Telemedicine in South Carolina has been getting more and more accessible to citizens over the years. Even though there’s still no parity law in SC, Palmetto State is a true telemedicine pioneer.

By welcoming telemedicine into the state, citizens of SC can receive help more quickly and efficiently. Considering how many rural and underserved areas South Carolina has, it is no wonder that they’ve decided to look into the wonders of telemedicine.

If you’re curious to know how far South Carolina has come in terms of telemedicine, we should analyze the laws, regulations, policies, and rules first. This is going to give you a good idea of how fertile the South Carolina grounds are for health care workers involved in telemedicine.

South Carolina Definition of Telemedicine

To understand better what telemedicine entails in South Carolina, let’s take a look at how the state defines it:

Telemedicine is the use of medical information about a patient that is exchanged from one site to another through electronic communications to provide medical care to a patient in circumstances in which face-to-face contact isn’t necessary. In this case, a physician or other qualified medical professional has determined that medical care can be provided through electronic communication with no loss in the efficacy or quality of the care. Electronic communication is the usage of interactive telecommunication equipment that typically includes audio and video equipment permitting two-way, real-time interactive communication between the patient and the physician or practitioner at the referring site. Telemedicine includes diagnostic, consultation, and treatment services.

You can see under SC Code Annotated Sec. 40-69-20(15). (Accessed Feb 2020) that the law of South Carolina groups telemedicine with veterinary services and says that ‘telemedicine is an audio, video, or data communication of medical information.’

South Carolina New Telemedicine Practice Standards

In 2016, the governor of South Carolina signed the South Carolina Telemedicine Act (S.B.1035) into law. This enabled new telemedical practice standards to take place in Palmetto State, and the law made a new section in the South Carolina Code (§40-47-37.)

Before the Act was signed into law, telemedicine in South Carolina relied only on the 2013 Advisory Opinion on Establishment of Physician-Patient Relationship as Prerequisite to Prescribing Drugs, 2015 Advisory Opinion on Telemedicine, and South Carolina Code §40-47-113.

How the 2016 Act Changed Telemedicine in South Carolina

With the new South Carolina Telemedicine Act, new rules were imposed, contributing to the overall definition of telemedicine within the state. These were some of the most notable changes:

1. Physicians who want to practice telemedicine within the borders of SC need to have a valid and up-to-date South Carolina medical license.
2. The definition of telemedicine in SC changed—since then, it has been defined as ‘the practice of medicine using electronic communications, information technology, or other means between a licensee in one location and a patient in another location with or without an intervening practitioner.’ As you can see, the definition doesn’t oblige health care workers to use either audio or video technology. They still need to use technology that is sufficient enough to diagnose patients accurately and sufficiently.
3. The standard of care needs to be the same as it would be if it were given in-person. If the quality of care starts lacking at any point, physicians aren’t allowed to practice telemedicine with that patient any longer.
4. A doctor-patient relationship can be established through telemedicine, meaning that in-person examination isn’t required.
5. All patient records need to be maintained, or created if a record doesn’t exist, by the physician. Records need to be in line with the applicable federal and state laws. Physicians are obliged to give record access to their patients, as are other practitioners, when lawfully required.
6. Any practitioner involved in telemedicine needs to be competent in the operation of telemedicine equipment and trained appropriately in the use of it.
7. Physicians can prescribe controlled substances to their patients without prior in-person interaction.

One thing to note, though, is that online prescriptions have certain limitations:

• Physicians aren’t allowed to prescribe abortion-inducing drugs
• Physicians need to comply with all applicable state and federal laws when prescribing controlled substances
• Lifestyle medications, such as erectile dysfunction drugs, as well as Schedule II and Schedule III drugs, cannot be prescribed unless physicians are allowed to do so by the Board
• Physicians should not prescribe controlled substances if an in-person examination is required to determine the patient’s diagnosis accurately

South Carolina Medicaid Eligible Services through Telemedicine

Services that are eligible for live video interactions are diagnostic, treatment, and consultation ones. These are some of the services that citizens of South Carolina can receive through telemedicine:

1. Patient consultation
2. Medication management
3. Individual psychotherapy
4. Psychiatric diagnosis, testing, and examination
5. Echocardiography
6. Neurobehavioral status examination
7. Electrocardiogram interpretation and report

Who Can Practice Telemedicine in South Carolina?

