In 1910 Pope St. Pius X allowed those who had been validly enrolled in a scapular confraternity to substitute a single medal for the cloth scapular or scapulars. The concession touches only the wearing: enrolment must still be made in the cloth scapular itself, by a priest with the faculty to do so, and the medal must afterwards be blessed. It is a permission of the Holy See governing a private devotion, not a liturgical rite.

First be enrolled in the scapular itself by a priest who has the faculty, receiving the cloth scapular in the usual way. Afterwards a medal bearing the image of the Sacred Heart of Jesus on one side and the Blessed Virgin Mary on the other may be blessed and worn in its place — a separate blessing is required for each scapular the medal replaces. Wear it constantly and keep the obligations of the scapular you were enrolled in, above all the daily prayer attached to it.

Citation

Enchiridion Indulgentiarum, 4th ed. (Apostolic Penitentiary, 1999), grant on the use of articles of devotion: a partial indulgence for the devout use of a crucifix, rosary, scapular or medal properly blessed by a priest. The governing norms are those of Paul VI, Indulgentiarum Doctrina (1967).

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