A source-verified guide to Texas's CME requirements for physicians — hours, mandatory topics, audit rules, and exemptions.[1]
Reviewed by Doug Doehrman, MD · Last reviewed April 21, 2026
For physicians, 48 hours is the total CME requirement. Texas also requires a set of one-time topics that count toward the 48-hour total.
“Medical Ethics/Professional Responsibility: At least 2 hours covering risk management, domestic abuse, or child abuse.”
“Pain Management & Opioids: At least 2 hours addressing safe and effective pain management related to the prescription of opioids including identification of drug-seeking behavior and prescribing standards.”
“Human Trafficking Prevention: One required course approved by HHSC that can count toward ethics requirements.”
These rules apply only when the trigger described under each card is met (for example, holding a state-issued controlled substance registration or treating a specific patient population). Each cites the underlying statute or rule directly.
Physicians practicing in OB/GYN, Maternal-Fetal Medicine, Family Medicine, Emergency Medicine, or other women's-health-adjacent specialties designated by TMB (15 specialties total per TMB FAQ #414)
“At least 1 hour of CME...in their first renewal period after license issuance, and at least 1 hour every third renewal period thereafter.”
Medical directors of pain clinics
“Pain Clinics: Medical directors must ensure 10 biennial hours in pain management for all personnel.”
EMS medical directors
“EMS Medical Directors: 12 initial hours in EMS medical direction, then 1 hour per biennium.”
EMS medical directors (ongoing maintenance after initial 12 hours)
“EMS Medical Directors: 12 initial hours in EMS medical direction, then 1 hour per biennium.”
Physicians whose practice includes treating patients in an emergency room setting
“at least two hours of continuing medical education relating to: (1) the provision of trauma-informed care to sexual assault survivors; (2) appropriate community referrals and prophylactic medications; (3) the rights of a sexual assault survivor under Chapter 56A, Code of Criminal Procedure...”
Credit must come from an organization accredited by the ACCME, AMA, Texas Medical Association, or AAFP. ACGME residency or fellowship time accrues toward the requirement. Teaching or presenting accredited CME can satisfy a portion of required hours.
| Credit system | Notes |
|---|---|
AMA PRA Category 1 min 24 hrs | At least 24 of your 48 hours must be formal Category 1 or 1A from an ACCME-accredited provider.SourceTMB Physician CE Requirements[1] |
AOA Category 1-A DOs only | AOA Category 1-A designated courses count toward the formal hour requirement for DOs.SourceTMB Physician CE Requirements[1] |
AAFP Prescribed | AAFP-approved courses count toward the formal hour requirement.SourceTMB Physician CE Requirements[1] |
Board-approved credit max 24 hrs | TMA-approved courses meeting AMA standards count as formal credit. Up to 24 of your 48 hours may be informal — self-study, hospital lectures, grand rounds, and case conferences not formally approved for CME credit all qualify.SourceTMB Physician CE Requirements[1] |
Physicians are responsible for retaining CME documentation and producing it on request. Requirements include course title, dates, hours, sponsoring organization, and accrediting body.
Board certification or recertification meeting ABMS standards exempts physicians from all CME requirements for one registration period. Maintenance of Certification programs satisfy formal/informal requirements but do not exempt ethics, pain management, or human trafficking training.[1]
Residency/fellowship training or completion within 6 months prior to renewal satisfies CME except for pain management and human trafficking requirements. Residents, fellows, and recent graduates are exempt from most CME but must still complete pain management and human trafficking training.[1]
Atlas CME tracks your hours, maps them to your state requirements, and reminds you before your your license anniversary renewal.
Every mandatory topic and conditional requirement above cites the underlying statute or rule. Numbered references below correspond to the bracketed citations next to each requirement.
“Physicians must complete at least 48 credits of continuing medical education every 24 months, with at least half of these hours (24 hours) in formal, Category 1 or 1A courses.”TMB Physician CE Requirements
“Medical Ethics/Professional Responsibility: At least 2 hours covering risk management, domestic abuse, or child abuse.”TMB Physician CE Requirements
“Pain Management & Opioids: At least 2 hours addressing safe and effective pain management related to the prescription of opioids including identification of drug-seeking behavior and prescribing standards.”TMB Physician CE Requirements
“Human Trafficking Prevention: One required course approved by HHSC that can count toward ethics requirements.”TMB Physician CE Requirements
“At least 1 hour of CME...in their first renewal period after license issuance, and at least 1 hour every third renewal period thereafter.”Tex. S.B. 31 (2025); TMB Physician CE Requirements · Effective 2026-01-01
“Pain Clinics: Medical directors must ensure 10 biennial hours in pain management for all personnel.”TMB Physician CE Requirements
“EMS Medical Directors: 12 initial hours in EMS medical direction, then 1 hour per biennium.”TMB Physician CE Requirements
“at least two hours of continuing medical education relating to: (1) the provision of trauma-informed care to sexual assault survivors; (2) appropriate community referrals and prophylactic medications; (3) the rights of a sexual assault survivor under Chapter 56A, Code of Criminal Procedure, including the opportunity to request the presence of an advocate as defined by Section 420.003, Government Code, and a forensic medical examination; (4) forensic evidence collection methods; and (5) applicable state law pertaining to the custody, transfer, and tracking of forensic evidence.”Tex. HB 47 (89R, 2025) § 17 · Effective 2025-09-01
“at least two hours of continuing medical education relating to: (1) the provision of trauma-informed care to sexual assault survivors; (2) appropriate community referrals and prophylactic medications; (3) the rights of a sexual assault survivor under Chapter 56A, Code of Criminal Procedure...”Tex. Occ. Code § 156.057 (as amended by Tex. HB 47, 89R, 2025) § 17 · Effective 2026-09-01