NDIS Claims Over 90 Days Face Extra Checks From 15 October — Provider and Participant Guide

From 15 October 2026, the NDIA will apply extra checks to claims submitted more than 90 days after a support was delivered. The agency’s 5 October notice says these claims may be held for up to 28 days while evidence is reviewed. Claims within 90 days continue through the usual process.

AI-generated image created for NextNews.

What providers should check before submitting

Use the date the support was delivered, not simply the invoice issue date, when assessing claim age. A late invoice does not make an old service recent. Keep supporting records that establish the service, date, participant, applicable support and agreed rate.

1. Run a report of unsubmitted supports approaching 60, 75 and 90 days old.
2. Reconcile invoices with attendance records, service notes and the service agreement.
3. Check cancellations, travel charges and price limits where relevant.
4. Ensure credit notes and replacement invoices do not result in a duplicate claim.
5. Assign responsibility for answering requests for further evidence and tracking held claims.

These are prudent record-keeping controls, not a substitute for the NDIA’s current claiming instructions. If a claim is rejected, the agency says it will provide a reason.

What plan managers and participants should know

Plan managers processing invoices from multiple providers should identify the actual service date, check that the support was delivered and verify that the invoice has not already been paid. A 28-day hold is a possible review period, not a guarantee of payment. Providers should communicate promptly if an invoice is queried and avoid submitting a new claim simply to bypass a review.

Self-managed participants who have paid for supports should retain dated invoices, receipts and relevant correspondence. The NDIA says timely claiming helps participants recover out-of-pocket expenses sooner. People uncertain about a particular expense can seek clarification before lodging.

Worked example: an old support, a newer invoice

Suppose a therapy session occurred on 1 July and the provider issued its invoice in September. A claim lodged on 14 October would be more than 90 days after delivery. The newer invoice date does not remove the possibility of additional checks. This is an illustration of the timing rule, not a judgement on any specific invoice.

Different from December’s rule

The NDIA’s legislative overview separately states that claims must be submitted within 90 days from December 2026. Tomorrow’s extra checks are not an automatic rejection of every older claim.

Why accurate records matter

The NDIA explains that older claims are harder to verify because relevant records and information may no longer be readily available. A service agreement alone may not establish that every billed session occurred. Organisations should be able to connect a claim to dated records of the support and any changes agreed with the participant.

For services involving travel, non-face-to-face work or short-notice cancellations, the provider should retain documentation supporting the charge under the applicable rules. If a participant disputes an invoice, investigate the concern rather than treating the new deadline as a reason to accelerate a questionable payment.

Internal billing controls also protect against accidental duplicate submissions after credit notes, cancellations or corrected invoices. A replacement invoice should be traceable to the original transaction so that the same support is not claimed twice.

What happens if the NDIA asks questions?

According to the official notice, the NDIA may request additional information before paying an older claim. It also says it will explain the reason for any rejection. Providers should respond with authentic records, retain correspondence and check whether any error can be corrected through the normal process. The agency has not promised that every claim will be resolved within a fixed number of days.

Participants and providers should avoid interpreting an administrative hold as proof of wrongdoing. Equally, an invoice being old does not remove the obligation to demonstrate that the claimed support was valid.

General information only, not legal or financial advice. Verify official guidance and seek independent professional advice. Full disclaimer.

Five actions to take this week

1. Prioritise legitimate backlogs nearing 90 days without rushing inaccurate submissions.
2. Set alerts for unbilled services after 30, 60 and 75 days.
3. Keep original invoices, credits, replacements and approval records together.
4. Investigate missing documents and incorrect rates before submission.
5. Review processes ahead of the separate December deadline and check official guidance for any exceptions.