Specialised Home Based Assistance For A Child

When to use this code

Use this code when a participant has been approved for high-intensity daily personal activities. These supports are for people with complex care needs requiring workers who have specialised training. The higher price reflects the additional skills and qualifications required. Standard personal care codes should not be used for participants approved at this level.

Common billing scenarios

• A provider delivers 2 hours of this support. They claim 2 hours at $59.06, totalling $118.12.
• A participant receives this support on an ongoing weekly basis. The provider submits claims at the end of each service period, documenting the hours delivered.

Provider notes

• Non-face-to-face delivery is allowed for this code. This means you can bill for activities like report writing, care coordination calls, or progress notes, provided your service agreement with the participant covers these activities. Keep clear records of what non-face-to-face work was done and how long it took.
• This code allows provider travel claims. Travel time to the participant can be billed, but keep in mind the NDIA expects travel to be reasonable. If you are seeing multiple participants in one area, split the travel cost across their plans.
• Short notice cancellation fees apply. If a participant cancels with less than 7 clear days notice (or 2 clear business days for some supports), you can charge up to 90% of the agreed fee. You must document the cancellation and have the cancellation policy in your service agreement.
• Core supports are the most commonly claimed category. Make sure your service agreements clearly state the code, rate, and cancellation terms. This reduces disputes at claiming time.