists.

Providing a quality placement, however, involves far more than allowing students to observe therapy sessions. It requires structured teaching, careful supervision and opportunities for students to gradually build their clinical reasoning and confidence.

Many practices are also finding innovative ways to expand placement opportunities. Project-based placements, service development initiatives and digital resources are allowing students to contribute meaningfully while developing skills beyond traditional clinical work.

For mobile and community-based services, creating rich learning experiences can be more challenging, particularly when students miss the informal learning that naturally occurs in shared office environments. Even so, many practices continue investing significant time and resources into supporting the future workforce.

Great supervision is a skill

High-quality placements rely on high-quality supervision.

Effective supervisors don't simply teach clinical skills. They help students develop professional judgement, provide constructive feedback and create safe opportunities to learn through experience.

Students also benefit from working with different supervisors who bring their own approaches to documentation, assessment and intervention planning. Learning that there can be more than one evidence-informed way to practise is an important part of becoming a reflective Occupational Therapist.

While providing honest feedback can sometimes feel uncomfortable, avoiding difficult conversations ultimately limits a student's growth. Supporting students to improve is one of the most valuable contributions supervisors can make to the profession.

Understanding NDIS billing during placements

Practices hosting students also need to understand current NDIS requirements.

Current guidance confirms that Occupational Therapy students undertaking clinical placements are unpaid learners. While they can provide supports under the supervision of a qualified Occupational Therapist with participant consent, the services delivered by students cannot be claimed through the NDIS.

This differs from employed Allied Health Assistants, whose services may be billable when delivered within their scope of practice. Understanding these distinctions helps practices structure placements appropriately while remaining compliant with current NDIS guidance.

Looking ahead

The Commonwealth Prac Payment is an important acknowledgement that students shouldn't have to experience financial hardship simply to complete mandatory placements.

However, strengthening the future Occupational Therapy workforce requires more than financial support. The profession also needs more placement opportunities, experienced supervisors who are supported to teach well and sustainable models that enable private practices, hospitals and community services to continue investing in student education.

Every placement helps shape a future Occupational Therapist. Supporting students through high-quality learning experiences isn't just about helping them graduate – it's an investment in the future of the profession and the communities Occupational Therapists serve.



Key takeaways for OTs

* The Commonwealth Prac Payment is a positive step towards reducing financial pressure for eligible Occupational Therapy students.
* Placement shortages remain a significant challenge for universities and the future Occupational Therapy workforce.
* Private practices are becoming increasingly important providers of student placements.
* Effective supervision requires dedicated time, structured teaching and constructive feedback.
* Student-delivered services on placement cannot currently be claimed through the NDIS.
* Supporting both students and supervisors is essential for building a sustainable Occupational Therapy profession.

Links

WikiQuip Waitlist: https://www.wikiquip.com.au/waitlist

Therapy Supports FAQ Document: https://pacfa.org.au/common/Uploaded%20files/PCFA/Documents/NDIS%20Therapy%20Supports_FAQs.pdf

Adding Private Clients to your OT Practice: https://www.verveotlearning.com.au/adding-private-clients-to-ot-practice

Taking a proper break without your business falling apart

For many Occupational Therapists, taking time off is easier said than done. Whether you run a private practice or work as a sole trader, holidays often come with the feeling that work is waiting for you when you return.

Without systems or support, time away can simply shift the workload rather than reduce it. Scheduling a buffer before and after leave can make returning to work much more manageable.

Stepping away also offers perspective. It highlights where your business depends too heavily on you and reminds us of the value of having a supportive professional community to help navigate the ongoing changes within the NDIS.

Navigating the new NDIS claiming codes

Several weeks into the new NDIS claiming arrangements, many therapists are still working through how the updated item codes should be applied.

While some providers have experienced few issues, others have encountered rejected invoices, confusion from plan managers and inconsistent interpretations of the new requirements. In many cases, the challenge appears to relate more to administrative processes than to the therapy itself.

One of the biggest areas of uncertainty is distinguishing between telehealth and non-face-to-face supports.

Rather than focusing only on whether an interaction occurred by phone or video, it can be more helpful to consider the clinical purpose of the interaction. If the therapist is delivering assessment, intervention, clinical reasoning or therapeutic decision-making, many clinicians would consider this a therapeutic service, regardless of whether it occurs face-to-face or remotely.

