OT Unplugged: Community of Practice Insights

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.

Pricing uncertainty continues to affect providers

For many providers, annual pricing updates remain a significant source of uncertainty. Business owners are often required to make decisions about staffing and service delivery without knowing exactly what future funding arrangements will look like.

Combined with rising employment costs and workforce reforms, these changes are placing increasing pressure on provider sustainability, particularly for smaller practices.

The growing loss of experienced therapists

Across Australia, many experienced occupational therapists are reconsidering their future within the NDIS. While financial pressures contribute to this trend, increasing administrative demands, system changes and frustration with decision-making processes are also driving clinicians away from the scheme.

The impact extends beyond individual businesses. Experienced therapists bring years of clinical reasoning, assessment expertise and mentorship to the profession. As these practitioners leave, participants lose access to valuable knowledge and support.

Moral injury and professional frustration

Many therapists report feeling that their professional expertise is being given less weight despite extensive assessment and evidence gathering. When recommendations are repeatedly challenged or dismissed, it can create significant professional frustration and contribute to moral injury.

For a profession built on evidence-based practice and participant-centred care, this can be particularly difficult. Over time, the emotional burden contributes to burnout and influences decisions to leave the sector altogether.

Advocacy and sector response

Recent NDIS consultation processes have demonstrated the strength of engagement across the disability sector. Thousands of submissions were lodged by clinicians, providers, participants and advocacy groups, highlighting widespread concern about proposed reforms.

While the outcome remains uncertain, these submissions reflect a profession determined to contribute its expertise and advocate for meaningful outcomes. Advocacy continues to be a core part of occupational therapy practice, both at an individual and systemic level.

AI in occupational therapy

Artificial intelligence is becoming increasingly common across healthcare, particularly for tasks such as note-taking, report drafting and written communication. Used appropriately, these tools can reduce administrative burden and improve efficiency.

However, AI cannot replace clinical reasoning. Occupational therapy relies on contextual understanding, professional judgement and relationship-based practice. Therapists remain responsible for ensuring documentation is accurate, clinically appropriate and reflective of participant needs.

The use of AI also raises important considerations around consent, privacy and data security. Clear communication with participants and strong governance processes remain essential as technology becomes more integrated into practice.

Looking ahead

The coming months are likely to bring further change across the NDIS landscape. Pricing decisions, legislative reforms and technological developments will continue to shape the way occupational therapists work and how participants access support.

While the challenges are significant, the profession’s ongoing commitment to advocacy, clinical excellence and participant-centred practice remains unchanged. Supporting workforce sustainability and valuing professional expertise will be critical to the future success of both occupational therapy and the NDIS.

Key takeaways for OTs

• Pricing uncertainty continues to create challenges for providers and business planning.
• Experienced occupational therapists are increasingly leaving the NDIS workforce.
• Moral injury is contributing to clinician burnout and workforce attrition.
• Strong engagement in consultation processes highlights the sector’s commitment to advocacy.
• AI can improve efficiency but cannot replace clinical reasoning and professional judgement.
• Participant consent, privacy and data security remain essential when using AI tools.
• Supporting workforce sustainability is critical for the future of participant care.

Award changes are reshaping workforce planning

One of the most significant developments for allied health businesses is the recent review of the Health Professionals and Support Services (HPSS) Award.

Although much of the attention has focused on wage increases, the bigger story may be the changes to classification levels and how occupational therapists are positioned within the award structure. The revised framework places greater emphasis on the responsibilities attached to a role rather than simply years of experience.

For many private practices, the most notable change is the inclusion of supervision responsibilities within the Level 2 classification. Therapists who supervise students, therapy assistants or other clinicians may now fall into a different classification than previously expected.

This shift creates important questions for business owners. Student supervision has long been viewed as a professional responsibility and a way of supporting the future workforce. However, if supervision activities influence classification and remuneration, practices may need to reconsider how these responsibilities are allocated and supported.

The changes are expected to commence in October, providing an opportunity for businesses to review role descriptions, employment agreements and career progression pathways before implementation.



Career progression is no longer just about experience

A common misunderstanding within allied health is that clinicians automatically progress through award levels as they accumulate years of experience.

In reality, award classifications are linked to the scope and responsibilities of a role. Leadership responsibilities, supervision duties, advanced clinical expertise and management functions all influence where a clinician sits within the award structure.

This distinction becomes increasingly important as practices grow. Not every experienced clinician will move into a higher classification, just as not every newer therapist will remain in an entry-level role. Progression is tied to responsibilities, not tenure alone.

