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California CME requirements 2026 rules for physicians, NPs, PAs, CRNAs and CAAs
California regulates four clinician professions through different boards, each with its own continuing-education rules: physicians (MD/DO), nurse practitioners (APRN/NP), physician assistants (PA) and nurse anesthetists (CRNA). Anesthesiologist assistants (CAA) cannot practice in California. Below, each profession's total hours, mandated topics, opioid/controlled-substance rule, and tracking, plus the one federal rule they share. Physician rules reviewed October 13, 2026.
Physicians (MD / DO)
Set by the Medical Board of California. Verified October 13, 2026.
General CME: 50 hours AMA PRA Category 1 every 2 years.
Opioid / controlled substance
12 hours one-time (by 2nd renewal / within 4 years): pain management and care of the terminally ill, including Schedule II addiction risk. Trigger: all except pathologists & radiologists.
✓ No board pre-approval needed, but the course must reach 12 hours and cover pain + end-of-life; the 8-hour core needs a CA addendum. Content gap, not an approval gap.
All mandated CME topics
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Pain management and care of the terminally ill (including Schedule II addiction risk for post-2019 licensees) | 12 | one-time (by 2nd renewal / within 4 years) | all except pathology/radiology |
| Geriatric medicine / dementia | At least 20% of hours (about 10) | per cycle while condition applies | IM/FM with >25% pts 65+ |
| Cultural & linguistic competency | embedded course content (no add-on hours) | ongoing (since 7/1/2006) | all courses |
| Implicit bias | embedded course content (not standalone) | ongoing (since 1/1/2022) | all courses |
Citation: Cal. Bus. & Prof. Code §§2190.5, 2190.6
Nurse Practitioners (APRN / NP)
Set by the California Board of Registered Nursing (BRN), separate from the physician rules above, with its own hours and topics. Verified July 20, 2026.
General CE: NPs renew RN license: 30 BRN-approved contact hours every 2 years (16 CCR 1451). First renewal exempt. If >25% patients age 65+, 6 of 30 hours must be gerontology/dementia.
Opioid / controlled substance
No standalone state opioid/controlled-substance CE mandate identified for this profession. The federal DEA MATE Act (one-time 8-hour training) still applies if you hold a DEA registration.
All mandated CE topics
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Pharmacology / pharmacotherapeutics (prescriptive authority) | None | per cycle | prescribers |
| Implicit bias | 1 | one-time within first 2 years after initial RN licensure | newly licensed RNs including NPs |
| Gerontology / older-adult care | 6 | per 2-year cycle (6 of 30) | NPs/RNs with >25% patients 65+ |
Tracking: Self-report/attestation at renewal (BreEZe); retain certificates 4 years; random audit. Not CE Broker.
Physician Assistants (PA)
Set by the Physician Assistant Board (California), separate from the physician rules above, with its own hours and topics. Verified July 20, 2026.
General CE: 50 hours approved (AMA PRA Category 1-equivalent) per 2 years or current NCCPA certificate (16 CCR 1399.615). Direct-patient-care CME must include implicit-bias curriculum; geriatric allocation for qualifying PAs.
Opioid / controlled substance
No standalone state opioid/controlled-substance CE mandate identified for this profession. The federal DEA MATE Act (one-time 8-hour training) still applies if you hold a DEA registration.
All mandated CE topics
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Pharmacology / pharmacotherapeutics (prescriptive authority) | 6 hours | per cycle | prescribers |
| Implicit bias | Course (no set hours) | embedded curriculum (no separate hour) in direct-patient-care CME | all PAs taking direct-patient-care CME |
| Geriatric medicine / elder & dementia care | 10 | per cycle - at least 20% of the 50 hours | primary-care PAs with >25% patients 65+ |
Tracking: Self-certify under penalty of perjury at renewal (BreEZe); random audit. Not CE Broker.
Nurse Anesthetists (CRNA)
Set by the California Board of Registered Nursing (BRN): issues the Nurse Anesthetist (NA) certificate to a California-licensed RN (BPC 2830), separate from the physician rules above, with its own hours and topics. Verified August 24, 2026.
General CE: The NA certificate is renewed 'every two years on or before the last day of the month following the certificate holder's birthday' (BPC 2833) and 'renewal fees for the certificates ... are due at the same time as your RN license renewal fee' (BRN lic-renewal page). CE is the underlying RN requirement: 30 hours of Board-approved CE per 2-year period, attested under penalty of perjury, certificates retained 4 years (16 CCR 1451). First RN renewal exempt. No CA regulation sets CRNA-specific CE; the BRN NA application PDF requires current certification/recertification by the national nurse anesthesia certifying body at initial certification.
