South Carolina
PMHNP Practice Requirements In South Carolina: Scope, Prescribing & Collaboration
Short answer: AANP lists South Carolina as restricted practice, so a PMHNP performs medical acts under a written practice agreement with a physician who is readily available for consultation, reviewed, dated and signed at least once a year (S.C. Code § 40-33-34). Schedule II through V must be designated in that agreement, with Schedule II nonnarcotics limited to a 30 day supply and Schedule II narcotics to five days outside hospice, palliative and long term care.
South Carolina PMHNP Rules At A Glance
| Topic | South Carolina Rule |
|---|---|
| Practice authority | Restricted practice on the AANP map. Medical acts performed by a nurse practitioner, including prescribing, must be performed pursuant to a practice agreement with a physician or medical staff (S.C. Code § 40-33-34). |
| Physician agreement | Written practice agreement with a physician who is readily available for consultation, reviewed at least annually, dated and signed by nurse and physician; a licensed NP must provide evidence of it (§ 40-33-34). |
| Physician limit | A physician may not hold practice agreements with more than six full time equivalent PAs, NPs, CNMs or CNSs combined, nor work with more than six at one time, unless the Board of Medical Examiners approves an exception (§ 40-47-195(D)(1)(c)). |
| Controlled substances | Schedule II through V only when designated in the practice agreement. Schedule II nonnarcotics: no more than a 30 day supply. Schedule II narcotics: five day supply, or 30 days in hospice, palliative or long term care (§ 40-33-34). |
| PDMP | Review SCRIPTS before issuing any Schedule II prescription. Exemptions: hospice patients, five day or shorter supplies, and established chronic condition patients, whose history you still check at least every three months (§ 44-53-1645). |
| Regulator | South Carolina Board of Nursing, Department of Labor, Licensing and Regulation, licenses APRNs and prescriptive authority; the Board of Medical Examiners enforces the physician side, including the six FTE cap (§ 40-47-195). |
Updated October 5, 2026
Practice Authority
South Carolina Practice-Authority Category (Restricted Practice)
The American Association of Nurse Practitioners (AANP) currently classifies South Carolina as a restricted practice state. In practice, a PMHNP in South Carolina can’t practice fully independent of a physician relationship and generally needs career-long supervision, delegation or a collaborative agreement for at least one element of practice.
Collaboration
Is A Collaborative Or Supervisory Agreement Required?
South Carolina generally requires supervision by, delegation from, or a collaborative agreement with a physician before an NP provides the full scope of care. State rule sets what any agreement must contain, how it’s documented and how often it’s reviewed.
Prescriptive Authority
Prescriptive Authority And Controlled Substances
South Carolina NPs who meet the state’s requirements can be granted prescriptive authority, and it can extend to controlled substances once the conditions are met. You’ll also need a separate federal DEA registration to prescribe them, and some substances carry additional conditions. State law and board rule set the specific scope and documentation, and the U.S. Drug Enforcement Administration covers the federal side.
Next Step
Credentialing Is A Separate Track
Scope of practice is only half of it. Getting paid by insurance in South Carolina means credentialing, and that track has its own payer rules, Medicaid program and enrollment timelines. Our South Carolina credentialing and payer enrollment page walks through it, and the PMHNP credentialing guide covers the national side.
Planning to open on your own? Our guide on how to start a PMHNP practice lays out licensure, collaboration and enrollment step by step. Know your numbers first, beginning with what PMHNP credentialing costs and what it costs to start a PMHNP practice.
If you’d rather hand us the work, First Practice Launch sets up a first practice’s payers, EHR, portals and billing for $6,000, or four monthly payments of $1,500. Joining a clinic instead? New Provider Credentialing covers five commercial payers for $2,750 per provider, and you can start with one payer.
FAQ
Frequently Asked Questions
Can A PMHNP Practice Independently In South Carolina?
No. Every medical act a nurse practitioner performs, prescribing included, has to run under a practice agreement with a physician or medical staff, and the agreement has to be reviewed, dated and signed at least once a year (S.C. Code § 40-33-34). There’s no hours based exit from the agreement, which is why AANP places South Carolina in the restricted group.
Can A PMHNP Prescribe Adderall In South Carolina?
Yes, if your practice agreement designates Schedule II prescribing. Stimulants are Schedule II nonnarcotics, so each prescription is limited to a 30 day supply (§ 40-33-34); the five day cap applies to Schedule II narcotics. You or your delegate must review the patient’s SCRIPTS history before each Schedule II prescription unless an exemption such as a five day supply or an established chronic condition relationship with a three month recheck applies (§ 44-53-1645).
How Many Nurse Practitioners Can A Physician Supervise In South Carolina?
Yes, there is a cap of six. A physician may not enter into practice agreements or scope of practice guidelines with more than the equivalent of six full time PAs, NPs, CNMs or CNSs combined, and may not work with more than six such clinicians at any one time (§ 40-47-195(D)(1)(c)). The Board of Medical Examiners can approve an exception if it finds quality of care and patient safety will be maintained.
This is general information, not legal advice. It applies the general nurse practitioner rules in South Carolina to PMHNPs. Rules change, so check with the South Carolina Board of Nursing and the AANP State Practice Environment map before you act on it. Last reviewed: September 26, 2026.
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