State Overview: South Carolina

Prior authorization requirements are up to the discretion of the state Medicaid program or insurance company.

South Carolina credentials two types of addiction counselors. A Certified Addiction Counselor (CAC) I requires either an associate degree in a relevant field or a bachelor's degree in any field, 270 hours of relevant education courses and 4,000 hours of supervised experience. A CAC II also requires either an associate degree in a relevant field or a bachelor's degree in any field, 450 hours of related education and 4,000 hours of experience. S.C. Code Ann. §40-75 and South Carolina Association of Alcoholism and Drug Abuse Counselors

Licensed professional counselors provide services to individuals, families, groups, marital counseling, play therapy, couples counseling, chemical abuse or dependency counseling, vocational counseling, school counseling, rehabilitation counseling, intervention, human growth and development counseling, behavioral modification counseling and hypnotherapy. Counselors provide assessment, crisis intervention, guidance and counseling to facilitate normal growth and development, including educational and career development. Diagnostic ability is not outlined in statute. S.C. Code Ann. §40-75-20(16)

The standards and requirements for certification of a peer support specialists were developed through a collaborative effort between the state's Department of Mental Health and a third-party, non-profit certification provider.

A practice agreement with a physician is required.

The agreement must outline information for delegated medical acts and a description of how consultation with the physician is provided. The agreement must be reviewed annually. If designated in the practice agreement, a NM may prescribe Schedules II-V. Schedule II non narcotics are limited to a thirty-day supply and Schedule II narcotics are limited to a five-day supply. S.C. Code Ann. §40-33-34(D); S.C. Code Ann. §40-33-34(F)

A practice agreement with a physician is required.

The agreement must outline information for delegated medical acts and a description of how consultation with the physician is provided. The agreement must be reviewed annually. If designated in the practice agreement, an NP may prescribe Schedules II-V. Schedule II non narcotics are limited to a thirty-day supply and Schedule II narcotics are limited to a five-day supply. S.C. Code Ann. §40-33-34(D); S.C. Code Ann. §40-33-34(F)

NPs are authorized to sign physician orders for scope of treatment forms if authorized to do by the practice agreement with a physician. S.C. Code Ann. §44-80-110

NPs are recognized in state policy as primary care providers. The South Carolina Physicians Services Provider Manual lists the provider types that may enroll as a primary care provider in the state Medicaid program.

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. S.C. Code Ann. §40-37-3-(B)

Optometrists may not give any medications through injection or intravenously. However, they administer the COVID-19 vaccine. S.C. Code Ann. §40-37290(5) and Joint Resolution 3707 (2021)

Optometrists may prescribe Schedule III-V controlled substances and Schedule II controlled substances containing hydrocodone combinations. S.C. Code Ann. §40-37-290

If employed by or contracted through the Department of Health and Environment Control, a dental hygienist may provide services under general supervision that does not require prior examination by a dentist in settings such as schools or nursing homes. The dental hygienist must carry professional liability insurance. S.C. Code Ann. §40-15-110(A)(10)

Statute does not identify dental therapists as an oral health provider.

South Carolina does not explicitly allow for the practice of teledentistry.

South Carolina has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act allowed pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

South Carolina does not allow pharmacists to modify prescriptions.

A person licensed under the South Carolina Pharmacy Practice Act who is acting in good faith and exercising reasonable care as a pharmacist and who is employed by a hospital or a pharmacy that is permitted by this State may dispense a self-administered hormonal contraceptive or administer an injectable hormonal contraceptive pursuant to a standing order by a prescriber to a patient who is: eighteen years of age or older; or under eighteen years of age if the person has evidence of a previous prescription from a practitioner for a self-administered hormonal contraceptive or an injectable hormonal contraceptive. S.C. Code Ann. §40-43-230

South Carolina does not allow pharmacists to prescribe tobacco cessation aids.

Supervision by a physician required for practice and prescriptive authority.

"Approved written scope of practice guidelines" means specific statements developed by a physician or the medical staff and a PA that establish physician delegation for medical aspects of care, including the prescription of medications. S.C. Code Ann. §40-47-20(5)

PAs may perform those duties and responsibilities including the prescribing and dispensing of drugs and medical devices that are lawfully delegated by their supervising physicians; provided, however, only PAs holding a permanent license may prescribe drug therapy. S.C. Code Ann. §40-47-935(A)(2)(B)(1)

Statute limits the number of PAs a physician may supervise.

A physician or medical staff who are engaged in practice with a PA, NP, CNM, or CNS must: […] not enter into scope of practice guidelines or practice agreements with more than the equivalent of six (6) full-time PAs, NPs, CNMs, or CNSs and must not practice in a situation in which the number of NPs, CNMs, or CNSs providing clinical services with whom the physician is working, combined with the number of PAs providing clinical services whom the physician is supervising, is greater than six individuals at any one time, provided, however, that the board may approve an exception to these requirements upon application by the physician, if the board determines that an exception is warranted and that quality of care and patient safety will be maintained. S.C. Code Ann. §40-47-195(D)(1)(c)

Chart co-signatures may be determined at the practice level.

The supervising physician or alternate must review, initial, and date the off-site PA's charts periodically as specified in the written scope of practice guidelines to ensure quality of care and patient safety. S.C. Code Ann. §40-47-955(C)

Statue allows adaptable proximity.

"Immediate consultation" means a supervising physician must be available for direct communication by telephone or other means of telecommunication. 'Supervising' means overseeing the activities of, and accepting responsibility for, the medical services rendered by a PA as part of a physician-led team in a manner approved by the board. S.C. Code Ann. §40-47-910

Supervision must be continuous but must not be construed as necessarily requiring the physical presence of the supervising physician at the time and place where the services are rendered, except as otherwise required for limited licensees. […] S.C. Code Ann. §40-47-955(A)

PA's may perform medical services within the written scope of practice guidelines under physician supervision. The State Medical Board must approve the proposed scope of practice guidelines. S.C. Code Ann. §40-47-938