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Missouri CME requirements 2026 rules for physicians, NPs, PAs, CRNAs and 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), regulated by the Missouri State Board of Registration for the Healing Arts. 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 Missouri Board of Registration for the Healing Arts. Verified October 13, 2026.
General CME: 50 hours every 2 years, including at least 1 hour on the health benefits of nutrition (effective 6/30/2026).
Opioid / controlled substance
No opioid-specific mandate. Federal MATE Act (8 hours one-time) only.
✓ No board pre-approval needed: the federal MATE Act requirement is a single 8-hour course.
All mandated CME topics
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Health benefits of nutrition | 1 | per 2-year cycle, within the 50 (effective 6/30/2026) | all |
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. Verified July 20, 2026.
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. Verified July 20, 2026.
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. Verified August 24, 2026.
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. Verified August 24, 2026.
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 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. 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)
- One special topic: at least 1 of the 50 hours must cover the health benefits of nutrition (20 CSR 2150-2.125(1), amendment effective 6/30/2026). No opioid-specific mandate.
Common questions about Missouri CME
How many CME hours does Missouri require for physicians?
Missouri requires 50 / 2 years of continuing medical education (20 CSR 2150-2.125). 50 hours every 2 years, including at least 1 hour on the health benefits of nutrition (effective 6/30/2026).
Does Missouri require opioid or controlled-substance CME?
Missouri does not currently mandate a recurring opioid/controlled-substance CME topic for all physicians. No opioid-specific mandate. Federal MATE Act (8 hours one-time) only.
Does my opioid CME course need Missouri board approval?
No board pre-approval: the federal MATE Act requirement is a single 8-hour course.
How is CME tracked in Missouri?
Missouri tracking: Self-report (attest at renewal). Board: Missouri Board of Registration for the Healing Arts.
Do nurse practitioners and physician assistants have different CME requirements in Missouri?
Yes. In Missouri, nurse practitioners (APRNs) are licensed by the board of nursing and physician assistants (PAs) by the PA/medical board, each setting its own CE hours and mandated topics. These differ from the physician (MD/DO) figures. The federal DEA MATE Act and most state opioid/controlled-substance prescribing CME still apply to APRNs and PAs who hold a DEA registration. See the profession-specific sections on this page.
What are the CME requirements for CRNAs and anesthesiologist assistants in Missouri?
CRNAs in Missouri are regulated by the Missouri State Board of Nursing (MSBN), Division of Professional Registration and must also maintain NBCRNA certification (a 4-year cycle of 60 Class A and 40 Class B credits). Certified anesthesiologist assistants are regulated by the Missouri State Board of Registration for the Healing Arts (Division of Professional Registration) and maintain NCCAA certification (50 CME hours every 2 years plus the CDQ exam). Whether the state accepts national recertification in place of counted hours is stated in each section on this page.
More on Missouri
- What a Missouri license costs, and how long the board says it takes
- What else can hold up a renewal: PDMP accounts, fingerprints, lawful presence
- Licensed in more than one state? How one course can count in several
- Adding a state through the Interstate Medical Licensure Compact
- Track Missouri CME next to your other licenses
Every license, certificate and renewal date on one list, checked against each board’s own rules, with a reminder before anything is due. 30 days free with a card on file. Licensed in more than one state? The free planner times your opioid and controlled-substance hours so one course counts in as many states as it can.
This page summarizes Missouri 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.