Medicare Benefits Schedule - Item 82350

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 service is provided to the patient individually and in person; and

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

Fee: $72.65 Benefit: 85% = $61.80

(See para AN.36.2, MN.16.1, MN.16.2 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $217.95

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Eating Disorders Treatment and Management Plans Explanatory Notes (items 90250-90257, 92146-92153, 90260-90261, and 92162-92163)

This note provides information on Eating Disorders Treatment and Management Plan (EDTMP) items and should be read in conjunction with the Eating Disorders General Explanatory Notes

Eating Disorder Treatment and Management Plan (EDTMP) items overview

The EDTMP items define services for which Medicare benefits are payable where practitioners undertake the development of a treatment and management plan for patients with a diagnosis of anorexia nervosa, bulimia nervosa, binge-eating disorder and other specified feeding or eating disorder diagnoses who meet the eligibility criteria.

The EDTMP items trigger eligibility for items which provide delivery of eating disorders psychological treatment services (up to a total of 40 psychological services in a 12-month period) and dietetic services (up to a total of 20 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. Eating Disorders treatment services are not available to the patient if the EDTMP has expired.

Preparation of the EDTMP must include:

• discussing the patient’s medical and psychological health status with the patient and if appropriate their family/carer;
• identifying and discussing referral and treatment options with the patient and their family/carer where appropriate, including identification of appropriate support services;
• agreeing goals with the patient and their family/carer where appropriate - what should be achieved by the treatment - and any actions the patient will take;
• planning for the provision of appropriate patient and family/carer education;
• a plan for crisis intervention and/or for relapse prevention, if appropriate at this stage;
• making arrangements for required referrals, treatment, appropriate support services, review and follow-up;
• documenting the results of assessment, patient needs, goals and actions, referrals and required treatment/services, and review date in the patient's plan;
• discussing and organising the appropriate reviews throughout the patient’s treatment; and
• discussing the need for the patient to be reviewed to access a higher intensity of eating disorder psychological treatment services in a 12-month period.
   

Preparing a Medical practitioner in general practice Eating Disorder Treatment & Management Plan (items 90250-90257 and 92146-92153)

Who can provide the service

Items in subgroup 1 of Group A36 can be rendered by a medical practitioner in general practice. This includes:

• Medical practitioners who can render a general practitioner service in Group A1 of the MBS (see note AN.0.9 for the types of medical practitioners). These medical practitioners can render a ‘general practitioner’ service for items in subgroup 1 of Group A36.
• Medical practitioners who are not general practitioners, specialists or consultant physicians. These medical practitioners can render a ‘medical practitioner’ service for items in subgroup 1 of Group A36.

What is Involved - Assess and Plan

It is expected that the practitioner developing the EDTMP has either performed or reviewed the assessments and examinations required to make a judgement that the patient meets the eligibility criteria for accessing these items.

Items 90250-90257 and their equivalent telehealth items (92146-92153) provide services for development of the eating disorder treatment and management plan. Where a comprehensive physical examination is performed, either on the same occasion or different occasion, the appropriate item could be claimed provided the time taken performing the assessment is not included in the time for producing the plan, or time producing the EDTMP is not included in the time for assessment.

It is emphasised that it is best practice for the practitioner to perform a comprehensive physical assessment to facilitate ongoing patient management and monitoring of medical and nutritional status.

Patient Assessment

An assessment of a patient with an eating disorders includes:

• taking relevant history (biological, psychological, social, including family/carer support);
• eating disorder diagnostic assessment;
• medical review including physical examination and relevant tests;
• conducting an assessment of mental state, including identification of comorbid psychiatric conditions;
• an assessment of eating disorder behaviours;
• an assessment of associated risk and any medical co-morbidity, including as assessment on how this impacts on the patients functioning and activities of daily living;
• an assessment of family and/or carer support; and
• administering an outcome measurement tool, except where it is considered clinically inappropriate.

