Aged Care fees and payments - annual, time limited and lifetime caps 065-19103046

From 1 July 2014, annual and lifetime caps were introduced to limit how much a person pays in:

• means tested care fees (MTCF) for residential care (post 1 July 2014 assessment scheme)
• Non-clinical care contributions (NCCC) for residential care (post 1 November 2025 assessment scheme)
• income tested care fees (ITCF) for home care (1 July 2014 - 31 October 2025 - post 1 July 2014 assessment scheme)
• individual contributions for Support at Home (SaH) from 1 November 2025 (lifetime cap only)

Lifetime caps are calculated using the total of all MTCF, NCCC, ITCF and SaH individual contributions made by a care recipient. For annual caps it is the total paid for the applicable cap year.

Residential care recipients, who reach a cap will still have to pay the basic daily fee (BDF), any accommodation payments and where applicable a Hotelling Contribution.

Annual and lifetime cap thresholds are subject to indexation.

Care recipients who were in home care prior to 1 July 2014 and remained in continuous care migrated to Support at Home as a category A care recipient with 0% contributions for life. Capping arrangements for home care and Support at Home do not apply for this group. The exception to this is when they moved to another aged care service and opted in to the post 1 July 2014 means assessment scheme before 1 November 2025.

Care recipients who were in residential care prior to 1 July 2014 continue to pay fees under their existing arrangements. From 1 November 2025, pre-1 July 2014 residential care recipients can remain on their existing assessment scheme or opt in to post 1 November 2025 assessment scheme only. They cannot opt in to the post 1 July 2014 assessment scheme and this does not apply for Support at Home.

See Aged Care means assessment for more details.

Note:

• Annual caps for home care ceased from 1 November 2025
• An annual cap that was applied prior to 1 November 2025 with an anniversary date after 1 November 2025 and residential care annual caps post 1 November 2025 will be honoured under Support at Home. In these scenarios the care recipient will have Support at Home contribution rates applied from their anniversary date
• For current caps and fees information, see the Resources page for links to the Department of Health, Disability and Ageing's website

Care recipients with a pre-1 July 2014 assessment scheme for either home or residential care, will have the lifetime cap applied for their means tested fees. This will occur if they:

• have moved to residential care for the first time, or
• are already in residential care and have opted in to the post 1 November 2025 assessment scheme

The lifetime cap will be set regardless of the amount of means tested fees paid by the care recipient.

The 12 month calculation period:

• commences from the date the care recipient first entered aged care (either home care or permanent residential care), or
• recommences on the anniversary of the first date aged care was received, even if the care type has changed or there has been a break in care, and
• includes any pre-entry leave for permanent residential care

Once a care recipient reaches their annual cap, they do not pay any more MTCF until the anniversary of their start date is reached. Historically for home care, the ITCF was not paid when the annual cap was reached, and recommenced when reaching the start date anniversary. Their service provider will receive full care subsidies from the Australian Government for their care.

The annual cap amount is indexed on 20 March and 20 September each year and:

• resets on each anniversary of a care recipient’s start date
• is applied based on the effective cap amount at the date it is reached
• remains in place even if a care recipient changes providers or services of the same care type

If the care recipient changes care type, the:

• accrual of fees will carry over, and
• new cap amount becomes applicable to the new entry

Note: if the care recipient reaches the residential care annual cap post 1 November 2025, then moves to Support at Home - contribution rates will not apply for Support at Home until the anniversary date.

Example 1:

• the care recipient reaches the annual cap while in home care (prior to 1 November 2025)
• the care recipient then moves to residential care within 12 months of commencing home care
• as the residential annual cap is higher, the care recipient will recommence paying their MTCF until the residential cap amount is reached

Example 2

• the care recipient reaches the annual cap while in residential care
• the care recipient then moves to home care (prior to 1 November 2025) within 12 months of commencing residential care
• as the annual cap amount for residential care is higher, the home care annual cap will apply to the new entry
• the care recipient will not have to pay their ITCF until the anniversary date is reached

Example 3

• the care recipient pays their MTCF while in residential care
• the care recipient then moves to home care (prior to 1 November 2025) within 12 months of commencing residential care
• the care recipient’s accrual of MTCF is below the residential annual cap but is higher than the home care annual cap
• the home care annual cap will apply to the new entry, and the care recipient will not have to pay their ITCF until the anniversary date is reached

Example 4

• the care recipient is grandparented under post 1 July 2014 assessment scheme and entered residential care after 1 November 2025
• the care recipient reaches their annual cap while in residential care
• moves to Support at Home after the annual cap is reached in residential care but before the anniversary date is reached
• as the annual cap amount for residential care was reached, the annual cap will apply to the new Support at Home entry
• the care recipient will not have to pay their contributions until the anniversary date is reached

When the care recipient's estimated annual cap date is reached, the care recipient will have a fee calculation occur to check they have reached their annual cap. This will create a Fee Trigger and when it is approved, this will apply the annual cap and reduce the MTCF to zero. When this happens:

• An annual cap letter is issued to the care recipient, nominee (where relevant) and the service provider
• Aged Care Staff Portal (ACSP) will display an annual cap date and show that the MTCF/ITCF/Support at Home contributions have been reduced to $0/0% until their anniversary date
• If there is an adjustment owing to the care recipient due to changes in the cap date (e.g. due to updated means information), this will be paid with the next monthly claim the residential care service provider lodges

Post 1 July 2014 assessment scheme

A care recipient's means tested fees (MTCF/NCCC), previous income tested care fees (ITCF), for home care, or individual contributions for Support at Home (SaH) continue to accrue for any period in care. Once a care recipient reaches their lifetime cap they will not have to pay any MTCF/NCCC/ITCF/contributions for the remainder of their time in care. This is regardless of the care type.

