Patient eligibility
To be eligible, your patient must be enrolled in Medicare and diagnosed with anorexia nervosa.
Or your patient may be eligible if they meet the following criteria:
- diagnosed with bulimia nervosa, binge-eating disorder or other feeding or eating disorder
- a score of 3 or more on the Eating Disorder Examination Questionnaire
- rapid weight loss or binge eating or inappropriate compensatory behaviour 3 or more times a week.
If your patient has not been diagnosed with anorexia nervosa they must also have at least 2 of the following indicators:
- body weight less than 85% of expected weight as a result of an eating disorder
- high risk of or current medical complications due to eating disorder behaviours and symptoms
- serious comorbid medical or psychological conditions that significantly impact their medical or psychological health
- hospital admittance for an eating disorder in the last 12 months
- inadequate treatment response to evidence-based eating disorder treatments over the last 6 months.
You can check patient eligibility in the Medicare Benefits Schedule (MBS) items online checker in HPOS. You can also call Medicare.
You can view a patient’s care plan history in HPOS.
You need your patient’s consent to check their eligibility for Medicare services.
You can read about billing an Eating Disorder Treatment and Management Plan.