For the seventh year in a row, the National Disability Insurance Agency (NDIA) has frozen the pricing rates for occupational therapy. To add insult to injury, travel reimbursements for therapists have been halved, and physiotherapists are facing a $10 per hour rate cut.
Meanwhile, federal politicians have just been awarded a 2.4% pay rise, conveniently aligned with inflation. For those delivering frontline care through the NDIS, the message is loud and clear: some professions are worthy of support during economic shifts, and others are expected to carry the weight, quietly.
But the silence is breaking. Occupational therapists across Australia are no longer willing to absorb the financial impact without protest. The profession—made up of nearly 90% women—is speaking up, loud and unified.
More Than a Job: A Lifeline in Communities
Occupational therapy isn’t flashy. It’s not delivered on TV or celebrated in headlines. It happens in homes, schools, hospitals, and communities—often one-on-one, deeply personal, and profoundly life-changing.
OTs work with people living with disabilities, children with complex needs, veterans recovering from trauma, and elderly individuals trying to remain safely independent at home. They prevent crises, reduce hospital admissions, and enable thousands to live with dignity and autonomy.
Yet for seven years, their essential work has received no inflation-linked increase. At the same time, every cost of operating a practice—from insurance and childcare to petrol and admin—has soared. Now, they’re being asked to do more, for even less.
Cutting Travel, Cutting Care
One of the most impactful blows? Travel reimbursements have been slashed in half. Many therapists rely on this funding to reach clients in their homes—especially those in remote or regional areas. These are not luxury visits. They are crucial to maintaining routines, safety, and quality of life.
Imagine if federal politicians had their travel allowances cut by 50%. The outrage would be deafening. Yet, when the same is done to health professionals who drive long hours to deliver care, the silence is expected. That expectation is breaking.
A Profession on the Brink
The consequences are already unfolding. According to Occupational Therapy Australia, 60% of OT practices either broke even or ran at a loss in 2023–24. That number is predicted to rise in 2025–26 if pricing isn’t urgently addressed.
Worse still, eight per cent of OTs have already left the NDIS space since the last pricing review. That’s over 7,000 participants affected.
The damage isn’t just financial. It’s human. With fewer therapists, waitlists grow longer. Outreach services shrink. And the people most in need—those with complex challenges or those living far from urban centres—are left behind.
The Real Problem Isn’t the Workers
If the NDIA wants to find savings, it should start with its own systems. Between 2021 and 2024, up to 77% of decisions reviewed at the Administrative Appeals Tribunal (AAT) were overturned in favour of participants. This isn’t a reflection of bad therapy reports. It’s a glaring sign of a broken internal process—one costing millions in legal fees and causing months of distress for families and providers alike.
Instead of cutting essential services, the NDIA should be fixing inefficiencies. Provider registration and fraud enforcement are sorely lacking. For example, over 1,000 providers billed the NDIS for music therapy in just six months, despite only about 600 being properly registered. That discrepancy could account for as much as $4 million in questionable claims.
The solution isn’t punishing frontline workers—it’s strengthening oversight and internal reform.
What Real Reform Looks Like
If the government is serious about sustaining the NDIS, it needs to stop stripping the system of the very people keeping it functional. Reform must focus on:
Transparent, co-designed pricing Real enforcement of provider standards Streamlined internal decision-making Protection against fraud and waste And genuine respect for the workforce holding it together
Because when occupational therapists walk away, it’s not just the system that suffers—it’s the thousands of lives they touch every single day.
The NDIS was built on the promise of choice and control. That promise is now at risk. You can’t offer participants real choice if the services they rely on no longer exist.
You can’t build a strong, fair, sustainable system by underpaying the women who form its foundation.
Occupational therapists aren’t asking for special treatment. They’re asking for fairness. For parity. For a seat at the table where decisions are made about their work, their pay, and their future.
They know how to fix this system. They’ve been holding it up for years. It’s time we listened.
