Texas physician CME requirements for 2026–2027

Texas CME requirements at a glance

Check what's due for your license

What's new for 2026–2027

• CE Broker is mandatory for renewals on or after September 1, 2026. The free Basic account is enough, and TMB blocks online renewal until your status shows Complete. (TMB CE Tracking)
• Forensic evidence collection (HB 47): 2 hours, starting with licenses that expire February 28, 2027. The statute covers physicians "whose practice includes treating patients in an emergency room setting" (Occ. Code §156.057). Urgent care is included by TMB guidance, not the statute text, and what counts is where you work, not your specialty. Courses must be approved by the Governor's Sexual Assault Survivors' Task Force. No approved course exists yet, and CE Broker currently shows forensic reporting as temporarily disabled. If you don't work in an ER, file the "Not Working in an ER Setting" attestation in CE Broker. (22 TAC §161.35(a)(3)(A); Texas Register, Aug. 28, 2026)
• Nutrition & metabolic health (SB 25): 1 hour for all physicians each renewal, starting with licenses that expire in May 2027 (TMB: on or after May 30, 2027). Formal or informal credit counts, and the course must follow Texas Nutrition Advisory Committee guidelines. (Occ. Code §156.061; §161.35(a)(3)(B))
• Life of the Mother Act (SB 31): a one-time free course on pregnancy-related emergencies, taken only in MyTMB. Only TMB's course counts. It's not reported in CE Broker, and renewal is blocked until TMB shows it complete. Required for TMB's listed specialties: OB/GYN, maternal-fetal medicine, obstetric anesthesia, critical care OB/GYN, family medicine/practice, emergency medicine, urgent care–FP, pediatric EM, others on TMB's list, or ABOG/AOBOG certified. It isn't AMA Category 1, but it can be reported as ethics. (TMB CE page)

More on the 2027 changes →

Formal vs informal CME

Formal (at least 24): AMA PRA Category 1 credit from ACCME or an ACCME-recognized state society, AAFP Prescribed, AOA Category 1-A, or TMA-approved. Informal (up to 24): self-study, hospital lectures, grand rounds and case conferences. (22 TAC §161.35(a)(1))

Ethics and overlaps

You need 2 formal hours of medical ethics and/or professional responsibility every renewal. Professional responsibility includes risk management, domestic abuse and child abuse. Human trafficking and pain/opioid courses also count toward ethics, and both count toward your 24 formal hours. CE Broker applies them automatically when you enter them in their own categories. (22 TAC §161.35(a)(2)(B))

Pain management & opioid prescribing

This applies only if you provide direct patient care. You need 2 formal hours within 1 year of license issuance, again at your next renewal, then every 4th renewal (every 8 years). TMB's example: done for the 2024 renewal, exempt in 2026, 2028 and 2030, due again in 2032. (Tex. Occ. Code §156.055; 22 TAC §161.35(a)(2)(C))

Human trafficking prevention

This applies only if you provide direct patient care. You need at least 1 hour from a course on HHSC's approved list, in your first renewal period after licensure, then every 3rd renewal (every 6 years). Even when it isn't due, CE Broker wants your most recent completion date. (Tex. Occ. Code §156.060; 22 TAC §161.35(a)(2)(A)) Free approved courses →

Carry-forward

You can carry up to 48 excess credits to the next registration period only, each in its own category. Required formal topics can't be carried forward. The rule excludes all §161.35(a)(2) credits: ethics, pain/opioid and human trafficking. TMB's web page names only ethics and opioid, so we follow the stricter rule text. (22 TAC §161.35(c)(2)-(3))

Exemptions & alternate compliance

• New licensees are exempt from the hours the first time they register. If your initial registration is under 24 months, no CE is due before your first renewal.
• Board certification or recertification within the prior 36 months (good for one registration), ABMS MOC / AOA OCC, or residency/fellowship (in training or finished within 6 months) covers the hours and ethics. None of these cover human trafficking, and whether they cover opioid depends on your specialty board. See TMB's CME Hours Requirement Chart.
• Written exemptions for catastrophic illness, military service of more than 1 year outside Texas, residence of more than 1 year outside the US, or good cause go through CE Broker at least 30 days before renewal. (CE Broker exemptions)
• Retired: exempt. Voluntary charity care: the rule requires 12 informal credits, even though TMB's web page lists it as exempt. (22 TAC §161.35(e))

Conditional specialty CME

• EMS off-line medical directors: 12 hours within 2 years, then 1 hour each renewal (Rule 169.12).
• Pain clinic personnel: 10 hours of pain CME each renewal (Rule 172.3).
• Tick-borne disease: encouraged, not required.

Before you renew

Report every course in CE Broker and wait for Complete. TMB won't open online renewal until it does. Also submit proof of lawful presence. See renewal dates & fees and how to report in CE Broker.

All rules & sources

Primary sources: TMB CE requirements · TMB CME Hours Chart · 22 TAC §161.35 (LII lags the Sept. 3, 2026 amendments) · Texas Register, Aug. 28, 2026 · Tex. Occ. Code ch. 156 · TMB: rule changes effective Jan. 9, 2025. Chapter 166 was repealed January 9, 2025; the CME rule is now 22 TAC §161.35. When TMB's page and the rule differ, we say so. If you're unsure, contact TMB Registrations ([email protected], 512-305-7030).

Texas CME requirements FAQ