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Missouri CME Requirements (2026): Physicians, NPs, PAs, CRNAs & CAAs
Missouri regulates five clinician professions through different boards, each with its own continuing-education rules — physicians (MD/DO), nurse practitioners (APRN/NP), physician assistants (PA), nurse anesthetists (CRNA), and anesthesiologist assistants (CAA, in the states that license them). Below, each profession's total hours, mandated topics, opioid/controlled-substance rule, and tracking, plus the one federal rule they share. Last reviewed 2026-08-24.
Physicians (MD / DO)
Set by the Missouri Board of Registration for the Healing Arts.
General CME: 50 hours every 2 years.
Opioid / controlled substance
No opioid-specific mandate. Federal MATE Act (8 hours one-time) only.
✓ No board pre-approval gate: No board pre-approval — the federal MATE Act requirement is a single 8-hour course.
All mandated CME topics
No additional mandated topics identified beyond the total above.
Citation: 20 CSR 2150-2.125
Nurse Practitioners (APRN / NP)
Set by the Missouri State Board of Nursing (MSBN), Division of Professional Registration — separate from the physician rules above, with its own hours and topics.
General CE: Missouri does NOT mandate any general continuing-education hours for RN, LPN, or APRN license renewal. APRN 'Document of Recognition' requires maintaining current national certification (recertification verified from a certifying body approved by the MSBN) rather than state-counted CE hours. The only numeric CE figure in rule applies to the rare UNCERTIFIED APRN, who must complete a minimum of 60 contact hours in the specialty area plus 800 clinical practice hours each renewal period (20 CSR 2200-4.100). Certified APRNs (the overwhelming majority) satisfy the requirement solely by maintaining national certification.
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
No additional mandated topics identified beyond the total above.
Tracking: Self-report / no state CE-hour tracking. MSBN does NOT use CE Broker for nurses. APRN recognition is maintained by keeping current national certification; the board verifies/audits primary-source evidence of recertification and unrestricted RN+APRN licensure.
Physician Assistants (PA)
Set by the Missouri Board of Registration for the Healing Arts (Advisory Commission for Physician Assistants), Division of Professional Registration — separate from the physician rules above, with its own hours and topics.
General CE: Missouri imposes NO independent state statutory CME-hour mandate for Physician Assistants. Licensure and renewal require the PA to maintain a current, active NCCPA certification. NCCPA certification maintenance requires 100 CME hours per 2-year cycle (at least 50 Category 1) — but this is a NATIONAL CERTIFICATION requirement, not a Missouri state statute/rule. The Missouri PA statutes (RSMo 334.735-334.749) and rules (20 CSR 2150-7) condition licensure on active NCCPA status rather than prescribing a state CE count.
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
No additional mandated topics identified beyond the total above.
Tracking: Self-report / certification-based. No CE Broker. The board verifies active NCCPA certification at licensure/renewal; NCCPA maintains the underlying CME logging.
Nurse Anesthetists (CRNA)
Set by the Missouri State Board of Nursing (MSBN), Division of Professional Registration — separate from the physician rules above, with its own hours and topics.
General CE: 20 CSR 2200-4.100(5)(A): certified APRNs must 'provide primary source evidence of recertification by a certifying body, approved by the MSBN, to the MSBN prior to the current expiration date'; failure results in lapse of the APRN license. Missouri imposes no general CE hours on RN or APRN renewal. The 60-contact-hr/800-practice-hr alternative applies only to APRNs practicing without national certification (grandfathered), which is not a CRNA pathway.
NBCRNA recertification is accepted in place of state CE. NBCRNA recertification is the sole competency requirement for CRNA renewal; there is no separate state CE hour count to satisfy. 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
No additional mandated topics identified beyond the total above.
Tracking: No state CE-hour tracking; MSBN verifies/audits primary-source NBCRNA recertification and unrestricted RN license. Not CE Broker.
Anesthesiologist Assistants (CAA)
Set by the Missouri State Board of Registration for the Healing Arts (Division of Professional Registration) — separate from the physician rules above, with its own hours and topics.
General CE: 20 CSR 2150-9.070: 'Each licensee shall complete and report at least forty (40) hours of continuing education each renewal period,' completed within the twenty-four (24)-month period prior to license expiration, accredited by NCCAA or the American Academy of Anesthesiologist Assistants. Licensee attests under penalty of perjury and keeps records 3 years; board may audit. Renewal due on or before January 31 of the renewal year (20 CSR 2150-9.060).
NCCAA recertification counts toward state CE (partial). Rule does not say NCCAA certification substitutes for the 40 hours, but the 40 hours must be NCCAA- or AAAA-accredited CE, and active NCCAA certification is a licensure condition (RSMo 334.400 definition; 20 CSR 2150-9.030). In practice NCCAA's requirement (50 CME hours per 2 years: 40 anesthesia + 10 general, plus the CDQ examination in year 4 and then every 10 years) more than satisfies the state total. National layer: NCCAA certification (50 CME hours every 2 years — 40 anesthesia + 10 general — plus the CDQ exam).
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
No additional mandated topics identified beyond the total above.
Tracking: Self-attestation at renewal; board audit (20 CSR 2150-9.070). Renewal fee $25 (pr.mo.gov fee page).
Federal — DEA MATE Act (all professions)
One rule is the same for everyone below. 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, applies in every state, and does not replace Missouri's recurring opioid/controlled-substance CME. 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)
- No special-topic CME mandate. 20 CSR 2150-2.125.
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.
Build my multi-state CME plan →This page summarizes Missouri board rules and statutes as of 2026-08-24 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 2026-07-20, with the opioid/controlled-substance timing structured on 2026-07-23; CRNA and CAA data was researched against nursing-board, medical-board and practice-act primary sources on 2026-08-24 (items the research could not pin to a primary source are flagged [VERIFY]). This is educational information, not legal advice — always verify current requirements with your own board before relying on them.