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SC · STATE RULES

Telehealth rules in South Carolina

South Carolina put its telemedicine rules in the Medical Practice Act rather than leaving them to a board policy, and the statute is blunt about what a remote prescriber may not do. Two narcotic schedules are closed off outside a short list of settings, every controlled prescription in Schedules II through V has to reach the pharmacy electronically, and the physician has to raise the subject of a primary care medical home with the patient. The physician compact is not on offer.

Book a DemoAll states
First visit
Async with conditions
Physician license
Own license, no compact
Controlled drugs
No Sched. II-III narcotics
Nurse practitioners
Restricted practice

Rules checked September 2026 · 12 sources cited

ONLY IN SOUTH CAROLINA

What is different about South Carolina

Each rule here is true of South Carolina and of none of the states that border it. Beside each one: what the neighbours do instead.

  1. 01 · Prescribing

    Two narcotic schedules are closed

    S.C. Code 40-47-37 shuts a door rather than setting a condition. A licensee whose practice runs entirely through telemedicine may not write a Schedule II-narcotic or Schedule III-narcotic prescription unless the patient sits in a hospital, in a medication-assisted treatment program, in palliative or hospice care, or in a program the board has authorized.

    Source: S.C. Code 40-47-37

    Across the border

    • North Carolina

      No schedule is placed off limits by statute in North Carolina, and the Medical Board's only brake is a warning that pain treatment can be a poor fit for an encounter conducted entirely at a distance.

      Source: NCMB Position Statement 5.1.4, Telemedicine

    • Georgia

      Georgia draws its line by indication instead of by schedule, withholding any authority to prescribe controlled substances for pain or chronic pain by electronic means and routing that treatment to a separate board rule.

      Source: Ga. Comp. R. & Regs. 360-3-.07

  2. 02 · Practice

    The patient hears about a medical home

    A licensee practicing solely through telemedicine has to discuss with the patient the value of having a primary care medical home and, where the patient asks for it, help locate options. S.C. Code 40-47-37 lists that conversation as a duty, so it belongs in the visit and in the chart rather than in a clinician's discretion.

    Source: S.C. Code 40-47-37

    Across the border

  3. 03 · Licenses

    No fast lane for out-of-state doctors

    The compacts this state has joined cover nursing, counseling, psychology, physical therapy, occupational therapy, speech-language pathology, social work and emergency medical services. The physician compact is not among them, so a doctor who wants to treat someone located here files an ordinary application with the Board of Medical Examiners.

    Source: Center for Connected Health Policy: South Carolina

    Across the border

  4. 04 · Prescribing

    Paper is gone for controlled drugs

    S.C. Code 44-53-360(k) states that a practitioner shall electronically prescribe any controlled substance included in Schedules II, III, IV and V. The exceptions are situational rather than categorical: direct dispensing, institutional and hospital discharge orders, a temporary technology failure, prescriptions on federal property, veterinary use and emergencies.

    Source: S.C. Code 44-53-360

    Across the border

    • North Carolina

      A narrower list applies in North Carolina, where the duty covers targeted controlled substances plus certain Schedule V codeine preparations and leaves the remaining controlled drugs alone.

      Source: G.S. 90-106

    • Georgia

      Georgia compels nothing of the kind. Its statute permits a Schedule II order to travel electronically under pharmacy board rules while written and oral orders stay available for the lower schedules.

      Source: O.C.G.A. 16-13-41

PRACTICE RULES

How telehealth works in South Carolina

Chapter 47 of Title 40 carries both halves of the framework: a definition of telemedicine broad enough to cover any electronic link between a licensee in one place and a patient in another, and a list of duties that tightens once a physician's practice is remote from end to end.

  1. 01

    Licensed here, with two openings

    A licensee delivering care by telemedicine must hold this state's medical license. Two exceptions survive: an informal consultation or second opinion given at another physician's request, and ongoing specialty treatment that began in another state, provided the care is not episodic and does not stretch on without in-person visits.

    Source: S.C. Code 40-47-37

  2. 02

    Know who is on the other end

    Before treating, the licensee verifies both the identity and the location of the patient, then gives the patient the licensee's own name, location and professional credentials. Anonymity on either side of the screen is not an option the statute leaves open.

    Source: S.C. Code 40-47-37

  3. 03

    Records built to the federal floor

    Medical records for a telemedicine encounter are generated and kept in compliance with state and federal law, the federal privacy and health technology statutes included, and made available to the patient and to other treating clinicians in the ordinary way.

    Source: S.C. Code 40-47-37

  4. 04

    The heaviest duties attach to remote-only practice

    The longest list in the section applies to a licensee practicing solely through telemedicine, which describes a national direct-to-consumer brand exactly. Quality and outcome monitoring, follow-up availability and the medical home conversation all sit in that subsection.

