Telehealth and telesupervision for ABA in South Carolina

No state license was found.

We could not verify this yet - check with the state licensing board.

We could not verify this yet - check with the state licensing board.

We could not verify this yet - check with the state licensing board.

As of 2026-10-21: the SC LLR counselor board page lists only Addiction Counselor, Marriage & Family Therapist, Professional Counselor, Psycho-Educational Specialist and Behavioral Telehealth Registration - no behavior analyst license category is listed there. The BACB's U.S. licensure table of states that currently require licensure does not list South Carolina. The cited official pages do not expressly state that no South Carolina behavior-analyst license is required, so the 'no state license required' conclusion is an inference from these sources; the South Carolina Association for Behavior Analysis (SCABA) states there are 'no laws prohibiting the practice of ABA or the use of the title "behavior analyst"', which supports that inference but is not a current regulatory determination. SC Senate Bill 630 (2021-2022 session), which proposed behavior analyst licensure, was last shown on the legislature website as residing in the Senate Committee on Labor, Commerce and Industry; it is an unpassed 2021-2022 proposal, not an active 2026 bill. Medicaid enrollment as an ABA analyst provider requires BACB certification (BCBA/BCaBA); licensed independent practitioners (LIPs) are a separate enrollment category.

We could not verify this yet - check with the state Medicaid agency or licensing board.

Controlling policy is the SCDHHS Autism Spectrum Disorder (ASD) Services Provider Manual dated July 1, 2026, adopted by Medicaid Bulletins 26-015 (May 15, 2026) and 26-021 (June 26, 2026). Authorizations approved before July 1, 2026, continue under the policy in effect at authorization; initial or continuing requests submitted on or after July 1, 2026, must meet the new manual. Managed-care organizations administer authorizations, coverage, and payment for their members. Covered population is Healthy Connections members under 21 under EPSDT. Telehealth is a mode of delivery, not an added benefit, and only synchronous HIPAA-compliant audio and video is payable unless a code says otherwise. Asynchronous telehealth is non-covered for ASD services. The GT modifier is required whether or not a telehealth place-of-service code is used, and it is the secondary modifier when another modifier is primary. Place-of-service 02 (telehealth, patient not at home) and 10 (telehealth in the patient's home) are the telehealth locations. Authorized ABA telehealth is for established patients only, where the manual indicates it, and is an adjunct. It cannot be the only or primary mode in place of in-person services. The member must be at a referring site inside the South Carolina Medicaid Service Area (SCMSA): the office of a physician, licensed independent practitioner, BCBA-D, BCBA, or BCaBA; a school; or the patient's home. S.C. Code Regs. 126-300 defines the SCMSA as South Carolina and adjacent areas within 25 miles of the border. The member must participate. A parent or guardian must present a minor under 18 unless law exempts that requirement; the parent need not stay unless therapeutically appropriate. The on-site presenter requirement is waived when the referring site is the home. Consent must be in the record, and the member may withdraw at any time. Distant-site ABA practitioners qualified for telehealth are enrolled BCBA-Ds, BCBAs, and BCaBAs. Enrolled ABA providers must be located in the SCMSA. Code rules: 97151 Behavior Identification Assessment is in person with the member and caregiver by a BCBA-D, BCBA, or BCaBA, has no prior authorization, is capped at 32 units per 12 months and 8 units per date of service (15-minute units), and cannot be completed via telehealth. 97152 and 0362T are in-person supporting assessments. 97153 Adaptive Behavior Treatment by Protocol (BCBA-D, BCBA, BCaBA, RBT, or, in a supervised clinic, a behavior technician) has no GT modifier. Home and school 97153 must be delivered by an RBT, BCaBA, BCBA, or BCBA-D. Limit: 160 units per week and 32 units per date of service. 97154 group protocol treatment and 97158 have no telehealth modifier. 97155 is administered in person by a BCBA-D, BCBA, or BCaBA with one member and is expected to be in person. It is not paid by telehealth on a routine basis or without prior authorization. It may be up to 10% of rendered 97153 hours, capped at 64 units per month and 16 units per week. Limited telehealth: for home-based treatment whose individualized plan of care addresses maladaptive and impairing behaviors, when the provider establishes severe access-to-care concerns (the manual's example is severe maladaptive behavior that prevents clinic-based treatment), up to 25% of the 97155 units approved may be telehealth only if the quality-improvement organization authorizes it and the claim uses GT. The enrolled provider must be physically in the SCMSA and able to travel so that a majority of 97155 is delivered directly to the patient. 97155 telehealth without prior approval is subject to recoupment, as is any 97153 in the same calendar month. The plan of care must justify use of GT for that 25% when applicable. 97156 Family Adaptive Behavior Treatment Guidance may be delivered by telehealth with GT. The code table does not attach a prior-authorization requirement to that GT modifier. At least 4 units (one hour) are required in each month that authorized direct treatment and protocol modification are rendered, to support generalization. Annual cap is 96 units per 12 months, not more than 16 units per date of service. 97156 is not a standalone benefit and is not a substitute when a behavior technician or RBT is unavailable. 97157 is an in-person multiple-family group service. 0373T is in person with the qualified provider on site. Autism measures or tests given by telehealth, reports of telehealth evaluations, and ASD diagnoses conferred by telehealth are not valid to establish medical necessity for ASD services. A comprehensive diagnostic assessment requires structured in-person observation supported by ADI-R, ADOS, or CARS administered by a licensed physician (MD/DO), licensed psychologist (PhD/PsyD), or licensed psycho-educational specialist. Developmental Evaluation Center code T1023 may be billed with GT, but that billing option does not make a telehealth ASD diagnosis valid for ASD-service eligibility. South Carolina does not license behavior analysts or RBTs. LLR's professional-board list has no behavior-analyst board. Medicaid enrollment requires BACB certification (BCBA-D, BCBA, or BCaBA) in good standing, not a state behavior-analyst license. S.C. Code § 40-42-20 (Telehealth and Telemedicine Modernization Act, 2024 Act No. 120, effective March 11, 2024) sets telehealth practice standards for state licensees, including the same standard of care as in-person care. It does not license behavior analysts and does not authorize RBT-delivered telehealth ABA. Private insurance: S.C. Code § 38-71-280 (2007 Act No. 65, effective July 1, 2008) requires group health plans and the State Health Plan to cover ASD treatment prescribed by the treating medical doctor. It does not apply to individual-market, individually underwritten, or small-employer plans. Eligibility requires diagnosis at age 8 or younger, and benefits run only to persons under 16. Behavioral therapy is capped at $50,000 per year, adjusted each January 1 by the CPI-U. The section does not mention telehealth or ABA procedure codes. Title 38, Chapter 71 contains no telehealth or telemedicine provision.

