Introduction
CME requirements for physicians vary dramatically by state—from zero hours in six states to 200 hours in Washington. Beyond total hours, states differ in mandatory topics, reporting cycles, and carryover allowances. This comprehensive guide provides state-by-state requirements to help physicians plan CME completion efficiently.
Quick Reference: All 50 States
Complete CME Requirements Table
| State | Total Hours | Period | Mandatory Topics | Carryover |
|---|---|---|---|---|
| Alabama | 25/year | Annual | Controlled substances | No |
| Alaska | 50 | 2 years | None specified | Limited |
| Arizona | 40 | 2 years | Opioids (3 hrs), pain (3 hrs) | No |
| Arkansas | 20/year | Annual | Prescribing (2 hrs) | No |
| California | 50 | 2 years | Pain (12 hrs once), geriatrics | No |
| Colorado | 30 | 2 years | None (starting Jan 2026) | TBD |
| Connecticut | 50 | 1 year | Sexual assault (2 hrs), opioids | No |
| Delaware | 40 | 2 years | Controlled substances | Yes (10) |
| Florida | 40 | 2 years | Medical errors (2 hrs), opioids (2 hrs) | No |
| Georgia | 40 | 2 years | None specified | No |
| Hawaii | 40 | 2 years | None specified | No |
| Idaho | 0 | N/A | None | N/A |
| Illinois | 150 | 3 years | Sexual harassment, opioids | No |
| Indiana | 0 | N/A | None | N/A |
| Iowa | 40 | 2 years | Chronic pain (2 hrs) | No |
| Kansas | 100 | 2 years | None specified | No |
| Kentucky | 60 | 3 years | Domestic violence (3 hrs), HIV/HCV | Yes (20) |
| Louisiana | 20/year | Annual | Prescribing (3 hrs) | No |
| Maine | 100 | 2 years | Opioid prescribing (3 hrs) | No |
| Maryland | 50 | 2 years | Opioids (2 hrs), PDMP (1 hr) | No |
| Massachusetts | 100 | 2 years | Risk management (30 hrs), opioids | No |
| Michigan | 150 | 3 years | Pain (3 hrs), opioids | No |
| Minnesota | 75 | 3 years | Opioid prescribing | Yes (15) |
| Mississippi | 40 | 2 years | None specified | No |
| Missouri | 50/year | Annual | None specified | No |
| Montana | 0 | N/A | None | N/A |
| Nebraska | 50 | 2 years | Opioid prescribing (3 hrs) | No |
| Nevada | 40 | 2 years | Ethics (2 hrs), suicide | No |
| New Hampshire | 100 | 2 years | Opioid prescribing (3 hrs) | No |
| New Jersey | 100 | 2 years | Opioids (1 hr), cultural | No |
| New Mexico | 75 | 3 years | Pain management (5 hrs) | No |
| New York | 0 | N/A | None for license | N/A |
| North Carolina | 60 | 1 year | None specified | No |
| North Dakota | 60 | 3 years | None specified | Yes (15) |
| Ohio | 100 | 2 years | Opioids/prescribing | No |
| Oklahoma | 60 | 1 year | One hour per prescription authority | No |
| Oregon | 60 | 2 years | Pain management (6 hrs) | No |
| Pennsylvania | 100 | 2 years | Patient safety (12 hrs), opioids | No |
| Rhode Island | 40 | 2 years | Opioid prescribing (2 hrs) | No |
| South Carolina | 40 | 2 years | Controlled substances | No |
| South Dakota | 0 | N/A | None | N/A |
| Tennessee | 40 | 2 years | Controlled substances (2 hrs) | No |
| Texas | 24 | 2 years | Ethics (2 hrs), opioids (2 hrs) | No |
| Utah | 40 | 2 years | Controlled substances (3.5 hrs) | No |
| Vermont | 0 | N/A | None | N/A |
| Virginia | 60 | 2 years | Opioids (2 hrs) | No |
| Washington | 200 | 4 years | Suicide (6 hrs), opioids (4 hrs) | No |
| West Virginia | 50 | 2 years | Opioid prescribing (3 hrs) | No |
| Wisconsin | 30 | 2 years | Opioid prescribing (2 hrs) | No |
| Wyoming | 60 | 3 years | None specified | Yes (20) |
| D.C. | 50 | 2 years | Cultural competency (2 hrs) | No |
States with No CME Requirement
Six states do not require CME for medical license renewal:
| State | Notes |
|---|---|
| Idaho | No state requirement; hospital privileges may require CME |
| Indiana | No state requirement; employers typically require CME |