Activities such as equipment research, report writing and administrative liaison may sit differently, but there are still situations where the guidance remains open to interpretation.

Until further clarification is provided, accurate documentation and sound clinical reasoning remain essential.

Clinical judgement still matters

One of the recurring messages was that Occupational Therapists should not lose sight of their professional judgement.

Many therapeutic interactions do not fit neatly into administrative categories. Conversations with parents, multidisciplinary case conferences and follow-up discussions often form an essential part of intervention, particularly for participants with complex support needs.

Rather than becoming overwhelmed by coding decisions, clinicians should ensure they can clearly justify the service they provided, document it appropriately and accurately record the time involved.

Are you actually billing for the work you do?

Time tracking remains one of the most effective ways to understand whether your business is financially sustainable.

Many therapists underestimate the amount of time they spend on reports, emails, clinical reasoning and other client-related tasks. Without measuring that time, it is easy to unintentionally underbill.

Simple approaches such as keeping a written activity log, using timers or trialling time-tracking software can help clinicians better understand where their day is actually spent. Even completing a snapshot of your work over several days can provide valuable insight into your productivity and billing patterns.

Understanding your own workflow also makes it easier to improve efficiency without compromising clinical quality.

Technology can improve efficiency

Artificial intelligence and productivity tools continue to evolve rapidly, offering opportunities to reduce administrative workload.

Speech-to-text software, automated time tracking and AI-assisted documentation can all save time when used appropriately. However, any technology used within healthcare must also be considered through the lens of privacy, confidentiality and professional responsibility.

Before adopting new software, clinicians should understand how client information is stored, processed and protected. Convenience should never come at the expense of participant privacy.

Cybersecurity is becoming everyone's responsibility

Cybersecurity is no longer only an issue for large organisations.

Healthcare providers are increasingly becoming targets for cyber attacks because of the sensitive nature of health information. Recent examples across the healthcare sector demonstrate the importance of having strong security systems, staff training and clear response plans in place.

As more clinical work becomes digital, Occupational Therapists need to remain vigilant about phishing emails, data breaches and the security of any software they introduce into their practice.

Protecting participant information is becoming an increasingly important part of professional practice.

Looking ahead

The NDIS will continue to evolve, and with every change comes a period of uncertainty. While new claiming rules and technology can create additional complexity, the foundations of good occupational therapy remain unchanged.

Strong clinical reasoning, accurate documentation, thoughtful business systems and supportive professional communities continue to be the best tools for navigating change with confidence.


Key takeaways for OTs
• Schedule genuine downtime before and after holidays rather than returning immediately to a full caseload.
• Use your clinical reasoning when deciding how therapeutic interactions should be claimed and document your decisions clearly.
• Track your time regularly to ensure you are billing accurately for the work you perform.
• Explore technology that improves efficiency while carefully considering privacy and data security.
• Review your cybersecurity practices and ensure your business has appropriate protections in place.
• Stay connected with professional communities to share knowledge and navigate ongoing NDIS changes together.

A profession in transition

The OT profession is in a period of significant change. On one hand, events like OTX 2026

are showcasing innovation, collaboration and exciting solutions to longstanding challenges. On the other, many clinicians and business owners are navigating major operational changes, particularly around NDIS pricing and service sustainability.

Together, these shifts reflect a profession that is evolving quickly, balancing opportunity with increasing complexity.



Why conferences still matter

OTX 2026 was a strong reminder of why in-person conferences continue to matter. While presentations offer valuable clinical learning, some of the most meaningful outcomes come from the conversations happening between sessions.

Networking, shared problem-solving and spontaneous discussions often create just as much value as formal education. These moments give OTs the opportunity to connect with others facing similar challenges, exchange ideas and feel part of a broader professional community.

That sense of connection remains one of the most valuable parts of attending live events.



Innovation in assistive technology

One of the standout innovations highlighted at OTX this year was the launch of WikiQuip, a platform designed to simplify access to assistive technology funding information.