    Source: S.C. Code 40-47-37

  5. 05

    Training on the tools counts

    The section expects a licensee to be trained on the telemedicine equipment in use, and it preserves the board's authority over telemedicine practice generally, so a discipline case can reach how a platform was operated as well as what was prescribed.

    Source: S.C. Code 40-47-37

FIRST VISIT

Can a first visit happen without a live call in South Carolina?

Yes, with conditions

Yes, with conditions. An evaluation need not happen in the same room where the licensee judges that an accurate diagnosis and treatment are possible, but the statute forbids opening a relationship at all when an in-person physical examination is necessary to reach the diagnosis.

The question turns on clinical judgment about the presentation rather than on the technology used to reach it. The statute permits a remote evaluation and then removes the option in the cases where hands are required, which puts the burden on triage rather than on modality.

  1. 01

    An evaluation comes before a diagnosis

    The licensee performs an appropriate evaluation before diagnosing or treating, and that evaluation need not be conducted in person where the licensee considers that an accurate diagnosis and treatment can be reached without one.

    Source: S.C. Code 40-47-37

  2. 02

    Some presentations are ruled out

    Where an in-person physical examination is necessary for diagnosis, the licensee is prohibited from establishing the relationship remotely. Intake that cannot sort those presentations out early will push visits into territory the statute has already closed.

    Source: S.C. Code 40-47-37

  3. 03

    Follow-up has to exist

    Appropriate follow-up care must be available to the patient, which makes continuity part of the entry decision rather than a question deferred to the end of the first visit.

    Source: S.C. Code 40-47-37

  4. 04

    The medical home question

    The value of a primary care medical home is discussed with the patient, and assistance in locating options follows if the patient requests it. A brand that positions itself as a replacement for primary care is arguing against a duty its own clinicians carry.

    Source: S.C. Code 40-47-37

PRESCRIBING

Prescriptions and controlled drugs in South Carolina

Three separate rules shape a remote prescription here: the telemedicine section's schedule ban, the controlled substances article's transmission mandate and its opioid ceiling, and the registration a prescriber holds before touching any of it.

  1. 01

    Narcotic schedules stay shut

    Schedule II-narcotic and Schedule III-narcotic prescriptions are not permitted through telemedicine outside the listed settings, so a remote-only practice treats them as unavailable rather than as available with paperwork.

    Source: S.C. Code 40-47-37

  2. 02

    Seven days to begin an opioid

    An initial opioid prescription for acute or postoperative pain may not exceed a seven-day supply. Cancer pain, chronic pain, hospice, palliative care, major trauma, major surgery, sickle cell disease, neonatal abstinence syndrome and medication-assisted treatment sit outside the ceiling when clinically indicated.

    Source: S.C. Code 44-53-360

  3. 03

    Every controlled order is electronic

    Because the transmission mandate covers all four controlled schedules rather than opioids alone, a prescribing integration here has to carry testosterone, stimulants and sedatives as well as pain medicine, with the statutory exceptions logged as exceptions.

    Source: S.C. Code 44-53-360

  4. 04

    A state registration sits under the federal one

    Anyone who manufactures, distributes or dispenses a controlled substance registers with the state department, and a licensee who prescribes controlled substances through telemedicine holds that registration alongside the federal one.

    Source: S.C. Code 44-53-290

  5. 05

    One drug class is excluded outright

    The telemedicine section separately bars prescribing abortion-inducing drugs through telemedicine, which is a categorical exclusion rather than a condition, and it sits independently of the schedule limits above.

    Source: S.C. Code 40-47-37

Federal rules apply on top of every state's. Prescribing controlled substances by telehealth without an in-person visit runs on DEA flexibilities currently extended through December 31, 2026, with a permanent rule still pending.

LICENSES

Who can treat patients in South Carolina

Physicians answer to the Board of Medical Examiners under the Department of Labor, Licensing and Regulation. The behavioral professions have a shortcut into the state that medicine does not.

  1. 01

    A full application, every time

    With no physician compact available, a clinician treating someone located here works from a license this board issued. There is no expedited multistate pathway and no telemedicine-only credential for doctors.

    Source: Center for Connected Health Policy: South Carolina

  2. 02

    Counselors and social workers register instead

    Out-of-state social workers and behavioral health professionals may register to serve clients located here for a $10 fee, provided they hold an active license elsewhere and carry no recent discipline. The register covers behavioral telehealth and reaches no further.