| Montana | No state requirement; MOC still required for board certification |
| New York | No state requirement; triennial registration only |
| South Dakota | No state requirement; triennial cycle |
| Vermont | No state requirement; annual renewal |
Important: Even without state requirements, physicians in these states typically need CME for: - Hospital credentialing - Specialty board MOC - Insurance panel participation - Employer requirements
States by CME Hours Required
Highest CME Requirements
| Rank | State | Hours | Period | Annual Equivalent |
|---|---|---|---|---|
| 1 | Washington | 200 | 4 years | 50/year |
| 2 | Illinois | 150 | 3 years | 50/year |
| 3 | Michigan | 150 | 3 years | 50/year |
| 4 | Kansas | 100 | 2 years | 50/year |
| 5 | Maine | 100 | 2 years | 50/year |
| 6 | Massachusetts | 100 | 2 years | 50/year |
| 7 | New Hampshire | 100 | 2 years | 50/year |
| 8 | New Jersey | 100 | 2 years | 50/year |
| 9 | Ohio | 100 | 2 years | 50/year |
| 10 | Pennsylvania | 100 | 2 years | 50/year |
Lowest CME Requirements (With CME)
| Rank | State | Hours | Period | Annual Equivalent |
|---|---|---|---|---|
| 1 | Texas | 24 | 2 years | 12/year |
| 2 | Arkansas | 20 | Annual | 20/year |
| 3 | Louisiana | 20 | Annual | 20/year |
| 4 | Alabama | 25 | Annual | 25/year |
| 5 | Wisconsin | 30 | 2 years | 15/year |
| 6 | Colorado | 30 | 2 years | 15/year |
Mandatory CME Topics by State
Opioid/Controlled Substance CME
Most states now require opioid-related CME. Here's the complete breakdown:
| State | Opioid CME Hours | Frequency | Additional Notes |
|---|---|---|---|
| Alabama | Required | Annual | Controlled substance prescribing |
| Arizona | 3 hours | Biennial | Plus 3 hours pain management |
| California | 12 hours | Once | Pain management (one-time) |
| Connecticut | Required | Annual | Opioid prescribing |
| Delaware | Required | Biennial | Controlled substances |
| Florida | 2 hours | Biennial | Prescribing controlled substances |
| Illinois | Required | Triennial | Opioid prescribing |
| Iowa | 2 hours | Biennial | Chronic pain management |
| Maine | 3 hours | Biennial | Opioid prescribing practices |
| Maryland | 2 hours + 1 | Biennial | Plus PDMP training |
| Massachusetts | Required | Biennial | Opioid education |
| Michigan | 3 hours | Triennial | Pain and symptom management |
| Minnesota | Required | Triennial | Opioid therapy best practices |
| Nebraska | 3 hours | Biennial | Opioid prescribing |
| New Hampshire | 3 hours | Biennial | Opioid prescribing |
| New Jersey | 1 hour | Biennial | Opioid prescribing |
| Ohio | Required | Biennial | Prescribing practices |
| Oregon | 6 hours | Biennial | Pain management |
| Pennsylvania | Required | Biennial | Opioid education |
| Rhode Island | 2 hours | Biennial | Opioid prescribing |
| South Carolina | Required | Biennial | Controlled substances |
| Tennessee | 2 hours | Biennial | Controlled substances |
| Texas | 2 hours | Biennial | Opioid prescribing |
| Utah | 3.5 hours | Biennial | Controlled substance prescribing |
| Virginia | 2 hours | Biennial | Opioid prescribing |
| Washington | 4 hours | 4 years | Opioid prescribing |
| West Virginia | 3 hours | Biennial | Opioid prescribing |
| Wisconsin | 2 hours | Biennial | Opioid prescribing |
Ethics CME Requirements
| State | Hours | Notes |
|---|---|---|
| Nevada | 2 hours | Medical ethics required |
| Texas | 2 hours | Professional ethics |
| Pennsylvania | Included | In patient safety requirement |
Other Mandatory Topics
| State | Topic | Hours |
|---|---|---|
| Connecticut | Sexual assault recognition | 2 hours |
| D.C. | Cultural competency | 2 hours |
| Florida | Medical errors prevention | 2 hours |
| Illinois | Sexual harassment | Required |
