PMHNP Practice Authority in South Carolina: Independence, Physician Agreements and Schedule II
South Carolina licenses psychiatric nurse practitioners as advanced practice registered nurses through the Board of Nursing, but performing medical acts requires a practice agreement with a physician who must be readily available for consultation — for the whole career, with no hours or years route out.
AANP classes South Carolina as restricted.
The prescribing facts that matter most: Schedule II non-narcotics, including ADHD stimulants, may be prescribed only if listed in the practice agreement, at a 30-day supply cap per prescription, while Schedule II narcotics are capped at five days.
Verify before you rely on this
At a glance
Advanced Practice Registered Nurse (APRN).
The APRN categories are nurse practitioner, certified nurse-midwife, clinical nurse specialist and certified registered nurse anesthetist (§ 40-33-20(5)).
The South Carolina Board of Nursing, administered under the South Carolina Department of Labor, Licensing and Regulation (SC LLR).
Restricted, per AANP's State Practice Environment map (updated 05/2026).
AANP's label, not a legal category.
None: § 40-33-34 has no provision for practising without a practice agreement, so the agreement is career-long.
A practice agreement with a physician who must be readily available for consultation: at most the equivalent of six full-time PAs, NPs, CNMs, or CNSs per physician (board exceptions possible), annual review, and board audits at least biennially.
The agreed medical acts must fall within the physician's usual practice and training or experience, unless the board approves an exception.
Non-narcotic Schedule II substances (the ADHD stimulants): only if listed in the practice agreement, and each prescription must not exceed a thirty-day supply.
Narcotic Schedule II: a five-day supply cap, with hospice, palliative-care and long-term-care exceptions.
May be prescribed if listed in the practice agreement and as authorized by Section 44-53-300.
The statute sets no day-supply cap for Schedules III through V.
Not enacted in South Carolina.
The compact is not in effect anywhere: it needs seven states and five had enacted it as of September 2026.
The South Carolina credential ladder
- Advanced practice registered nurse (nurse practitioner)(APRN)Other
The licence the South Carolina Board of Nursing issues (S.C. Code ch. 40-33).
Performing medical acts is not part of the licence alone: a nurse practitioner who performs medical acts must do so pursuant to a practice agreement with a physician (§ 40-33-20(5), (40); § 40-33-34(C)).
- APRN with prescriptive authority under a practice agreementOther
The PMHNP's practising status for the whole career: prescriptive authorization (issued with a board identification number) is valid for two years unless terminated for cause, the initial authorization expiring with the APRN licence, and prescribing runs through the practice agreement — Schedules III to V as listed, Schedule II non-narcotics capped at a thirty-day supply per prescription, Schedule II narcotics at five days (§ 40-33-34(E)(2), (F)(1)).
Restricted: medical acts run through a career-long practice agreement
AANP's May 2026 map puts South Carolina in its restricted tier.
The label is AANP's advocacy classification; the legal fact behind it is § 40-33-34(C): a licensed NP performing medical acts must do so pursuant to a practice agreement with a physician who must be readily available for consultation.
The same subsection carries a requirement a job description may not mention: the NP must spend a portion of time practising in an underserved or rural area or serving an underserved population, and the statute's definition of underserved population reaches Medicaid and Medicare patients, residents of long-term care settings and institutions, and the uninsured.
For what AANP’s full, reduced and restricted tiers mean, see can a PMHNP practice independently?
“A licensed NP, CNM, or CNS performing medical acts must do so pursuant to a practice agreement with a physician who must be readily available for consultation.”
No transition-to-practice route
South Carolina has no hours or years threshold after which an NP stops needing a practice agreement: § 40-33-34 contains no provision for practising without one, so the agreement is career-long.
A new graduate and an NP with twenty years in practice work under the same structure.
The one timing rule that resembles a transition is not one: a new graduate must provide evidence of specialty certification within one year of program completion, which is a licensure condition, not a step toward independence.
The practice agreement: contents, a six-practitioner ratio, annual review
The agreement must set the medical aspects of care: the medical conditions for which therapies may be initiated, continued or modified, the treatments, the prescribable drug therapies, and situations requiring direct physician evaluation or referral.
