How many CME credits do I need? Part 1: requirements by state (2026)

Somewhere between "renew by" and "attest under penalty of perjury," every physician asks the same question: how many hours do I actually owe?

According to the Federation of State Medical Boards (FSMB), 63 of 67 state and territorial boards require substantial CME (at least 15 hours a year), 55 of 67 require specific topics, and 28 of 67 accept equivalents such as board certification. Four states set no general hour count at all.

This is Part 1 of our guide and covers your state license. Your specialty board keeps its own scoreboard; that's in Part 2: Requirements by Specialty Board.

These physician tables do not cover PA licensure. PAs can use our separate NCCPA and state CME requirements guide. For education expenses, see our CME tax deduction guide; satisfying a credit requirement does not establish deductibility.

How to read the state tables

• Hours and cycle. Total hours per renewal period. To compare states, divide by the cycle length.
• Category 1 minimum. How many hours must be AMA PRA Category 1 Credit™ (or the board's equivalent) from accredited providers. "All" means every hour must be Category 1.
• Category 2 / self-directed counts? Whether the board lets some hours come from AMA PRA Category 2 Credit™, informal learning or self-directed study, and how much. This is where well-documented independent study can legitimately carry part of the load.
• Required topics. Mandated subjects. Most must be met with approved courses, and many apply only to prescribers or certain specialties.
• Board certification swaps. Many states accept board certification or MOC participation in place of some or all hours. We note the big ones; topic mandates often survive the swap.
• MD vs. DO. These tables cover allopathic (MD) boards. Several states (including Arizona, California, Florida, Maine, Michigan, Nevada, Oklahoma, Pennsylvania, Tennessee, Vermont, Washington and West Virginia) have a separate osteopathic board with different hours and AOA category rules. DOs should check their own board.
• Federal layer. Every DEA registrant also owes a one-time 8-hour training on substance use disorders under the MATE Act (for registrations or renewals since June 27, 2023).

Tables summarize the FSMB's August 2026 overview with selected board updates. Topic highlights are not exhaustive; first-renewal rules, exemptions and alternative pathways can differ. Your board's current rules and renewal application control.

Northeast: CME requirements by state

The Northeast is a region of extremes. New York sets no hour count at all, while Pennsylvania, New Jersey and New Hampshire ask for 100 hours every two years. The upside of those big numbers: all three let a large share come from Category 2, and Massachusetts lets every hour be Category 1 or 2.

Midwest: CME requirements by state

The Midwest holds two of the four states with no hour count (Indiana and South Dakota) and two of the biggest three-year totals (Illinois and Michigan, 150 hours each). Illinois is the friendliest to self-directed learners in the region: up to 90 of its 150 hours can be informal, and the rule names journal reading outright.

South Atlantic: CME requirements by state

Along the Atlantic coast, 40 to 50 hours every two years is the norm, and Category 1 is the rule. Maryland is the exception: half of its 50 hours can be Category II. Virginia trimmed its requirement in 2025 to 30 accredited hours, so ignore older guides that still say 60.

South Central: CME requirements by state

Three states here (Alabama, Arkansas and Louisiana) run on an annual clock, so there's no coasting through year one. Texas stands out for flexibility: up to half of its 48 hours can be informal self-study, grand rounds or case conferences, recorded so you can send them to the board on request.

West: CME requirements by state

The West is a mixed bag: California's tidy 50 Category 1 hours, Montana's no-hour policy, Colorado's brand-new 30-hour rule, and Washington's 200-hour, four-year marathon. Washington and Wyoming are the region's open doors for self-directed learning. Washington even has a named category (Category V) for independent journal reading.

Where self-directed learning counts

If you do your best thinking with a stack of reading and a quiet afternoon, these are the boards that make room for it (MD licenses, per FSMB and board sources):

• Washington: up to 80 of 200 hours in Category V (self-directed, including independent reading of journals and books), plus up to 80 each in Categories II–IV.
• Illinois: up to 90 of 150 hours from informal activities, including journal reading and consultation with peers.
• Pennsylvania: up to 80 of 100 hours as Category 1 or 2.
• New Jersey and New Hampshire: up to 60 of 100 hours as Category II.
• Massachusetts: all 50 credits may be Category 1 or 2, and a board policy lets you claim reading done for patient care or clinical updating.
• Wyoming: any combination of Category I or II across 60 hours.
• Kentucky: 30 of 60 hours may be Category I or II.
• Maryland: up to 25 of 50 hours as Category II.
• Texas: up to 24 of 48 hours as informal self-study, lectures, grand rounds or case conferences.
• Partial or state-defined: Michigan permits only board-listed Category 2 activities; Kansas uses its own Category II definition. Do not assume all non-Category 1 hours qualify as independent reading.

Two checks matter. First, topic-specific rules control eligible activities: independent reading is not a substitute for an approved course unless your board expressly permits it. Second, document self-directed hours. Boards audit, and an audit letter asks you to show what you learned, when, and for how long. Texas, for example, says informal hours must be recorded so they can be easily sent to the board on request, and Virginia and Maryland ask you to keep documentation for six years.

Under AMA rules, physicians may self-claim AMA PRA Category 2 Credit™ for learning that meets the AMA's criteria, such as reading authoritative medical literature. For what that looks like in practice, see Category 2 CME examples.