Risk assessment for a patient with an eating disorder should include identification of:

• medical instability and risk of hospitalisation;
• level of psychological distress and suicide risk;
• level of malnourishment;
• identification of psychiatric comorbidity;
• level of disability;
• duration of illness;
• response to earlier evidence-based eating disorders treatment;
• level of family/carer support.

It should be noted that the patient's EDTMP should be treated as a living document for updating as required. In particular, the plan can be updated at any time to incorporate relevant information, such as feedback or advice from other health professionals on the diagnosis or treatment of the patient.

Preparing a Consultant Psychiatrist Eating Disorder Treatment & Management Plan (90260-90261 and 92162-92163)

Who can provide the service

Items in subgroup 2 of Group 36 can be rendered by consultant psychiatrists (items 90260 and 90261, and their respective telehealth items 92162 and 92163).

What is Involved – Assess and Plan

Items 90260-90261 and their equivalent telehealth items (92162 and 92163) provide access to specialist assessment and treatment planning. It is expected that items will be a single attendance. However, there may be particular circumstances where a patient has been referred by a GP for an assessment and management plan, but it is not possible for the consultant to determine in the initial consultation whether the patient is suitable for management under such a plan. In these cases, where clinically appropriate, other appropriate consultation items may be used. In those circumstances where the consultant undertakes a consultation (in accordance with the item requirements) prior to the consultation for providing the referring practitioner with an assessment and management plan. It is expected that such occurrences would be unusual for the purpose of diagnosis under item 90260.

Patient Assessment

In order to facilitate ongoing patient focussed management, an assessment of the patient must include:

• administering an outcome measurement tool during the assessment and review stages of treatment, where clinically appropriate. The choice of outcome tool to be used is at the clinical discretion of the practitioner;
• conducting a mental state examination;
• taking relevant history (biological, psychological, behavioural, nutritional, social);
• assessing associated risk and any co-morbidity; and
• making a psychiatric diagnosis for conditions meeting the eligibility criteria.

Risk assessment for a patient with an eating disorder should include identification of:

• medical instability and risk of hospitalisation;
• level of psychological distress and suicide risk;
• level of malnourishment;
• identification of psychiatric comorbidity;
• level of disability;
• duration of illness;
• response to earlier evidence-based eating disorders treatment;
• level of family/carer support.
   

Where a consultant psychiatrist provides an EDTMP service, the service must also include:

• administering an outcome measurement tool, where clinically appropriate. The choice of outcome tool to be used is at the clinical discretion of the practitioner. Practitioners using such tools should be familiar with their appropriate clinical use, and if not, should seek appropriate education and training; and
• conducting a mental state examination.

Consultation with the patient’s managing practitioner

A written copy of the EDTMP should be provided to the patient’s managing practitioner, within a maximum of two weeks of the assessment. It should be noted that two weeks is the outer limit and in more serious cases more prompt provision of the plan and verbal communication with the managing practitioner may be appropriate.

Additional Claiming Information (general conditions and limitations)

Patients seeking benefits for items 90250-90257 and 90260-90261 will not be eligible if the patient has had a claim within the last 12-months.

Items 90250-90257 cannot be claimed with Items 2713, 279, 735, 758, 235 and 244. Items 90261 cannot be claimed with Items 110, 116, 119, 132, 133.

Consultant psychiatrist and paediatrician EDTMP items 90260-90261 do not apply if the patient does not have a referral within the period of validity.

Before proceeding with the EDTMP the medical practitioner must ensure that:

(a) the steps involved in providing the service are explained to the patient and (if appropriate and with the patient's permission) to the patient's carer; and

(b) the patient's agreement to proceed is recorded.

The medical practitioner must offer the patient a copy of the EDTMP and add the document to the patient's records. This should include, subject to the patient's agreement, offering a copy to their carer, where appropriate. The medical practitioner may, with the permission of the patient, provide a copy of the EDTMP, or relevant parts of the plan, to other providers involved in the patient's treatment.

