Eating Disorder Plans: What Psychologists Need to Track Between Referrals, Reviews and Expiry

A client has appointments booked, treatment is underway and an eating disorder plan is on file. Then someone notices that the next appointment may fall beyond a review milestone, the referral authorises fewer services than expected, or the plan is approaching expiry.

The clinical need may be clear while the Medicare position still needs checking.

An Eating Disorder Treatment and Management Plan, or EDTMP, requires practices to coordinate several separate things: the plan period, referral authorisation, treatment counts, medical reviews and communication between clinicians. Recording only “sessions remaining” leaves too much unexplained.

This guide explains the main checkpoints and suggests a practical way to track them.

Information checked 2 November 2026. This is educational guidance for Australian psychologists, not an individual eligibility decision or a complete billing manual. Check current MBS requirements for the service being provided. The suggested workflow and fictional example are my own, not an official Medicare protocol.

A plan does not authorise every future appointment

Eligible patients can access up to 40 eating disorder psychological treatment services and 20 dietetic services during the EDTMP’s 12-month period, subject to the relevant requirements. These are maximums, not a prescription for everyone to receive the same amount of treatment. ^[1]

The plan and referral have different functions. The plan documents care needs and recommendations. A written referral authorises a course of services; the plan alone isn't a referral. ^[2]

A valid referral is in writing and signed and dated by the referring practitioner. It should include the patient's name, date of birth and address, their symptoms or diagnosis, current medications and the number of services. No specific Medicare form is required. ^[2]

The referring practitioner decides eligibility and how many services to refer for. If you're unsure whether a client is eligible, contact the referring medical practitioner. Services Australia can also help confirm claimed services on 132 150. ^[3]

For psychologists, the useful questions are:

• Is the EDTMP current?
• Is there a valid referral for the proposed service?
• How much of that referral has already been used?
• Have the required reviews occurred?
• What services have been used elsewhere or through an overlapping pathway?
• Is this provider and this service eligible for the proposed item?

Avoid treating a plan’s existence as confirmation that all these questions have been resolved. Eligible clinical and registered psychologists can provide these services, and the MBS expects the practitioner to have appropriate skills, knowledge and experience in eating disorder treatment. ^[1]

Keep three separate records

A single number can conceal different problems. A client might have unused services within the overall limit but need another referral or medical review before the next Medicare-funded course.

This table is an organisational aid. Check each part against the relevant documents rather than calculating eligibility from a diary alone.

Know the review milestones

The MBS describes a staged pathway through psychological treatment. Reviews help determine whether continuing or changing treatment is appropriate. ^[1][2]

Further treatment remains subject to clinical indication, a valid referral, the service limit and the plan remaining current. ^[1][2]

A review has to cover treatment efficacy, including a discussion with the patient about whether treatment is meeting their needs. The practitioner then modifies the plan in writing to continue or revise the treatment, and gives the patient a copy. ^[2] Asking for the modified plan is a reasonable way to confirm that a review has happened.

A psychologist’s treatment review or progress letter does not replace the required medical EDTMP review. The psychologist supplies relevant clinical information; the practitioner performing the medical review has their own requirements to meet. The medical plan-preparation and review items are performed by eligible GPs, medical practitioners, consultant psychiatrists or consultant paediatricians, rather than the treating psychologist. ^[2]

Arrange specialist review before the deadline becomes immediate

The MBS says a specialist review can happen at any time in treatment. It must be conducted, and the relevant MBS item claimed, before the patient can access more than 20 psychological treatment services. ^[2] Booking the appointment isn't the same as completing it.

Where treatment beyond 20 services looks likely, the MBS says the specialist referral should happen at the first practitioner review, after the first course of 10, if it hasn't been started earlier. ^[4]

Your coordination record could distinguish:

• referral requested;
• specialist appointment booked;
• review completed;
• review outcome received;
• relevant claiming requirement verified;
• further referral received.

Record who confirmed each step and when. If a requirement is uncertain, seek clarification rather than assuming an appointment or a generic specialist letter has resolved it.

