Personal care vs domestic assistance: The hidden SAH billing challenge 

The Support at Home (SAH) billing rules require a clear separation between personal care and domestic assistance services.  
 
In the past, these costs were often bundled as personal care and domestic assistance are often delivered in the same visit. But now, providers must allocate costs correctly across service categories.  

StewartBrown’s August 2025 Support at Home Price Survey Sector Report shows that while the median hourly rates for these services are relatively close at $115 for personal care and $109 for domestic assistance, the real complexity sits beneath the surface. 

Each category attracts different participant co-contribution rates, with Independence (personal care) services requiring a up to 5% co-contribution from full pensioners, compared to up to 17.5% for Everyday Living (domestic assistance). 

This means that two services delivered in the same visit may be billed and recovered differently depending on their classification. For providers, that introduces new layers of administrative and billing complexity, particularly when personal and domestic tasks are part of the same appointment. 

In this blog, we’ll explore the billing challenges created by SAH, why these small differences matter, and practical ways providers can manage complexity using digital tools to streamline operations and maintain accurate cost recovery. 

Understanding the complexity 

StewartBrown’s August 2025 survey highlights several factors driving administrative complexity for everyday living services under SAH:  

• Bundled services: Personal care and domestic assistance are often delivered together. Providers must now split and allocate costs correctly across service categories. 
• Service granularity: Visit length, service type, and delivery method (home, clinic, or telehealth) affect how pricing is applied. 
• Co-contribution differences: Participant contributions vary by category, even when provider rates are similar. 
• Service list separation: SAH requires all services to align with approved service categories, creating a need for structured billing logic and clear cost allocation. 

For providers managing hundreds or thousands of visits each week, these rules introduce significant administrative effort. Manual tracking, pricing adjustments, and reconciliation can quickly consume staff time and create room for error. 

The challenge for providers 

Even small inconsistencies in pricing or allocation can cause problems when multiplied across a large caseload. Common challenges include: 

• Manual adjustments: Staff must track and apply different co-contribution rates and service categories, increasing the risk of mistakes. 
• Bundled visits: When personal and domestic assistance are delivered together, billing must be split correctly to match participant budgets. 
• Audit readiness: Misalignment between co-contribution % and approved services can result in compliance issues. 
• Volume pressure: Everyday living services are often high-volume, which amplifies administrative load and potential for error. 

Many providers are also finding that as SAH rules come into place, billing and reporting workloads have increased. But with the right technology, billing and reporting can be standardised and automated.  

How AlayaCare simplifies billing and compliance 

AlayaCare is designed to make SAH compliance simple. Our billing system is set up to handle the unique SAH pricing logic, helping providers maintain accuracy and reduce administrative overhead. 

With AlayaCare, providers can:  

• Apply co-contribution rules automatically based on service category, participant type, and funding source. 
• Split bundled visits accurately so that personal care and domestic assistance are billed to the correct funding episodes. 
• Set dynamic pricing rules that adapt to service type, visit length, and client group. 
• Forecast budgets in real time, with interactive charts tracking planned versus delivered services and a clear breakdown of government versus client contributions. 
• Generate audit-ready reporting that shows exactly how each visit was billed and recovered. 

These tools remove the need for manual calculation, reduce billing errors, and ensure every claim aligns with SAH billing standards. 

Keeping SAH billing simple 

Everyday living services may seem simple, but under Support at Home, different service categories and co-contribution rates add real administrative complexity. Providers need to track budgets, split bundled visits, and ensure every service is billed correctly. 

Digital tools like AlayaCare automate these tasks, reduce errors, and keep you compliant, while freeing staff to focus on care. 

Interested to learn more? Contact our friendly team today!