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Psych PAs: Duties and Billing?

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I recently transferred over to inpatient psychiatry.  It is a pretty interesting field and seems to have a lot of potential for PAs.  Since I am new to it I am mostly doing H&Ps and DC summaries and doing the medical management for patients admitted with other issues besides the psych stuff (diabetes, cardiac, renal, wound management from SA, and pretty much anything that can be handled without needing a medical admit).  The Psychiatrists are training me more on psychopharmacology and psychiatric evals.  The problem is that my SP is a Psychiatrist and when I am doing the medical management on the service I cannot bill for it if they are doing psych eval the same day per our billing people.  Psych has different rules apparently and even split service billing gets tricky.  So, because I am listed as a Psychiatry PA if the Doc does the psych eval and I do the eval and management of the patient's Diabetes then we can only bill for the Psych eval since I am told it is double billing.  However, if we consult the hospitalist service then they can bill for that.  We are thinking about changing me over to the hospitalist service and be assigned to psych with a psych and hospitalist SP.  It is frustrating because we can get some complex patients where I am doing a full medical H&P, creating a treatment plan, ordering and following labs, making changes, doing daily assessments and basically working as a hospitalist yet cannot bill for 80% of my work.

So, my question is what kind of duties do other Psych PAs do and more importantly how do you all bill for it?


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