Orthotics and Prosthetics involve the provision of customised devices designed to support or replace a body part to enhance movement, functionality, or comfort for people with disabilities. These devices are externally applied and assist participants in managing their neuromuscular and skeletal systems.
The following information is to provide you with examples of what the NDIS may fund. It’s important to note that this is only a guide to assist you make an informed decision. Only your My NDIS Contact, an NDIS Delegate, or the explicit written information in a current NDIS plan serves as the source of truth. The NDIS considers requests based on whether the support is related to your disability and whether it meets the NDIS Reasonable and Necessary Guidelines.
Examples include:
- Custom Orthotics: Ankle-Foot Orthoses (AFOs), Knee-Ankle-Foot Orthoses (KAFOs), Spinal Orthoses, and other devices tailored to the participant's needs.
- Prosthetic Limbs: Upper and lower limb prosthetics, including sockets, terminal devices, and necessary componentry.
- Assessment and Fitting Services: Professional services for the assessment, specification, fitting, and training in the use of orthotic and prosthetic devices.
- Maintenance and Repairs: Ongoing support to ensure the functionality and safety of the devices.Custom prosthetic limbs
These supports aim to increase independence, improve mobility, and enhance the overall quality of life for NDIS participants.
NDIS Funding for Orthotics and Prosthetics
Requires NDIS Confirmation Support Is In-Line with the NDIS Plan
Orthotics and Prosthetics are Assistive Technology (AT) supports that require specific NDIS approval. The NDIS may fund:
- ⚠️ Design, manufacture, and fitting of customised functional prosthetics and orthotics
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Assessment and prescription by qualified professionals such as:
- Prosthetists
- Orthotists
- Pedorthists
- Podiatrists
- Occupational Therapists trained in these areas
- ✅ Training in the use of orthotic or prosthetic devices
- ⚠️ Maintenance, spare parts, and consumables specifically related to the funded device
These supports fall under mid-cost or high-cost Assistive Technology and require evidence and clinical justification to be considered reasonable and necessary under the NDIS.
Common items include:
- ⚠️ Orthosis: custom footwear, custom shoes, ankle-foot orthotic (AFO), or other custom-made orthotic devices
- ⚠️ Prosthesis: arm, hand, leg, or foot prostheses for function or leisure
- ⚠️ Accessories related to prostheses
👉 Key NDIS Guideline: Assistive Technology Explained
NDIS Prior Approval Requirements
- ⚠️ High-Cost Assistive Technology: Devices over $15,000 require detailed assessments and quotes.
- ⚠️ Custom-Made Devices: Tailored orthotics and prosthetics need professional justification and cost estimates.
- ⚠️ Specialized Componentry: Advanced or non-standard components must demonstrate value for money and necessity.
What is Not Funded?
The NDIS generally does not fund:
- ❌ Standard, everyday footwear that is not specifically modified or custom-designed for a disability-related need. Regular shoes without modifications are considered everyday expenses.
- ❌ Cosmetic Enhancements: Upgrades for aesthetic purposes without functional benefit are not funded.
- ❌ Interim Prosthetic Limbs: Temporary prosthetics provided during rehabilitation are typically not covered.
- ❌ Items or services that are considered day-to-day living costs for the broader population without disability-specific justification
- ❌ Supports Covered by Other Systems: Items that fall under the responsibility of other government services, such as acute medical care, are excluded.
Examples of items not funded:
- ❌ Non-modified shoes
- ❌ Standard orthotics or insoles without clinical evidence of disability-specific need
👉 More information: Supports NDIS Funds and Does Not Fund
Helpful NDIS Information & Links
For more tailored advice or help with funding applications for orthotic or prosthetic supports, participants should consult with their allied health professionals and NDIS planner.
What’s next?
If a custom orthotic or prosthetic are specifically included in your plan, you can proceed with a quote for approval if this has already been approved by the NDIS.
If these supports are not included in your plan, speak with your My NDIS Contact or Support Coordinator to discuss your goals and provide evidence to request the support. The support must be included in the NDIS Plan or we would require written confirmation from the NDIS to confirm the support is in-line with the current NDIS plan.
Participant Responsibilities
NDIS participants play a key role in managing their supports responsibly. Here’s what participants need to know:
| Responsibility | What It Means |
|---|---|
| 🎯 Know Your Goals | Ensure any support purchased helps achieve goals in your NDIS plan. |
| 💰 Understand Budget Categories | Each category has rules about what you can use funds for. |
| 📜 Be Aware of Stated Supports | Some plans include exact supports – others are more flexible but must still meet NDIS guidelines. |
| ⏳ Know Your Funding Periods | Be aware of how your funding is spread across the life of your plan. |
| ✅ Spend in Line with the Plan | Supports must meet the NDIS Reasonable and Necessary criteria. |
👉 If you're unsure whether a support is claimable, speak with your Plan Manager or Support Coordinator.
How to Get a Support Funded by the NDIS
To explore whether a support may be funded:
- Check your NDIS plan goals and categories.
- Consider how the support relates to your disability and functional capacity.
- Contact your My NDIS Contact for written confirmation or request the support is included.
For more information, visit:
👉 Kismet Healthcare – NDIS Supports
👉 NDIS Operational Guidelines