As of this moment, there aren’t many medical fields that the State of South Carolina allows to take part in telemedicine. There is only a handful of them:

• Psychiatrists
• Physicians
• Nurse Practitioners
• Physician Assistants

Since the vast majority of Physician Assistants work in the primary care field, this is good news for those who are involved in telemedicine. Most patients seek primary care practitioners because the majority of them need treatment for common injuries and illnesses.

Citizens of South Carolina will get to experience the wonders and privileges of telemedicine in no time, as telemedicine is expanding at the speed of light. More and more people will start hopping on board, especially during and after the COVID-19 pandemic.

If you’re looking to get yourself involved in telemedicine, now is the right time to do so. Using Curogram, you will be able to find your spot in the world of telehealth quickly and easily. Our goal is to provide healthcare workers with the most technologically advanced assets that will improve their time management and workflow efficiency.

In case you’re wondering why this would be the right time to tackle telemedicine, it’s simply because people have started recognizing the advantages of being in the comfort of their homes while, in a way, being at the doctor’s at the same time. Once the pandemic is over, telemedicine will take over the entire world, so don’t miss out on this opportunity.

South Carolina Telemedicine during the COVID-19 Pandemic

Many states are changing certain requirements for telemedicine practices because of the COVID-19 pandemic, and South Carolina is no exception. These are the main highlights of what’s changed during the global emergency:

• The South Carolina Board of Medical Examiners has declared that out-of-state practitioners are now allowed to treat the citizens of SC both in-person and through telemedicine
• Licensed Nurse Practitioners are enabled to treat existing patients through telemedicine
• The South Carolina Board of Medical Examiners in Psychology are encouraged to continue their therapeutic relationships with patients through telemedicine
• Practitioners involved in telemedicine are temporarily allowed to prescribe Schedule II and Schedule III drugs without having to consult the Board first

South Carolina Medicaid has also announced that there would be certain changes in terms of coverage during the pandemic:

• Behavioral health services were expanded by temporary policy changes and are covered through Federally Qualified Health Centers and Rural Health Clinics
• Additional telemedicine services administered by physicians are covered by these temporary policy changes
• Additional telemedicine benefits for Federally Qualified Health Centers and Rural Health Clinics are provided by policy changes
• Coverage of additional management services and evaluation conducted through telemedicine were also brought by the policy changed

The best way to keep in touch with your patients during the global emergency is to use Curogram, which is fully HIPAA compliant and comes with numerous benefits. Texting is a preferred way of communication, and that’s why our app lets users rely on SMS messaging. Since Curogram was introduced, phone volumes have dropped all the way to 50%!

Make sure to check the app out and find out more about its features.

License for SC Telemedicine Practice

Even though many have been making a multiple-year effort to introduce certain laws that would make telemedicine in South Carolina defined more cohesively, there’s still no sign of them. In a way, this is fantastic news for all healthcare workers who wish to tackle telemedicine because you don’t need a separate license for it as of yet.

Laws may change, but it looks like a long shot if we take the current state of things into consideration. This is one of the reasons why you should get into telemedicine as soon as possible—certain regulations might be imposed in the future that may give you a harder time to join the field.

South Carolina Medicaid Reimbursement

Since store-and-forward doesn’t meet the established conditions for telemedicine in South Carolina, it is not reimbursed. There are certain circumstances in which live video is reimbursed by South Carolina Medicaid:

• If medical care can be proceeded with safely
• If the given medical care is individualized and specific to the patient’s diagnosis, symptoms, or treatment

The only thing South Carolina Medicaid reimburses for is home health monitoring, though only through the Home Aging Program. Even under that circumstance, the reimbursement only applies to particular conditions if the patient is eligible.

Following that example, there is no reimbursement for:

• FAX
• Email
• Telephone
• Cell phone video interactions

Since electronic visual encounters through platforms such as Skype aren’t considered face-to-face contact, it is reimbursed at the T1016 MTCM encounter rates. This only applies to targeted case management, though.

You should know that certain private insurance companies in South Carolina will reimburse telemedicine services, though. Patients should double-check this with their insurance companies, just to make sure.

Telepsychiatry in South Carolina is eligible for reimbursement if:

• The client is present in real-time
• GT modifier is used for billing the client for telepsychiatric services
• The communication transfer rate of all of your equipment must be at least 384 kbps

Medicaid reimbursement in South Carolina is not available for certain MH services, such as injectables, CI Individual Family, NS, Mental Health Assessment by non-physicians and SPD, Group and Multiple FP, and psychological testing that requires in-person encounters. 

