Texas Certified Nurse-Midwife license renewal and CE requirements
Texas nurse-midwives must complete 20 contact hours of continuing education every two years to renew their license with the Texas Board of Nursing.
A Texas license always expires on the last day of the nurse's birth month, in odd numbered years if the nurse was born in an odd numbered year and in even numbered years if the nurse was born in an even numbered year. The advanced practice license and the underlying registered nurse license renew together on that date. An initial license runs 6 to 29 months before the first renewal, and the first licensing period after a delinquent renewal or a reactivation can also run 6 to 29 months; every licensing period after that is two years. Renewal is filed in the Texas Nurse Portal. A license not renewed by the expiration date goes delinquent and the nurse may not practice until it is renewed and returned to active status.
Summary
Texas nurse-midwives must complete 20 contact hours of continuing education every two years to renew their license with the Texas Board of Nursing. A Texas license always expires on the last day of the nurse's birth month, in odd numbered years if the nurse was born in an odd numbered year and in even numbered years if the nurse was born in an even numbered year. The advanced practice license and the underlying registered nurse license renew together on that date. An initial license runs 6 to 29 months before the first renewal, and the first licensing period after a delinquent renewal or a reactivation can also run 6 to 29 months; every licensing period after that is two years. Renewal is filed in the Texas Nurse Portal. A license not renewed by the expiration date goes delinquent and the nurse may not practice until it is renewed and returned to active status. Texas also mandates specific subjects. Nursing jurisprudence and nursing ethics: 2 contact hours on a periodic schedule set by the board (all nurses, including nurse-midwives). Human trafficking prevention: required every renewal cycle (any nurse, including a nurse-midwife, who provides direct patient care). Older adult or geriatric care: 2 contact hours every renewal cycle (any nurse, including a nurse-midwife, whose practice includes older adult or geriatric populations). Forensic evidence collection: a one-time requirement of 2 contact hours (any nurse, including a nurse-midwife, employed in an emergency room setting, including a nurse who could float to or be scheduled in an emergency room and contract, temporary, per diem, agency or travel nurses whose duties include emergency room work; separately, any nurse who performs a forensic examination on a sexual assault survivor). Pharmacotherapeutics: 5 contact hours every renewal cycle (Nurse-midwives who hold prescriptive authority). Safe and effective pain management related to the prescription of opioids and other controlled substances: 4 contact hours every renewal cycle (Nurse-midwives who have entered into a prescriptive authority agreement authorizing the prescribing of opioids). Authorization to receive information from the Texas Prescription Monitoring Program: a one-time requirement of 2 contact hours (Nurse-midwives authorized to receive information from the Texas Prescription Monitoring Program). Hours do not carry over between cycles and the first renewal is exempt.
Texas Certified Nurse-Midwife renewal and continuing education rules
"Not stated" means the board's pages and rules we read do not address it. We do not fill in typical values.
