Eating Disorder Treatment Plan (EDP) explained.
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Last Updated: 1st Jul 2024
What is an Eating Disorder Treatment Plan (EDP)?
The Eating Disorders Treatment Plan (EDP) was introduced by the Australian Government on November 1st 2019 to facilitate increased support for people who have an eating disorder through Medicare.
Under the scheme the following 4 diagnoses are eligible for a Eating Disorder Treatment Plan (EDP) referral:
Diagnosis of Anorexia Nervosa, or
Diagnosis of Bulimia Nervosa, Binge Eating Disorder, or Otherwise Specified Eating Disorder (OSFED) - you will need to discuss additional questionnaire and severity eligibility criteria with your doctor.
If you qualify for the Eating Disorder Treatment Plan (EDP) you will be eligible to receive a Medicare rebate of $141.85 for an appointment with a Clinical Psychologist, or $96.65 Medicare rebate for an appointment with a Psychologist.
This Medicare rebate amount will increase once you reach your individual/family Extended Medicare Safety Net (EMSN) threshold of $2414.00 (General) – where you will then receive back 80% of the out-of-pocket expense for your ongoing sessions with a Psychologist.
Our practice administration staff will process the Medicare rebate for your convenience, and it will be transferred directly to your account following this.
How do I get a Referral to see a psychologist under the Eating Disorder Treatment Plan (EDP)?
To be eligible for this referral you will need to make an appointment with your GP / Paediatrician / Psychiatrist and request they complete an Eating Disorder Treatment Plan (EDP) for you.
Download the Eating Disorder Treatment Plan (EDP) .rtf Template here if your GP does not have the form.
Once you commence appointments your clinician will write to your referrer, and anyone else on your Treatment Team, to confirm the commencement of appointments.
How long does my Eating Disorder Treatment Plan last?
Your Eating Disorder Treatment Plan expiries 12 months from the date it was completed.
What’s the maximum amount of psychologist sessions I can claim under the Eating Disorder Treatment Plan (EDP)?
Under this plan you are eligible to receive up to a maximum of 40 Medicare rebated appointments.
You will be allotted an initial 10 sessions, after which time following a review and re-referral with your doctor you will be eligible to receive a further 10 rebated appointments.
In some cases, following a Specialist Psychiatry review appointment, you may then be eligible to receive a further 20 rebated sessions, issued in lots of 10.
Your GP/Paediatrician/Psychiatrist will assess whether you meet criteria for one of the above eating disorder diagnoses and if eligible then they will complete this referral.
If you meet criteria for one of these diagnoses this is the preferred referral plan according to Medicare. As such, you may also initially attend an appointment under the previously mentioned Mental Health Care Plan (MHCP), and then have the plan changed to the Eating Disorder Treatment Plan (EDP).
Following the completion of an initial 10 rebated appointments your clinician will ask you to meet with your referring doctor should you wish to obtain a further allotment of 10 rebated appointments.
Do I need to see a Psychiatrist under the Eating Disorder Treatment Plan (EDP)?
Following the completion of 20 sessions you may be eligible to explore whether a further 20 Medicare rebated appointments (to a maximum of 40 rebated sessions) is possible. To release the allocation of these further appointments you will need to have a psychiatrist review appointment. You will also need to check whether your psychiatrist, or one that you book an appointment with, is comfortable to complete this 20 session Eating Disorder Treatment Plan (EDP) Review, as typically only Psychiatrists who are experienced in eating disorder treatment may wish to do so. Some eating disorder Psychiatrists also provide one off “Eating Disorder Treatment Plan (EDP) Review” appointments specifically for this purpose.
We recommend that you consider booking an appointment with a psychiatrist after your first Eating Disorder Treatment Plan (EDP) Review with your GP, as many psychiatrists have long wait times for appointments. This psychiatry review can be completed at ANY time between session 11 & 20.
Rebates & Medicare Tips!
How to ensure you don’t get charged a full private fee?
You are responsible for obtaining a referral should you wish to receive a Medicare rebate for your appointments.
Our administration and clinical team can assist you with keeping track of the number of Medicare claims that have been made under your referral at our practice, and will prompt you to obtain a re-referral should you wish to continue to receive further rebates.
Upon payment of your appointment, our administration staff will email you a copy of your receipt and the Medicare claim information. Noted on your receipt will be a running count of appointments that have been claimed on your behalf, and the number of rebated appointments that is remaining in this current allotment of session rebates as per referral. We suggest you monitor this number, so that together we can ensure the continuation of rebates if this is important to you.
If any of the above is confusing, or if you have any further questions about the Eating Disorder Treatment Plan (EDP) / Claiming with Medicare for your Psychologist fees, please get in contact with our Admin team!
We are more than happy to talk it through with you over the phone.