The order matters. The specialist reviews first and sends recommendations to the referring GP or medical practitioner. That practitioner then does their own review and can refer for more psychological services if clinically indicated. ^[2]

Plan expiry has its own date

An EDTMP expires 12 months after the date it was prepared. A review does not extend or restart that period. After expiry, further Medicare-funded eating disorder treatment requires a new EDTMP, not another review of the expired plan. ^[5][6]

Check the preparation date rather than treating 1 January as a reset. Keep the expiry date separate from the number of services remaining on a referral.

What happens when a referral runs out?

A referral covers the number of services authorised by the referring practitioner. It remains valid only within the current EDTMP period. Changing psychologists does not create a new course or make previously used services available again. ^[3]

An exhausted referral and an expired plan therefore need different responses:

These are checks on Medicare funding, not instructions to stop clinically necessary care. If access is interrupted, discuss an appropriate care plan and confirmed costs with the client. ^[2][5][3]

Arrange a new plan rather than extending the old one

For ongoing care after expiry:

1. 1Arrange an appointment with an eligible medical practitioner. This may be a GP, medical practitioner, consultant psychiatrist or consultant paediatrician. They assess ongoing eligibility and whether a new EDTMP is appropriate. ^[6]
2. 2Have a new plan prepared. Plan preparation and plan review have different MBS items. A review of the previous plan does not substitute for preparation of a new one. ^[2][5]
3. 3Obtain new written referrals. The new plan is not itself a referral. Psychological treatment is referred in courses of up to 10 services; dietetic referrals can include up to 20 services within the applicable limits. ^[2][6]
4. 4Apply the usual requirements to the new plan period. Check eligibility, course limits, review milestones, specialist-review requirements and overlapping services. Do not assume the previous plan's referral or review paperwork automatically authorises the next course. ^[1][2]

Unused services do not accumulate. Once the old plan expires, services left on its referral cannot be used under that plan or added to the new plan's maximum. Keep the old record for the previous period and start a separate record for the new plan. ^[5][3]

As a practice workflow, set an advance reminder that allows time to discuss ongoing care and arrange the necessary appointments. Choose the lead time around local access and the person's circumstances; there is no reminder interval prescribed in this article.

A client explanation you can adapt

“Your eating disorder plan is due to expire on [verified date]. A review does not extend it. If you need ongoing treatment under this Medicare pathway, an eligible medical practitioner will need to assess whether a new plan is appropriate and provide new referrals. Any unused services under the old plan cannot be used after it expires. Let's discuss the appointments and costs early so we can plan your ongoing care.”

Adapt this explanation to the person's verified circumstances. Do not promise that the next plan, referral or rebate has already been approved.

Check Better Access overlap rather than adding two allowances

Better Access and the eating disorder pathway can't simply be treated as independent pots of psychology sessions.

The MBS explanatory notes say Better Access services delivered before an EDTMP is prepared don't count towards its psychological service cap. Those delivered while the EDTMP is active do count. ^[1][7]

A client with both an EDTMP and a Mental Health Treatment Plan therefore has a combined maximum of 40 individual psychological services. That total includes eating disorder services and any eligible individual Better Access services used while the EDTMP is active; Better Access retains its own limits. A second plan is only expected where the person has significant co-occurring conditions that need psychological treatment beyond eating disorder care. ^[1]

The eating disorder items do not apply to admitted hospital patients. Check other funding arrangements separately rather than assuming the same service can be funded twice. ^[1]

For example, a client may have seen another psychologist for a co-occurring condition during the active plan period. Your own eating disorder appointment count may therefore be incomplete.

Record the service date, pathway and verification source. Clarify how overlapping services affect the person’s position before making a promise about remaining Medicare-funded care.

Make clinical reports useful to the reviewing practitioner

Services Australia requires allied health reports after the first and last service and at other clinically appropriate times. Reports should cover assessment, treatment provided and recommendations for future care. ^[3] The MBS adds that reports after later services are required as clinically needed. ^[4] Services Australia also says it isn't appropriate to pre-empt the referring practitioner's decision about which services the patient needs. ^[3]

For a forthcoming review, a concise update can also help the medical practitioner understand the clinical decision ahead. Depending on relevance and scope, explain:

• the agreed treatment goals and approach;
• changes since the previous report, including the client’s account;
• the measures or observations supporting your conclusions;
• barriers to participation or progress;
• current concerns requiring medical attention or team discussion;
• why continuing, modifying or increasing the level of care is recommended;
• what remains uncertain.

