Document ID: chunk:federal_register_of_legislation:F2024C01105:schedule:3:p5
Version: federal_register_of_legislation:F2024C01105
Segment Type: schedule
Provision Reference: sch 3 (pt 5/8)
Character Range: 309487–312496

for a service to which any of items 104 to 109 of the general medical services table or items 91822, 91823 or 91833 applies.

3.1.6  Eligible patient for eating disorders items

    (1) For an item in Subgroups 19, 20, 21 or 22 of Group M18, a patient is an eligible patient if the patient meets the requirements for a patient specified in clause 2.31.2 of the general medical services table.

3.1.7  Limitations on allied health eating disorders items

    (1) For an item in Subgroups 20 and 22 of Group M18, the service must involve the provision of any of the following mental health care management strategies:
        (a) family based treatment (including whole family, parent based therapy, parent only or separated therapy);
        (b) adolescent focused therapy;
        (c) cognitive behavioural therapy;
        (d) cognitive behavioural therapy‑anorexia nervosa;
        (e) cognitive behavioural therapy for bulimia nervosa and binge‑eating disorder;
        (f) specialist supportive clinical management;
        (g) maudsley model of anorexia treatment in adults;
        (h) interpersonal therapy for bulimia nervosa and binge‑eating disorder;
        (i) dialectical behavioural therapy for bulimia nervosa and binge‑eating disorder;
        (j) focal psychodynamic therapy.
    (2) An item in Subgroup 20 or 22 of Group M18 does not apply to a service providing a treatment to a patient under an eating disorder treatment and management plan if:
        (a) the service is provided more than 12 months after the plan is prepared; or
        (b) the patient has already been provided with 40 services under the plan; or
        (c) the service is provided after the patient has already been provided with 10 services under the plan but before a recommendation by a reviewing practitioner is given that additional services should be provided under the plan; or
        (d) the service is provided after the patient has already been provided with 20 services under the plan but before recommendations that additional services should be provided under the plan are given by each of the following:
           (i) a medical practitioner (other than a specialist or consultant physician);
           (ii) a consultant physician practising in the specialty of psychiatry or paediatrics; or
        (e) the service is provided after the patient has already been provided with 30 services under the plan but before a recommendation is given by a reviewing practitioner that additional services should be provided.

     (2A) A reference in subclause (2) to a service providing a treatment to a patient includes any service to which item 309, 311, 313, 315, 2739, 2741, 2743, 2745, 80002, 80006, 80012, 80016, 80102, 80106, 80112, 80116, 80129, 80131, 80137, 80141, 80154, 80156, 80162, 80166, 91168, 91171, 91174, 91177, 91194, 91195, 91196, 91197, 91198, 91199, 91200, 91201, 91202, 91203, 91204, 91205, 91859, 91861, 91862, 91863, 91864, 91865, 91866, or 91867 applies that is provided to another