Skip to content
  • There are no suggestions because the search field is empty.

Specified Supports

Specify which item codes can / cannot be used for claims in a PACE Plan. (Available from Friday 22nd August 2025)

 

Table of Contents:
Overview
Select Specified Supports
  Default Setting
  Select Item Codes
Claim Line Creation / Review

Overview

This functionality is exclusive to PACE plans and enables Plan Managers to specify eligible item codes within each category for claims processing. This approach provides Plan Managers with enhanced oversight of allowable support items in each Category, without the need to implement Alerts.

Example use-case configurations include:

- Category 15 – Improved Daily Living Skills: where the plan specifies that funding is to be used for one or more particular therapies, you can limit claims to those item codes or therapies only. This helps ensure that non-compliant claims are not submitted.

- Core: you can exclude therapy items from Assistance with Daily Life; exclude items from the flexible Core budget when Home and Living is included in the Plan; exclude consumable item codes that are not reasonable and necessary for the Plan; and specify that only adult or only early childhood item codes are permitted in a Plan.

NOTE: This feature can only be accessed for editing by Directors and Plan Managers with elevated 'Service Agreement' permission.

Specified Supports can be configured at any stage of a PACE plan; however we recommend you implement this feature when a new PACE plan is detected. You will receive a notification from Planability when either a new PACE plan is found or an existing PACE plan is reassessed.

Select Specified Supports

Specified Supports is managed from the Participants Plan. 

Default Setting:

By default, all item codes in available Support Categories will be included and will be permitted during the claim process. The number of permitted codes / available codes is displayed in the listing.

Select Item Codes

  • Click on the numbers shown in a Category for Permitted Item Codes 

Choose the Specification Type:
  • Include All Support Items - this will select ALL codes as available and claimable; or
  • Include Specific Support Items - only the codes you check will be claimable; or
  • Exclude Specific Support Items - the codes you check will be blocked from being claimed

 

  • Select from the list and click Save

The number of item codes selected and permitted will display:

How will this be reflected during Claim Creation / Claim Review?

Only the permitted codes can be selected during manual Claim Line creation

When reviewing a claim that has been created via Scanning (Bulk Import / Mailbox / Individual Scan), the claim line will display an error if the code is not permitted:

Claim Edit:

Claim Details:

This error is a blocking error which will prevent the claim from being sent for approval or submitted to the NDIS.