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Medical practitioners can refer eligible patients with eating disorders to allied health professionals. Allied health professionals can claim Medicare benefits for some services.
Allied health professional eligibility
These allied health professionals can provide eating disorder services:
- dietitians
- clinical psychologists
- psychologists
- occupational therapists
- social workers.
If you’re an allied health professional, you can check your eligibility for Medicare benefits through the Medicare Benefits Schedule (MBS) items online checker in HPOS. You can also call Medicare.
Patient eligibility
The referring medical practitioner is responsible for deciding if your patient is eligible for an EDP.
If you’re an allied health professional and you’re not sure if your patient is eligible, you can contact the referring medical practitioner. You can continue to treat patients who aren’t eligible, but they can’t access Medicare benefits for the services you provide.
Patients are eligible for other allied health support if their medical practitioner has completed either:
- Team Care Arrangements (TCAs)
- Mental Health Case Conferences (MHCCs).
You can check patient eligibility in the MBS items online checker in HPOS. You can also call us on the Medicare program line.
Claiming limits
In a 12 month period, your patient can access up to:
- 40 psychological treatment services
- 20 dietetics services.
The 12 month period starts from the date of the EDP.
Referral requirements
The referring medical practitioner decides:
- the number and combination of services that are appropriate for your patient
- whether your patient’s condition would benefit from allied health services.
In each referral, your patient can be referred for up to:
- 10 psychological treatment services
- 20 dietetics services.
It isn’t appropriate for allied health professionals to:
- provide a partly completed referral form to a referring medical practitioner for signing
- pre-empt the decision about the services that your patient requires.
Allied health professionals should keep a copy of the referral form for 2 years.
Reporting requirements
Allied health professionals must provide a written report to the referring medical practitioner after the first and last service. They can provide the reports more often if clinically necessary.
Reports should include all the following:
- investigations, tests and assessments carried out on your patient
- any treatment provided
- recommendations on how to manage your patient’s condition in the future.