| Kentucky | Domestic violence | 3 hours |
| Kentucky | HIV/Hepatitis C | Required |
| Massachusetts | Risk management | 30 hours total |
| New Mexico | Pain management | 5 hours |
| Washington | Suicide assessment | 6 hours |
CME Carryover Rules
States Allowing Carryover
| State | Max Carryover | Conditions |
|---|---|---|
| Alaska | Limited | Check current rules |
| Delaware | 10 hours | To next cycle |
| Kentucky | 20 hours | Excess hours carry |
| Minnesota | 15 hours | To next triennial |
| North Dakota | 15 hours | To next triennial |
| Wyoming | 20 hours | To next triennial |
States with No Carryover
Most states (44) do not allow CME credit carryover. Hours completed in one cycle cannot count toward the next cycle.
Strategy: Complete exactly what's required, don't significantly over-complete.
CME Reporting Requirements
Self-Reporting States
Most states use a self-reporting system where physicians: - Attest to completion at renewal - Maintain records for audit period - Provide documentation if audited
Audit-Based Verification
| State | Audit Rate | Record Retention |
|---|---|---|
| California | Random | 4 years |
| Florida | Random | 4 years |
| Texas | Random | 4 years |
| Massachusetts | Random | 6 years |
| New York | N/A | N/A (no CME) |
Recommendation: Keep CME certificates for at least 6 years regardless of state requirements.
Planning Multi-State CME Compliance
Step-by-Step Strategy
- Identify all licensed states and their requirements
- Find the highest total hours among your states
- List all mandatory topics across jurisdictions
- Create a master CME plan that satisfies all requirements
- Track completion by state (some CME may not count everywhere)
Example: Physician Licensed in TX, CA, and MA
| Requirement | TX | CA | MA | Strategy |
|---|---|---|---|---|
| Total hours | 24/2yr | 50/2yr | 100/2yr | Complete 100 hours |
| Opioids | 2 hrs | 12 hrs once | Required | Complete 12 hrs once |
| Ethics | 2 hrs | No | No | Complete 2 hrs |
| Risk mgmt | No | No | 30 hrs | Complete 30 hrs |
| Pain | No | One-time | No | Covered by opioids |
CME Credit Types
AMA PRA Category 1 Credit
The gold standard accepted by all states: - Accredited by ACCME-recognized providers - Most medical conferences qualify - Online CME from accredited providers - Journal-based CME from major publications
Acceptable Alternatives
| Credit Type | States Accepting |
|---|---|
| AOA Category 1A | All states (for DOs) |
| AAFP Prescribed | Many states |
| Specialty board CME | Varies by state |
| Hospital CME | If accredited |
Credits That May NOT Count
| Credit Type | Caution |
|---|---|
| Non-accredited conferences | Verify acceptance |
| International CME | State-specific rules |
| Online-only from non-ACCME | Check accreditation |
| MOC points | May differ from CME hours |
CME and Board Certification
MOC vs. State CME
| Aspect | State CME | Specialty MOC |
|---|---|---|
| Required by | Medical board | Specialty board |
| Consequence | License lapse | Certification lapse |
| Hours | State-determined | Board-determined |
| Topics | May include mandates | Specialty-focused |
| Self-assessment | Usually not | Often required |
Overlapping Strategy
Complete MOC-qualifying CME to satisfy both requirements: - Many state hours can count toward MOC - MOC self-assessment may count as state CME - Plan CME to serve both purposes
Free CME Resources
Accredited Free CME Sources
| Source | Type | Hours Available |
|---|---|---|
| CDC TRAIN | Online modules | 100+ hours |
| Medscape | Online courses | Extensive |
| UpToDate | Point-of-care | Varies |
| AAFP | Selected courses | 20+ free |
| Journal CME | Article reviews | Ongoing |
State-Specific Free CME
