State Telemedicine Policy Information
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South Carolina Telemedicine Policy
South Carolina Telemedicine Policy
Although there is no telehealth parity law yet in South Carolina, the Palmetto State is a pioneer in other areas, bringing the benefits of telemedicine to a growing number of patients.
South Carolina developed a statewide telepsychiatry network for all hospital emergency departments, which has collectively had the effect of increased quality, better triage, assessment and initial treatment of patients. The network also allows hospitals to direct critical personnel and financial resources to more pressing needs, helping hospitals realize significant savings.
State Policy Overview
Additional State Telemedicine Info
A telemedicine parity law requires private payers to reimburse telemedicine services in the same way as in-person services. There is not yet a telemedicine parity law in South Carolina despite a multi-year effort to introduce legislation regarding coverage under private insurance. However, some private insurance companies will still reimburse telehealth.
South Carolina’s Medicaid will reimburse for live telemedicine and telepsychiatry.
Type Of Telemedicine Covered
South Carolina Medicaid will reimburse for live telemedicine and telepsychiatry. The program also allows some reimbursement of remote patient monitoring through the Medicaid Home Again Program for Community Long-Term Care. This program transitions residents of nursing care facilities into their own homes.
Covered Health Services
South Carolina Medicaid covers the following health care services when offered via telehealth:
- Office or other outpatient visits
- Inpatient consultation
- Individual psychotherapy
- Pharmacologic management
- Psychiatric diagnostic interview examination and testing
- Neurobehavioral status examination
- Electrocardiogram interpretation and report only
Remote patient monitoring services are covered through the Medicaid Home Again Program for Community Long Term Care, for:
- Body weight
- Blood pressure
- Oxygen saturation
- Blood glucose levels
- basic heart rate
Eligible Healthcare Providers
Under South Carolina Medicaid, the following healthcare providers can practice telemedicine:
- Nurse Practitioners
- Physician Assistants
South Carolina law states that healthcare providers must have a relationship with the patient in order to prescribe medications via telehealth. Luckily, the law also allows the physician to establish that relationship through telehealth when the following steps are met:
- Comply with HIPAA
- Adhere to current standards of practice
- Provide an appropriate examination
- Verify the identity and location of the patient
- Establish a diagnosis through the use of accepted medical practices
- Ensure the availability of follow-up care
- Prescribe within a practice setting fully in compliance with the law
Physicians are not permitted to prescribe Schedule II or III prescriptions based on a telemedicine encounter.
Informed Patient Consent
No consent requirements are stated or have been written into law.
Cross-State Telemedicine Licensing
The physician must be licensed in South Carolina to practice telemedicine. However, South Carolina has just introduced legislation to join the Interstate Medical Licensure Compact, which facilitates the licensing process for out-of-state physicians.
Restrictions On Locations
Unfortunately South Carolina Medicaid does place some restrictions on the patient’s location for telehealth services. To receive care via telehealth, the patient needs to go to an eligible originating site:
- Practitioner offices
- Hospitals (inpatient and outpatient)
- Rural Health Clinics
- Federally Qualified Health Centers
- Community Mental Health Centers
- Public Schools
- Act 301 Behavioral Health Centers
The telehealth provider needs to be located within the South Carolina Medical Service Area, which includes areas in North Carolina and Georgia that are within 25 miles of the South Carolina border.
Wondering how to bill for telemedicine services through South Carolina Medicaid? Luckily, the Medicaid Provider Manual gives you full instructions. Simply use the appropriate CPT code along with the Telemedicine modifier, GT. You will be reimbursed at the same rate as the in-person service.
Here is a list of the eligible CPT codes:
- Office or other outpatient visits (CPT codes 99201 – 99215)
- Inpatient consultation (CPT codes 99251-99255)
- Individual Psychotherapy (CPT codes 90832-90838)
- Psychiatric diagnostic interview examination (CPT code 90791
- Neurobehavioral status examination (CPT code 96116)
- Electrocardiogram interpretation and report only (CPT code
- Echocardiography (CPT code 93307, 93308, 93320, 93321, and