Clear role descriptions and transparent career pathways can help both employers and clinicians understand what advancement looks like and how different positions align with award expectations.



Rising costs continue to challenge practice sustainability

Award changes are arriving at a time when operating costs are already increasing across the allied health sector.

While salary increases often receive the greatest attention, they represent only one component of the financial pressures facing businesses. Workers compensation premiums, payroll tax, superannuation obligations, insurance costs and administrative expenses all continue to rise.

For occupational therapy practices, particularly those working in paediatrics, overheads can be substantial. Assessment tools, intervention resources, sensory equipment and clinical materials represent ongoing investments that are essential for service delivery but are often overlooked in broader discussions about business viability.

As these costs continue to increase, business owners are being forced to make increasingly careful decisions about staffing structures, leadership roles and growth opportunities.



Why financial awareness matters more than ever

The reality is that many of the most significant costs in running a practice are largely invisible to clinicians.

Insurance premiums, workers compensation, payroll tax and compliance obligations can add tens of thousands of dollars to annual operating expenses. As teams grow, these costs often increase at a rate that outpaces expectations.

This makes financial literacy an increasingly important skill for practice owners. Understanding profit margins, overheads and workforce costs is no longer optional. It is essential for making informed decisions about recruitment, remuneration and long-term sustainability.

With continued uncertainty around future NDIS pricing arrangements, businesses that understand their numbers will be better positioned to adapt to whatever changes emerge.



Preparing for Payday Super

Another important change for employers is the introduction of Payday Super from 1 July.

Although many payroll systems are now equipped to manage the administrative side of these payments, the change will require businesses to think differently about cash flow. Superannuation obligations will become more immediate, reducing the flexibility that previously existed around payment timing.

For practices already managing increasing employment costs, this serves as another reminder of the importance of strong financial planning and forecasting.



NDIS uncertainty remains a significant challenge

Alongside workforce and business pressures, occupational therapists continue to navigate an increasingly complex NDIS environment.

Across Australia, clinicians are reporting inconsistencies in planning decisions, funding outcomes and documentation expectations. Reports are being returned for reasons that often appear contradictory, with different planners applying different interpretations to similar situations.

Questions continue to arise around assessment tools, report formats, assistive technology recommendations and home modification applications. In many cases, therapists are left wondering whether they are seeing a genuine policy change or simply an isolated interpretation from an individual decision-maker.

The lack of consistency can make it difficult for clinicians to determine when they should adapt their practice and when they should challenge a decision.



Looking for patterns rather than reacting to isolated decisions

One of the most effective ways to navigate uncertainty is to avoid overreacting to individual experiences.

A single unusual decision does not necessarily indicate a systemic change. However, when the same issue begins appearing repeatedly across different participants, regions and planners, it may signal a broader trend that warrants attention.

Professional networks and peer communities play a critical role in identifying these patterns. Sharing experiences helps clinicians separate isolated incidents from genuine changes in practice expectations.

Taking a measured approach can reduce unnecessary changes to templates, reports and clinical processes while still allowing therapists to respond appropriately when genuine trends emerge.



Supporting participants through an evolving system

Many clinicians are also becoming more cautious when discussing plan reassessments and funding reviews with participants.

Where there is strong clinical evidence supporting additional funding or supports, recommendations should continue to be made confidently. However, it is equally important that participants understand the potential risks associated with reassessment processes in the current environment.

Open and transparent conversations allow participants to make informed decisions while ensuring recommendations remain grounded in clinical reasoning and functional need.



Looking ahead

Occupational therapists have always adapted to change, but the current environment requires a particularly careful balance between clinical excellence and business sustainability.

The practices most likely to thrive will be those that understand both the operational realities of running a business and the evolving landscape of the NDIS. While uncertainty remains, informed decision-making, financial awareness and strong clinical reasoning will continue to provide the strongest foundation for success.



Key takeaways for OTs

• Review award classifications and role descriptions before the HPSS Award changes commence.
• Ensure supervision responsibilities are clearly defined and aligned with award requirements.
• Understand the true cost of operating a practice, including insurance, payroll tax and compliance obligations.
• Prepare cash flow systems for Payday Super requirements.
• Avoid making significant changes to clinical documentation based on isolated NDIS decisions.
• Look for patterns across multiple cases before adjusting templates or reporting practices.
• Continue making recommendations that are supported by strong clinical evidence.
• Help participants understand both the opportunities and risks associated with plan reviews and reassessments.

P.S. To join the OT Unplugged Podcast dinner, email training@verveot.com.au to reserve your spot. It will be held on Tuesday 23 June following the OTX drinks on Day 1 of OT Exchange.