Summary for Referrers- Eating Disorder Management Plans

What is the new Eating Disorder Specific Medicare Benefits Schedule?

On 1 November 2019 64 new items were added to the Medicare Benefits Schedule (MBS) to enable support to eligible patients with an eating disorder under an Eating Disorder Treatment and Management Plan (EDTP).

The EDMP enables eligible patients to access Medicare rebates for up to 40 eating disorder psychological treatment (EDPT) sessions and up to 20 eating disorder dietetic treatment (EDDT) sessions in a 12 month period

A summary of the items is available here.

Who is eligible for an EDMP?

Eligibility criteria is as follows:

Patients with a clinical diagnosis of anorexia nervosa; or
Or have a clinical diagnosis of either: bulimia nervosa, binge-eating disorder, other specified feeding or eating disorder AND

2.1 The person has been assessed as having an EDE-Q score of 3 or more; and

2.2 The person’s condition is characterised by rapid weight loss, or frequent binge eating or inappropriate compensatory behaviours (3 or more occurrences per week); and

2.3 The person has at least two of the following indicators:

2.3.1 Body weight less than 85% expected weight (where weight loss is directly attributable to the eating disorder);

2.3.2 Current or high risk of medical complications due to eating disorder behaviours and symptoms;

2.3.3 Serious comorbid medical or psychological conditions significantly impacting on medical or psychological health status with impacts on function;

2.3.4The person has been admitted to hospital for an eating disorder in the previous 12 months;

2.3.5 The person has experienced inadequate treatment response to evidence-based eating disordered treatment over the past 6 months despite active and consistent treatment.

How do people access an EDMP?

We have developed the following flowchart to assist in understanding the requirements to access an EDTP.

Flow Chart to access Eating Disorder Treatment Plan items

How do I refer?

A referral template is available here

Where can I access the EDE-Q?

A printable version of the EDE-Q is available here

An online version of the EDE-Q is available here

What if my patient isn’t eligible?

Patients who do not meet the eligibility criteria for an EDTP may still be eligible for rebates under other medicare schemes including the Better Access Treatment Plan as well as a Chronic Disease Management Plan.

We recommend being mindful that many clients who do not meet the eligibility criteria for an EDTP will experience this as invalidating. We recommend being mindful of this to ensure this feedback is delivered with sensitivity.

Who is eligible to provide treatment under the EDTP?

Practitioners eligible to provide Eating Disorder Psychological Treatment (EDPT) services under the EDTP include those Mental Health Professionals who are currently eligible to provide focused psychological services under the Better Access program. This includes:

Psychiatrists
GPs
Clinical psychologists
Psychologists
Mental health social workers
Mental health occupational therapists

All of our psychologists at BodyMatters are eligible to provide these services.

Practitioners eligible to provide Eating Disorder Dietetic Treatment (EDDT) services under the EDMP are all suitably trained Accredited Practicing Dietitians.

Our dietitian is eligible to provide these services.

Please refer to our “meet our team” page for more information on who you can refer to or contact us to discuss who might be the best practitioner for your patient.

Which therapies can be delivered under the EDTP?

The approved psychological treatments to be delivered under medicare:

Family Based Treatment for Eating Disorders (EDs) (including whole family, Parent Based Therapy, parent only or separated therapy)
Adolescent Focused Therapy for EDs
Cognitive Behavioural Therapy (CBT) for EDs (CBT-ED)
CBT-Anorexia Nervosa (AN) (CBT-AN)
CBT for Bulimia Nervosa (BN) and Binge-eating Disorder (BED) (CBT-BN and CBT BED)
Specialist Supportive Clinical Management (SSCM) for EDs
Maudsley Model of Anorexia Treatment in Adults (MANTRA)
Interpersonal Therapy (IPT) for BN, BED
Dialectical Behavioural Therapy (DBT) for BN, BED

What about telehealth?

BodyMatters offers telehealth services. Patients eligible to receive online treatment under the Better Access scheme can also access these services under the EDMP.