The physician may not sign an agreement with an NP performing a medical act, task, or function outside the physician's usual practice, training, or experience, unless the board approves an exception.
It must be reviewed at least annually, dated and signed by both, and produced to the board within seventy-two hours of request; the board audits agreements at random at least biennially; practice-setting or physician changes must be reported within fifteen business days.
One physician may hold agreements with at most the equivalent of six full-time PAs, NPs, CNMs, or CNSs combined, counting supervised PAs, though the board may approve an exception on application.
Proximity: § 40-47-195(C)(3) requires prior board approval when a supervising physician is not at the supervised practitioner's site (2018 Act 234 replaced the 45-mile rule), but it is written for supervision and protocols, not practice agreements — confirm with the board.
For who signs these agreements and what they cost, see PMHNP collaborative practice agreements.
“not enter into scope of practice guidelines or practice agreements with more than the equivalent of six full-time PAs, NPs, CNMs, or CNSs and must not practice in a situation in which the number of NPs, CNMs, or CNSs providing clinical services with whom the physician is working, combined with the number of PAs providing clinical services whom the physician is supervising, is greater than six individuals at any one time”
Schedule II: stimulants at a 30-day cap, narcotics at five days
Prescriptive authority requires 45 pharmacotherapeutics contact hours, 15 of them in controlled substances if the NP initially applies to prescribe Schedules II through V, plus a board prescriber identification number.
It runs two years unless terminated for cause; the initial authorization expires with the APRN licence.
Renewal takes 20 pharmacotherapeutics continuing-education hours every two years, two on controlled substances for an NP with controlled-substance authority.
Schedule II non-narcotics — ADHD stimulants — may be prescribed if listed in the practice agreement, each prescription capped at a thirty-day supply, so an outpatient PMHNP can prescribe them.
Schedule II narcotics are capped at five days, and no second prescription without the physician's written agreement, unless the patient is in hospice, palliative care, or a long-term care facility, where the cap is thirty days.
In a solely-telemedicine relationship, Schedule II through V prescriptions are only permitted pursuant to a practice agreement, and drugs restricted by the unread § 40-47-37(C)(6) need joint committee approval.
The § 44-53-300 registration is referenced; the administering agency was not captured in the sources read.
For the federal DEA rules on prescribing controlled substances by telehealth, see prescribing controlled substances by telehealth.
“(d) may include Schedule II nonnarcotic substances if listed in the practice agreement and as authorized by Section 44-53-300, provided, however, that each such prescription must not exceed a thirty-day supply”
The DEA registration does not widen the South Carolina limits
A PMHNP registers with the DEA as a mid-level practitioner, and that registration covers only what South Carolina lets the NP prescribe.
A DEA form listing Schedules II through V does not override the practice-agreement conditions or the 30-day and five-day Schedule II caps.
Telehealth is the same: the DEA and HHS telemedicine flexibilities, extended through December 31, 2026, remove the federal in-person visit requirement, but they lift no state limit.
For a nurse-patient relationship established solely by telemedicine, § 40-33-34(I)(5) permits Schedule II through V prescriptions only pursuant to a practice agreement, and drugs restricted by the unread § 40-47-37(C)(6) need a joint committee of the Board of Medical Examiners and the Board of Nursing to approve them.
For how an FNP moves into psychiatric practice, see FNP to PMHNP.
APRN Compact: not in South Carolina, and not in effect anywhere
South Carolina has not enacted the APRN Compact.
The compact takes effect only once seven states enact it, and as of September 2026 five had (Delaware, North Dakota, South Dakota, Utah and Wyoming), so no APRN holds a multistate APRN licence today.
The Nurse Licensure Compact is an RN compact and gives no nurse practitioner authority in another state.
To practise as a PMHNP in South Carolina you need a South Carolina APRN licence, a practice agreement and the board's prescriptive authorization.
2024 telemedicine wording; the Schedule II caps date to 2018–2019
2024 Act No. 120 (H.4159), effective March 11, 2024, amended the telemedicine subsection only, adding telehealth and confirming that an APRN performing medical acts via telemedicine under a practice agreement need not be licensed to practise medicine.