Establishing a Doctor-Patient Relationship

Although health care workers don’t need to establish a doctor-patient relationship in-person, it is necessary that they do it remotely in case of telemedicine usage. To achieve that successfully, this is what is required of you to do:

1. Be licensed in South Carolina
2. Verify your patient’s identity and location
3. Tell them your full name, professional credentials, and where you’re located
4. Be compliant with all the applicable state and federal laws
5. Evaluate your patient properly before diagnosing and treating them
6. Ensure availability for follow-up care
7. Maintain your patients’ records or create them if there are no pre-existing ones
8. Give a diagnosis that’s approved by accepted medical practices that may include mental status, patient history, and laboratory and diagnostic testing
9. Talk about the value of having a primary care medical home with your patient
10. Prescribe controlled substances only in compliance with all applicable federal and state laws

South Carolina Medicaid Eligible Sites

Not all originating sites in South Carolina are eligible for telemedicine practices. All of those that are eligible, however, need to be located within the South Carolina Medical Service Area, which also includes NC and GA within a 25-mile long distance from the border itself.

If you want to know which originating sites are eligible for telemedicine practices, take a look at this list:

1. Public schools
2. Rural health clinics
3. Community mental health centers
4. Hospitals (outpatient and inpatient)
5. Practitioner offices
6. Behavioral health centers (Act 301)

South Carolina Telemedicine Facility Fee

Originating sites are going to receive facility fees only for services related to telemedicine. In the Physicians Provider Manual, p. 221 (Feb. 2020) (July 2019). (Accessed Feb. 2020), you can find some information on performing two separate services on the same day, stating that ‘if a provider from the referring site performs a separately identifiable service for the beneficiary on the same day as telemedicine, documentation for both services must be clearly and separately identified in the beneficiary’s medical record, and both services are eligible for full reimbursement.’

When operating as a referring site, hospitals that serve as providers are eligible to receive facility fees in case they practice telemedicine.

South Carolina Remote Patient Monitoring Policy

To be allowed to monitor patients remotely, healthcare workers need to make sure that they know which telemonitoring requirements they need to fulfill. If you want to practice telemonitoring, appropriate equipment needs to check on these things regularly:

• Oxygen saturation
• Bodyweight
• Blood glucose levels
• Blood pressure
• Heart rate information

You need to pay attention to the following services::

1. Telemonitoring all week round
2. Send recorded patient data electronically—transmission costs need to be covered by the provider of telemonitoring services
3. The unit of service is one day of full telemonitoring of the patient in their house

The daily reimbursement rate includes charting data from monthly recordings, patient calls, and visits that serve as follow-ups, monitoring of data, phone calls that patients make to primary care during the telemonitoring services, equipment installation and removal, and training the patient to use it properly.

To participate, patients need to have at least one of the following illnesses and must meet the listed conditions:

• Having Hypertension, Insulin-Dependent Diabetes Mellitus, Congestive Heart Failure, or Chronic Obstructive Pulmonary Disease
• Visiting the emergency room and/or being hospitalized at least twice within the previous 12 months
• Being capable of using telemonitoring equipment, as well as taking care of it
• Being capable of transmitting data or having someone else do it in their stead
• Having a primary care physician who approves of the telemonitoring services and who’s responsible for acting upon the patient’s recorded data

Medicaid Consent in South Carolina

For the dissemination of patient’s information to any other entities, the patient needs to submit written consent. They are allowed to withdraw that consent at any time if they no longer want to use telemedicine.

If a child uses telemedicine, their parent or guardian needs to be present during the telemedicine session.

South Carolina Cross-State Licensing

As we’ve already mentioned, practitioners who wish to take part in telemedicine don’t need to get a separate license for it. What they do need, though, is to be licensed within the state of South Carolina, but they don’t need to reside there to practice telemedicine.

Why You Should Choose Curogram for a Successful Start in Telemedicine

Curogram is a one-of-a-kind text messaging platform intended for medical practices that can help you have an easy start in telemedicine in South Carolina. Using our app will give you countless benefits, both in the short and long run. As soon as you start using it, you will notice how the app makes a difference in the way you approach your work.

If you’re curious to find out more about Curogram, check out some of its main advantages:

Certified EHRs are of great relevance—they ensure protection against any risk. Knowing that we’ve integrated our platform with any EHR! If you’re curious to see which EHRs Curogram integrates with, check out some of these:

Register for a free demo to discover the benefits of using Curogram!

Telemedicine by State

Don’t see your state? We just haven’t written about it yet! Stay tuned on our blog or check out our article on telemedicine reimbursement by state.