South Carolina Telemedicine Policy

Telemedicine in South Carolina : Policies

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.

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 Drugs2015 Advisory Opinion on Telemedicine, and South Carolina Code §40-47-113.

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 Telemedicine Medicaid Policy

South Carolina Medicaid reimburses for live video under certain circumstances. Store-and-forward is not reimbursed as it does not meet established conditions for the use of telemedicine. South Carolina Medicaid reimburses for home health monitoring through the Home Aging Program for some conditions when a patient is eligible.

Consent is required in order to disseminate information or images obtained from telemedicine, to other entities. See Pg. 38 of the Medicaid Providers Manual

South Carolina Medicaid reimburses for live video telemedicine and telepsychiatry services. See Pg. 34-38 of the Medicaid Providers Manual

South Carolina Medicaid will not reimburse for store and forward, as it is not “real-time interactive communication”.See Pg. 34 of the Medicaid Providers Manual

South Carolina Telemedicine CPT Codes

Unique CPT codes do not exist specifically for telemedicine or telehealth. Instead a modifier is applied to existing codes.

  • For interactive audio and video sessions, place a GT modifier in front of the CPT codes you typically use for in person services.
  • For services provided via an asynchronous telecommunication system, simply add a GQ modifier in front of the CPT codes you typically use for in person services.

South Carolina Telehealth Parity

Parity does not currently exist.  In addition, it does not appear to be a priority for the state legislature as there are no related bills proposed.

 

 

State Policy Overview

  • Medicaid
  • Private Payers
  • Parity