Texas Physician (MD) license renewal and CE requirements
Texas physicians (MD) must complete 48 CME credits of continuing education every two years to renew their license with the Texas Medical Board.
Physician registration renews every two years. Licenses expire at one of four points in the year, February 28, May 31, August 31, or November 30, and the board assigns the period at the time of licensure. Even numbered licenses expire in even numbered years and odd numbered licenses expire in odd numbered years. Physicians can register online 60 to 90 days before expiration, and there is a 30 day grace period before a $75 penalty applies.
Summary
Requirements are changing. Two Texas requirements are mid-transition. Mandatory CE tracking through CE Broker for all TMB licensees begins September 1, 2026, and the new two-hour forensic evidence collection requirement for emergency and urgent care physicians has no board-approved coursework yet, so the board says it will first apply to licenses expiring February 28, 2027. Confirm both with the board before your renewal.
Texas physicians (MD) must complete 48 CME credits of continuing education every two years to renew their license with the Texas Medical Board. Physician registration renews every two years. Licenses expire at one of four points in the year, February 28, May 31, August 31, or November 30, and the board assigns the period at the time of licensure. Even numbered licenses expire in even numbered years and odd numbered licenses expire in odd numbered years. Physicians can register online 60 to 90 days before expiration, and there is a 30 day grace period before a $75 penalty applies. Texas also mandates specific subjects. Medical ethics and/or professional responsibility: 2 CME credits every renewal cycle. Pain management and opioid prescribing: 2 CME credits on a periodic schedule set by the board (physicians who practice direct patient care, defined by the board as any in-person or real-time audio or visual communication with a patient or the patient's legal medical decision-maker for evaluation, treatment, diagnosis, testing, or interpreting test results). Identification and assistance of trafficked people: 1 CME credit on a periodic schedule set by the board (physicians who practice direct patient care as defined by the board). Pain management CME for pain management clinic personnel: 10 CME credits every renewal cycle (the medical director and all personnel of a pain management clinic). Pregnancy-related medical emergencies (The Life of the Mother Act, SB 31): a one-time requirement (physician applicants and licensees who provide obstetric care, identified by the board through reported specialties and board certifications including maternal and fetal medicine, obstetrical anesthesia, obstetrics and gynecology, emergency medicine, family medicine and family practice, urgent care family practice, and pediatric emergency medicine). Forensic evidence collection (House Bill 47): 2 CME credits (physicians whose practice includes treating patients in an emergency room or urgent care setting, renewing on or after September 1, 2026. Licensees who do not treat patients in emergency rooms can attest in CE Broker that they are not working in an ER setting to remove the requirement.); the board does not state how often. EMS medical direction CME: 1 CME credit every renewal cycle (physicians serving as an off-line (EMS) medical director). No more than 24 CME credits may be self-study or online, up to 48 excess CME credits carry over to the next cycle, and the first renewal is exempt.
Texas Physician (MD) 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 | Staggered by license numberFirst renewal is prorated. |
| Continuing education required | Yes |
| Hours per cycle | 48 CME credits |
| Category 1 minimum | 24 CME credits |
| Self-study or online cap | At most 24 CME credits |
| Carryover to next cycle | Yes, up to 48 CME credits |
| First renewal exempt | Yes |
| Other accepted activities | Board certification or recertification in the preceding 36 months under a program meeting ABMS, AMA, Advisory Board for Osteopathic Specialists, or AOA standards (valid for a maximum of one registration); Meeting ABMS Maintenance of Certification (MOC) or AOA Osteopathic Continuous Certification (OCC) program requirements; Current residency or fellowship training, or completion of that training within six months before the renewal application; Serving as a board-appointed physician performing a competency evaluation or practice monitoring of another physician, one formal credit per hour up to 12 hours |
48 CME credits per 24 month registration period, measured against the biennial registration period rather than the calendar year. At least 24 must be formal AMA PRA Category 1 credits designated by ACCME, an ACCME recognized state medical society, the American Academy of Family Physicians, AOA Category 1-A, the Texas Medical Association, the board (ethics and professional responsibility only), or earned as a board-appointed evaluator. The remaining credits may be informal self-study, hospital lectures, grand rounds, or case conferences. Newly licensed physicians are exempt the first time they register, and an initial registration period shorter than 24 months carries no CE requirement before the first renewal. Up to 48 excess credits carry forward to the next registration period only; ethics and pain management credits required by rule cannot be carried forward. A CME deficiency can be remedied within 30 days after the registration renewal is due. Voluntary charity care status is reduced to 12 informal credits per biennium; retired status is exempt.
