Practice Agreement · NP
South Carolina Written Practice Agreement for Nurse Practitioners
Required. The Written Practice Agreement is the written instrument South Carolina law names for a Nurse Practitioner working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
SC removed the word 'supervision' from its Nurse Practice Act in 2018, but NPs still require a written practice agreement to practice or prescribe — no experience-based independence pathway exists today. A pending bill (S.45/H.3580) would create a 2,000-clinical-hour pathway to full practice authority; not yet law.
What a South Carolina Written Practice Agreement must contain
Governed by the South Carolina Board of Nursing and the South Carolina Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Nurse Practitioner shall perform medical acts only pursuant to a written practice agreement with the Physician, as required by S.C. Code § 40-33-34. The practice agreement shall state the names, addresses, and South Carolina license numbers of the Nurse Practitioner and the Physician; the nature of practice and practice location(s) of each; the dates the agreement was entered into and last reviewed or amended; how the Physician's consultation is provided; and the medical conditions for which the Nurse Practitioner may initiate or modify therapy, the treatments and drug therapies permitted, and the situations requiring the Physician's direct evaluation or referral.
The practice agreement shall be reviewed, dated, and signed by the Physician and the Nurse Practitioner at least annually, and shall be produced to the South Carolina Board of Nursing within seventy-two (72) hours of a request. The Physician must remain readily available to the Nurse Practitioner in person, by telecommunication, or by other electronic means.
- The Written Practice Agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- 2026 S.C. Act No. 166 (S.449), codified at S.C. Code §§ 40-43-245 and 40-47-205statute
Authorizes collaborative practice agreements between a South Carolina pharmacist and physician, effective May 18, 2026, but provides that such agreements may not be implemented until the South Carolina Board of Pharmacy and Board of Medical Examiners adopt implementing regulations.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
Available remotely (no on-site requirement)
§40-33-34: the collaborating physician must be 'readily available for consultation' and must practice within SC's geographic boundaries. No mile/minute radius or on-site standard is codified.
Supervision ratio
Up to 6 at a time (combined across provider types)
Same combined cap as `pa` — §40-47-195(D)(1)(c) counts NP, CNM, and CNS practice agreements together with PA scope-of-practice guidelines toward one physician's shared limit of 6.
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
§40-33-34: Schedule III–V if listed in the practice agreement; Schedule II nonnarcotic capped at a 30-day supply per prescription; Schedule II narcotic capped at a 5-day initial supply, with any further prescription requiring written physician agreement (exempt for hospice, palliative-care, or long-term-care patients). Requires 45 contact hours of pharmacotherapeutics education (15 on controlled substances if reciprocating from another state) and 20 CE hours every 2 years to renew (2 of which on controlled-substance prescribing).
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Corporation under Title 33, Chapter 19 for nursing services, or a physician-owned entity per SC's common-law CPOM doctrine (see `pa` entry).
Legal sources for these rules (3)
- S.C. Code § 40-33-34 — Performance of Medical Acts; Qualifications; Practice Agreements; Prescriptive Authorization; Anesthesia Care; Definitionssecondary
- S.C. Code § 40-47-195 — Supervising Physicians; Scope of Practice Guidelines (combined 6-provider cap)
- 2025-2026 S.C. Bill S.45/H.3580 — proposed APRN full-practice-authority pathway (pending, not enacted)
About South Carolina's rules
A physician may not hold practice agreements/scope-of-practice guidelines with more than a COMBINED 6 full-time-equivalent PA+NP+CNM+CNS at once (§40-47-195(D)(1)(c)) — a single shared cap, not four separate ones. A widely-repeated '3 PA' cap was repealed in 2019 (Act 32). SC remains restricted-practice for APRNs; a 2,000-hour full-practice-authority bill (S.45/H.3580) is pending, not yet law.
Other clinicians in South Carolina: see the state overview.