An eating disorder treatment plan sets out agreed goals, the treatment approach, review dates and the multidisciplinary team. Under Medicare, the plan itself is prepared by a GP, psychiatrist or paediatrician. Your psychological objectives sit beneath it, and they need to be written so each 10-session review can show measurable progress.
That review structure is what makes eating disorder planning different from every other treatment plan you write. Here is what the rules require, how the gates shape your objectives, and examples to adapt.
Who writes the eating disorder treatment plan?
The Eating Disorder Treatment and Management Plan (EDTMP) is a Medicare item claimed by a medical practitioner. Per the MBS Eating Disorders general explanatory notes (AN.36.1), it is prepared in general practice (items 90250 to 90257), by a psychiatrist (90260) or by a paediatrician (90261). Psychologists, occupational therapists and accredited mental health social workers do not prepare it.
What you write is your own psychological treatment plan, which sits beneath the EDTMP and feeds the medical practitioner's reviews of it. Conflating the two is the most common documentation problem here: careful therapy goals that never reach the document the reviewing GP actually reads.
What must the EDTMP contain?
The EDTMP explanatory notes (AN.36.2) require goals agreed with the patient, and with their family or carer where appropriate, covering what treatment should achieve and any actions the patient will take. The plan must also cover patient and family education, a crisis intervention or relapse prevention plan where appropriate at that stage, arrangements for referrals and follow-up, and documentation of assessment results, patient needs, goals and actions, required services and a review date.
Two details shape your own objectives. The notes call the EDTMP a living document, updatable at any time to incorporate advice from other treating professionals, so your reports can and should change it. And it expires 12 months after preparation, giving every objective a hard calendar boundary.
How do the Medicare review gates change how you write objectives?
This is the part most templates miss. The items run on a stepped model of care in which a course of treatment is 10 psychological services, and a review is required after each course before the next one is available.
- Sessions 1 to 10. The plan triggers an initial course of up to 10 psychological services, plus up to 20 dietetic services across the 12 months.
- Before session 11. A first review of the EDTMP, to assess progress against the plan or update it.
- Before session 21. Two further reviews: one in general practice, one by a psychiatrist (item 90266) or paediatrician (item 90267). Both must recommend more intensive treatment.
- Before session 31. A fourth review, to reach the maximum of 40 services in the 12-month period.
So write objectives in blocks of 10 sessions, each ending in evidence a reviewing practitioner can act on. An objective that matures at session 14 will be assessed at the session 10 review with nothing to show. The review notes (AN.36.3) confirm the review must cover progress against the EDTMP goals and record a recommendation on whether the patient continues.
The specialist review can occur at any point before 20 services. If you believe at session 6 that the patient will need more than 20, say so in writing then, not at the session 20 review when the referral pathway starts from scratch.
What do good eating disorder treatment plan objectives look like?
Goals are the direction. Objectives are the measurable steps, each with a baseline, a target and a review point.
Goal: restore regular, adequate eating.
- Move from an average of 1.5 eating occasions per day at baseline to 3 meals and 2 snacks per day on at least 5 days per week, reviewed at session 10 against the food and behaviour record.
- Reduce mealtime avoidance behaviours (eating alone, meals over 45 minutes) from daily to fewer than 2 days per week by session 10.
Goal: reduce binge eating and compensatory behaviour.
- Reduce objective binge episodes from 5 per week at baseline to fewer than 2 per week by session 10, and to fewer than 1 per fortnight by session 20.
- Eliminate self-induced vomiting after the evening meal, with no episodes in the two weeks before the session 10 review.
Goal: reduce overvaluation of shape and weight.
- Reduce the EDE-Q global score from baseline, re-administered at sessions 10, 20 and 30 to align with review points.
- Practise one exposure to a previously avoided clothing or mirror situation per week from session 4, with distress rated before and after.
Goal: strengthen family or carer support (adolescents).
- Parents independently plan and supervise all main meals by session 8, measured by weekly parent report and meal completion rates.
- Both parents attend at least 8 of the first 10 sessions.
Each has the same four parts: a baseline number, a target number, a measurement method, and a session point that lands on a review gate.
Which outcome measures should the objectives be pegged to?
The eligibility criteria point to the answer. Under AN.36.1, patients with bulimia nervosa, binge-eating disorder or other specified feeding or eating disorder need an Eating Disorder Examination Questionnaire score of 3 or more, plus rapid weight loss or 3 or more binge or compensatory occurrences per week, plus at least two of five indicators: clinically underweight at under 85% of expected weight, current or high risk of medical complications, serious comorbidity, hospital admission in the previous 12 months, or inadequate response to evidence-based treatment over the past six months. A clinical diagnosis of anorexia nervosa is sufficient on its own.