| Renewal cycle | Two-year (24 months) |
|---|---|
| Renewal deadline | Tied to the licensee's birth month |
| Continuing education required | Yes |
| Hours per cycle | 20 contact hours |
| Self-study or online cap | No cap stated |
| Carryover to next cycle | No |
| First renewal exempt | Yes |
| Other accepted activities | Achieving, maintaining or renewing the board approved national nursing certification recognized for the nurse-midwife role and population focus area, in place of the 20 contact hours; Academic courses, converted at 10 contact hours per academic quarter hour and 15 contact hours per academic semester hour; Development or presentation of a program approved by a board recognized credentialing agency, credited one for one with the hours awarded to participants; Authorship of a manuscript related to nursing and health care published in a nursing or health related textbook or journal, credited at one contact hour per distinct publication; Category I continuing medical education in the advanced practice role and population focus area, accepted for every requirement except nursing jurisprudence and nursing ethics |
Texas replaces rather than stacks. Board Rule 216.3 requires every nurse to complete 20 contact hours of continuing nursing education in the nurse's area of practice within the licensing period or to achieve, maintain or renew a board approved national nursing certification in that area of practice. For an advanced practice registered nurse the same 20 hours are earned in the advanced practice role and population focus area recognized by the board, and the board states plainly that this satisfies the requirements to renew both the registered nurse license and the advanced practice license, so the 20 advanced practice hours are not in addition to the 20 registered nurse hours. A nurse-midwife who holds prescriptive authority owes at least 5 additional contact hours in pharmacotherapeutics, which the board says are above and beyond the 20. A nurse-midwife with prescriptive authority who prescribes controlled substances owes at least 3 more contact hours related to prescribing controlled substances, also above and beyond, and the board states that a prescriber of controlled substances therefore needs a total of 28 contact hours each licensing period. The other targeted requirements recorded below count inside the 20 rather than on top of it. Hours must be earned inside the licensing period and by the time the renewal application is filed, and additional hours may not be carried over to the next period. A nurse is exempt from most continuing competency requirements at the first renewal following initial licensure as long as that renewal is timely, with the forensic evidence collection requirement the one exception, and the same exemption applies for the licensing period immediately after a delinquent renewal or a reactivation. Basic Life Support and CPR courses do not count. A nurse with Volunteer Retired authorization in the advanced practice role instead completes 20 contact hours meeting the Rule 216.3(c) criteria in the two years before applying, may not hold prescriptive authority, and is exempt from the targeted requirements.
Required CE topics for Texas certified nurse-midwifes
State-specific subject mandates. Where a mandate applies only to some licensees, the scope is listed.
| Topic | Hours | Frequency | Applies to | Citation |
|---|---|---|---|---|
| Nursing jurisprudence and nursing ethicsAt least 2 contact hours before the end of every third two-year licensing period, so roughly once every six years, for licensing periods beginning on or after January 1, 2014. Content must cover the Texas Nursing Practice Act, the board's rules including 217.11 Standards of Nursing Practice, the board's position statements, principles of nursing ethics and professional boundaries. National certification may not be used for this one, and an advanced practice nurse may not substitute continuing medical education: only continuing nursing education counts. The hours count inside the 20. | 2 contact hours | Periodic | All nurses, including nurse-midwives | 22 Tex. Admin. Code 216.3(g) |
| Human trafficking preventionA human trafficking prevention course approved by the Executive Director of the Texas Health and Human Services Commission, covering identifying and assisting victims, before the end of every licensing period, for renewals on or after September 1, 2020. The board states no hour count. Certification may not be used; an HHSC approved course is required. Hours may count inside the 20. HHSC revised its course review standards in March 2025 and is reviewing previously approved courses under them. | Not stated | Every renewal | Any nurse, including a nurse-midwife, who provides direct patient care | 22 Tex. Admin. Code 216.3(i) |
| Older adult or geriatric careAt least 2 contact hours before the end of every licensing period, for licensing periods that began on or after January 1, 2014. Content may cover elder abuse, age related memory changes and disease processes, end of life issues, health maintenance and health promotion. A board approved certification related to older adult or geriatric populations may be used, and an advanced practice nurse may use Category I continuing medical education. The hours count inside the 20. | 2 contact hours | Every renewal | Any nurse, including a nurse-midwife, whose practice includes older adult or geriatric populations | 22 Tex. Admin. Code 216.3(h) |