The medical practitioner EDTMP cover the service of developing an EDTMP. A separate consultation item can be performed with the EDTMP if the patient is treated for an unrelated condition to their eating disorder. Where a separate consultation is performed, it should be annotated separately on the patient’s account that a separate consultation was clinically required/indicated.

All consultations conducted as part of the EDTMP must be rendered by the medical practitioner and include a personal attendance with the patient. A specialist mental health nurse, other allied health practitioner, Aboriginal and Torres Strait Islander health practitioner or Aboriginal and Torres Strait Islander health worker with appropriate mental health qualifications and training may provide general assistance to the medical practitioner in provision of this care.

Additional Claiming Information (interaction with Chronic Condition Management and Better Access)

It is preferable that wherever possible patients have only one plan for primary care management of their disorder. As a general principle the creation of multiple plans should be avoided, unless the patient clearly requires an additional plan for the management of a separate medical condition.

The Chronic Condition Management (CCM) items (items 231, 232, 392, 393, 729, 731, 965, 967, 92026, 92027, 92029, 92030, 92057, 92058, 92060 and 92061) continue to be available for patients with chronic medical conditions, including patients with complex needs. 

Where a patient has a separate chronic medical condition, it may be appropriate to manage the patient's medical condition through a CCM Plan, and to manage their eating disorder through an EDTMP. In this case, both items can be used. Where the patient receives dietetic services under the CCM arrangements (item 10954), these services will count towards the patients maximum of 20 dietetic services in a 12-month period. 

Where a patient has other psychiatric comorbidities, these conditions should be managed under the EDTMP. Once a patient has a claim for an EDTMP, the patient should not be able to have a claim for the development or review of a Mental Health Treatment plan by a GP (items 2700, 2701, 2715 and 2717) or medical practitioner in general practice (items 272, 276, 281 and 282) within 12-months of their EDTMP unless there are exceptional circumstances.

For the purpose of the 40 eating disorder psychological treatment count; eating disorder psychological treatment service includes a service provided under the following items: 90271-90278, 92182, 92184, 92186, 92188, 92194, 92196, 92198, 92200, 2721, 2723, 2725, 2727, 283, 285, 286, 287 and items in Groups M6, M7 and M16 (excluding item 82350). 

Related Items: 110 116 119 132 133 231 232 235 244 272 276 281 282 283 285 286 287 392 393 729 731 735 758 965 967 2700 2701 2715 2717 2721 2723 2725 2727 82350 90250 90251 90252 90253 90254 90255 90256 90257 90260 90261 90271 90272 90273 90274 90275 90276 90277 90278 92026 92027 92029 92030 92057 92058 92060 92061 92146 92147 92148 92149 92150 92151 92152 92153 92162 92163 92182 92184 92186 92188 92194 92196 92198 92200

Eating Disorders General Explanatory Notes (items 82350, 82352, 82354, 82355, 82357-82360, 82362, 82363, 82365-82368, 82370, 82371, 82373-82376, 82378, 82379, 82381-82383; 93074, 93076, 93079, 93084, 93087, 93092, 93095, 93100, 93103, 93108, 93110, 93113, 93118, 93121, 93126, 93129, 93134, 93137)

This note provides a general overview of the full range of 1 November 2025 eating disorders items and supporting information more specifically on the Category 8 – Miscellaneous Services: Group M16 – Eating disorders services (items 82350, 82352, 82354, 82355, 82357-82360, 82362, 82363, 82365-82368, 82370, 82371, 82373-82376, 82378, 82379, 82381-82383; 93074, 93076, 93079, 93084, 93087, 93092, 93095, 93100, 93103, 93108, 93110, 93113, 93118, 93121, 93126, 93129, 93134, 93137).

It includes an overview of the items, model of care, patient eligibility, and links to other guidance and resources.