When the care recipient's estimated lifetime cap date is reached, the care recipient will have a fee calculation occur to check they have reached their cap. This will create a Fee Trigger and when it is approved, this will set the lifetime cap and reduce the MTCF/NCCC/contributions to zero. When this happens:

• A lifetime cap letter is issued to the care recipient, nominee (where relevant) and the service provider
• ACSP will display a lifetime cap date and show that the MTCF/ITCF or contribution rates have been reduced to 0
• If there is an adjustment owing to the care recipient due to changes in the cap date (e.g. due to updated means information), this will be paid with the next claim the service provider lodges (Residential care or Support at Home)

Pre-1 July 2014 home care recipients

Pre-1 July 2014 home care recipients who moved to permanent residential aged care after 12 September 2024 will have their lifetime cap applied from 1 November 2025 or their date of entry in residential aged care, whichever is the later. This occurs without having to accrue means tested fees to the lifetime cap threshold.

Post 1 November 2025 assessment scheme

Lifetime cap

From 1 November 2025, residential permanent care recipients, based on their means, may be asked to contribute towards their hotelling supplement and non-clinical care costs which replaces the Means Tested Care Fee (MTCF). Care recipients must be paying a non-clinical care contribution for it to accrue towards both their lifetime and time limited cap. There are no capping arrangements (annual, lifetime or time limited) for the Hotelling Contribution.

The NCCC has both a daily and lifetime cap amount. The daily cap is an amount that is calculated as the daily equivalent of the post 1 July 2014 annual caps on the residential care MTCF. The lifetime cap is set and published by the Department of Health, Disability and Ageing.

Support at Home has different lifetime caps depending on the scheme a care recipient is assessed under:

• Post 2014 (grandparented) care recipients will have a special lower lifetime cap rate
• Post 2025 (non-grandparented) care recipients will have a higher lifetime cap amount

When the care recipient's estimated lifetime cap date is reached, the care recipient will have a fee calculation occur to check they have reached their cap. This will create a Fee Trigger and when it is approved, this will set the lifetime cap and reduce the NCCC to zero. When this happens:

• A lifetime cap letter is issued to the care recipient, nominee (where relevant) and the service provider
• ACSP will display a lifetime cap date and show that the NCCC has been reduced to $0
• If there is an adjustment owing to the care recipient due to changes in the cap date (e.g. due to updated means information), this will be paid with the next monthly claim lodged for residential care or in the next claim for Support at Home

See the Resources page for a link to the Department of Health, Disability and Ageing's Schedule of Fees and Charges.

Time Limited Cap - residential care only

The NCCC will also have a time limited cap applied. The time limited cap is an accrual of the NCCC contributions and:

• accrues regardless of the amount paid
  • e.g. could be $2.15 or $101.16 per day and will accrue for that day
• to accrue, the days do not need to be continuous, and
• are accumulative to be included in the calculation

If a care recipient reaches the time limited cap their NCCC will be set to zero for the remainder of their time in residential care. This does not apply for Support at Home.

Effective on 1 November 2025 the time limited cap is 1460 days (which is 4 years).

When the care recipient's estimated time-limited cap date is reached, the care recipient will have a fee calculation occur to check they have reached their cap. This will create a Fee Trigger and when it is approved, this will set the time-limited cap and reduce the NCCC to zero. When this happens:

• A lifetime cap letter is issued to the care recipient, nominee (where relevant) and the service provider
• ACSP will display a lifetime cap date and show that the NCCC has been reduced to $0
• If there is an adjustment owing to the care recipient, this will be paid with the next monthly claim for residential care the service provider lodges

See the Resources page for a link to the Department of Health, Disability and Ageing's Schedule of Fees and Charges.

For residential care and home care (pre-1 November 2025) a care recipient is not liable to pay more than the annual cap threshold amount in any care year.

Any means tested care fees paid in residential care counts towards:

• the annual cap in home care (pre-1 November 2025) in the anniversary year a care recipient moves to home care (pre-1 November 2025)
• also count towards the lifetime cap in home care (pre-1 November 2025) and Support at Home.

Any income tested care fees paid in home care (pre-1 November 2025) count towards the annual cap in residential care in the anniversary year that a care recipient moves into residential care. These fees also count towards the lifetime cap in residential care and Support at Home.

Aged care systems calculate and apply an annual or lifetime cap based on income and asset information recorded. This includes care recipients with means not disclosed (MND).

If a reassessment changes the date of an annual or lifetime cap, aged care systems reassess fees and resets caps if required. In ACMPS, this applies for all care periods based on the date of effect of the reassessment. ACSP will calculate the impact where there has been a manual adjustment.

The different approach in how ACMPS and ACSP applies the reassessment of income and assets is due to the care recipient’s resident status in ACSP. For ACSP, the care recipient’s resident status (that is, low or not low means) determines their accommodation status.

The System for the Payment of Aged Residential Care (SPARC) is the legacy aged care payment system for residential care. SPARC was a view only system from 11 August 2022 and decommissioned in 2023.

To view the legacy SPARC process, see the historical version.