on this page
This guide gives you information about eating disorder treatment and management plan services if you’re a:
- general practitioner (GP) or medical practitioner working in general practice
- consultant physician in psychiatry
- consultant physician in paediatrics.
Who is eligible
To be eligible, your patient must be enrolled in Medicare and diagnosed with anorexia nervosa.
Your patient may also be eligible if they meet the following criteria:
- diagnosed with bulimia nervosa, binge-eating disorder or other feeding or eating disorder
- a score of 3 or more on the Eating Disorder Examination Questionnaire
- rapid weight loss or binge eating or inappropriate compensatory behaviour 3 or more times a week.
If your patient has not been diagnosed with anorexia nervosa they must also have at least 2 of the following indicators:
- body weight less than 85% of expected weight as a result of an eating disorder
- high risk of or current medical complications due to eating disorder behaviours and symptoms
- serious comorbid medical or psychological conditions that significantly impact their medical or psychological health
- hospital admittance for an eating disorder in the last 12 months
- inadequate treatment response to evidence-based eating disorder treatments over the last 6 months.
You can check if your patient is eligible for Medicare through the Health Professionals Online Services (HPOS) item checker. You can also call Medicare.
You need your patient’s consent to check their eligibility for Medicare services.
How to create a plan
You must create a treatment and management plan before you can claim Medicare benefits for eating disorder services.
Treatment and management plans document the:
- diagnosis of the patient’s eating disorder
- patient’s goals, treatments and referrals for the next 12 months.
You must offer the patient a copy of their plan. You can also offer the patient’s carer a copy of the plan with the patient’s consent. You can also give them education material about the eating disorder.
How many services you can refer
You can refer your patient for up to:
- 10 psychological treatment services
- 20 dietetics services.
You must review your patient’s plan after every 10 psychological treatment services. You’ll need to do 4 reviews if the patient needs all 40 psychological treatment services under their plan.
Read more about how to review and renew a plan for information about the review process.
How this plan works with other care plans
Most patients will only have one care plan in place.
A patient can have an eating disorder plan as well as a:
- chronic disease management plan
- mental health treatment plan.
Services under other care plans count towards the total services the patient can have under their eating disorder plan.
| Care plan type | Services that count toward total |
|---|---|
| GP Mental health treatment plan | All treatment services under the Better Access Initiative |
| Chronic Disease Management plan | Dietetic treatment services (item 10954) |
Your patient’s treatments may also include either or both:
- Team Care Arrangements (TCAs)
- Mental Health Case Conferences (MHCC).
They both require involvement of a multidisciplinary team. TCAs must both:
- be prepared by the patient’s usual medical practitioner or someone at the same practice
- involve at least 2 other eligible health providers.
Read more about Chronic disease GP Management Plans and Team Care Arrangements.
What MBS items you can claim
You can claim the following Medicare Benefits Schedule (MBS) items for eating disorder plans. These include face-to-face and telehealth services.
General and medical practitioner items for plans and reviews
| Health professional | Items | Brief description |
|---|---|---|
| GP (no mental health skills training) | 90250, 90251, 92146, 92147 | Prepare an eating disorder treatment and management plan |
| GP (with mental health skills training) | 90252, 90253, 92148, 92149 | Prepare an eating disorder treatment and management plan |
| GP | 90264, 92170, 92176 | Review an eating disorder treatment and management plan |
| Medical practitioner (no mental health skills training) | 90254, 90255, 92150, 92151 | Prepare an eating disorder treatment and management plan |
| Medical practitioner (with mental health skills training) | 90256, 90257, 92152, 92153 | Prepare an eating disorder treatment and management plan |
| Medical practitioner | 90265, 92171, 92177 | Review an eating disorder treatment and management plan |
Psychiatrist and paediatrician items
| Health professional | Items | Brief description |
|---|---|---|
| Consultant physician in Psychiatry | 90260, 92162 | Prepare an eating disorder treatment and management plan |
| Consultant physician Psychiatry | 90266, 92172 | Review an eating disorder treatment and management plan |
| Consultant physician in Paediatrics | 90261, 92163 | Prepare an eating disorder treatment and management plan |
| Consultant physician Paediatrics | 90267, 92173 | Review an eating disorder treatment and management plan |
GP and medical practitioner treatment items
To claim these items you must be registered with Medicare to provide focused psychological strategies (FPS).
