Please see the information below regarding referrals under the Eating Disorder Management Plan (EDMP) for details around eligibility, item codes etc. We have done our best to make sense of the legislation around the EDMP but anyone using this website is responsible for cross checking the information below with Medicare, either through the Medicare website or by phoning Medicare.
Email referrals to: contact@exhalepsychology.com.au
or fax to (07)3358 1311
General Practitioners and Psychiatrists can refer to our team at Exhale Psychology Centre or to a specific team member, and can be:
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Please email us for a template you can use for the EDMP.
EDMP’s (as with MHCP’s) commence on the date the referrer meets with the patient and uses the relevant billing code. The doctor then has 10 days to write the EDMP and send it to the psychologist or dietitian. It is important to include the date the EDMP commenced on this letter, and not just the date the letter was written.
EDMPs run by both calendar year AND 12 months from when they were written. Meaning that patients can access up to 40 psychology rebates and 20 dietetic rebates per calendar year, provided those sessions fall within 12 months of the initial EDMP start date.
EDMPs automatically expire 12 months from their start date, and a new EDMP cannot be written during that 12 months (unlike MHCPs). So while the GP or psychiatrist and review an EDMP a little early than scheduled, a new EDMP cannot be written until 12 months following the previous one.
EDMPs last 12 months from their start date regardless of the review date, whereas MHCPs last until all sessions are used.
Patients can go from a MHCP to an EDMP, but not the other way around. That is, if a patient has exhausted their MHCP, then can then have an EDMP written, but can only access 20 rebates under the EDMP (no more than 40 rebates total per calendar year). Patients under an EDMP wanting so go to a MHCP must wait 12 months from when the EDMP commenced.
Patient Eligibility
1. If diagnosed with AN, a patient is eligible and does not need to meet the criteria
2. If diagnose with another eating disorder eg. BN, OSFED etc. the patient must meet the following criteria:
Non AN Eligibility Criteria:
a) Have an ED diagnosis
b) Score 3 or higher on the EDE-Q
c) Meet one of the following criteria:
1. Experiencing rapid weight loss
2. Binge eating at least 3 times a week
3. Engage in an inappropriate compensatory behaviour at least 3 times a week, such as purging, severe compensatory exercise etc.
d) Also have at least two of the following indicators:
1. Body weight less than 85% of expected weight as resulting of an eating disorder
2. High risk of, or current medical complications due to eating disorder behaviours and symptoms
3. Serious comorbid medical or psychological conditions that significantly impact their medical or psychological health
4. Hospital admittance for an eating disorder in the last 12 months
5. Inadequate treatment response to evidence-based eating disorder treatments over the last 6 months
Psychologist Eligibility
Not all psychologists are able to see patients under the EDMP. Psychologists must have the relevant education and training to deliver one of the following approved treatments:
- CBT - Enhanced for EDs (CBT-E)
- DBT for BN and BED
- Family Based Treatment for EDs (including whole family, parent based, parent only, or separated therapy)
- Adolescent Focused Therapy for EDs
- CBT for AN (CBT-AN) CBT for BN and BED (CBT-BN and CBT-BED)
- Specialist Supportive Clinical Management (SSCM) for EDs
- Maudsley Model of AN Treatment in Adults (MANTRA)
- Interpersonal Therapy for BN, BED
- Focal Psychodynamic Therapy for EDs
All staff at Exhale Psychology are qualified to treat patients on an EDMP.
Dieticians
For patients seeing a dietician under the plan, all the referrer needs to do is add the dietician as part of treatment recommendations on the plan - and ensure that the dietician has a copy of the plan.
Codes for Initial Plan
90250 - GP appointment for over 20 minutes but under 40 minutes, where the GP has not undertaken specialist mental health skills training
90251 - GP appointment for over 40 minutes, where the GP has not undertaken specialist mental health skills training
90252 - GP appointment for over 20 minutes but under 40 minutes, where the GP has undertaken specialist mental health skills training
90253 - GP appointment for over 40 minutes, where the GP has undertaken specialist mental health skills training
90260 - Psychiatry appointment for at least 45 minutes
Codes for EDMP Review
90256 - GP appointment to review the plan. No minimum length
90266 - Psychiatry appointment to review plan for at least 30 minutes
For further details under what is needed for each item code, search the specific item code at http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Home
Initial EDMP - GP or psychiatrist can start the plan
10 Session Review - GP or psychiatrist can do this review
20 Session Review - GP can do this review. Please note that at this point a psychiatrist needs to be involved. If a psychiatrist has not conducted a review by this point, then a GP and psychiatrist must BOTH conduct a 20 session review. 20 session reviews cannot be done by a psychiatrist without a GP also reviewing the plan.
30 Session Review - GP or psychiatrist can do this review