Aged care assessment (ACAT): how the algorithm decides, and what you can do

If you have seen the news about the aged care assessment "algorithm", here is the short answer. For ongoing help at home, the assessor records answers in the Integrated Assessment Tool (IAT), and the tool works out the classification. On 6 October 2026 the Department published exactly how. Two scores narrow the result to two possible levels. Then a formula built from six recorded items, including one question about whether the carer can keep going, picks between them.

The Department calls it "a fixed, repeatable points scoring system". The IAT User Guide says the outcome the system generates "must first be accepted by the assessor", so the assessor cannot swap in a classification of their own. This guide explains the method in plain words. [Department of Health, Disability and Ageing, Ongoing home support classification levels assignment and Support at Home classification system, 6 October 2026; IAT User Guide, published 28 August 2026]

What a family can control is simpler, and it matters: whether the assessor hears the complete, accurate picture. Not a worst-day performance. The real one, including the help that happens quietly every day. This guide covers the assessment from the first call to the first service, and the two deadlines that come after it. If a visit is coming up soon, start with how to prepare for the aged care assessment.

Is the aged care assessment decided by an algorithm?

For ongoing help at home, largely yes. The IAT generates the Support at Home classification from the assessment answers, and the assessor must accept it. For other kinds of care, such as residential care, respite or the End-of-Life Pathway, the assessor makes the recommendation in the support plan. The rules below say exactly what the home support classification is built from.

Can the assessor change the result?

Not for ongoing help at home. If the tool finds someone ineligible for home support, the system offers a prompt to override to a higher classification. The IAT User Guide is blunt about it: "Assessors must not take this action." The assessor can still recommend a different kind of care in the support plan, such as residential care or the Restorative Care Pathway. [IAT User Guide, published 28 August 2026]

How does the algorithm work out a classification?

In two steps. First it checks that the person has some care need. Then it uses three things, always in the same order: a score for everyday activities, a score for whether those needs are being met, and compounding factors. The two scores narrow the result to two possible levels. The compounding factors pick one. [Department of Health, Disability and Ageing, Support at Home classification system, 6 October 2026]

Lower scores mean more need, and a higher classification. The Department's own explainer, Ongoing home support classification levels assignment, says the points system gives people with similar needs consistent outcomes, wherever they live and whoever does the assessment. [Department of Health, Disability and Ageing, 6 October 2026]

Which scores lead to which classification?

The Aged Care Rules 2025 set out exactly which combination leads to which result, for people who pass the eligibility check. CHSP is the Commonwealth Home Support Program, the entry-level program, now extended to 30 June 2029. The other results are Support at Home classifications 1 to 8.

The Department's own worked example shows the last step at work. "Lonny" scores 41 for everyday activities and 30 for needs met. His daughter used to visit daily to help, "but she is feeling burnt out", and he reports feeling isolated. Those compounding factors put him in Support at Home classification 1. Under the Rules' table, the same two scores without significant compounding factors would mean CHSP. [Department of Health, Disability and Ageing, Ongoing home support classification levels assignment, 6 October 2026; Aged Care Rules 2025, s81-10]

What are compounding factors, and who decides them?

A formula decides; there is no separate overall call by the assessor. It uses six items the assessor records. The result is a yes or no: a score above zero means "significant compounding factors", and the person gets the higher of their two possible classifications. [Support at Home classification system, 6 October 2026]

There are 11 different formulas, one for each branch of the decision tree, and how much each item counts changes from one to the next. The Department doesn't rank the items, and neither do we. What matters is that each one is answered accurately. If you are a carer and the arrangement really can't go on as it is, say so plainly, so the assessment records it. [Support at Home classification system: "the weighting given to each of these variables depends on an older person's position in the classification tree"]

Does a diagnosis count?

Towards the classification, only in two narrow ways. A dementia diagnosis confirmed by a geriatrician or neurologist, or one of a few listed conditions linked to memory and thinking, can set the memory indicator. And the frailty screen counts listed illnesses. The list of medicines the person takes is not used. A diagnosis can also matter for priority: motor neurone disease adds 5 priority points, enough for Urgent on its own (see the priority table below). [Support at Home classification algorithm technical details, Questions and Constructed Variables tabs, 6 October 2026; Aged Care Rules 2025, s87-5]

Everything else about a health condition reaches the classification through its effects. That means what it stops the person doing, whether that need is being met, and what the continence questions and the mood, frailty and memory screens record. So tell the assessor what a condition stops the person doing, not just its name. If a GP or specialist letter describes this, bring it.

So the part a family can influence is the input, not the formula. One example: an activity recorded as done "without help" scores as independent, and the need is then treated as fully met, so one answer counts in both scores. How the assessor records each answer, and what the IAT User Guide tells them, is in the IAT user guide, explained.

What is the ACAT assessment — and is it still called that?

