Education guide - Eating disorder treatment and management plans

Information for medical practitioners about eating disorder treatment and management plans.

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 be diagnosed with anorexia nervosa.

Your patient may also be eligible if they meet the following criteria:

  • be 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 need to 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 in a 12 month period. You’ll need to need to do 4 reviews if the patient needs all 40 psychological treatment services in 12 months.

See 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 1 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 in the 12 month period.

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)

Example

You create a mental health treatment plan for your patient on 5 July 2019. By 1 November 2019 they’ve had 4 treatment services.

On 1 November 2019 you create an eating disorder treatment and management plan for your patient.

Your patient’s mental health treatment plan still has up to 6 treatment services left. These services can be used until 31 December 2019 (these services are available per calendar year).

They can access 40 psychological treatment services under the eating disorder plan from 1 November 2019 to 1 November 2020.

The 6 services from the mental health plan are included in the 40 services for the 12 months of the new plan.

What MBS items you can claim

Medicare Benefits Schedule (MBS) items for eating disorder plans are in the table below.

Make sure you read the relevant MBS item descriptions and explanatory notes at MBS Online.

General and medical practitioner items (subgroup 1)

Health professional Items Brief description
GP (no mental health skills training) 90250, 90251 Prepare an eating disorder treatment and management plan
GP (with mental health skills training) 90252, 90253 Prepare an eating disorder treatment and management plan
GP 90264 Review an eating disorder treatment and management plan
Medical practitioner (no mental health skills training) 90254, 90255 Prepare an eating disorder treatment and management plan
Medical practitioner (with mental health skills training) 90256, 90257 Prepare an eating disorder treatment and management plan
Medical practitioner 90265 Review an eating disorder treatment and management plan

Psychiatrist and paediatrician items

Health professional Items Brief description
Consultant physician in  Psychiatry 90260, 90262 Prepare an eating disorder treatment and management plan
Consultant physician Psychiatry 90266, 90268 Review an eating disorder treatment and management plan
Consultant physician in Paediatrics 90261, 90263 Prepare an eating disorder treatment and management plan
Consultant physician Paediatrics 90267, 90269 Review an eating disorder treatment and management plan

GP and medical practitioner 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 to 90274, 90279 to 90280 Attendance items to provide eating disorder psychological treatment services
Medical practitioner (FPS) 90275 to 90278, 90281 to 90282 Attendance items to provide eating disorder psychological treatment services

Allied health professional items

Health professional Items Brief description
Dietitian 82350, 82351 Dietetics service of at least 20 minutes
Clinical psychologist 82352 to 82357 Eating disorder psychological treatment for an individual patient
Clinical psychologist 82358 to 82359 Eating disorder psychological treatment for a group of 6 to 10 patients
Psychologist 82360 to 82365 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 to 82373 Eating disorder psychological treatment for an individual patient
Occupational therapist 82374 to 82375 Eating disorder psychological treatment for a group of 6 to 10 patients
Social worker 82376 to 82381 Eating disorder psychological treatment for an individual patient
Social worker 82382 to 82383 Eating disorder psychological treatment for a group of 6 to 10 patients

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
  • Treatment and management plan.
  • Referrals for psychological and/or dietetics services.
2 Up to:
  • 10 psychological treatment services with relevant health professionals
  • 20 dietetics services with an eligible dietitian (these can be used over the 12 month period).
Report back to 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)
  • Additions or alterations to the treatment and management plan.
  • Referrals for psychological services (and dietetics if not all 20 were referred initially).
4 Up to 10 psychological treatment services with relevant health professionals.
Any remaining dietetics services from initial referral.
Report back to 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.
  • Additions or alterations to the treatment and management plan.
  • Referrals for psychological services (and dietetics if not all 20 were referred initially).
6 Up to 10 psychological treatment services with relevant health professionals.
Any remaining dietetics services from initial referral.
Report back to 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)
  • Additions or alterations to the treatment and management plan.
  • Referrals for psychological services (and dietetics if not all 20 were referred initially).
8 Up to 10 psychological treatment services with relevant health professionals.
Any remaining dietetics services from initial referral.
Report back to referring health professional
9 New treatment and management plan required at the end of the 12 month period. Return to step 1.  

What information relates

Read more about:

Read our website disclaimer.

Contact us for Medicare provider enquiries.

Provide your feedback on our education resources.

Page last updated: 1 November 2019