NDIS Claim Limits: Mastering the 2-Year Rule

Published: Feb 11, 2026 2:23:35 PM

Many NDIS providers don’t lose money because they deliver poor services. They lose it because claims are submitted too late.

A shift worked. Notes were written. An invoice was eventually raised. But somewhere between service delivery and claim submission, time slipped by. Under the NDIS’s current claiming rules, that delay can now permanently wipe out revenue.

Since October 2025, the NDIS claim time limit is no longer flexible or negotiable. It is enforced automatically by NDIA systems. If a claim is lodged more than two years after the support start date, it is rejected outright, regardless of the reason.

For providers, this has turned claiming from a background admin task into a core operational risk. Understanding the rule is only the first step. The real challenge is building workflows that make late claims impossible.

NDIS providers have two years from the support start date to submit a claim for payment. From 3 October 2025, NDIA systems automatically reject any claim that falls outside this two-year window.

There are no system overrides built into the portal. If the date has passed, the claim will not go through.

 

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Key dates every provider should know

These dates come directly from NDIA guidance and should be reflected in internal policies and training materials.

  • 3 October 2024
    The NDIS Act change took effect, introducing a two-year claiming limit, supported by a transition period.
  • Midnight 2 October 2025
    The 12-month grace period ended.
  • From 3 October 2025 onwards
    NDIA systems automatically reject claims more than two years after the support start date.

By early 2026, this rule is no longer “new”. It is fully enforced and already affecting provider cashflow.

 

Why providers still get caught out (even when they know the rule)

Most late claims are not caused by ignorance. They are caused by small, everyday breakdowns in workflow that compound over time.

Common patterns include:

  • Services delivered on time, but notes completed days or weeks later
  • Timesheets waiting for approval while teams juggle workloads
  • Invoices batched monthly or quarterly “when admin has time”
  • Claims sitting in draft status with no clear escalation point

Individually, these delays feel manageable. Together, they quietly push claims closer to the two-year cut-off until the system rejects them automatically.

The fix is not asking staff to work harder. It is designing a claiming process where ageing items are visible early and acted on consistently.

 

What “automatic rejection” changes in real life

Before this rule was enforced, late claims were messy but sometimes recoverable. Providers could follow up, correct errors, or resubmit.

Now, the risk is silent expiry.

Teams can spend hours preparing an invoice, only to discover the claim is blocked because the service date falls outside the two-year window. There is no review stage where context or explanation is considered.

At the same time, valid claims are usually paid quickly, often within a few business days. This makes late or rejected claims stand out sharply in cashflow reports.

In practical terms, time-limit control is now a cashflow control.

 

Common invoicing mistakes that quietly increase time-limit risk

Many of the most common NDIS invoicing mistakes do not directly cause rejections. Instead, they slow the process down. That delay is what creates exposure to the two-year rule.

Using the wrong support or line item code

NDIS pricing updates regularly. Using an outdated or incorrect code often leads to claims being returned for correction, pushing submission further down the timeline.

Non-compliant invoice formatting

Missing required details such as service dates, participant information, or correct descriptions can cause invoices to stall while issues are fixed.

Incomplete documentation

Late or missing progress notes, travel logs, or approvals mean invoices cannot be finalised promptly.

Delayed invoicing cycles

Monthly or quarterly batching allows older services to age unnoticed, especially during staff turnover or busy periods.

Incorrect rates or GST treatment

Even small pricing errors can trigger rejection or resubmission, adding weeks to the process.

Invoicing the wrong funding manager

Sending invoices to the wrong party creates back-and-forth that delays claims and increases administrative load.

Individually, these issues feel administrative. In combination, they are the main reason claims drift toward the two-year deadline.

 

Two provider workflows that prevent late claims

There is no single “right” model. What matters is consistency and visibility. The two workflows below reflect what works in practice.

Workflow A: End-of-month claiming (tight cadence model)

Best for providers aiming for predictable cashflow and minimal aged debt.

How it works:

  • Services delivered throughout the month
  • Notes and timesheets finalised weekly
  • Invoices issued on a fixed monthly schedule
  • Claims submitted immediately after invoice approval

Key controls:

  • Weekly deadlines for documentation
  • A short claim validation checklist
  • Clear ownership of claim submission

Why it works:
If claims are submitted within weeks, they never approach the two-year cut-off.

Workflow B: Late-invoice recovery (backlog clean-up model)

Best for providers with ageing data, historical issues, or recent system changes.

How it works:

  • Run reports based on service date, not invoice date
  • Group unclaimed items into ageing bands
  • Prioritise older services first
  • Run weekly claim sprints to reduce risk

Typical ageing bands:

  • 0–6 months: routine
  • 6–12 months: priority
  • 12–18 months: urgent
  • 18–24 months: critical

Why it works:
Risk is addressed deliberately before claims cross the two-year line.

 

Where delays usually start (the real risk map)

Providers looking to protect NDIS provider claims should identify their weakest link.

Common starting points include:

  • Notes and timesheets lagging behind service delivery
  • Service agreement changes not reflected in billing rules
  • Invoices raised “when time allows”
  • Claims left in draft without escalation

Each of these points should have a defined deadline, owner, and escalation rule.

 

Using AI and automation as early warning systems

AI does not need to decide claims. Its value lies in monitoring time and prompting action early.

Effective uses include:

  • Alerts when notes or timesheets are overdue
  • Reminders tied to service dates, not invoice dates
  • Dashboards showing unclaimed services by ageing band
  • Ranked work queues prioritising the oldest or highest-value items

The goal is simple: nothing reaches 18 months without leadership visibility.

 

A practical claiming calendar most providers can adopt

Weekly:

  • Review missing notes and timesheets
  • Approve completed documentation

Monthly:

  • Run invoices on fixed dates
  • Submit claims promptly
  • Reconcile claim statuses and address rejections

Quarterly:

  • Review claims aged over 12 months
  • Confirm backlog reduction plans

This cadence turns the two-year rule from a compliance risk into a managed process.

 

What to do when an NDIS claim is rejected for time-limit reasons

If a claim is rejected:

  • Confirm the support start date
  • Check whether it exceeds the two-year window
  • Identify where the internal delay occurred
  • Add a control to prevent recurrence

The learning from one rejected claim is often more valuable than the claim itself.

 

How systems help providers operationalise the rule

Many providers struggle not because they misunderstand the rule, but because their systems do not align service delivery, evidence, invoicing, and claiming.

Well-designed platforms support:

  • Consistent timesheet approvals
  • Automated reminders for missing documentation
  • Clear reporting by service date
  • Early visibility of ageing risk

This reduces reliance on memory, manual tracking, and last-minute scrambles.

 

Quick self-check for providers

Ask yourself:

  • Can we see unclaimed services by service date?
  • Do we know what is approaching 12, 18, or 24 months?
  • Are claims submitted on a fixed schedule?
  • Do overdue items trigger escalation automatically?

If any answer is “no”, there is hidden exposure.

By 2026, the NDIS claim time limit is no longer a policy change. It is an operational reality. Providers who treat claiming as a disciplined, system-supported process protect their cashflow and reduce unnecessary stress.

Those who rely on memory, goodwill, or last-minute clean-ups risk losing revenue permanently.

The two-year rule does not punish good providers. It rewards organised ones.