| Health professional | Items | Brief description |
|---|---|---|
| GP (FPS) | 90271-90274, 92182, 92184, 92194, 92196 | Attendance items to provide eating disorder psychological treatment services |
| Medical practitioner (FPS) | 90275-90278, 92186, 92198, 92188, 92200 | Attendance items to provide eating disorder psychological treatment services |
Allied health professional items
| Health professional | Items | Brief description |
|---|---|---|
| Dietitian | 82350, 93074, 93108 | Dietetics service of at least 20 minutes |
| Clinical psychologist | Eating disorder psychological treatment for an individual patient | |
| Clinical psychologist | 82358-82359 | Eating disorder psychological treatment for a group of 6 to 10 patients |
| Psychologist | Eating disorder psychological treatment for an individual patient | |
| Psychologist | 82366 to 82367 | Eating disorder psychological treatment for a group of 6 to 10 patients |
| Occupational therapist | 82368-82373, 93092, 93095, 93126, 93129 | Eating disorder psychological treatment for an individual patient |
| Occupational therapist | Eating disorder psychological treatment for a group of 6 to 10 patients | |
| Social worker | 82376-82381, 93100, 93103, 93134, 93137 | Eating disorder psychological treatment for an individual patient |
| Social worker | 82382-82383 | Eating disorder psychological treatment for a group of 6 to 10 patients |
Make sure you read the relevant MBS item descriptions and explanatory notes at MBS Online.
Consultation items and treatment and management plan items
Some eating disorder treatment and management plan items can’t be claimed with some other consultation items on the same day for the same patient.
The MBS item and explanatory notes provide more information about what consultation items you can’t claim with an eating disorder treatment and management plan item.
How to review and renew a plan
You must review treatment and management plans after every 10 psychological treatment services.
Eating disorder plans expire after 12 months. You must renew a plan before your patient can access further psychological or dietetic treatment services.
The table below shows the 12 month cycle of treatment items and reviews process.
Treatment items and reviews
| Step | Service | Documents |
|---|---|---|
| 1 | New treatment and management plan created by GP, consultant physician in psychiatry or consultant physician in paediatrics. |
|
| 2 |
Up to:
|
Report back to the referring health professional. |
| 3 | Review treatment and management plan (GP, medical practitioner working in general practice, consultant physician in psychiatry or consultant physician in paediatrics). |
|
| 4 |
Up to 10 psychological treatment services with relevant health professionals. Any remaining dietetics services from initial referral. |
Report back to the referring health professional. |
| 5 |
GP or medical practitioner working in general practice AND consultant physician in psychiatry or paediatrics review the treatment and management plan. Both health professionals must review the treatment and management plan before more treatment services can be provided to the patient. |
|
| 6 |
Up to 10 psychological treatment services with relevant health professionals. Any remaining dietetics services from initial referral. |
Report back to the referring health professional. |
| 7 | Review treatment and management plan (GP, medical practitioner working in general practice, consultant physician in psychiatry or consultant physician in paediatrics). |
|
| 8 |
Up to 10 psychological treatment services with relevant health professionals. Any remaining dietetics services from initial referral. |
Report back to the referring health professional. |
| 9 |
New treatment and management plan required at the end of the 12 month period. Return to step 1. |
 |
Telehealth
Telehealth restrictions
You can’t claim telehealth attendance items for services provided to admitted hospital and hospital in-the-home patients.
Telehealth MBS items can’t be used for email consultations.
Ongoing Telehealth Arrangement
MBS telehealth video and phone services introduced on a temporary basis in response to the COVID-19 pandemic are now permanent.
Find more about MBS telehealth services on MBS Online.
Contact us for Medicare provider enquiries.
Provide your feedback on our education resources.