ACAT stood for Aged Care Assessment Team. From 9 December 2024 the Single Assessment System brought the separate assessment workforces together and replaced them. Families and many health workers still say ACAT. Government pages now say "aged care assessment", and the tool every assessor uses is the Integrated Assessment Tool. [health.gov.au, Single Assessment System, checked 28 September 2026]

Our guide to the ACAT assessment walks through each step, from the first call to the outcome letter.

A triage step comes first to work out what kind of assessment is needed, then an assessor does the full assessment. The result decides whether the person can get government-funded care, what kind, and for help at home, the classification and the priority category.

Step 1 — Call My Aged Care to register

Every path to government-funded aged care starts with My Aged Care. Call 1800 200 422 (Monday to Friday 8am to 8pm, Saturday 10am to 2pm) or apply online at myagedcare.gov.au. You can make the call for your parent. The assessment itself is free. [My Aged Care, checked 28 September 2026]

The older person has to agree. Assessors must obtain consent, written or verbal, before triage and assessment. If your parent cannot give consent because they have lost decision-making ability, an appointed decision maker with legal authority can give it for them. [Aged Care Assessment Manual, section 5.1]

If help is needed now, there is no advantage in waiting. Funding for ongoing help at home is allocated by priority category and then by the approval date on the assessment outcome letter, so a later start means a later place in the queue. If you would rather put the request in writing, the free ACAT letter tool drafts one.

If your parent is in hospital now and a discharge is being planned, start with the hospital discharge guide. Assessments can be done in hospital for people who are admitted.

Who qualifies?

People aged 65 or older, Aboriginal and Torres Strait Islander people aged 50 or older, and people aged 50 or older who are experiencing or at risk of homelessness, with care needs that meet the criteria. The criteria are about age and care needs. Income and assets come in later, when the contribution towards services is worked out. [Department of Health, Disability and Ageing, Support at Home priority system guide, October 2025; My Aged Care]

Step 2 — The assessment: how to prepare and what it decides

Assessments for help at home are done face to face in the person's usual home when it is safe to do so. The assessor asks about everyday activities, health and medications, memory, mood, social life, safety at home and the carer's situation. Where possible they must watch the person do everyday tasks, rather than rely only on what they are told. The answers become the classification, so the job is completeness, not performance. [Aged Care Assessment Manual]

The national median wait for an assessment was 26 days in April to June 2026. [My Aged Care]

Why "describe the worst day" is the wrong advice

A lot of advice online says to describe the person's worst day. The assessment is not built for that. Assessors are told to ask the person to show how tasks are done at home and to observe them. For each activity, "without help" means managing as often as needed with no physical, verbal or standby assistance. So prompting, reminding and standing by all count as help, for memory reasons as well as physical ones. [IAT User Guide; Aged Care Assessment Manual]

A family that describes that everyday help accurately is giving the assessor exactly what the tool asks for. Staging a bad day does not help, and neither does letting the person put on a good one.

The question to get right: is the need being met?

For each activity where help is needed, the assessor records whether the need is completely unmet, partially met, completely met, or does not need help. Two details in the IAT User Guide matter:

That instruction is about aged care services. It does not tell assessors to set aside help from family or friends. So if you are the one quietly filling the gaps, say so, and be precise: what you do, how often, and what happens on the days you cannot. Help that is real but partial, unreliable or not sustainable should be described as exactly that.

The Department's classification pages published on 6 October 2026 describe the needs met score as including "formal care (such as services they are already receiving)", so its documents don't fully agree. Either way, if services are in place, tell the assessor what they cover and what happens on the days they don't. [IAT User Guide; Support at Home classification system, 6 October 2026]

Your own situation counts too. The carer profile is one of the compounding factors in the rules, and a carer whose arrangements are unsustainable or at crisis point is one of the signs of urgent need in the Assessment Manual. [Aged Care Rules 2025, s81-7; Aged Care Assessment Manual, s5.7.6]

What to have ready

The assessor may run a short memory check, and may ask a family member how the person's memory compares with five to ten years ago. There is nothing to practise for it.

New to these terms? See the full glossary →

The wait times they don't tell you upfront

There are two waits. The first is for the assessment itself: a national median of 26 days in April to June 2026. The second is for funding, and it depends on the priority category in the assessment outcome letter. My Aged Care's current estimates run from within a month for urgent priority to 7 to 8 months for standard.

As at 30 June 2026, 106,977 people were waiting for an ongoing Support at Home place. [My Aged Care, data current as at 10 August 2026]

Where the "12 months" comes from

You may have seen 12 months quoted. The figure is real, but it measures something different. The Department's first Aged Care Act 2024 Wait Times Report, published 12 May 2026, found a median of 347 days from application to starting services for ongoing Support at Home, over the reporting period 1 November 2025 to 31 March 2026. The report calls this "elapsed time" because it covers the whole path from application to the first service, including time that is not spent in a queue.

How the priority category is decided

The priority category comes from points set in the Aged Care Rules 2025, using what the assessor records. Each circumstance that applies adds its points:

Two things follow from that table. An assessed urgent need is worth 2 points on its own, which is Medium, not Urgent. And for someone who is housed, is not Aboriginal or Torres Strait Islander and does not live in an MM 5 to 7 area, the most these points can add up to is 4, which is High. Reaching it needs an urgent need, living alone and a cognitive impairment together. Motor neurone disease is the exception.