| Forensic evidence collectionAt least 2 contact hours within two years of the initial date of employment in an emergency room setting, covering forensic evidence collection and age or population specific nursing interventions sufficient to meet Government Code 420.031 on the Attorney General approved evidence collection kit and protocol. A nurse who performs a forensic examination on a sexual assault survivor must complete basic forensic evidence collection training before performing the exam. This is the only requirement a first time renewer is not exempt from. Records must be kept indefinitely, even after changing employers. An advanced practice nurse may use forensic evidence collection continuing medical education approved by the Texas Medical Board. The hours count inside the 20. | 2 contact hours | One time | Any nurse, including a nurse-midwife, employed in an emergency room setting, including a nurse who could float to or be scheduled in an emergency room and contract, temporary, per diem, agency or travel nurses whose duties include emergency room work; separately, any nurse who performs a forensic examination on a sexual assault survivor | 22 Tex. Admin. Code 216.3(d) |
| PharmacotherapeuticsAt least 5 additional contact hours of continuing education in pharmacotherapeutics before the end of every licensing period. The board states these are above and beyond the 20 hours required for all nurses. Certification may not be used; Category I continuing medical education may. | 5 contact hours | Every renewal | Nurse-midwives who hold prescriptive authority | 22 Tex. Admin. Code 216.3(c)(3) |
| Safe and effective pain management related to the prescription of opioids and other controlled substancesNot less than 2 hours annually, which the board states means 4 hours every licensing period, covering reasonable standards of care, identification of drug seeking behavior in patients, and effectively communicating with patients about a prescription for an opioid or other controlled substance. It applies to licensure renewals on or after January 1, 2021. Hours count inside the 20. Certification may not be used; Category I continuing medical education may. | 4 contact hours | Every renewal | Nurse-midwives who have entered into a prescriptive authority agreement authorizing the prescribing of opioids | 22 Tex. Admin. Code 216.3(c)(4) |
| Authorization to receive information from the Texas Prescription Monitoring Program2 hours of continuing education related to approved procedures of prescribing and monitoring controlled substances. An advanced practice nurse licensed before September 1, 2020 was due by September 1, 2021; one licensed after September 1, 2020 is due no later than one year after the initial licensure date. The board describes it as a time limited requirement. Hours count inside the 20. Certification may not be used; Category I continuing medical education may. | 2 contact hours | One time | Nurse-midwives authorized to receive information from the Texas Prescription Monitoring Program | 22 Tex. Admin. Code 216.3(c)(6) |
Documentation and audit
| Proof submitted at renewal | No, attestation only |
|---|---|
| Keep records for | 6 years |
| Board audits compliance | Yes |
| Approved providers | Continuing nursing education must be approved by a credentialing agency or provider recognized by the board. The board's list includes the American College of Nurse-Midwives, the American Association of Critical-Care Nurses, the American Association of Nurse Anesthetists, the American Association of Nurse Practitioners, the American Nurses Credentialing Center, colleges and universities in the United States, the Emergency Nurses Association, NAPNES, NALPN, NAPNAP, the National League for Nursing, other state boards of nursing and the Texas League of Vocational Nurses, plus programs approved by those umbrella organizations. Human trafficking prevention courses must be on the HHSC approved list. |
Common questions
- How many CE hours does a Texas CNM need to renew?
- Texas nurse-midwives must complete 20 contact hours of continuing education every two years to renew their license with the Texas Board of Nursing. Texas replaces rather than stacks. Board Rule 216.3 requires every nurse to complete 20 contact hours of continuing nursing education in the nurse's area of practice within the licensing period or to achieve, maintain or renew a board approved national nursing certification in that area of practice. For an advanced practice registered nurse the same 20 hours are earned in the advanced practice role and population focus area recognized by the board, and the board states plainly that this satisfies the requirements to renew both the registered nurse license and the advanced practice license, so the 20 advanced practice hours are not in addition to the 20 registered nurse hours. A nurse-midwife who holds prescriptive authority owes at least 5 additional contact hours in pharmacotherapeutics, which the board says are above and beyond the 20. A nurse-midwife with prescriptive authority who prescribes controlled substances owes at least 3 more contact hours related to prescribing controlled substances, also above and beyond, and the board states that a prescriber of controlled substances therefore needs a total of 28 contact hours each licensing period. The other targeted requirements recorded below count inside the 20 rather than on top of it. Hours must be earned inside the licensing period and by the time the renewal application is filed, and additional hours may not be carried over to the next period. A nurse is exempt from most continuing competency requirements at the first renewal following initial licensure as long as that renewal is timely, with the forensic evidence collection requirement the one exception, and the same exemption applies for the licensing period immediately after a delinquent renewal or a reactivation. Basic Life Support and CPR courses do not count. A nurse with Volunteer Retired authorization in the advanced practice role instead completes 20 contact hours meeting the Rule 216.3(c) criteria in the two years before applying, may not hold prescriptive authority, and is exempt from the targeted requirements.