Required CE topics for Texas physician (md)s
State-specific subject mandates. Where a mandate applies only to some licensees, the scope is listed.
| Topic | Hours | Frequency | Applies to | Citation |
|---|---|---|---|---|
| Medical ethics and/or professional responsibilityTwo of the 24 formal hours. Professional responsibility includes but is not limited to risk management, domestic abuse, and child abuse. Formal courses must be approved for ethics or professional responsibility credit by the accrediting agency; the board ended its own ethics course approval process in 2016 but kept the requirement. These credits cannot be carried forward. | 2 CME credits | Every renewal | All licensees | 22 TAC 161.35(a)(2)(B) |
| Pain management and opioid prescribingAt least two hours of formal CME within one year of the date of license issuance and again as part of the second renewal, then at least two hours every eight years, which is every four renewals. Content must cover best practices and multi-modal approaches to pain management, safe and effective pain management related to opioid and controlled substance prescribing including standards of care, identifying drug-seeking behavior and communicating with patients, and prescribing and monitoring controlled substances. The hours may also be credited toward the ethics and professional responsibility requirement or toward the 10 hour pain clinic requirement. These credits cannot be carried forward. | 2 CME credits | Periodic | Physicians who practice direct patient care, defined by the board as any in-person or real-time audio or visual communication with a patient or the patient's legal medical decision-maker for evaluation, treatment, diagnosis, testing, or interpreting test results | Texas Occupations Code 156.055; 22 TAC 161.35(a)(2)(C) |
| Identification and assistance of trafficked peopleAt least one hour in the first renewal period after license issuance and at least one hour every third renewal period thereafter, which is every six years. The course must be approved by the Texas Health and Human Services Commission and counts as part of the 24 formal hours; it may also be credited toward ethics or professional responsibility. | 1 CME credit | Periodic | Physicians who practice direct patient care as defined by the board | Texas Occupations Code 156.060; 22 TAC 161.35(a)(2)(A) |
| Pain management CME for pain management clinic personnelThe medical director of a pain management clinic must ensure biennially that all personnel, including the medical director, are properly licensed and, where applicable, have 10 hours of CME related to pain management. The two hour pain management and opioid prescribing hours may be credited toward this 10 hours. | 10 CME credits | Every renewal | The medical director and all personnel of a pain management clinic | 22 TAC 172.3 |
| Pregnancy-related medical emergencies (The Life of the Mother Act, SB 31)One-time mandatory course delivered free through the MyTMB portal. A licensee who is required to take it cannot complete renewal until the course shows complete in the board's system. The course is not AMA Category 1 credit because TMB is not an accredited CME provider; it may be counted toward the ethics hours. A course on the same topic from another provider does not satisfy the statutory requirement. | Not stated | One time | Physician applicants and licensees who provide obstetric care, identified by the board through reported specialties and board certifications including maternal and fetal medicine, obstetrical anesthesia, obstetrics and gynecology, emergency medicine, family medicine and family practice, urgent care family practice, and pediatric emergency medicine | Senate Bill 31 (The Life of the Mother Act) |
| Forensic evidence collection (House Bill 47)Courses must be approved by the Governor's Sexual Assault Survivors' Task Force and must be a formal category 1 course or approved or recognized by the Texas Board of Nursing. The board states that because no approved coursework was available yet, the requirement will begin for physicians whose licenses expire February 28, 2027. Whether it recurs every cycle was not stated on the pages read. | 2 CME credits | Frequency not stated | Physicians whose practice includes treating patients in an emergency room or urgent care setting, renewing on or after September 1, 2026. Licensees who do not treat patients in emergency rooms can attest in CE Broker that they are not working in an ER setting to remove the requirement. | House Bill 47 (89th Texas Legislature); Texas Health and Safety Code 323.0045 |
| EMS medical direction CMEWithin two years before or after first notifying the board of the position, an off-line medical director must complete 12 hours of formal CME in EMS medical direction, or hold ABMS certification in Emergency Medical Services or an AOA Certificate of Added Qualification in EMS, or complete a DSHS approved EMS medical director course. After that, one hour of formal CME in EMS medical direction is required at each biennial renewal. | 1 CME credit | Every renewal | Physicians serving as an off-line (EMS) medical director | 22 TAC 169.12 |
Documentation and audit
| Proof submitted at renewal | Yes |
|---|---|
| Keep records for | Not stated |
| Board audits compliance | Not stated |
| Approved providers | CME certificates are not sent to the board with the registration. The board has partnered with CE Broker, and mandatory CE tracking for all TMB licensees begins September 1, 2026: licensees provide their completion documents to CE Broker as part of the online reporting requirement before renewal, and an online renewal is blocked if CE has not been reported. Formal credit must be designated by ACCME, an ACCME recognized state medical society, the American Academy of Family Physicians, AOA Category 1-A, the Texas Medical Association, or the board for ethics and professional responsibility. |
Common questions
- How many CE hours does a Texas MD need to renew?
- Texas physicians (MD) must complete 48 CME credits of continuing education every two years to renew their license with the Texas Medical Board. 48 CME credits per 24 month registration period, measured against the biennial registration period rather than the calendar year. At least 24 must be formal AMA PRA Category 1 credits designated by ACCME, an ACCME recognized state medical society, the American Academy of Family Physicians, AOA Category 1-A, the Texas Medical Association, the board (ethics and professional responsibility only), or earned as a board-appointed evaluator. The remaining credits may be informal self-study, hospital lectures, grand rounds, or case conferences. Newly licensed physicians are exempt the first time they register, and an initial registration period shorter than 24 months carries no CE requirement before the first renewal. Up to 48 excess credits carry forward to the next registration period only; ethics and pain management credits required by rule cannot be carried forward. A CME deficiency can be remedied within 30 days after the registration renewal is due. Voluntary charity care status is reduced to 12 informal credits per biennium; retired status is exempt.
