1. Australian Government. Medicare Benefits Schedule Book — July 2026. Group A36, Eating Disorder Services. AN.36.1–AN.36.4. mbsonline.gov.au
2. Services Australia. Eligibility of an eating disorder health care plan. Updated January 2025. servicesaustralia.gov.au
3. Services Australia. Requirements of an Eating Disorder health care plan. Updated August 2025. servicesaustralia.gov.au
4. Services Australia. Review eating disorder health care plans.servicesaustralia.gov.au
Disclaimer: This tool is for educational reference only. It does not constitute medical or billing advice. MBS item fees are indexed annually — verify at mbsonline.gov.au before billing. Eligibility criteria reflect Services Australia guidance as of January 2025. Always confirm patient eligibility using HPOS and current MBS notes. This site is independent and not affiliated with Services Australia or the Department of Health.
MBS Book July 2026Services Australia Jan 2025Clinician use only
Two-tier eligibility: Anorexia nervosa is automatically eligible. All other eating disorders require EDE-Q ≥3, symptom frequency ≥3×/week, plus at least 2 of 5 additional indicators. Work through each question below.
Step 1 — Diagnosis
1
What is the patient's confirmed eating disorder diagnosis?
✅
Eligible — Anorexia nervosa is automatically eligible
No further criteria need to be met. Patient is eligible for an EDTMP. You may proceed to prepare the plan (Tab 2 for items, Tab 3 for documentation checklist).
⛔
Not eligible — No confirmed diagnosis
A confirmed clinical diagnosis is required before an EDTMP can be prepared. If assessment is in progress, complete the diagnostic workup first. An EDE-Q score alone is not sufficient without a clinical diagnosis.
3
Rapid weight loss, binge eating, or inappropriate compensatory behaviour — frequency
Step 4 — Additional Indicators
0 of 5 selected
Patient must meet at least 2 of the following 5 criteria:
✅
Eligible for EDTMP
All three criteria met: EDE-Q ≥3, symptom frequency ≥3×/week, and 2+ additional indicators. Patient is eligible for an Eating Disorder Treatment and Management Plan.
⚠️
Criteria not fully met — check below
One or more eligibility criteria have not been satisfied. Review each criterion above.
Filter by your situation — select your role, whether you hold current mental health skills training (MHST), consultation type, and the service you are billing. Items are from MBS Group A36, July 2026.
SERVICE TYPE:
MH SKILLS TRAINING:
DELIVERY:
Co-claiming restriction
Some EDTMP items cannot be claimed with certain other consultation items on the same day for the same patient. Check the relevant MBS item explanatory notes at mbsonline.gov.au and use the HPOS MBS items online checker before billing. The EDTMP preparation and review items are generally incompatible with standard GP consultation items (23/36/44) on the same day.
Required documentation for a valid EDTMP — per MBS Note AN.36.2 and Services Australia requirements (updated January 2025). Tick each element as you complete it.
0 of 9 completed
Opinion on diagnosis documentedClinical diagnosis of anorexia nervosa, bulimia nervosa, BED, or OSFED recorded in the plan
Treatment options and recommendations for 12 monthsOutline of recommended treatment approach for the coming 12-month period
Referral plan to allied health documentedMental health services (psychologist, OT, social worker) and dietetic services identified and referrals arranged
Goals agreed with patient (and carer if appropriate)Treatment goals documented, discussed, and agreed — including what should be achieved by treatment and actions patient will take
Patient and carer education providedEducation about the eating disorder provided or arranged. Plan for ongoing education documented
Crisis intervention / relapse prevention planCrisis plan and/or relapse prevention strategy documented where clinically appropriate at this stage
Review schedule discussed and documentedPlan for reviews throughout treatment discussed with patient — including when reviews will occur and what they involve
Copy of plan offered to patient and carerPatient (and carer where appropriate and patient agrees) offered a copy of the completed plan
Plan documented in patient recordAll elements — assessment, goals, actions, referrals, review date — recorded in the patient's clinical record
✅
All required elements completed
Documentation is complete. You can now bill the appropriate preparation item (Tab 2). Keep a copy of the plan in the patient record.
Track EDTMP session usage. A review (item 90264) is required after each course of 10 psychological sessions. 3 reviews needed for the full 40. Dietetic sessions are tracked separately (max 20). Plan expires 12 months from preparation date.