Overview

All 1 November 2025 eating disorder items:

The eating disorders items define services for which Medicare benefits are payable where service providers undertake assessment and management of patients with a diagnosis of anorexia nervosa and patients with other specified eating disorder diagnoses who meet the eligibility criteria (see – patient eligibility). It is expected that there will be a multidisciplinary approach to patient management through these items.

The items mean eligible patients are able to receive a Medicare benefit for development of an eating disorders treatment and management plan by a medical practitioner in general practice (Group A36, subgroup 1), psychiatry or paediatrics (Group A36, subgroup 2). Patients with an eating disorders treatment and management plan (EDTMP) will be eligible for comprehensive treatment and management services for a 12-month period, including:

• Up to 20 dietetic services under items 10954, 82350, 93074 and 93108.
• Up to 40 eating disorder psychological treatment services (EDPT services).  
• Review and ongoing management services to ensure that the patient accesses the appropriate level of intervention (Group A36, subgroup 3).

EDPT services includes mental health treatment services which are provided by an eligible allied health professional. In addition, an eligible general practitioner (GP) or an eligible prescribed medical practitioner (PMP) who has the appropriate training recognised by the General Practice Mental Health Standards Collaboration can provide focussed psychological strategies services as part of an arrangement for the treatment of an assessed mental disorder under a Mental Health Treatment Plan. These treatment services include:

• Medicare mental health treatment services currently provided to patients under the ‘Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (‘Better Access’) initiative.
  • This includes GP and PMP items 2721, 2723, 2725, 2727, 283, 285, 286, 287, 91818, 91819, 91820, 91821; 91842, 91843, 91844, 91845 and
  • This includes allied health items in Groups M6 and M7; and
  • Patients can only access these services under Better Access if they have a Mental Health Treatment Plan. These services will count towards the maximum 40 psychological sessions under an EDTMP.
• New items for EDPT services provided by suitably trained medical practitioners in general practice (items 90271, 90272, 90273, 90274, 90275, 90276, 90277, 90278, 92182, 92184, 92186 and 92188; 92194, 92196, 92198 and 92200)
• New items for EDPT services provided by eligible clinical psychologists (items 82352-82359, 93076 and 93079), eligible psychologists (items 82360-82367; 93084 and 93087; 93118, 93121), eligible occupational therapists (items 82368-82375; 93092 and 93095; 93126 and 93129) and eligible social workers (items 82376-82383; 93100 and 93103)
   

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 EDTMP to continue accessing EDPT services. 
 

Patient Eligibility

The eating disorder items are available to eligible patients in the community. These items do not apply to services provided to admitted (in-hospital) patients.

The referring practitioner is responsible for determining that a patient is eligible for an EDTMP and therefore eating disorder psychological and dietetic services.

‘Eligible patient’ defines the group of patients who can access the new eating disorder services. There are two cohorts of eligible patients.

1. Patients with a clinical diagnosis of anorexia nervosa; or
2. Patients who meet the eligibility criteria (below), and have a clinical diagnosis of any of the following conditions:
   1. bulimia nervosa;
   2. binge-eating disorder;
   3. other specified feeding or eating disorder.

The eligibility criteria, for a patient, is:

1. a person who has been assessed as having an Eating Disorder Examination Questionnaire score of 3 or more; and
2. the condition is characterised by rapid weight loss, or frequent binge eating or inappropriate compensatory behaviour as manifested by 3 or more occurrences per week; and
3. a person who has at least two of the following indicators:
   1. clinically underweight with a body weight less than 85% of expected weight where weight loss is directly attributable to the eating disorder;
   2. current or high risk of medical complications due to eating disorder behaviours and symptoms;
   3. serious comorbid medical or psychological conditions significantly impacting on medical or psychological health status with impacts on function;
   4. the person has been admitted to a hospital for an eating disorder in the previous 12 months;
   5. inadequate treatment response to evidence-based eating disorder treatment over the past six months despite active and consistent participation.