No private-payer telehealth coverage or payment-parity statute. S.C. Code Chapter 40, Title 42 (2024 Act No. 120, effective March 11, 2024) is a licensee practice-standard law, not an insurance mandate. Title 38, Chapter 71, including the autism mandate at § 38-71-280, does not address telehealth. The Center for Connected Health Policy's South Carolina profile, last updated August 16, 2026, reports no private-payer law, no service parity, and no payment parity. Medicaid telehealth ABA is paid as the underlying CPT code with GT, in lieu of a duplicate face-to-face service, under the ASD manual rather than under a parity statute.

Telehealth cannot be the sole or primary ABA modality. In person: 97151 (no telehealth exception), including direct observation in the natural environment and every requested service location, an in-person Vineland interview, and, when required, a functional behavior assessment with direct observation; 97152; 0362T and 0373T with the physician, BCBA, or BCaBA physically on site, immediately available, and interruptible; 97153, including all home and school direct treatment; 97154 and 97158; and 97157. 97155 must be mostly in person: no routine telehealth, and any telehealth is limited to 25% of approved 97155 units with prior authorization. The rendering ABA provider must be located in the SCMSA (South Carolina plus 25 miles) and, for 97155 telehealth, able to travel to the patient. Uncredentialed behavior technicians may deliver services only during a one-time 90-day grace period, only in a clinic, and only while an enrolled BCBA-D, BCBA, or BCaBA is physically on site. Diagnostic access requires in-person ADI-R, ADOS, or CARS. A telehealth ASD diagnosis is not valid. Caseload rules assume the enrolled analyst both supervises the assigned RBT under BACB rules and separately delivers in-person direct services to each member. BCBA caseload maximums are 12 cases without a BCaBA and 16 with one; a BCaBA maximum is 12. Counting: 30–40 hours/week = 1 case, 10–25 hours = 1/2 case, under 10 hours = 1/4 case. Minimum family guidance is 4 units of 97156 in each month of rendered direct treatment. 97153 limits are 160 units/week and 32 units/day; 97155 limits are 10% of rendered 97153, 64 units/month, and 16 units/week.

No state statute or LLR rule authorizes or prohibits RBT supervision by telehealth, because South Carolina does not license behavior analysts, assistant behavior analysts, or RBTs. For Medicaid, BACB supervision is not a billable service. The ASD manual lists supervision and staffing, staff meetings, training, and supervision, and behavior-technician, RBT, or BCaBA supervision hours required for credentialing or BACB certification as non-covered. It states Medicaid does not reimburse clinical supervision done to meet professional-board requirements, and that indirect behavior-technician or RBT case supervision is not reimbursable as 97155. 97155 is payable only for time the enrolled provider spends in session with the member. The analyst may, during that direct session, instruct the technician in a new or modified protocol. That overlap may be telehealth only inside the 25% 97155 cap, with quality-improvement-organization prior authorization and GT, for qualifying home-based cases. 97155 may not be billed at the same time as 97153 when the enrolled provider is teaching an RBT how to deliver the member's initial protocol. RBTs are not listed as distant-site telehealth practitioners. S.C. Code § 40-42-20's same-standard-of-care rule applies to state licensees using telehealth and does not create a tele-supervision benefit for RBTs.