State CE is owed in addition to NBCRNA. Neither BPC 2825-2833.6 nor 16 CCR 1450-1459 provides that NBCRNA recertification substitutes for the 30-hour RN CE. NBCRNA Class A credits from BRN-approved providers (CEP) may be counted toward the 30 hours if the provider is BRN-recognized (16 CCR 1456), but recertification status itself is not accepted in lieu. Initial NA certification requires current NBCRNA certification (BRN NA instructions, na-instruct.pdf). Whether BRN verifies continued NBCRNA certification at NA certificate renewal is not stated on the BRN renewal page (only fee). Confirm with BRN. National layer: NBCRNA continued certification (4-year cycle: 60 Class A + 40 Class B credits, MAC Check).
Opioid / controlled substance
No standalone state opioid/controlled-substance CE mandate identified for this profession. The federal DEA MATE Act (one-time 8-hour training) still applies if you hold a DEA registration.
All mandated CE topics
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Implicit bias | 1 | one-time within first 2 years after initial RN licensure | newly licensed RNs (incl. CRNAs who obtain initial CA RN license on/after 1/1/2023) |
| Gerontology / older-adult care | 6 | per 2-yr cycle (6 of 30) | RNs/CRNAs whose patient population is >25% age 65+ |
Tracking: Self-attestation at renewal via BreEZe under penalty of perjury; retain CE certificates 4 years; random audit (16 CCR 1451(b)-(d)). Not CE Broker. NA certificate renewed with RN license plus separate NA renewal fee.
Anesthesiologist Assistants (CAA)
Not authorized to practice in California. Verified August 24, 2026.
Certified anesthesiologist assistants cannot practice in California: there is no CAA license, certification or physician-delegation pathway, so there are no state CE requirements to track here. Pending / recent legislation: AB 985 (Ahrens, 2025-26) 'Anesthesiologist Assistant Practice Act' sponsored by the California Society of Anesthesiologists - passed Assembly B&P 17-0 (April 22, 2025), Appropriations 15-0 (May 7, 2025), Assembly floor 64-1 (June 3, 2025); in the Senate the bill was gutted-and-amended (August 29, 2025) into an unrelated Chiquita Canyon Landfill property-tax measure and chaptered as Ch. 174, Stats. 2025 (October 1, 2025) - the AA provisions did not become law. CSA states 'legislative activity is currently paused' (safeanesthesiacare.com). No 2026 successor bill identified as of August 24, 2026. NCCAA certification requirements (50 CME hours every 2 years + the CDQ exam) still apply nationally.
Federal: DEA MATE Act (all professions)
One rule is the same for every profession on this page. Every DEA-registered prescriber (physicians, nurse practitioners, physician assistants, and any CRNA or CAA who holds a DEA registration) must complete a one-time 8-hour training on treating patients with opioid or other substance use disorders, as a condition of DEA registration/renewal (since June 27, 2023). It is federal and applies in every state, and it does not replace California's own one-time opioid/controlled-substance course. A MATE-qualifying accredited course will usually still count toward your state general CME/CE total. How the MATE Act differs from state rules
Authority: MATE Act §1263, Consolidated Appropriations Act 2023 (21 U.S.C. §823).
Notes (physician data)
- Total is 50 hours (some summaries say 100). Implicit bias and cultural competency are course-content mandates, not extra hours. No standalone recurring opioid CME.
- DOs: the figures above are the Medical Board of California's. Osteopathic requirements now diverge. The OMBC conformed to statute effective October 1, 2025: 50 hours per 2-year cycle with at least 20 AOA Category 1-A, plus new mandated topics. Verify with the Osteopathic Medical Board of California.
Pick your profession and all your states in the free planner and get one 5-year schedule that batches your opioid/controlled-substance CME so a single course covers as many licenses as possible.
This page summarizes California board rules and statutes as of October 13, 2026 for five separately-regulated professions: physicians (MD/DO), nurse practitioners (APRNs), physician assistants (PAs), nurse anesthetists (CRNAs), and anesthesiologist assistants (CAAs). Each is governed by its own board and its hour totals and mandated topics differ. Never assume one profession's figures apply to another. Physician data is compiled from FSMB and state medical-board sources; APRN/PA data was validated against nursing- and PA/medical-board rules on July 20, 2026, with the opioid/controlled-substance timing structured on July 23, 2026; CRNA and CAA data was researched against nursing-board, medical-board and practice-act primary sources on August 24, 2026 (items the research could not pin to a primary source are marked “Confirm with the board”). This is educational information, not legal advice. Always verify current requirements with your own board before relying on them.