    Source: Center for Connected Health Policy: South Carolina

  3. 03

    Forty hours, and prescribing is optional

    Renewal of an active permanent license needs forty Category I hours of continuing medical education every two years, thirty of them tied directly to the licensee's own practice area. Up to two hours may cover approved procedures for prescribing and monitoring controlled substances, which leaves the subject elective.

    Source: S.C. Code 40-47-40

  4. 04

    Nurse practitioners work to a written agreement

    On the American Association of Nurse Practitioners map this is a restricted state, and the practice agreement is where an advanced practice nurse's prescribing authority is actually written down, including which Schedule II drugs may be ordered and for how many days.

    Source: S.C. Code 40-33-34

How Tessic Health's providers are licensed in South Carolina

ADVERTISING

Marketing to patients in South Carolina

There is no comprehensive consumer privacy act here, so marketing answers to the Unfair Trade Practices Act and to the disclosure duties the telemedicine section already imposes on the clinical encounter.

  1. 01

    Triple damages need a finding first

    The Unfair Trade Practices Act makes unfair or deceptive acts in trade unlawful, and a court may treble a consumer's actual damages only after finding that the violation was willful or knowing. That finding, not the deception itself, is what raises the exposure.

    Source: S.C. Code 39-5-140

  2. 02

    The storefront cannot hide the clinician

    Because the treating licensee has to give the patient a name, a location and professional credentials, a brand that presents care as coming from the company rather than from a named clinician is designing against a statutory duty.

    Source: S.C. Code 40-47-37

  3. 03

    Do not advertise a closed door

    Marketing that suggests a remote route to a Schedule II-narcotic or Schedule III-narcotic prescription describes something the statute withholds from remote-only practice, and the claim would be measured against the clinician's license as well as the consumer statute.

    Source: S.C. Code 40-47-37

  4. 04

    The medical home talk is not an upsell

    The conversation about a primary care medical home is part of the regulated encounter, so it belongs in the clinical flow rather than in a retention screen, and it should not be reframed as a reason to buy a longer subscription.

    Source: S.C. Code 40-47-37

TESSIC HEALTH IN SOUTH CAROLINA

How Tessic Health's providers cover South Carolina

Because the statute's heaviest duties attach precisely to a practice that runs entirely through telemedicine, the product here is built around the remote-only subsection rather than around the general telehealth definition.

  1. 01

    Triage before the prescription

    Intake for a patient located here is written to identify presentations that need a physical examination and to route them to local care, because the statute forbids opening the relationship remotely in exactly those cases.

  2. 02

    The medical home talk is recorded

    Each first encounter here captures the discussion about the value of a primary care medical home, and where the patient asks for help finding one, the assistance given is noted in the chart.

  3. 03

    Narcotic requests leave the platform

    No Schedule II-narcotic or Schedule III-narcotic prescription is written for a patient in this state through the remote practice, and a request for one is answered with a referral rather than with a workaround.

  4. 04

    Controlled orders move electronically

    Controlled prescriptions across all four schedules are transmitted electronically for patients here, and the prescriber holds the state registration next to the federal one before writing any of them.

  5. 05

    Dispensing and the price of the drug

    Medication for a patient in this state is dispensed at 0% markup by pharmacies permitted to ship into it, and anything that has to stay cold travels in cold-chain packaging.

COMMON QUESTIONS

Questions about telehealth in South Carolina

  • Usually yes. An evaluation need not be in person where the licensee judges an accurate diagnosis and treatment achievable, but the statute bars establishing the relationship at all when a physical examination is necessary for the diagnosis. That makes triage the deciding step.

  • Schedule II-narcotic and Schedule III-narcotic prescriptions are not permitted through telemedicine outside hospitals, medication-assisted treatment programs, palliative or hospice care, and board-authorized programs. Abortion-inducing drugs are separately excluded from telemedicine prescribing.

  • No. The state's compact memberships cover nursing, counseling, psychology, therapy, social work and emergency medical services, but not physicians. A doctor treating someone located here applies to the Board of Medical Examiners for a full license.

  • Yes, and the duty reaches Schedules II through V rather than opioids alone. The listed exceptions are situational, covering direct dispensing, institutional orders, a temporary technology failure, federal property, veterinary use and emergencies.

  • A licensee practicing solely through telemedicine discusses with the patient the value of having a primary care medical home and helps locate options when asked. It is a listed duty in the telemedicine section, so it is documented rather than left to judgment.

  • No. This is a restricted practice state, so an advanced practice nurse prescribes under a written practice agreement with a physician. That agreement sets which controlled substances may be ordered and the days of supply allowed for each.

SOURCES

Rules checked September 2026 · 12 sources cited. A planning summary, not legal advice. Statutes, board rules and enforcement priorities change; a brand's own counsel should review its model and marketing before launch.

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