Navigating AT funding in Australia can be incredibly complex. Clinicians often spend significant time trying to determine which schemes apply, what evidence is required and how to move through application processes. WikiQuip has been designed to reduce that complexity by creating a centralised resource for both clinicians and assistive technology users.

The platform brings together practical guidance on assistive technology categories, assessment requirements, funding pathways and documentation processes. This addresses a major gap in the sector, particularly when considering how fragmented AT access currently is across Australia.

There are currently 109 funding schemes across national, state and territory systems that may provide access to assistive technology. Despite how often the NDIS dominates conversations, only around 10 per cent of Australians who require assistive technology are eligible for NDIS funding. That leaves most people navigating alternative pathways, often with very limited guidance.

WikiQuip aims to bridge that gap by making access pathways easier to understand and more practical to navigate.



Innovation matters more than ever

What stood out most from OTX was not just the energy in the room, but the clear momentum across the profession.

OTs are continuing to build smarter systems, stronger resources and more practical solutions to longstanding challenges. That innovation is becoming increasingly important as clinicians navigate growing administrative complexity, funding changes and rising business pressures.

The profession is not simply responding to change. It is actively shaping better ways forward.



Understanding the NDIS pricing changes

The recent NDIS pricing changes have created a lot of discussion across allied health. While the changes initially caused understandable concern, the reality is that for most providers, the impact is largely administrative rather than clinical.

The core services being delivered have not changed. Instead, the biggest shift is around clearer billing categories and more detailed coding requirements. Providers now need to ensure services are accurately categorised under areas such as direct support, non-face-to-face work, travel, telehealth and NDIA-requested reports.

For many practices, this means reviewing billing systems and ensuring invoicing processes are set up correctly. While that may create short-term administrative work, it does not fundamentally change service delivery.



What counts as an NDIA-requested report?

One of the biggest areas of confusion has been around NDIA-requested reports. Many clinicians have assumed this means the NDIA must directly contact a provider and request a report. That is not the case.

NDIA-requested reports are not new and have existed in pricing arrangements for years. These reports generally refer to documentation required to inform funding decisions, such as plan reviews, functional assessments, assistive technology applications or home modification requests.

This differs from routine clinical reporting. Reports created for therapy planning, education or communication with families and support teams are typically considered non-face-to-face clinical work rather than NDIA-requested reports.

Understanding this distinction is important because it affects how services are billed and claimed.



Why business sustainability matters

The pricing changes have also reinforced a broader issue for the profession: financial sustainability.

Private practices and sole traders are increasingly being challenged to balance high-quality clinical care with rising operational demands. Staffing structures, overheads, award classifications and service delivery models all need regular review to ensure businesses remain viable.

This is not simply about compliance. Sustainable businesses are better positioned to support staff, maintain service quality and continue delivering care without creating unnecessary financial strain or burnout.

As the sector continues to change, financial literacy and business strategy are becoming essential skills for practice owners.



Looking ahead

Despite the complexity of current reforms, there is plenty of reason for optimism. The profession continues to adapt, innovate and find better ways to support both clinicians and clients.

From new tools like WikiQuip to stronger conversations around sustainability and service delivery, OTs are continuing to lead meaningful change.

The challenges are real, but so is the opportunity. For clinicians willing to stay informed, remain adaptable and invest in connection, there is a great deal to be excited about.



Key takeaways for OTs
• OTX 2026 highlighted the value of connection, collaboration and innovation across the OT profession.
• WikiQuip is addressing a major gap in assistive technology funding access.
• The latest NDIS pricing changes are primarily administrative rather than clinical.
• NDIA-requested reports relate to reports informing funding decisions, not routine clinical documentation.
• Financial sustainability is becoming an increasingly important focus for practice owners and sole traders.

Links

WikiQuip: https://www.wikiquip.com.au/

OTA’s clinical award: https://otaus.com.au/resources/ot-school-of-victoria-clinical-award

NDIA’s Provider Support email address: provider.support@ndis.gov.au

Noelle from HR for Health Leaders: https://hrforhealthleaders.com.au/

What Occupational Therapists Need to Know About the 2026–27 NDIS Pricing Update

The 2026–27 NDIS Pricing Schedule and Annual Pricing Review have now been released.

For Occupational Therapists, the immediate headline is relatively positive. OT rates remain unchanged, avoiding the cuts seen across several other allied health professions.