- How often does a Texas CNM license need to be renewed?
- Certified Nurse-Midwife licenses in Texas renew every two years. A Texas license always expires on the last day of the nurse's birth month, in odd numbered years if the nurse was born in an odd numbered year and in even numbered years if the nurse was born in an even numbered year. The advanced practice license and the underlying registered nurse license renew together on that date. An initial license runs 6 to 29 months before the first renewal, and the first licensing period after a delinquent renewal or a reactivation can also run 6 to 29 months; every licensing period after that is two years. Renewal is filed in the Texas Nurse Portal. A license not renewed by the expiration date goes delinquent and the nurse may not practice until it is renewed and returned to active status.
- What specific CE topics are required for Texas nurse-midwives?
- Nursing jurisprudence and nursing ethics: 2 contact hours on a periodic schedule set by the board (all nurses, including nurse-midwives). Human trafficking prevention: required every renewal cycle (any nurse, including a nurse-midwife, who provides direct patient care). Older adult or geriatric care: 2 contact hours every renewal cycle (any nurse, including a nurse-midwife, whose practice includes older adult or geriatric populations). Forensic evidence collection: a one-time requirement of 2 contact hours (any nurse, including a nurse-midwife, employed in an emergency room setting, including a nurse who could float to or be scheduled in an emergency room and contract, temporary, per diem, agency or travel nurses whose duties include emergency room work; separately, any nurse who performs a forensic examination on a sexual assault survivor). Pharmacotherapeutics: 5 contact hours every renewal cycle (Nurse-midwives who hold prescriptive authority). Safe and effective pain management related to the prescription of opioids and other controlled substances: 4 contact hours every renewal cycle (Nurse-midwives who have entered into a prescriptive authority agreement authorizing the prescribing of opioids). Authorization to receive information from the Texas Prescription Monitoring Program: a one-time requirement of 2 contact hours (Nurse-midwives authorized to receive information from the Texas Prescription Monitoring Program). Citations: nursing jurisprudence and nursing ethics (22 Tex. Admin. Code 216.3(g)), human trafficking prevention (22 Tex. Admin. Code 216.3(i)), older adult or geriatric care (22 Tex. Admin. Code 216.3(h)), forensic evidence collection (22 Tex. Admin. Code 216.3(d)), pharmacotherapeutics (22 Tex. Admin. Code 216.3(c)(3)), safe and effective pain management related to the prescription of opioids and other controlled substances (22 Tex. Admin. Code 216.3(c)(4)), and authorization to receive information from the Texas Prescription Monitoring Program (22 Tex. Admin. Code 216.3(c)(6)).
- Do Texas nurse-midwives have to submit CE certificates at renewal?
- Licensees attest to completion at renewal rather than submitting certificates, the board audits a sample of renewals and asks for documentation, and records must be kept for 6 years. Continuing nursing education must be approved by a credentialing agency or provider recognized by the board. The board's list includes the American College of Nurse-Midwives, the American Association of Critical-Care Nurses, the American Association of Nurse Anesthetists, the American Association of Nurse Practitioners, the American Nurses Credentialing Center, colleges and universities in the United States, the Emergency Nurses Association, NAPNES, NALPN, NAPNAP, the National League for Nursing, other state boards of nursing and the Texas League of Vocational Nurses, plus programs approved by those umbrella organizations. Human trafficking prevention courses must be on the HHSC approved list.
- Is the first Texas CNM renewal exempt from CE?
- Yes. Texas does not require continuing education for a CNM's first renewal.
Sources
Last verified September 10, 2026. Every value above was read from one of these.