Most families can't know the category in advance, because the 2 points for urgent need depend on the assessor's judgement, from what they see and hear. In the Department's own examples, the assessor "determines" whether urgent service provision is needed. The Assessment Manual describes urgent need as an urgent and immediate risk to personal safety, an immediate risk of needing residential care, not being able to go home safely from hospital, or a carer whose arrangements are unsustainable or at crisis point. If any of these is true, tell the assessor plainly and give examples. This is the mechanism the rapid review is looking at, so these rules may change. [Aged Care Rules 2025, s87-5; Aged Care Assessment Manual, s5.7.6; Department of Health, Disability and Ageing, Support at Home ongoing services priority categories assignment, 6 October 2026]

While you wait

When waits are longer than expected, My Aged Care may assign interim funding: 60% of the approved budget, so the most critical services can start, with the rest assigned when it becomes available. Interim funding is not offered in the urgent category. People already using the Commonwealth Home Support Program (CHSP) keep it while they wait, and anyone waiting can ask My Aged Care about CHSP services or residential respite in the meantime. For more detail, see aged care assessment wait times. [My Aged Care, checked 28 September 2026; Aged Care Assessment Manual]

Step 3 — Your classification and what it's worth

If the person is approved, the assessment organisation sends a Notice of Decision letter, which My Aged Care also calls the assessment outcome letter. It sets out the services approved, the reasons and evidence for the decision, your right to a review, and a copy of the support plan. For ongoing help at home it also gives the classification and the priority category. [My Aged Care, checked 28 September 2026]

The classification sets the quarterly budget available for care once funding is allocated. Current figures, from 1 October 2026 and indexed each July:

A budget is not a list of services. What it buys in hours depends on the prices the provider charges. To see what each classification can mean in real care, read what your classification means in real care hours.

If the result doesn't match what was true

You can ask for a review. Put the request in writing within 28 days of receiving the Notice of Decision. The letter explains how, My Aged Care has a request form, and requests go to agedcarereviews@health.gov.au. The Department acknowledges the request within 14 days and has 90 days to decide. If there is no decision by then, the original decision stands. If you still disagree, you can apply to the Administrative Review Tribunal. [Aged Care Assessment Manual, section 11; My Aged Care]

What aged care costs — and what you contribute

Ongoing Support at Home services are paid from the classification budget, and for some services part of the price is your own contribution. Clinical supports, such as nursing, allied health, care management and, since 1 October 2026, personal care, attract no contribution. Independence services (such as social support, transport and respite) and everyday living services (such as cleaning, home maintenance and meals) do, at rates set by your income and assets assessment. Everyday living carries the highest rates, and full pensioners contribute the least.

Care management is a fixed 10% of every quarterly budget, set aside for every participant. It is not a fee a provider chooses. [Support at Home program manual v4.4; health.gov.au personal care contribution changes]

To estimate your own contributions, use the government's Support at Home fee estimator. This is general information, not financial advice. For advice on your situation, speak with a licensed financial adviser; Services Australia's Financial Information Service gives free general information. For the rates in full, read Support at Home contribution rates, and for how the program works as a whole, the Support at Home guide.

Step 4 — Choosing a provider. The 56-day clock starts now.

When funding is allocated, a second letter arrives. From the date of that letter you have 56 days to enter a service agreement with a provider and start services. You can contact My Aged Care for a 28-day extension if you need more time. If services have not started by then, the funding is withdrawn and goes to the next person in the queue. [My Aged Care, checked 28 September 2026]

Withdrawn is not the end. You can re-join the Support at Home Priority System by calling My Aged Care, and the program manual says your original approval date is kept. [My Aged Care; Support at Home program manual v4.4, section 6.9]

The letter comes with a referral code, which you give to the provider you choose. If more than one service was approved, each one's funding can arrive separately, so you can start one without waiting for the rest.

There is no automatic provider. You choose. Before you sign:

For what to compare and what to check in the agreement, read how to choose a home care provider. [Support at Home program manual v4.4; ACQSC]

Home care vs residential care — the question families avoid

Support at Home brings services to the person in their own home. Residential care means moving into an aged care home with care available around the clock, and for some people it is the right option. The two approvals are not either-or. A residential care approval stays in effect, and a residential classification only applies from the day the person moves in, so an approval for residential care can sit alongside Support at Home while you decide. [Aged Care Assessment Manual; Aged Care Rules 2025, s80-35]

The question to ask honestly: is the risk of staying home, such as falls, missed medication or confusion without supervision, now greater than the disruption of moving? If you are not sure, the residential care guide walks through it.

When the system doesn't work — who to call and what to say

Each kind of problem has its own route.

For the full sequence, with what to say at each step, read the escalation ladder guide.

Go deeper on the aged care assessment