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Medicare for dietitians: three pathways, and what each pays
Most of the confusion about Medicare and dietetics is not about the item numbers. It is about which pathway a patient is on, because the pathway decides how many sessions they get, and that ranges from five a year to twenty.
Here is how the three pathways differ, what each one requires before you can bill, and the mistakes that cost private practices the most money.
All figures below are the schedule fees effective 1 July 2026. They are indexed, usually on 1 July, so check the current value on MBS Online before you quote a number to a patient. This is general information for clinicians, not billing advice.
The rate is the same. The volume is not.
Every dietetic allied health item carries the same schedule fee: $74.55, with a Medicare benefit of $63.40 (85%). Whether you see the patient face to face, by video or by phone, and whichever pathway referred them, the rate does not change.
What changes is how many times you can do it.
| Pathway | Sessions | Shared with other providers? |
|---|---|---|
| Chronic Disease Management | 5 per calendar year | Yes — across all allied health |
| Eating Disorder Plan | Up to 20 per plan period | No — dietetic services have their own block |
| ATSI health check follow-up | Per the health check arrangement | Separate from CDM |
That first row is where the money goes missing.
CDM: five services, and they are not all yours
Under a Chronic Disease Management plan the patient gets up to five allied health services per calendar year, shared across every allied health provider they see. Not five dietitian visits. Five visits total, and the physiotherapist, the podiatrist and the exercise physiologist are drawing on the same five.
A patient who has already had four physio sessions this year has one left. If you book them a six-session program on the assumption that CDM covers five of them, you will be writing off the difference or having an awkward conversation in week two.
Ask at the first appointment what other allied health they have used this calendar year. It takes ten seconds and it is the single most useful question in the intake.
The items:
- 10954 — face to face
- 93000 — video
- 93013 — phone
The referral requirement: a GP referral under an active GP Management Plan and Team Care Arrangement, in place before the first service. A referral written after the fact does not retrospectively make the service claimable.
Eating Disorder Plans: twenty sessions, and a different referrer
An Eating Disorder Plan is a genuinely different arrangement. It allows up to 20 dietetic services in a 12-month plan period, and those services are not shared with physiotherapy or podiatry — the dietetic block is its own.
The items:
- 82350 — face to face
- 93074 — video
- 93108 — phone
The referral must be under an Eating Disorder Plan prepared by an eligible practitioner. This is not a GPMP with a note attached; it is a specific plan type.
For a patient with an eating disorder, the difference between the two pathways is four times the funded care. If a referral arrives as a CDM plan for a patient who would be eligible for an EDP, that is a conversation worth having with the referring GP before you start.
ATSI health check follow-up
Item 81320 covers dietetic follow-up arising from an Aboriginal and Torres Strait Islander health check. It sits outside the CDM five and is worth checking for separately rather than assuming a patient is on a CDM plan.
Telehealth is a different item, not a modifier
Video and phone each have their own item number. You cannot bill the face-to-face item for a video consult and note the mode in the record. For CDM, note that 93000 and 93013 are generic allied-health items rather than dietitian-specific ones, and they still draw on the same five.
What this costs in practice
Three things account for most of the lost revenue we hear about:
Assuming the five CDM services are yours. They are shared. Ask.
Not checking whether an EDP is available. A patient referred on a CDM plan who meets EDP criteria is getting five funded sessions instead of twenty.
Billing the wrong mode. A rejected claim is not just the fee, it is the time to find out why and resubmit.
None of these are clinical problems. They are admin problems, and they are the kind that get solved by having the right question in front of you at the right moment rather than by remembering harder.
Look it up instead of remembering it
We built two free tools for exactly this, and they need no account:
- The Medicare rebate finder gives you the item number, schedule fee, benefit and patient gap for any pathway and mode.
- The eligibility checker is written for patients: three questions, and it tells them whether they can get a rebate, how many visits and what to ask their GP. It is the page to send someone who emails asking “does Medicare cover this?”
Both are free and stay free. Inside AI Dietitians the same reference sits alongside the patient record, so the item number is where the note is, rather than in another tab.
References
- Services Australia / Department of Health, MBS Online — the authoritative source for item numbers, schedule fees and benefits. Fees indexed 1 July annually.
- Department of Health, Chronic Disease Management (CDM) items — the five-services-per-calendar-year rule, shared across allied health.
- Department of Health, Eating Disorder Plans — up to 20 dietetic services per plan period.
- Dietitians Australia, Medicare for dietitians
Schedule fees and benefits are those effective 1 July 2026 and are indexed annually. Item numbers, session limits and referral requirements change. Always confirm the current details on MBS Online before billing. This article is general information for clinicians and is not billing, legal or financial advice.