Medicare Benefits Schedule - Note MN.16.2

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Category 8 - MISCELLANEOUS SERVICES

MN.16.2

Eating Disorders Dietetic Tratment Services

Eating Disorders Dietetic Treatment Services (82350 and 82351)


This note provides information on the Category 8 – Miscellaneous Services: Group M16 – Subgroup 1 (82350-82351) and should be read in conjunction with MN.16.1 Eating Disorders General Explanatory Notes.

Eating Disorder Dietetic Treatment Services Overview

Provision of eating disorder dietetic services by a suitably trained Dietitian (82350 and 82351) are for patients with anorexia nervosa and other patients with complex presentations of diagnosed eating disorders who meet the eligibility requirements and would benefit from a structured approach to the management of their treatment needs in the community setting.

A patient with an EDP plan can access up to 20 dietetic services under items 10954, 82350 and 82351 in a 12 Month Period. For any particular patient, an eating disorder treatment and management plan expires at the end of a 12 month period following provision of that service. After that period, a patient will require a new EDP to continue accessing eating disorders dietetic services.

Provider Eligibility

In order to provide eating disorder dietetic services, Dietitians must be an 'Accredited Practising Dietitian' as recognised by the Dietitians Association of Australia (DAA). 

Checking patient eligibility for services

Note: The 12 month period commences from the date of the EDP.

Patients seeking rebates for eating disorders dietetic services must have had an Eating Disorder Treatment Plan (EDP) 90250-90257 or 90260-90263 in the previous 12 Months. The plan must require that the patient needs dietetic services for treatment of their eating disorder, and the patient must be provided with a referral for access to the dietetic health services.

If the EDP service has not yet been claimed, the Department of Human Services will not be aware of the patient's eligibility. In this case the allied health professional should, with the patient's permission, contact the practitioner who developed the plan to ensure the relevant service has been provided to the patient.

Support:

If there is any doubt about whether a patient has had a claim for an eating disorder service, health professionals can access the Health Professionals Online System (HPOS). HPOS is a fast and secure way for health professionals and administrators to check if a patient is eligible for a Medicare benefit for a specific item on the date of the proposed service. However, this system will only return advice that the service/item is payable or not payable.

Patients can also access their own claiming history with a My Health Record or by establishing a Medicare online account through myGov or the Express Plus Medicare mobile app.

Alternatively, health professionals can call the Department of Human Services on 132 150 to check this information, while patients can seek clarification by calling 132 011.

Additional Claiming Information (general conditions and limitations)

Reporting Back

After each course of treatment, the relevant dietitian is required to provide the referring medical practitioner with a written report on assessments carried out, treatment provided and recommendations for future management of the patient’s condition. This reporting is required after the first service, as clinically required following subsequent services and after the final service.

This reporting will inform the managing practitioner’s reviews of the EDP and enable the practitioner to assess the patient’s progress and response to treatment.

Written reports should include, at a minimum:

  • any investigations, tests, and/or assessments carried out on the patient;
  • any treatment provided; and
  • future management of the patient's condition or problem.

The report to the Practitioner must be kept for 2 years from the date of service.

Where appropriate, it is expected that the report will also be provided to the patients and/or the patient’s family/carer (with the patient’s agreement).

Related Items: 82350 82351


Related Items

Category 8 - MISCELLANEOUS SERVICES

82350

82350 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2022

Dietetics health service provided to an eligible patient by an eligible dietitian if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

(b)     the person is not an admitted patient of a hospital; and

(c)     the service is provided to the person individually and in person; and

(d)     the service is of at least 20 minutes in duration

Fee: $65.85 Benefit: 85% = $56.00

(See para MN.16.1, MN.16.2 of explanatory notes to this Category)

Category 8 - MISCELLANEOUS SERVICES

82351

82351 - Additional Information

Item Start Date:
01-Nov-2019
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2022

Dietetics health service provided to an eligible patient by an eligible dietitian if:

(a)     the service is recommended in the patient’s eating disorder treatment and management plan; and

(b)     the person is not an admitted patient of a hospital; and

(c)     the attendance is by video conference; and

(d)     the patient is located within a telehealth eligible area; and

(e)     the patient is, at the time of the attendance, at least 15 kilometres by road from the dietitian; and

(f)      the service is of at least 20 minutes duration

Fee: $65.85 Benefit: 85% = $56.00

(See para MN.16.1, MN.16.2, MN.16.4 of explanatory notes to this Category)


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change