New Medicare changes are set to come into place on November 1, 2019.
This landmark reform will mean that some Australians living with eating disorders will be able to access increased support through Medicare.
The Eating Disorder Plan (EDP) is an evidence-based model of treatment, structured to ensure multi-disciplinary treatment with ongoing assessment by a GP or psychiatrist. People who are eligible for the EDP will be able to access up to 20 Medicare-subsidised sessions with a dietitian, and up to 40 subsidised sessions with a mental health clinician (such as a social worker, or psychologist) over a 12-month period.
The EDP model has been designed to support a Stepped Model of Care (see page 3 here). This is to ensure ongoing communication between all treating providers throughout the course of psychological treatment. Within the EDP, it is strongly encouraged that a client’s family and/or carers should be involved in the treatment planning and discussions wherever appropriate.
Eating Disorders Qld will be able to support people on an EDP, for both dietetics and counselling appointments. For those who are not assessed as eligible for the EDP, we still have several options. We can see clients who are referred by their GP under both Mental Health Care Plans or Enhanced Primary Care plans (Medicare) – both are Medicare plans that support access to psychological and dietetic services. We are also now able to accept NDIS clients. Finally, we will still offer our normal free services for any clients who do not have access to either NDIS funding or Medicare funding.
We hope that the increased opportunity for Medicare and NDIS subsidised counselling will reduce the waiting times for those clients who do not have other funded options. Our service eligibility criteria will remain the same as always, ensuring that those clients who do not fall within the EDP criteria are still able to access appropriate care.
We are currently reviewing our Medicare service model and will announce any updates or changes as they come.
- A GP, psychiatrist, or paediatrician must assess your suitability and prepare an EDP for you
- Up to a maximum of 40 psychological treatment sessions with a mental health clinician in a 12-month period. These 40 sessions will be inclusive of any sessions provided under the Better Access plan provided in the same calendar year of the EDP being established.
- Up to a maximum of 20 sessions with a dietitian in a 12-month period. These 20 sessions will be inclusive of any sessions provided by a dietitian under the Chronic Disease Management plan in the same calendar year of the EDP being established.
- GP reviews must take place at set intervals in order to be able to access all 40 treatment sessions.
- Following GP referral, you should contact EDQ and request to see a practitioner under the EDP. Our normal intake process will still apply – first a brief phone call, and then an in-person session. Following this, you will be placed on the appropriate waiting list for counselling, dietetics, or group programs.
- Our current rate for Medicare sessions with either a psychologist, social worker or dietitian is $120.00. The rebate is dependent on the qualifications of the treating practitioner: Dietitian $53.80, Registered Psychologist $86.15,or Social Worker $79.95.
- Clients who have accessed sessions under an EDP are not able to also access free individual counselling at EDQ, but ARE able to continue to participate in our group programs
- For any questions on the Medicare reform, contact The Butterfly Foundation hotline on 1800 334 673
- For any questions on accessing Medicare services at Eating Disorders Qld, contact us on 07 3844 6055 or
- Eating Disorders Qld: PDF Guide
- Eating Disorders Victoria: Visual Guide to Navigating Changes
- The Butterfly Foundation: A Quick Guide for Consumers
- National Eating Disorders Collaboration: Guide for Practitioners
- Eating Disorders Qld: EDE-Q for Practitioners
- Inside Out: Guide for Consumers
- Inside Out: Guide for Health Professionals
- Medicare: Education Guide for Health Professionals