These additional prompts are a suggested reporting framework, not a mandatory national template. Avoid generating a lengthy report that obscures the decision the reviewing practitioner needs to make.

Give each task an owner

“The client knows they need a review” doesn't establish that someone has arranged it or received the outcome.

Agree responsibilities with the client and relevant clinicians. Reception staff can follow an administrative process, while unresolved clinical questions and eligibility concerns need appropriate escalation.

Services Australia permits care-plan history checks through HPOS with patient consent and provides assistance with claimed-service information. A local tracker supports that verification; it doesn't replace it. ^[3] Clients can also view their care plan history through myGov. ^[8]

A fictional example

Alex has attended 18 psychological treatment services during the current EDTMP period. A specialist appointment has been requested, but the practice has no confirmation that it has occurred. Further appointments are already booked.

If a valid referral covers services 19 and 20, these may attract a rebate if the plan is current and all other requirements have been met. Before service 21 can attract a rebate under this pathway, the required medical reviews must be complete, including the specialist review and relevant claim, with a valid referral for the next course. ^[2][5]

Writing “22 sessions left” in the file would miss the immediate issue.

The practice instead:

1. 1Checks the plan period, referral authorisation and verified service history.
2. 2Clarifies the required review arrangements with Alex and the managing practitioner.
3. 3Sends a focused clinical update through the agreed information-sharing process.
4. 4Records what is booked, what is completed and what remains unconfirmed.
5. 5Discusses the next appointments and any costs without promising a Medicare rebate prematurely.

The psychologist also considers continuity and clinical risk. An administrative barrier calls for an explicit care discussion, rather than an unexplained cancellation or an assumption that Alex can pay privately.

Costs need care too. Explain the practice fee, expected Medicare rebate and amount payable by the client. Check any Medicare Safety Net effect separately rather than promising a lower gap. Private health insurance ancillary cover can't top up a Medicare benefit. It may apply once Medicare services run out, depending on the cover. ^[1]

This example illustrates coordination, not a decision about Alex’s individual eligibility.

Use a coordination record that shows the next action

A practical record can contain:

• EDTMP preparation date and expiry date;
• managing practitioner and agreed communication arrangements;
• referral date, authorised course and remaining course services;
• psychological services used during the plan period;
• overlapping Better Access services requiring reconciliation;
• separate dietetic service information where relevant to team coordination;
• review milestones and supporting documentation;
• specialist referral, appointment, completion and verification status;
• reports sent, recipient and date;
• unresolved issue, responsible person and follow-up date;
• what has been explained to the client about access and costs.

Store only necessary information in an authorised practice system. Use clear labels such as verified, client-reported and awaiting confirmation.

The record should help someone see the next task without reconstructing the entire history from appointment notes.

Keep Medicare coordination separate from clinical urgency

An available service doesn't establish that outpatient treatment is the right level of care. An exhausted referral or delayed review doesn't establish that clinical care is no longer needed.

When clinical or medical concerns require action, follow the appropriate assessment and escalation pathway within your competence and service arrangements. Don't wait for a routine Medicare milestone to address an urgent concern.

Before the next appointment, ask: What has been verified, what still needs to happen, and who is following it up?

For clear records of the treatment itself, see how to write psychology progress notes. The Therapist Resources hub brings together related clinical documentation guides, and the clinical documentation collection contains practice resources. A template does not establish Medicare eligibility.

Sources

1. 1.MBS Online: MN.16.1 Eating Disorders General Explanatory Notes.Back
2. 2.MBS Online: AN.36.3 Preparation and Review of Eating Disorder Treatment and Management Plans.Back
3. 3.Services Australia: Allied health referrals for eating disorder treatment services.Back
4. 4.MBS Online: Item 82379, Eating Disorders Items Stepped Model of Care.Back
5. 5.Services Australia: Review an eating disorder treatment and management plan.Back
6. 6.Services Australia: Requirements for an eating disorder treatment and management plan.Back
7. 7.Department of Health, Disability and Ageing: Eating Disorders Medicare Benefits Schedule FAQs, published 20 October 2026.Back
8. 8.Services Australia: Eating disorder treatment and management plans.Back
9. 9.Department of Health, Disability and Ageing: Eating disorder resource collection. Further reading.Back