Disability-Related Health Consumables - High Cost

When to use this code

Use this code for consumable items related to the participant’s disability needs. Consumables are items that get used up or need regular replacement, such as continence products, wound care supplies, or low-cost assistive items. These items must be directly related to the participant’s disability and not things that everyone would typically purchase.

Common billing scenarios

• A participant orders a monthly supply of continence products through their provider. The provider claims the cost of supplies each month under this code.
• A participant purchases low-cost AT items (e.g. non-slip mats, adapted utensils) from an approved supplier. The supplier claims the cost per item under the consumables code.

Provider notes

• This is a quotable support, so there is no fixed price limit. You will need to submit a detailed quote to the NDIA or the participant’s plan manager before delivering the service. The quote should break down the expected costs and justify why the amount is reasonable.
• This is a Core support, which means participants can generally use their Core funding flexibly across different Core categories (unless their plan states otherwise). Check with the participant’s plan manager if you are unsure about flexibility.