Some state medical associations offer free CME to members: - Texas Medical Association - California Medical Association - Massachusetts Medical Society
Key Takeaways
- CME ranges from 0-200 hours depending on state
- Six states require no CME (ID, IN, MT, NY, SD, VT)
- Opioid CME now mandatory in most states
- Carryover is rare - only 6 states allow it
- Multi-state physicians should plan around strictest requirements
- MOC and state CME overlap with proper planning
- Keep records 6+ years for potential audits
Frequently Asked Questions
Which states don't require CME for medical license renewal?
Six states have no CME requirement for license renewal: Idaho, Indiana, Montana, New York, South Dakota, and Vermont. However, physicians in these states typically still need CME for hospital privileges, specialty board MOC, insurance panel participation, and employer requirements. The state licensing board just doesn't mandate it.
Can I use the same CME for multiple states?
Yes, if the CME is AMA PRA Category 1 credit from an ACCME-accredited provider, it generally counts in all states. However, state-specific mandatory topics (like California's 12-hour pain management or Massachusetts' 30-hour risk management) may not satisfy other states' requirements. Plan to complete all mandatory topics across your licensed states.
How do I track CME for multiple states with different cycles?
Create a master tracking system that includes: each state's total requirement, mandatory topics, cycle dates, and completion status. Complete your strictest state's requirements as baseline, then verify mandatory topics are covered for all states. Use a spreadsheet or tracking software like CredentialMate to manage deadlines and documentation separately.
Do CME hours carry over to the next renewal cycle?
Only six states allow carryover: Alaska (limited), Delaware (10 hours), Kentucky (20 hours), Minnesota (15 hours), North Dakota (15 hours), and Wyoming (20 hours). The other 44 states with CME requirements do not allow excess hours to count toward the next cycle. Don't significantly over-complete your requirements.
What counts as AMA PRA Category 1 Credit?
AMA PRA Category 1 Credit comes from activities accredited by organizations recognized by the Accreditation Council for Continuing Medical Education (ACCME). This includes most medical conferences, hospital grand rounds (if accredited), online CME from major providers (Medscape, UpToDate), journal-based CME from major publications, and many specialty society educational programs. Always verify accreditation before completing an activity.
Conclusion
CME requirements vary significantly across states, making careful planning essential for physicians—especially those licensed in multiple jurisdictions. Understanding your state's specific hours, mandatory topics, and cycle timing enables efficient compliance without last-minute stress.
Use CredentialMate to track CME requirements across all your licensed states, receive deadline reminders, and document completion for audit protection.
References
[1]: FSMB - Continuing Medical Education by State https://www.fsmb.org/siteassets/advocacy/key-issues/continuing-medical-education-by-state.pdf Last verified: January 2026
[2]: BoardVitals - CME Requirements by State https://www.boardvitals.com/blog/cme-requirements-by-state/ Last verified: January 2026
[3]: Physicians Thrive - CME Requirements 2025 https://physiciansthrive.com/cme-requirements-for-physicians-by-state/ Last verified: January 2026
[4]: ACCME - State Medical Board Requirements https://www.accme.org/state-medical-boards Last verified: January 2026
[5]: CDC TRAIN - Free CME Resources https://www.train.org/ Last verified: January 2026
[6]: Medscape Education https://www.medscape.com/education Last verified: January 2026