However, while pricing may appear stable on the surface, the update raises important questions around billing, travel and the long-term sustainability of OT services.

OT pricing remains unchanged

The maximum hourly rate for Occupational Therapists remains unchanged at $193.99 per hour, with provider travel remaining at $97 per hour.

Given concerns about possible pricing cuts, many OT providers will see this as a positive outcome. While there has been no increase to reflect rising wages and operating costs, there has also been no reduction.

For many practices, this was likely the best realistic outcome.

The biggest issue is missing guidance

The biggest challenge is not the pricing itself, but the lack of guidance.

Unlike previous years, the Pricing Schedule currently provides rates and line items without the detailed billing guidance providers usually rely on.

This means there is still uncertainty around travel claiming rules, billing caps, support definitions and claiming requirements.

Right now, OTs know the rates, but not exactly how some of those supports can be claimed in practice.

Travel remains unclear

Travel is one of the biggest unresolved issues.

Although provider travel remains listed at $97 per hour, there is no clear guidance confirming whether existing travel caps still apply.

There is still uncertainty around whether the 30-minute metro cap remains, whether the 60-minute regional cap still applies, or whether travel rules have changed more broadly.

This is particularly important for mobile OT services and regional providers.

New billing line items mean immediate updates

One of the biggest practical changes is the introduction of new billing line items.

The updated structure separates direct service, cancellation, non-face-to-face work, provider travel, telehealth and NDIA requested reports into separate billing categories.

This creates greater billing clarity, but also means many practices will need to urgently update billing systems, CRMs, invoicing templates and internal workflows.

Non-face-to-face billing is becoming clearer

One positive change is the clearer distinction between standard non-face-to-face work and NDIA requested reports.

General non-face-to-face tasks appear to include preparation, documentation, case notes and standard reporting such as functional capacity assessments.

NDIA requested reports generally refer to reports used to support funding decisions, such as assistive technology, home modifications and home and living reports.

This distinction will be important for compliant billing moving forward.

Pricing decisions are shifting

One of the most important long-term changes is how future pricing decisions are being made.

This year, the NDIA used more than 16 million therapy transactions to benchmark therapy pricing against Medicare, private health and comparable government schemes.

This reflects a clear shift toward external market benchmarking and less emphasis on provider operating realities such as wage pressures, overheads and workforce challenges.

This has significant implications for private OT practice sustainability.

Demand is rising while providers are falling

Another major theme is the changing therapy market.

Therapy supports now account for approximately 10% of total NDIS expenditure, while demand for therapy continues to grow.

At the same time, active therapy providers have declined by 3.9%, with unregistered provider numbers declining by 4.9%.

Demand is rising while provider numbers are shrinking, increasing pressure on service access, waitlists and workforce sustainability.

What this means for Occupational Therapists

At a high level, this year’s pricing update feels relatively stable for Occupational Therapists.

There are positives. OT rates remain protected, there have been no immediate pricing cuts and billing categories may be becoming clearer.

But there are also challenges. Practices need to prepare for immediate billing updates, key guidance remains missing and uncertainty around future pricing remains.

For Occupational Therapists, this update feels like short-term relief.

But beneath that stability, there are meaningful shifts in pricing, billing and market dynamics that every OT should be paying attention to.

Key takeaways for OTs

• OT rates remain unchanged at $193.99 per hour, with travel remaining at $97 per hour.
• The biggest concern is missing guidance around billing and claiming rules.
• Travel remains one of the biggest unresolved issues.
• New billing line items will require urgent system updates.
• Non-face-to-face billing appears more clearly separated from NDIA requested reports.
• Future pricing decisions are increasingly based on external benchmarking.
• Demand for therapy is rising while provider numbers are declining.
• The update provides short-term stability, but long-term uncertainty remains.

Occupational Therapists are frequently asked to provide ‘robust evidence’ for NDIS funding decisions, but what does that really mean? Explore why observation, clinical reasoning and context matter when assessing functional capacity.

When Occupational Therapists write reports for the NDIS, one phrase appears repeatedly: robust evidence. Whether it’s a funding review, access request, assistive technology application or change in support needs, Therapists are often asked to provide stronger justification and more comprehensive evidence.

