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Texas CME requirements for internists
Texas sets one CME total for physicians in every specialty: 48 hours every 2 years (24 formal Category 1), with 8 mandated topics. As an internist you also keep up ABIM Maintenance of Certification (MOC). Below: both, and where one certificate counts for each.
Texas: the state rule
Checked against the Texas Medical Board's rules on October 13, 2026. Citation: Tex. Occ. Code ch. 156; TMB Board rule 161.35.
General CME: 48 hours every 2 years (minimum 24 Category 1).
Opioid / controlled substance
At least 2 hours, safe/effective pain management re: prescribing opioids & other CS. First two renewal periods, then at least every 8 years. Trigger: renewals designating direct patient care.
No board pre-approval needed: any ACCME AMA PRA Category 1 course covering §156.055 content counts. CE Broker reporting has been mandatory since September 1, 2026 (SB 912): renewal will not open without a CE Broker 'Complete' status.
Mandated topics, and whether each reaches internists
| Topic | Hours | Timing | Who it applies to | For internists |
|---|---|---|---|---|
| Medical ethics and professional responsibility (includes risk management, domestic abuse and child abuse) | 2 | per biennium | all | Applies to all physicians. |
| Controlled substances / opioid / pain management | 2 | first 2 renewal periods, then at least every 8 years | physicians in direct patient care (non-direct-care may waive) | Applies if you provide direct patient care. Check whether this applies to your practice. |
| Human trafficking prevention (standalone, HHSC-approved) | 1 | 1st renewal then every 3rd renewal | physicians in direct patient care | Applies if you provide direct patient care. Check whether this applies to your practice. |
| Pain management clinic CME | 10 | biennial (per 22 TAC 172.3(d)(2)) | pain-clinic directors/personnel | Check whether this applies to your practice. |
| Nutrition and metabolic health | 1 | every renewal, for licenses expiring on or after May 30, 2027 | all physicians (Tex. Occ. Code §156.061; 22 TAC 161.35) | Applies to all physicians. |
| Laws governing pregnancy-related medical emergencies (TMB's own free course, via MyTMB) | 1 | one-time (before first renewal after 1/1/2026) | physicians providing obstetric care | Check whether this applies to your practice. |
| Forensic evidence collection / sexual assault survivor care (HB 47): SASTF-approved courses only | 2 | per 2-year cycle, beginning with licenses expiring 2/28/2027 (no approved coursework yet) | any physician treating patients in an ER or urgent-care setting, practice setting, not specialty; attest out via CE Broker if this isn't you | Applies by setting, not specialty: only if you treat patients in an ER or urgent-care setting. Check whether this applies to your practice. |
| EMS (off-line) medical direction | 12 initial, then 1 per renewal | 12 hours within 2 years of notifying the Board (or ABMS EMS board certification / AOA CAQ / a DSHS-approved course), then 1 hour each biennial renewal (Board rule 169.12) | off-line EMS medical directors | Check whether this applies to your practice. |
Notes from the Texas page
- (1) Opioid and controlled-substance CME: 2 hours within the first year of licensure and at the second renewal, then at least every 8 years (Occ. Code 156.055), for physicians in direct patient care. (2) Pain-clinic CME: 10 hours every 2 years (22 TAC 172.3(d)(2)). (3) Nutrition and metabolic health: 1 hour at every renewal for licenses expiring on or after May 30, 2027 (Tex. Occ. Code §156.061; 22 TAC 161.35).
Full detail, including the rules for NPs, PAs, CRNAs and CAAs: Texas CME requirements.
Your board: ABIM Maintenance of Certification (MOC)
Board figures as tracked in the Ledger, last checked August 1, 2026. Confirm in your board portal.
The American Board of Internal Medicine (ABIM) runs MOC on a 5-year cycle: 100 MOC points in any mix of CME, self-assessment or quality improvement, plus the Longitudinal Knowledge Assessment (or the traditional 10-year exam).
Most accredited CME converts to MOC points 1:1. The old 2-year point rule was eliminated in December 2024.
DOs certified by the AOBIM follow the AOA's Osteopathic Continuous Certification instead, with different credit rules.
What usually overlaps
- Opioid course. An accredited opioid course that covers Texas's required content can count toward the opioid requirement and toward the general 48-hour total at the same time, when the activity awards the credit Texas accepts.
- Board CME. Most accredited CME converts 1:1 to ABIM MOC points, so a Category 1 activity that also awards MOC points can count toward your 100 points and toward Texas's hours at the same time. Check what credit each certificate awards.
- Federal MATE Act. If you hold a DEA registration, the one-time 8-hour training is federal and does not replace Texas's own rules. A MATE-qualifying accredited course will usually still count toward Texas's general total.
For internists in Texas
- Pace: Texas asks for 48 hours every 2 years, about 24 a year. ABIM asks for 100 MOC points over 5 years, about 20 a year. Certificates that carry credit both accept count toward each, so plan to the larger of the two.
One record for your licenses and your board
The Ledger counts one certificate toward every state and board requirement it satisfies, at full hours each, and reminds you before anything is due. 30 days free with a card on file.
Common questions
How many CME hours does Texas require for internists?
Texas's total is the same for physicians in every specialty: 48 hours every 2 years (24 formal Category 1), plus 8 mandated topics, some limited to certain practices. Checked against the Texas Medical Board's rules on October 13, 2026.
Does ABIM MOC count toward Texas's CME hours?
Most accredited CME converts 1:1 to ABIM MOC points, so a Category 1 activity that also awards MOC points can count toward your 100 points and toward Texas's hours at the same time. Check what credit each certificate awards.
Related
- Texas CME requirements, all professions
- CME requirements for all 51 jurisdictions
- CME by state and specialty
- Opioid and controlled-substance CME by state
A summary of the Texas physician rules as checked on October 13, 2026 and of ABIM rules as last checked August 1, 2026. Informational, not legal advice. Rules change mid-cycle: verify with the Texas Medical Board and your board before relying on any entry.