No 2024 change to the Schedule II caps was found: the section's current controlled-substance wording comes from the 2018 Act 234 rewrite, and 2019 Act 87 added the long-term-care exception to the narcotics provisions.
Check the General Assembly before assuming nothing has moved since.
What This Page Does — and Doesn’t — Cover
This page summarizes the South Carolina statute, rules, board pages and other documents cited above, as read for this state-by-state PMHNP practice authority series, current as of September 2026.
It does not list application forms, fees beyond those cited above, or processing times, and it is not a substitute for the instructions the South Carolina Board of Nursing publishes.
Hour totals, exams and supervision rules change by statute and by board rule; for how the PMHNP and psychiatrist roles compare, see PMHNP vs psychiatrist.
Confirm every requirement with the South Carolina Board of Nursing before you count hours, register for an exam or apply — and before you take one of the psychiatric nurse practitioner jobs in South Carolina that asks for it.
What Psychiatric Nurse Practitioner Job Listings in South Carolina Show Right Now
From the 14 active psychiatric nurse practitioner listings on BehavioralHires as of October 29, 2026.
Employers with the most openings
Pay employers post
- 7% of psychiatric nurse practitioner listings in South Carolina state any pay at all.
Benefits and work arrangement
- 36% remote or telehealth and 64% hybrid; the rest are on-site
- 401k Matchnamed in 93%
- Continuing Education Budgetnamed in 79%
Source: active psychiatric nurse practitioner listings on BehavioralHires, updated daily. Pay figures use only listings that state pay (midpoint of each posted range). Benefits count listings that name the benefit; a listing that doesn’t mention one may still offer it.
Browse 14 jobs →Frequently Asked Questions
Can a PMHNP practice independently in South Carolina?
No. A licensed nurse practitioner performing medical acts must do so under a practice agreement with a physician who is readily available for consultation, and § 40-33-34 provides no hours or years route out of it.
The agreement lasts the whole career, with an annual review and a six-practitioner ratio per physician.
AANP classes South Carolina as restricted.
Confirm current requirements with the South Carolina Board of Nursing.
Can a psychiatric nurse practitioner prescribe ADHD stimulants in South Carolina?
Yes, on conditions.
Schedule II non-narcotic substances, the class ADHD stimulants fall in, may be prescribed if they are listed in the practice agreement, and each prescription must not exceed a thirty-day supply.
Schedule II narcotics are separate: a five-day supply cap, with hospice, palliative-care and long-term-care exceptions.
Confirm the drugs you need are listed in your practice agreement with the South Carolina Board of Nursing.
How many NPs can one South Carolina physician have a practice agreement with?
At most the equivalent of six full-time practitioners combined: the cap counts the NPs, CNMs and CNSs the physician works with plus the PAs the physician supervises, at no more than six individuals at any one time.
The board may approve an exception on the physician's application if it determines an exception is warranted and quality of care and patient safety will be maintained.
Can a South Carolina PMHNP prescribe controlled substances by telehealth?
Only within the statute's own conditions. § 40-33-34(I) covers nurse-patient relationships established solely by telemedicine: prescribing is allowed only in a practice setting fully compliant with the chapter, and Schedule II through V prescriptions are only permitted pursuant to a practice agreement — a necessary condition, not an authorization in itself.
An APRN may not establish a telemedicine relationship for the purpose of prescribing when an in-person physical examination is necessary for diagnosis.
Drugs restricted by § 40-47-37(C)(6), a section the sources did not include, need approval by a joint committee of the two boards.
Confirm with the board.
More South Carolina & Psychiatric Nurse Practitioner Resources
Sources
- S.C. Code ch. 40-33, Nurses (Nurse Practice Act) — scstatehouse.gov (retrieved 2026-09-24)
- S.C. Code § 40-47-195, Supervising physicians; scope of practice guidelines — scstatehouse.gov (retrieved 2026-09-24)
- AANP, State Practice Environment (updated 05/2026) (retrieved 2026-09-24)
- DEA/HHS, Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities (90 FR 61301) (retrieved 2026-09-24)
Sourced from the statute, rules, board pages and other documents cited above.
Verified September 2026.
This is career information, not legal or clinical advice — confirm current rules with the South Carolina Board of Nursing.