- How often does a Texas MD license need to be renewed?
- Physician (MD) licenses in Texas renew every two years. Physician registration renews every two years. Licenses expire at one of four points in the year, February 28, May 31, August 31, or November 30, and the board assigns the period at the time of licensure. Even numbered licenses expire in even numbered years and odd numbered licenses expire in odd numbered years. Physicians can register online 60 to 90 days before expiration, and there is a 30 day grace period before a $75 penalty applies.
- What specific CE topics are required for Texas physicians (MD)?
- Medical ethics and/or professional responsibility: 2 CME credits every renewal cycle. Pain management and opioid prescribing: 2 CME credits on a periodic schedule set by the board (physicians who practice direct patient care, defined by the board as any in-person or real-time audio or visual communication with a patient or the patient's legal medical decision-maker for evaluation, treatment, diagnosis, testing, or interpreting test results). Identification and assistance of trafficked people: 1 CME credit on a periodic schedule set by the board (physicians who practice direct patient care as defined by the board). Pain management CME for pain management clinic personnel: 10 CME credits every renewal cycle (the medical director and all personnel of a pain management clinic). Pregnancy-related medical emergencies (The Life of the Mother Act, SB 31): a one-time requirement (physician applicants and licensees who provide obstetric care, identified by the board through reported specialties and board certifications including maternal and fetal medicine, obstetrical anesthesia, obstetrics and gynecology, emergency medicine, family medicine and family practice, urgent care family practice, and pediatric emergency medicine). Forensic evidence collection (House Bill 47): 2 CME credits (physicians whose practice includes treating patients in an emergency room or urgent care setting, renewing on or after September 1, 2026. Licensees who do not treat patients in emergency rooms can attest in CE Broker that they are not working in an ER setting to remove the requirement.); the board does not state how often. EMS medical direction CME: 1 CME credit every renewal cycle (physicians serving as an off-line (EMS) medical director). Citations: medical ethics and/or professional responsibility (22 TAC 161.35(a)(2)(B)), pain management and opioid prescribing (Texas Occupations Code 156.055; 22 TAC 161.35(a)(2)(C)), identification and assistance of trafficked people (Texas Occupations Code 156.060; 22 TAC 161.35(a)(2)(A)), pain management CME for pain management clinic personnel (22 TAC 172.3), Pregnancy-related medical emergencies (The Life of the Mother Act, SB 31) (Senate Bill 31 (The Life of the Mother Act)), forensic evidence collection (House Bill 47) (House Bill 47 (89th Texas Legislature); Texas Health and Safety Code 323.0045), and EMS medical direction CME (22 TAC 169.12).
- Do Texas physicians (MD) have to submit CE certificates at renewal?
- Proof of completion must be submitted with the renewal. CME certificates are not sent to the board with the registration. The board has partnered with CE Broker, and mandatory CE tracking for all TMB licensees begins September 1, 2026: licensees provide their completion documents to CE Broker as part of the online reporting requirement before renewal, and an online renewal is blocked if CE has not been reported. Formal credit must be designated by ACCME, an ACCME recognized state medical society, the American Academy of Family Physicians, AOA Category 1-A, the Texas Medical Association, or the board for ethics and professional responsibility.
- Is the first Texas MD renewal exempt from CE?
- Yes. Texas does not require continuing education for a MD's first renewal.
Sources
Last verified September 7, 2026. Every value above was read from one of these.
- Continuing Education Requirements for Physicians, Texas Medical BoardState board page, accessed September 7, 2026
- Physician Renewal, Texas Medical BoardState board page, accessed September 7, 2026
- 22 Tex. Admin. Code 161.35, Continuing Medical Education (CME) Requirements for License RenewalThird-party summary, accessed September 7, 2026
Texas has no separate osteopathic board: the Texas Medical Board licenses and renews both MDs and DOs under the same rules, and the same sources are cited in the MD and DO records. The board's formal credit list expressly includes AOA Category 1-A alongside AMA PRA Category 1. Hours, the 24 formal credit minimum, carryover, first-registration exemption, and the ethics, human trafficking, and pain management mandates were read on the board's CE page and confirmed in 22 TAC 161.35, which the board's own page names as the governing rule. The rule text was read on Cornell LII because the Texas Secretary of State moved its administrative code viewer to an Appian portal that no automated client could read; Cornell is cited as third_party_summary because it mirrors rather than publishes the rule. Two topic keys are not on the canonical list: obstetric_emergencies for the Life of the Mother Act course and forensic_evidence_collection for the HB 47 requirement. Whether the board audits CME and how long records must be kept were not stated on the pages read and are left null. The forensic evidence requirement's recurrence is not stated, so frequency is unknown.
Provided for general reference. Requirements change through legislative sessions and rulemaking, so confirm with the Texas Medical Board before relying on them for a renewal. Spot something out of date? Tell us and we will fix it.