The Eating Disorders Items Stepped Model of Care

The eating disorder items incorporate a ‘stepped model’ for best practice care for eligible patients with eating disorders that comprise:

• assessment and treatment planning
• provision of and/or referral for appropriate evidence-based eating disorder specific treatment services by allied mental health professionals and provision of services by dietitians
• review and ongoing management items to ensure that the patient accesses the appropriate level of intervention.

The Stepped Model

‘STEP 1’ – PLANNING (trigger eating disorders pathway) 90250-90257, 92146-92153, 90260-90261, 92162 or 92163

An eligible patient receives an EDTMP developed by a medical practitioner in general practice (items 90250-90257 and 92146-92153), psychiatry (items 90260 or 92162) or paediatrics (items 90261 or 92163).

 ‘STEP 2’ – COMMENCE INITIAL COURSE OF TREATMENT (psychological & dietetic services)

Once an eligible patient has an EDTMP in place, the 12-month period commences, and the patient is eligible for an initial course of treatment up to 20 dietetic services and 10 eating disorder psychological treatment (EDPT) services. A patient will be eligible for an additional 30 eating disorder psychological treatment services in the 12-month period, subject to reviews from medical practitioners to determine appropriate intensity of treatment.

For patients with co-occurring mental health issues which require a Mental Health Treatment Plan to access psychological services under the Better Access initiative, Better Access mental health treatment services provided before an EDTMP has commenced do not count towards the EDPT services. However, any that are provided after the EDTMP has commenced do count as long as the patient still has a Mental Health Treatment Plan, valid referral and review requirements in place. Further information on the Better Access initiative is available at AN.0.78 – Better Access Initiative. 

 ‘STEP 3” – CONTINUE ON INITIAL COURSE OF TREATMENT 90264-90267 (managing practitioner review and progress up to 20 EDPT services)

It is expected that the managing practitioner will be reviewing the patient on a regular, ongoing and as required basis. However, a patient must have a review of the EDTMP (90264-90267; 92170-92173, 92176 and 92177), to assess the patient’s progress against the EDTMP or update the EDTMP, before they can access more than 10 eating disorder psychological services. This is known as the ‘first review’. The first review should be provided by the patient’s managing practitioner, where possible.

‘STEP 4’ FORMAL SPECIALIST AND PRACTITIONER REVIEW 90266-90267 (continue beyond 20 EDPT services)

A patient must have two additional reviews before they can access more than 20 eating disorder psychological services. One review (the ‘second review’) must be performed by a medical practitioner in general practice (who is expected to be the managing practitioner), and the other (the ‘third review’) must be performed by a paediatrician (90267 or 92173) or psychiatrist (90266 or 92172). Should both recommend the patient requires more intensive treatment, the patient would be able to access an additional 10 eating disorder psychological treatment services in the 12-month period. These reviews are required to determine that the patient has not responded to treatment at the lower intensity levels.

The patient’s managing practitioner should be provided with a copy of the specialist review.

The specialist review by the psychiatrist or paediatrician can occur at any point before 20 eating disorder psychological treatment services. The practitioner should refer the patient for specialist review as early in the treatment process as appropriate. If the practitioner is of the opinion that the patient should receive more than 20 eating disorder psychological treatment services, the referral should occur at the first practitioner review (after the first course of treatment) if it has not been initiated earlier.

Practitioners should be aware that the specialist review can be provided via video (92172 and 92173). Where appropriate, provision has been made for practitioner participation on the patient-end of the video consultation.

It is expected that the managing practitioner will be reviewing the patient on a regular, ongoing and as required basis. However, a patient must have a review of the EDTMP (90264-90267, 92170-92173, 92176 or 92177), to assess the patient’s progress against the EDTMP or update the EDTMP, before they can access the next course of treatment.