The challenge is that there is no clear definition of what robust evidence actually looks like. As a result, many OTs are left wondering how much evidence is enough and what information carries the greatest weight.

The answer often lies in moving beyond self-report and gathering information from multiple sources to build a complete picture of a person’s functional capacity.

Why self-report is only part of the story

Most assessments begin with conversation. We ask people about their daily routines, the tasks they complete independently and the areas where they need support. These discussions provide valuable information, but they are only one piece of the puzzle.

People naturally interpret their abilities through their own experiences and expectations. Some individuals may overestimate their independence, while others may underestimate what they can do. This is why Occupational Therapists are trained to look beyond verbal responses and consider how a person actually performs tasks in real-world situations.

The value of observation in functional assessments

Observation remains one of the most powerful assessment tools available to OTs.

A person may report that they independently manage meal preparation, household tasks or personal care. However, observing the environment can reveal important details that provide additional context.

A walk through the home may identify signs that tasks are not being completed consistently. Alternatively, it may demonstrate a level of independence that exceeds what was initially reported. Both outcomes are clinically important.

Environmental observations, task completion and functional demonstrations help Therapists validate information, identify barriers and understand how a person’s abilities translate into everyday life. This observational evidence often strengthens the overall assessment and contributes to more robust clinical reasoning.

Understanding function within context

One of the most important principles of occupational therapy is that function does not occur in isolation.

Performance can vary significantly depending on the environment, available supports and expectations placed on the individual. A person may demonstrate greater independence in one setting and require substantial assistance in another.

For example, some individuals may perform tasks independently in structured environments such as school, work or day programs, while requiring significantly more support at home. In other situations, highly supportive family members may unintentionally complete tasks on behalf of the person, masking their true abilities.

Without considering context, Therapists risk drawing incomplete conclusions about a person’s functional capacity.

Why clinical reasoning matters

Robust evidence is not simply about collecting more information. It is about interpreting that information accurately.

Occupational Therapists draw on clinical knowledge, experience and evidence-based practice to identify patterns and understand how a person’s diagnosis may impact their function. This becomes particularly important when working with conditions characterised by fluctuating capacity.

A snapshot assessment conducted on a person’s best day may not accurately reflect the support they require over time. Likewise, a single observation may not capture the impact of fatigue, pain, mental health challenges or episodic symptoms.

Strong clinical reasoning allows Therapists to synthesise multiple sources of information and determine what is most representative of the individual’s everyday experience.

The role of standardised assessments

Standardised assessments can provide valuable objective data when selected appropriately and interpreted correctly.

However, assessment scores alone rarely tell the full story. A percentile rank or functional score only becomes meaningful when the Therapist explains what it represents and how it relates to everyday function.

The most effective reports integrate standardised assessment results with observational findings, collateral information and clinical interpretation. This approach creates a comprehensive picture of a person’s strengths, challenges and support needs.

The challenge of future support needs assessments

As discussions continue around NDIS support needs assessments, many OTs have raised concerns about the potential loss of observation-based assessment.

Functional capacity cannot always be accurately understood through questionnaires or interviews alone. Observation, environmental assessment and task analysis provide critical insights that help Therapists distinguish between reported abilities and actual performance.

Without these opportunities, there is a risk that assessments may overlook important nuances that influence a person’s daily functioning and support requirements.

Building truly robust evidence

When Occupational Therapists talk about robust evidence, they are rarely referring to a single assessment tool or a larger volume of paperwork.

Instead, robust evidence comes from combining multiple sources of information, including self-report, observation, standardised assessments, collateral input and professional clinical reasoning.

It is this synthesis that allows OTs to understand not only what a person says they can do, but what they actually do, how they do it and what support they need to participate meaningfully in everyday life.

Key takeaways for OTs
• Robust evidence involves more than self-report and should include observation wherever possible.
• Functional performance must be interpreted within the context of the person’s environment and supports.
• Clinical reasoning is essential when assessing fluctuating capacity and complex presentations.
• Standardised assessments are valuable when appropriately selected and clearly interpreted.
• Observation and task analysis remain critical components of comprehensive functional assessments.
• Strong reports synthesise multiple sources of information to create an accurate picture of support needs.