Why Category 2 is still worth logging, even when it won't count

Practice in a state like California or Ohio, where Category 2 doesn't count toward your license? It can still earn its keep. Six reasons:

• The AMA's own award counts it. The AMA Physician's Recognition Award lets Category 2 fill up to 30 of the 50 credits for a one-year award, 60 of 100 for two years and 90 of 150 for three.
• Licenses travel and rules change. Add a license through a move or the Interstate Medical Licensure Compact, and you may land in a state that accepts self-directed hours, such as Pennsylvania, Texas, Illinois or New Jersey. Rules shift too: Virginia rewrote its requirement in 2025. A log you already kept is ready when that happens.
• Your employer may still pay for it. CME allowances are set by your employer, not your board, and many policies ask for a program and proof of participation rather than a credit type. Check yours.
• It supports expense records. A dated learning log can help your tax adviser evaluate education expenses. It does not establish deductibility, and travel and lodging have separate requirements.
• It's how you prepare for your board's assessment. Longitudinal assessments such as ABIM's LKA, ABFM's longitudinal assessment and MOCA-Peds test what you know, and much of that comes from your own reading.
• It's the learning that changes your practice. The new guideline, the paper a colleague sent, the question from Tuesday's clinic: most of what keeps you current never comes with a certificate.

Shift CME helps organize participation records. Your journal modules, your check-in and any course evaluation you submit are saved together in Records, available for you to review alongside the documentation required by a board, employer or tax adviser. Physicians must evaluate each activity against AMA criteria and the accepting board's rules; a participation record does not itself create credit.

Where Shift CME fits

Shift CME helps you schedule self-directed learning and keep a record of your participation.

You plan a self-directed conference at a destination you choose from our list, for every day of your dates, weekends included. Each study day runs 9:00 AM to 2:00 PM local time, with journal modules chosen for your specialty. When you confirm, you get a confirmation PDF, dated that day, that lists your program, venue and study days, so the plan is documented before you book a flight.

A simple check-in from your phone confirms you're at your destination. After your last study day, we email your conference records and keep them together in Records. Knowledge checks and evaluations are optional unless required for the AMA CME credit you choose to claim.

Here's how that lines up with the state rules above:

• In states that accept Category 2 or informal hours (Washington, Illinois, Pennsylvania, New Jersey, New Hampshire, Massachusetts, Wyoming, Kentucky, Maryland, Texas and others), well-documented self-directed study is a legitimate part of meeting the requirement. Physicians may self-claim AMA PRA Category 2 Credit for qualifying self-directed learning, and your Shift CME records can support your own self-claim. Whether and how much you claim is your call under your board's rules.
• If you're audited, your plan, your check-in and any reflections are already in one place instead of scattered across inboxes.
• If you have a CME allowance, a dated plan made before you travel is useful for a reimbursement request. See how to use your CME allowance. Self-employed physicians can share the same records with their tax adviser.

It depends on the session. A presentation or journal module offers AMA PRA Category 1 Credit™ only where its accredited provider offers a CME activity and supplies instructions for claiming it; then you claim it as that provider directs. That credit comes from the provider, not from Shift CME, and not every session offers it. Physicians may also self-claim AMA PRA Category 2 Credit™ for learning they judge meets the AMA's requirements, and your Shift CME records can support that claim. Nurse practitioners and physician assistants follow their own certifying bodies' rules: NCCPA lets PAs self-claim Category 2 CME, while AANPCB and ANCC require accredited contact hours, which Shift CME does not award. Shift CME conferences don't cover state-mandated topic courses; those still come from approved providers. In Category 1-only states such as California, Ohio or North Carolina, think of it as a structured way to keep learning; only Category 1 activities you complete count toward your hour count. You can explore a sample conference to see what a plan looks like.

FAQ: CME requirements by state

Sources

1. Federation of State Medical Boards, Continuing Medical Education Board-by-Board Overview (last updated August 2026)
2. Texas Medical Board, Continuing Education Requirements for Physicians
3. Florida Board of Medicine, Medical Doctor Renewal
4. Medical Board of California, Continuing Medical Education
5. Pennsylvania State Board of Medicine, CME requirements (MD unrestricted license)
6. Illinois Admin. Code tit. 68, § 1285.110
7. Michigan Admin. Code R 338.2443
8. Michigan State Medical Society, MD Licensure Requirements
9. Virginia Admin. Code 18VAC85-20-235
10. Washington Admin. Code 246-919-460
11. Massachusetts Board of Registration in Medicine, CME requirements
12. Maryland Board of Physicians, 2026 renewal information
13. Kentucky Board of Medical Licensure, Continuing Medical Education
14. Mississippi State Board of Medical Licensure, CME Requirements
15. Connecticut Department of Public Health, Continuing Medical Education
16. Vermont Board of Medical Practice, CME rules
17. Rhode Island Department of Health, Physicians
18. Iowa DIAL, Continuing Education for Physicians
19. Colorado DORA, CME requirements begin with the 2027 renewal cycle
20. New York State Education Department, Physician License Requirements
21. DEA Diversion Control Division, MATE Act Q&A
22. AMA, What to know about the other kind of CME credit
23. Shift CME, How it works
24. Shift CME, Sample conference
25. Arkansas State Medical Board, physician CME FAQ
26. New Mexico, 16.10.4 NMAC: continuing medical education and 16.10.14 NMAC: pain management