- Education, Continuing Nursing Education and Competency, Texas Board of NursingState board page, accessed September 10, 2026
- Licensure Renewal, Texas Board of NursingState board page, accessed September 10, 2026
- Advanced Practice Registered Nurse applications, Texas Board of Nursing (the roles available for APRN licensure, including Nurse-Midwife)State board page, accessed September 10, 2026
- Midwives, Texas Department of Licensing and Regulation (the separate state midwife license)State board page, accessed September 10, 2026
Texas has a distinct nurse-midwife credential and the regulator is the Board of Nursing, the common pattern: the nurse-midwife holds an advanced practice registered nurse license with the Nurse-Midwife role on top of a Texas registered nurse license. The rule was established as governing the nurse-midwife rather than another kind of midwife from the board's own advanced practice application page, which lists Nurse-Midwife among the roles and population focus areas available for APRN licensure, and from the continuing education page, which lists the American College of Nurse-Midwives among the credentialing agencies whose continuing nursing education the board recognizes. Texas separately licenses midwives through the Texas Department of Licensing and Regulation, an entirely different agency with its own renewal and continuing education program; nothing from that program is recorded here. On certification: Board Rule 216.3(b) makes a board approved national nursing certification an alternative to the 20 contact hours rather than a separate obligation, and the advanced practice application requires national certification in the role and population focus area, so certification both qualifies the licensee and can substitute for the hours. The board does not name the American Midwifery Certification Board on the pages read, so no certifying body is named here and no AMCB module or credit total is recorded. Two topic keys are not on the canonical list and are flagged here: pharmacology for the pharmacotherapeutics hours as the brief directs, controlled_substances for the three hour controlled substance prescribing requirement, prescription_monitoring_program for the Prescription Monitoring Program education because it is neither opioid specific nor the same requirement as 216.3(c)(3), and forensic_evidence_collection, which matches the key already used in the Texas registered nurse and nurse anesthetist records. Two requirements on the board's page were checked for effective dates and deliberately left out: Rule 216.3(c)(5), one hour annually on best practices and alternative treatment options for prescribers of opioids, applied only to renewals occurring between September 1, 2019 and August 31, 2023 and has expired, and the tick-borne disease item in 216.3(f) is written as encouragement rather than a requirement. The board's own pages could not be read through the standard fetch tool, which reported that it was unable to verify the first certificate in the site's TLS chain; they were read as rendered HTML over a plain HTTPS request to the same official host. The Texas Secretary of State administrative code site at texreg.sos.state.tx.us now returns only a Site Has Moved notice pointing at an Appian portal, so the rule text itself was read where the board reproduces and cites it, subsection by subsection, on the continuing education page. Two disagreements with existing Texas records are worth recording. First, the existing tx-np and tx-crna records both omit the three contact hour controlled substance prescribing requirement in 216.3(c)(3), which the board's page states applies to any APRN with prescriptive authority who prescribes controlled substances; the same page states the resulting 28 hour total for such a prescriber. Second, tx-np records 25 contact hours per cycle while tx-rn and tx-crna record 20; this record uses 20, the figure the board states is unconditional for every nurse including an APRN, and keeps the conditional prescriber hours in mandatory_topics where their scoping is visible. Corrected 2026-09-10: a mandatory topic claiming 3 additional contact hours related to prescribing controlled substances was removed. It cited 22 TAC 216.3(c)(3), which is the 5 hour pharmacotherapeutics paragraph already recorded here, and no 3 hour controlled substance requirement exists in 216.3(c). The board's continuing competency page lists only three targeted advanced practice items: pharmacotherapeutics 5 contact hours in addition to the 20, pain management and prescription of opioids 4 contact hours per licensing period which do count toward the 20, and the one time 2 hour Prescription Monitoring Program course under 216.3(c)(6).
Provided for general reference. Requirements change through legislative sessions and rulemaking, so confirm with the Texas Board of Nursing before relying on them for a renewal. Spot something out of date? Tell us and we will fix it.