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On 1 November 2019, 64 NEW Medicare Benefits Schedule (MBS) item numbers were introduced to support a model of evidence-based care for eligible patients living with an eating disorder.
The new MBS item numbers for eating disorders are underpinned by the NEDC’s National Practice Standards for Eating Disorders, which promote a coordinated, consistent and multi-disciplinary approach to the treatment and management of eating disorders within Australia.
These item numbers are specific for patients with anorexia nervosa, or with severe presentations of bulimia nervosa, binge eating disorder or other specified feed and eating disorders (OSFED) who meet the eligibility criteria. Practitioners should refer to the relevant diagnostic criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
What is the eligibility criteria for patients with diagnoses other than anorexia nervosa?
a. The person has a clinical diagnosis of either bulimia nervosa, binge-eating disorder, or other specified feeding or eating disorder; and
b. The person has been assessed as having an Eating Disorders Examination Questionnaire (EDE-Q) score of 3 or more; and
c. 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
d. The person has at least two of the following indicators:
i. clinically underweight with body weight less than 85% of expected weight where weight loss is directly attributable to the eating disorder;
ii. current or high risk of medical complications due to eating disorder behaviours and symptoms;
iii. serious comorbid medical or psychological conditions significantly impacting on medical or psychological health status with impacts on function;
iv. the person has been admitted to a hospital for an eating disorder in the previous 12 months;
v. inadequate treatment response to evidence-based eating disorder treatment over the past six months despite active and consistent participation.
Eligible patients will be able to receive a Medicare Rebate for:
- the development of an Eating Disorder Plan (EDP) by a medical practitioner (including a General Practitioner, Psychiatrist or Paediatrician);
- General Practitioner reviews of their progress against the treatment plan after every 10 sessions of psychological treatment;
- specialist review by a Psychiatrist or Paediatrician after 20 sessions of psychological treatment;
- up to 40 sessions of evidence-based eating disorder psychological treatment (in a 12 month period) with a suitably trained Clinical Psychologist, Registered Psychologist, Accredited Mental Health Social Worker or Accredited Mental Health Occupational Therapist, or with a General Practitioner who meets the General Practice Mental Health Standards Collaboration requirements and is entered on the Register as being eligible to render a Focused Psychological Strategy service; and
- up to 20 dietetic services with an Accredited Practising Dietitian (in a 12 month period).
Eating Disorder Management Plans - EDP
An eating disorder treatment and management plan (EDP) is needed for those eligible to access the eating disorder specific MBS items. This plan is developed by a GP or medical practitioner (items 90250-90257), consultant psychiatrist (items 90260-90262) or consultant paediatritian (items 90261-90263). See the MBS Quick Reference Guide for more information.
InsideOut Institute for Eating Disorders has developed an EDP template in .rtf file which can be download here.
What are the evidence-based treatments approved for use by practitioners delivering psychological treatment under an EDP?
- Family Based Treatment (FBT) for Eating Disorders
- Adolescent Focused Therapy for Eating Disorders
- Cognitive Behaviour Therapy for Eating Disorders (CBT-E)
- Cognitive Behaviour Therapy for Anorexia Nervosa (CBT-AN)
- Cognitive Behaviour Therapy for Bulimia Nervosa and Binge Eating Disorder (CBT-BN or CBT-BED)
- Specialist Supportive Clinical Management (SSCM) for Eating Disorders
- Maudsley Model of Anorexia Treatment in Adults (MANTRA)
- Interpersonal Therapy (IPT) for Bulimia Nervosa and Binge Eating Disorder
- Dialectical Behaviour Therapy (DBT) for Bulimia Nervosa and Binge Eating Disorder
- Focal Psychodynamic Therapy for Eating Disorders
It is expected that professionals will have the relevant education and training to deliver these services.
There will be an evaluation of the new MBS items after 12 months to assess if the MBS items are operating as intended for patients and providers.
A joint response from The Butterfly Foundation, NEDC and Australia New Zealand Academy for Eating Disorders (ANZAED) addressing Frequently Asked Questions is available here.
The full Medicare Benefits Schedule Book can be accessed online. Content relating to eating disorders can be found in the following sections:
Pages 182-195 - General explanatory notes, patient eligibility, overview of items, EDE-Q, telehealth
Pages 346-358 - Item specific information for GPs and other Medical Practitioners
Pages 1386-1394 - Item specific information for Dietitians, Psychologists, Occupational Therapists and Social Workers
Additional Information and Support
The NEDC has developed resources to support specific professionals working with high-risk groups or individuals living with an eating disorder. These resources are available to download and print.
Visit the Professional Development area on our website for additional information and see the panel on the right of this page for links to useful forms and further information.
For further support or assistance to locate an eating disorder practitioner or service, contact the NEDC online or visit:
National Practice Standards for Eating Disorders
Eating disorders are a distinct group of complex illnesses with treatment requirements that are different to other types of mental...Read more
Workforce Core Competencies: A competency framework for eating disorders in Australia
This document sets out the workforce core competencies for the safe and effective identification of and response to eating disorders...Read more