Clinic template
An NDIS service agreement template for allied health clinics
This is the service agreement a clinic signs with an NDIS participant before starting therapy, covering what supports are provided, the price against the NDIS price limit for that support, the notice period and fee for a short notice cancellation, and how billing differs depending on whether the participant is NDIA managed, plan managed, or self managed.
Last checked 25 Sep 2026 against the sources listed at the end of this page.
Free template ยท Cliniko
Document: NDIS service agreement, plus Cliniko billable item setup: allied health (general)
The template: 11 fields
| Section | Field | Type | Notes |
|---|---|---|---|
| Parties and duration | Participant and provider details | Text | Full name, NDIS number and contact details for the participant, ABN and contact details for the provider. |
| Parties and duration | Start date and review or end date | Text | State whether the agreement runs to the end of the participant's current plan or is ongoing, with a review date noted either way. |
| Supports and price | Supports provided | Text | Name the support by its NDIS line item, for example Therapy, Physiotherapist, Direct Service, not just a general description like physiotherapy sessions. |
| Supports and price | Price per support | Text | State the hourly or per session price, no higher than the current NDIS price limit for that item and area (national, remote or very remote loading). |
| Supports and price | Provider travel | Text | State whether travel is charged, at what rate against the NDIS provider travel price, and the 30 minute each way cap that applies in Modified Monash Model zone 1 to 3 areas. |
| Cancellations | Short notice cancellation policy | Text | State the notice period (commonly less than 2 clear business days) and that up to 100 per cent of the session price can be claimed for a short notice cancellation or non attendance, at the provider's discretion. |
| Plan management | How this participant's plan is managed | Radio | Options: NDIA managed / Plan managed / Self managed. This changes who receives the invoice and how quickly it needs to be actioned. |
| Plan management | Non face to face work | Text | State clearly if any report writing or non face to face work directly serving the participant's goals will be charged, since this requires the participant's prior written agreement in the service agreement itself. |
| Ending the agreement | How either party can end it | Text | State the notice period for either party to end the agreement, and what happens to sessions already booked. |
| Sign off | Participant or nominee signature and date | Text | A nominee can sign on the participant's behalf; note who signed if not the participant. |
| Sign off | Provider signature and date | Text |
Build it in Cliniko
- Draft the agreement as a standard document in your practice's word processor or a Cliniko patient form for the fields that need a signature, since a service agreement is not one of Cliniko's own template types the way letters and treatment notes are.
- Price every support named in the agreement against the current NDIS Pricing Schedule for that item and area, and update the agreement's stated prices each 1 July when the schedule is republished rather than leaving an old figure in an active agreement.
- Write the short notice cancellation clause to match the matching NDIS short notice cancellation item for each support, and be explicit that charging it is at the provider's discretion, not automatic.
- Ask early which plan management type applies, since it changes where the invoice goes: NDIA managed claims are made through the NDIS portal against the plan, plan managed participants are invoiced through their plan manager, and self managed participants are invoiced directly and pay the provider themselves.
- In Cliniko, add a billable item for each NDIS support named in the agreement (for example Therapy, Physiotherapist, Direct Service) plus separate items for provider travel and short notice cancellation, so invoices itemise them against the correct support rather than folding them into one session fee.
- Store a signed copy of the agreement against the participant's Cliniko patient file, and set a review reminder ahead of the participant's plan end date so the agreement, and its prices, get renewed rather than lapsing silently.
The agreement is where price limits and reality meet
An NDIS price limit is a ceiling, not a price a provider has to charge, and the service agreement is the document where a clinic actually sets what it will charge a specific participant for a specific support, within that ceiling. Getting this wrong in either direction causes problems: pricing above the limit is a compliance issue, and never revisiting the agreement when the NDIS schedule updates each 1 July leaves a clinic charging a stale rate that under recovers for the work done. This template treats price, not just the description of the support, as something the agreement has to state clearly against the current schedule.
Plan management type changes how you get paid, not just who you invoice
Whether a participant is NDIA managed, plan managed or self managed determines the entire billing pathway a clinic has to follow: claims through the NDIS portal against the plan, invoices to a plan manager, or invoices directly to the participant who then seeks reimbursement or pays from their own funds. A service agreement that does not record which applies leaves reception guessing at invoice time, and can mean unpaid work sits for months before anyone realises the wrong process was followed from the start. Establishing this on day one, before the first session, is the actual value of the agreement beyond the price list.
Short notice cancellation is a right, not an obligation, to charge
The NDIS pricing arrangements allow a provider to claim up to 100 per cent of a session's price where a participant gives less than the required notice or does not attend, but they do not require it. A service agreement that states the cancellation policy clearly, and that charging it is at the provider's discretion, protects the clinic's ability to charge it when needed while leaving room to waive it for a participant with a genuine, recurring reason for short notice changes, which is common among NDIS participants managing complex support needs.
Sources
- A service agreement between an NDIS participant and a provider can set out how supports will be delivered, what supports will be given, how much they cost and how the participant will pay for them, alongside the roles and responsibilities of each party. National Disability Insurance Agency (NDIS), checked 25 Sep 2026.
- The NDIS Pricing Schedule sets the physiotherapy direct service price limit (item 01_721_0128_1_3) at $183.99 an hour nationally for 2026-27, effective 1 July 2026, with a short notice cancellation item (01_721_0128_1_3_CA) priced at the same rate, claimable at the provider's discretion where the participant gives less than 2 clear business days' notice or does not attend, and provider travel priced at 50 per cent of the direct rate and capped at 30 minutes each way in Modified Monash Model zone 1 to 3 areas. National Disability Insurance Agency (NDIS), checked 25 Sep 2026.
- Non-face-to-face work such as report writing that directly serves a participant's goals can be claimed under the same support item, but only with the participant's prior written agreement recorded in the service agreement, and never for administration, training or claim processing. National Disability Insurance Agency (NDIS), checked 25 Sep 2026.
- Cliniko's billable items can be added individually under Settings, Billable items, or bulk imported by CSV with the fields Item code, Name, Price (ex. tax), Taxable and Item type. Cliniko Help, checked 25 Sep 2026.