Eating Disorder Medicare Items

In Australia, people experiencing an eating disorder are eligible for mental health and dietetic support through Medicare. The information on this page is relevant to people seeking treatment for an eating disorder and for health professionals. It outlines the various supports available through Medicare, including specific care and treatment plans, referrals, and overlap between care and treatment plans.

Medicare items and plans for eating disorders

People experiencing an eating disorder can access mental health treatment either through an Eating Disorder Treatment and Management Plan (EDP) or a Mental Health Treatment Plan (MHTP). Dietetic treatment can be accessed through an EDP or a Chronic Disease Management (CDM) Plan. Click on the headings below to learn more about these supports.

Eating Disorder Treatment and Management Plan (EDP)

An EDP provides up to 40 sessions of evidence-based psychological treatment from a mental health professional and up to 20 sessions of dietetic services from an accredited practicing dietitian over a 12-month period. People with a clinical diagnosis of anorexia nervosa, or with severe presentations of bulimia nervosa, binge eating disorder, or other specified feeding and eating disorders (OSFED) are eligible for this type of plan.

If a person is experiencing comorbid mental health difficulties in addition to an eating disorder, treatment for this comorbid mental health condition should occur under the EDP psychological treatment services.

More detailed information on EDPs can be accessed here.

Mental Health Treatment Plan (MHTP)

A person who does not meet the criteria for an EDP can still receive up to 10 sessions of psychological treatment from a mental health professional over a 12-month period under a Mental Health Treatment Plan (MHTP, also known as the Better Access Initiative). Support is available through eligible psychologists, social workers, occupational therapists, general practitioners (GP), and other medical practitioners.

The rebate is available to people with a diagnosed mental disorder, such as an eating disorder, or comorbid conditions such as depression and anxiety. Someone experiencing disordered eating alongside a diagnosed mental disorder can also access treatment under the Better Access Initiative.

A MHTP can be created by a GP, psychiatrist or paediatrician and a referral made to an eligible treatment provider. After six sessions, the mental health professional must report back to the referring medical practitioner on the progress of treatment. The referring practitioner determines the need for further services and can re-refer for the remainder of the available psychological sessions.

Moving between a MHTP and an EDP

If a person has an EDP in place, the development or review of a MHTP should not occur unless there are exceptional circumstances. Treatment for co-occurring mental health conditions should occur under the EDP psychological treatment services. If a person had an MHTP in place and then an EDP was developed, any mental health sessions accessed under the MHTP will count towards the maximum 40 psychological sessions available under the EDP. See page 190 of the full Medicare Benefits Schedule Book for further information.

Carers may be eligible to access an MHTP to help them maintain their own mental health while providing care. It is important to speak with a GP about supports available.

Chronic Disease Management (CDM) Plan

CDM Plans are available for people living with chronic medical conditions and who require multidisciplinary, team-based care from a GP and at least two other health or care providers. This includes complex needs which may or may not be associated with an eating disorder. In some cases, it may be appropriate for management of a medical condition to be provided under a CDM and treatment for an eating disorder provided under an EDP. In this case, both Plans and items can be used.

A CDM is developed and managed by a GP and this type of plan enables a GP to plan and coordinate the multidisciplinary care team and treatments.

If a person experiencing an eating disorder has an EDP in place but accesses dietetic treatment under the CDM Plan, these services will count towards the maximum of 20 dietetic services under the EDP. Access to other healthcare providers nominated within the CDM Plan will not be impacted.

For more information see Services Australia.

Medical reviews

While accessing treatment and support from a mental health professional and/or dietitian, it is still important to have a medical practitioner, such as a GP, providing regular medical monitoring and reviews. In addition to medical reviews, GPs can help to monitor care plans and make additional referrals if required.

July 2021 changes

Commencing 13 March 2020 and extending until 31 December 2021, the Australian Government made a number of temporary Medicare Benefits Schedule (MBS) telehealth (video and telephone) items available to help reduce the risk of community transmission of COVID-19 and provide protection for people experiencing eating disorders and health care providers. From 1 July 2021, GPs and Other Medical Practitioner telephone items were streamlined. This change aligns with how the items are being used by providers and is also based on expert advice about the use of telephone-based services.

No changes to face-to-face items or telehealth items delivered via videoconference have been made.

Click here to access a fact sheet produced by NEDC containing information about the new, continuing and discontinued telephone items from 1 July 2021, which may be relevant to GPs and Other Medical Practitioners providing services via telephone to patients experiencing an eating disorder.

July 2023 changes - Case conferences

From 1 July 2023, 21 new Medicare Benefits Schedule (MBS) items have been made available for eligible providers to organise and coordinate or participate in case conferences to discuss a patient’s mental health care. These MBS changes were informed by the Better Access Evaluation, the Productivity Commission’s Mental Health inquiry and the Select Committee’s inquiry into Mental Health and Suicide Prevention. The changes aim to improve access to multidisciplinary, collaborative and coordinated mental health care.

Case conferences can be held for people who have been referred for Better Access services under a Mental Health Treatment Plan (MHTP) or have an active Eating Disorder Treatment and Management Plan (EDP). The case conference must be organised by the medical practitioner (GP, other medical practitioner, consultant psychiatrist or consultant paediatrician) and involve at least two other members of the multidisciplinary care team providing different types of treatment to the person. The person must also agree to the case conference taking place and the involvement of all practitioners in the conference. An invitation to attend the case conference should be made to the person, however they can decide not to attend. If the person, family members, carers, or other people providing support to the person experiencing the eating disorder attend the case conference, they do not count towards the minimum number of providers required.

It is expected that a person experiencing an eating disorder would not require more than four case conferences within a 12-month period.

For more information about case conferences, such as a list of the new items and factsheet, please visit MBS Online.

Further information and support

Lived experience, families, and supports

For further support or assistance to locate an eating disorder practitioner or service, contact the Butterfly Helpline or the Butterfly Referral Database.

For information about how to find a GP, mental health professional, and dietitian able to provide treatment see the Butterfly Foundation, and ANZAED Credential Clinician database.

Professionals

Information on MBS Items can be accessed at MBS Online.

Visit the professional development area on our website for additional information on upcoming training and events.