Group Activities - High Intensity - Sunday

When to use this code

Use this code for high-intensity personal care on a Sunday. High-intensity supports are for participants with complex needs that require workers with additional training or qualifications. Sunday rates include a higher loading than Saturday, which means this code will use funding faster than standard weekday codes. Do not use standard-intensity codes for participants approved for high-intensity support, as the worker skill requirements are different.

Common billing scenarios

• A participant attends a day program at a centre for 6 hours. The provider bills 6 hours at the group rate, which is lower than one-on-one support because costs are shared across participants.
• A centre-based program runs a cooking skills workshop for 4 participants over 2 hours. Each participant’s plan is billed for 2 hours at the group rate.

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.