If the EDE-Q established eligibility, it should be the instrument tracking change, and re-administering it at sessions 10, 20 and 30 gives every review a like-for-like comparison. Do not let a general distress measure stand in for it: a falling K10 alongside an unchanged EDE-Q global score is a meaningful finding, and the reviewing practitioner needs both. Behavioural frequency counts matter as much, because the eligibility criteria are written in behavioural terms.
How should the plan handle medical risk and the team?
Eating disorders are not a single-clinician condition. The MBS notes reference the ANZAED eating disorder treatment principles and clinical practice standards, whose eight principles include early intervention, co-ordination of services, evidence-based services, involvement of significant others and multidisciplinary care. The companion standards for mental health professionals add managing psychiatric risk, and monitoring and evaluation, as core practice areas.
In plan terms: name the medical monitoring arrangement, including who checks weight, vitals and bloods, at what interval, and what result triggers a call. Write the relapse prevention and crisis plan into the document. AN.36.1 also notes these items do not apply to admitted patients, so an escalation to inpatient care suspends the community pathway, and your objectives should say what happens on discharge.
PractaLuma is AI-native practice management software for Australian mental-health practices, and its plan management workflow keeps goals, baselines and review dates on the record rather than in a document nobody reopens between sessions.
What goes in the report back to the referring practitioner?
Reporting is mandatory, not courteous. The allied health eating disorder notes (MN.16.3) require the allied mental health professional to give the referring medical practitioner a written report on assessments carried out, treatment provided and recommendations for future management, after the first service, as clinically required after subsequent services, and after the final service. The report must be kept for two years from the date of service.
Because the reviewing practitioner must record a recommendation on whether treatment continues, your end-of-course report is the evidence base for the next 10 sessions. Write it to answer that directly: here is the baseline, here is where the patient is now, here is what remains, and here is the number of further sessions I recommend and why. Our guide to the psychologist letter to a referring GP covers the structure, and report writing assembles it from the record and scores you have already captured.
How do Better Access sessions interact with the eating disorders plan?
They count, but only from the right date. AN.36.1 states that for patients with co-occurring mental health issues requiring a Mental Health Treatment Plan, Better Access services provided before the EDTMP commenced do not count towards the eating disorder total, while those provided after it commenced do, provided the plan, referral and review requirements remain in place. So if you are already seeing a client under Better Access when an eating disorder plan is prepared, the count restarts against a larger allowance. Our guide to mental health treatment plans and referral requirements covers the Better Access side.
The approved treatments are specified: family based treatment, adolescent focused therapy, CBT for eating disorders and its anorexia nervosa and bulimia nervosa or binge-eating disorder variants, specialist supportive clinical management, MANTRA, interpersonal therapy and dialectical behaviour therapy for bulimia nervosa and binge-eating disorder, and focal psychodynamic therapy. Name the modality in the plan: a practitioner judging whether the patient responded to lower-intensity treatment needs to know what was delivered.
Frequently asked questions
How many sessions does an eating disorder treatment plan cover? Up to 40 psychological services and up to 20 dietetic services in a 12-month period, released in courses of 10 sessions, each gated by a review.
Can a psychologist write the eating disorder treatment plan? No. The EDTMP is prepared by a GP, psychiatrist or paediatrician. Psychologists write their own treatment plan and objectives beneath it, and report back so the plan can be reviewed and updated.
What happens when the 12 months is up? The EDTMP expires 12 months after the date it was prepared, and the patient needs a new plan to keep accessing these services. Build that date into your objectives rather than discovering it mid-course.
Should goals include a target weight? Weight restoration is a medical objective managed by the treating medical practitioner, so reference it rather than own it. Psychological objectives are better anchored to eating behaviour, compensatory behaviour, avoidance and the EDE-Q.
Where can I find eating disorder specific training? AN.36.1 lists ANZAED, the InsideOut Institute and the National Eating Disorders Collaboration, alongside state services in Victoria, Queensland, South Australia and Western Australia.
Before you write the next plan
The rules reward one habit: write objectives in 10-session blocks, measure them with the instrument that established eligibility, and report in the form the reviewing practitioner needs. See what PractaLuma includes, or read our guides to writing a therapy treatment plan and anxiety treatment plan goals and objectives.
This article is general information for Australian clinicians, not clinical or billing advice. MBS item numbers, fees and requirements change. Check current requirements on MBS Online and confirm eligibility with Services Australia before claiming.