‘STEP 5’ ACCESS TO MAXIMUM INTENSITY OF TREATMENT 90266-90267 (continue beyond 30 EDPT services)

To access more than 30 eating disorder psychological treatment services in the 12-month period, patients are required to have an additional review (the ‘fourth review’) to ensure the highest intensity of treatment is appropriate. Subject to this review, a patient could access the maximum of 40 eating disorder psychological treatment services in a 12-month period. The fourth review should be provided by the patient’s managing practitioner, where possible. 

An Integrated Team Approach

A patient’s family and/or carers should be involved in the treatment planning and discussions where appropriate. The family can be involved in care options throughout the diagnosis and assessment, and are usually the support unit that help to bridge the gap between initial diagnosis and eating disorder specific treatment.

The National Standards for the safe treatment of eating disorders specify a multi-disciplinary treatment approach that provides coordinated psychological, physical, behavioural, nutritional and functional care to address all aspects of eating disorders. People with eating disorders require integrated inter-professional treatment that is able to work within a framework of shared goals, care plans and client and family information. Frequent communication is required between treatment providers to prevent deterioration in physical and mental health (RANZCP Clinical Guidelines: Hay et al., 2014). Consider regular case conferencing to ensure that the contributing team members are able to work within a shared care plan and with client and carers to achieve best outcomes.

Clinical guidelines and other resources

Eating Disorders Training

It is expected that allied health professionals who are providing services under these items have appropriate training, skills and experience in treatment of patients with eating disorders and meet the national workforce core competencies for the safe and effective identification of and response to eating disorders. More information is available at National Eating Disorders Collaboration and ANZAED. 

Training Services

Allied health professionals should contact their professional organisation to identify education and training which may assist to practitioners to gain the skills and knowledge to provide services under these items.

The following organisations provide training which may assist practitioners to meet the workforce competency standards:

• The Australia and New Zealand Academy of eating disorders (ANZAED) - National
• InsideOut Institute - National
• The National Eating Disorders Collaboration - National
• The Victorian Centre of Excellence in Eating Disorders (CEED) - VIC
• Queensland Eating Disorder Service (QuEDS) - QLD
• Statewide Eating Disorder Service (SEDS) - SA
• WA Eating Disorders Outreach & Consultation Service (WAEDOCS) – WA

This list is not exhaustive, but has been included to provide examples on the types of training available which may assist practitioners to upskill in this area.

 

 

Related Items: 82350 82352 82354 82355 82357 82358 82359 82360 82362 82363 82365 82366 82367 82368 82370 82371 82373 82374 82375 82376 82378 82379 82381 82382 82383

Eating Disorders Dietetic Treatment Services (82350, 93074 and 93108)

This note provides information on the Category 8 – Miscellaneous Services: Group M16 – Subgroup 1 (82350, 93074 and 93108) 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, 93074 and 93108) 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 eating disorder treatment and management plan (EDTMP) can access up to 20 dietetic services under items 10954, 82350, 93074 and 93108 in a 12-month period. For any particular patient, an EDTMP expires at the end of a 12-month period following provision of that service. After that period, a patient will require a new EDTMP 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 EDTMP.

Patients seeking benefits for eating disorders dietetic services must have had an Eating Disorder Treatment Plan (EDTMP) 90250-90257, 92146-92153, 90260, 90261, 92162 or 92163 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 EDTMP service has not yet been claimed, the Services Australia 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 a patient’s eligibility, Services Australia will be able to confirm whether a patient has had a claim for an eating disorder service, as well as the number of services already claimed by the patient. Additionally, providers can also access the Health Professionals Online System (HPOS) to view a patient’s history.

Allied health professionals can call Services Australia on 132 150 to check this information, while unsure patients can seek clarification by calling 132 011 or view their care plan history in their Medicare online account through myGov to help track services that have been claimed.

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 EDTMP 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 93074 93108