Important information

• These item numbers are specific for patients with anorexia nervosa or with severe presentations of other eating disorders including bulimia nervosa, binge eating disorder and other specified feed and eating disorders (OSFED). Practitioners should refer to the relevant diagnostic criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• The eligibility criteria for patients with diagnoses other than anorexia nervosa are:
  • The person has been assessed as having an Eating Disorders Examination Questionnaire (EDE-Q) score of 3 or more;
  • The person’s condition is characterised by rapid weight loss, or frequent binge eating, or inappropriate compensatory behaviours (3 or more occurrences per week);
  • The person has at least two of the following:
    • Body weight less than 85% expected weight, where weight loss is directly attributable to the eating disorder;
    • current or high risk of medical complications due to eating disorder behaviours and symptoms;
    • serious co-morbid medical or psychological conditions significantly impacting on medical or psychological health status with impacts on function;
    • the person has been admitted to hospital for an eating disorder in the previous 12 months;
    • the person has experienced 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).
• Evidence-based treatments that have been approved for use by practitioners delivering psychological treatment in this context are:
  • 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.

What items to bill? New Eating Disorder Plans are not equivalent to Mental Health Plans or Care Plans. However, the timing structure resembles GP Mental Health Plans.

Item 90250 VR GP without MHST < 20 min (resembles 2700)– EDP preperation of at least 20 minutes but < 40 minutes by GP without mental health training. $72.85

Item 90251VR GP without MHST > 40 min ( resembles 2701)– EDP preperation of at least 40 minutes by GP without mental health training $107.25

Item 90252 VR GP with MHST < 20 min ( resembles 2715)– EDP preperation of at least 20 minutes but < 40 minutes by GP with mental health training $92.50

Item 90253 VR GP with MHST > 40 min ( resembles 2717) – EDP preperation of at least 40 minutes by GP with mental health training $136.25

Item 90254 non-VR GP without MHST < 20 min ( resembles 272) – EDP preperation of at least 20 minutes but < 40 minutes by OMP without mental health training $58.30

Item 90255 non-VR GP without MHST > 40 min ( resembles 276) – EDP preperation of at least 40 minutes by OMP without mental health training $85.80

Item 90256 non-VR GP with MHST < 20 min ( resembles 281) – EDP preperation of at least 20 minutes but < 40 minutes by OMP with mental health training $74.00

Item 90257 non-VR GP with MHST > 40 min ( resembles 282) – EDP preperation of at least40 minutes by OMP with mental health training $109.00