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North Carolina CME Requirements (2026): Physicians, NPs, PAs, CRNAs & CAAs
North Carolina 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 North Carolina Medical Board.
General CME: 60 hours every 3 years.
Opioid / controlled substance
3 hours Category 1 every 3-year cycle — controlled-substance prescribing practices including chronic pain. Trigger: any MD/DO who prescribes CS.
✓ No board pre-approval gate: No board pre-approval — no designated course; the NCMB posts an options list 'as a courtesy.' DEA MATE Act training also satisfies it.
All mandated CME topics
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Controlled substances / opioid / chronic pain prescribing | 3 | per 3-year cycle | controlled-substance prescribers |
Citation: 21 NCAC 32R .0101(b)
Nurse Practitioners (APRN / NP)
Set by the North Carolina Board of Nursing (NP approval granted jointly with the NC Medical Board) — separate from the physician rules above, with its own hours and topics.
General CE: 50 contact hours of continuing education every two years, beginning with the first renewal after initial approval to practice. A minimum of 20 of the 50 hours must be within the NP's national certification area and approved by a national credentialing body or the ACCME. An NP who holds a current national certification by a national credentialing body is deemed in compliance with the 50-hour requirement.
Opioid / controlled substance
1 hour, every year, for holders of controlled-substance prescriptive authority. Timing is built into the free multi-state planner.
All mandated CE topics
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Pharmacology / pharmacotherapeutics (prescriptive authority) | 50 contact hours | per cycle | prescribers |
| Opioid / controlled-substance prescribing | 1 | Minimum of 1 CE hour completed within the preceding 12 months, and completed PRIOR to prescribing controlled substances (recurring while maintaining CS prescriptive authority). | NPs who prescribe controlled substances (as defined in 21 NCAC 36 .0809(2)). |
Tracking: Self-tracked. Documentation of all CE completed within the previous five years shall be maintained by the NP and made available upon request to either Board (NC Board of Nursing or NC Medical Board). No mandatory upfront submission; audited on request.
Physician Assistants (PA)
Set by the North Carolina Medical Board — separate from the physician rules above, with its own hours and topics.
General CE: At least 50 hours of Continuing Medical Education (CME) every two years, all recognized by the National Commission on Certification of Physician Assistants (NCCPA) as Category I CME. The two-year period begins on the PA's birthday following issuance of the license. A PA who holds current NCCPA certification is deemed in compliance with the 50-hour requirement (by attesting to current NCCPA certification on annual renewal), but is NOT exempt from the controlled-substance CME requirement. Interprofessional CE and cultural competency / implicit bias courses qualify if NCCPA-approved.
Opioid / controlled substance
2 hours, every 2 years, for holders of controlled-substance prescriptive authority. Timing is built into the free multi-state planner.
All mandated CE topics
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Pharmacology / pharmacotherapeutics (prescriptive authority) | None | per cycle | prescribers |
| Opioid / controlled-substance prescribing | 2 | At least 2 hours from the required 50 hours per two-year cycle. | PAs who prescribe controlled substances. |
Tracking: Self-tracked. The PA shall provide CME documentation for inspection by the Board or its agent upon request. Attestation of NCCPA certification on annual license renewal. No mandatory upfront submission; audited on request.
Nurse Anesthetists (CRNA)
Set by the North Carolina Board of Nursing (NCBON) — CRNA recognition is by NCBON alone; unlike NP approval it does not involve the NC Medical Board — separate from the physician rules above, with its own hours and topics.
General CE: CRNAs are RNs with NCBON recognition to practice nurse anesthesia: requirements are a current NC RN license or compact privilege plus current NBCRNA certification (21 NCAC 36 .0226(b); NCBON CRNA page). NCBON's continuing-competence rule for RNs (21 NCAC 36 .0232) offers eight options; national certification/recertification by a Board-recognized body is one, so an NBCRNA-certified CRNA meets RN continuing competence without additional hours. NCBON's 50-hr NP continuing-competence rule (21 NCAC 36 .0807) does NOT apply to CRNAs.
NBCRNA recertification is accepted in place of state CE. NBCRNA certification is the sole competence mechanism for CRNA recognition (must recertify on NBCRNA's cycle and report to NCBON) and is an accepted option for RN continuing competence under 21 NCAC 36 .0232. 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: Self-tracked. NCBON notifies the CRNA ~60 days before NBCRNA certification expiry; CRNA updates recognition online with new certification number/expiration ($25). RN continuing-competence documentation retained by the licensee and produced on NCBON audit request. No CE Broker.
Anesthesiologist Assistants (CAA)
Set by the North Carolina Medical Board — separate from the physician rules above, with its own hours and topics.
General CE: 21 NCAC 32W .0105(a): AAs must complete at least 40 hours of CME for every two-year period and keep documentation available for Board inspection; (b) must comply with all NCCAA recertification requirements including registration of CME credit and passing the Examination for Continued Demonstration of Qualifications (CDQ). License renews annually within 30 days of the licensee's birthday (NCMB).
NCCAA recertification is accepted in place of state CE. Maintaining NCCAA certification (which itself requires 50 CME hours per 2 years (40 anesthesia + 10 general) and the CDQ examination (year 4, then every 10 years)) is the state standard; renewal requires attesting to current NCCAA certification. 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: Annual renewal attestation of NCCAA certification; CME records subject to Board inspection (21 NCAC 32W .0105).
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 North Carolina'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)
- MATE training satisfies. Only topic mandate.
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 North Carolina 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.