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Washington CME Requirements (2026): Physicians, NPs, PAs, CRNAs & CAAs
Washington 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 Washington Medical Commission.
General CME: 200 hours every 4 years.
Opioid / controlled substance
One-time ≥1 hour — best practices in opioid prescribing (or the WAC ch. 246-919 opioid rules). Trigger: any physician licensed to prescribe opioids.
✓ No board pre-approval gate: No board pre-approval — any qualifying 1-hour ACCME Category 1 course on opioid-prescribing best practices counts.
All mandated CME topics
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Suicide assessment, treatment & management | 6 | one-time | all (residents exempt) |
| Health equity | 2 | every 4 years (recurring) | all |
| Opioid prescribing / pain best practices | 1 | one-time | opioid prescribers |
Citation: WAC 246-919-875 / 246-853-685
Nurse Practitioners (APRN / NP)
Set by the Washington State Nursing Care Quality Assurance Commission (Washington State Board of Nursing), Department of Health — separate from the physician rules above, with its own hours and topics.
General CE: 30 contact hours of continuing education per 2-year renewal period in each ARNP designation (WAC 246-840-360). ARNPs must also maintain an active RN license and satisfy RN continuing competency (currently 96 practice hours + 8 CE hours yearly under the post-2021 annual model).
Opioid / controlled substance
4 hours, one time, 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) | 15 hours | per cycle | prescribers |
| Opioid / controlled-substance prescribing | 4 | One-time; complete by the end of the first full CE reporting period after January 1, 2019, or during the first full CE reporting period after initial licensure, whichever is later. Counts toward NCQAC-required CE. | ARNPs licensed to prescribe opioids (chronic pain management specialists have separate requirements under WAC 246-840-493) |
| Suicide assessment, treatment, and management training | 6 | One-time; by the end of the first full continuing education reporting period after the initial license (requirement in effect since Jan 1, 2016) | ARNPs (and RNs). Certified registered nurse anesthetists (CRNAs) are exempt. |
| Health equity continuing education | 2 | Minimum 2 hours at least once every 4 years (nursing applies it per renewal; all nurses required by their 2026 renewal, then continuing) | ARNPs and RNs credentialed under Title 18 RCW subject to CE |
Tracking: Self-reported at renewal; no prior approval of CE required. Licensee retains documentation for audit by the Commission. RN license renews annually (birthday); ARNP designation renews every 2 years (birthday).
Physician Assistants (PA)
Set by the Washington Medical Commission (WMC) — separate from the physician rules above, with its own hours and topics.
General CE: 100 hours of continuing medical education per 2-year renewal cycle, of which a minimum of 40 hours must be AMA/AAPA Category I (accredited sponsorship); the remaining 60 may be Category I or II (WAC 246-918-180). Current NCCPA certification, an AAPA maintenance program, or other Commission-approved program may satisfy the requirement.
Opioid / controlled substance
1 hour, one time, 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 |
|---|---|---|---|
| Opioid / controlled-substance prescribing | 1 | One-time; at least one hour, completed by the end of the PA's first full CE reporting period after January 1, 2019, or during the first full CE reporting period after initial licensure, whichever is later. Counts toward applicable CE. | Physician assistants licensed to prescribe opioids |
| Suicide assessment, treatment, and management training | 6 | One-time; by the end of the first full continuing education reporting period after initial licensure (requirement in effect since Jan 1, 2016) | Physician assistants |
| Health equity continuing education | 2 | Minimum 2 hours at least once every 4 years | Physician assistants credentialed under Title 18 RCW subject to CE |
Tracking: Self-reported/attested at renewal every 2 years; no prior approval of CME required; the Commission does not keep documentation on file. Licensee retains records and may be audited (WAC 246-918-180; chapter 246-12 WAC).
Nurse Anesthetists (CRNA)
Set by the Washington State Board of Nursing (formerly Nursing Care Quality Assurance Commission), Department of Health — separate from the physician rules above, with its own hours and topics.
General CE: WAC 246-840-360: ARNP renewal requires an active WA RN license, current certification from the WAC 246-840-302 certifying body (NBCRNA for CRNAs), and 30 contact hours of CE during the renewal period in each ARNP designation, attested by written declaration. Prescriptive authority renews with the ARNP license and needs 15 additional pharmacotherapeutic hours (WAC 246-840-450). The underlying RN license (annual, birthday) requires 96 active practice hours + 8 CE hours (2 health equity) each 12 months (WAC 246-840-220(2)).
NBCRNA recertification counts toward state CE (partial). Current NBCRNA certification is a mandatory condition of the CRNA designation ('An ARNP license becomes invalid when the certification expires', WAC 246-840-302(2)) and a copy of recertification must be emailed to the Board, but it does NOT replace the 30 CE hours — those must still be attested. In practice NBCRNA CPC Class A credits are ordinary CE and can be counted toward the 30 (and, if pharmacotherapeutic, toward the 15). National layer: NBCRNA continued certification (4-year cycle: 60 Class A + 40 Class B credits, MAC Check).
Opioid / controlled substance
4 hours, one time, 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 |
|---|---|---|---|
| Anesthesia-specific CE | 30 | per cycle | all CRNAs |
| Pharmacology / pharmacotherapeutics | 15 | per cycle | CRNAs who hold ARNP prescriptive authority. Washington has no CRNA carve-out from prescriptive authority; a CRNA who prescribes/orders drugs under the ARNP license must hold and renew prescriptive authority and therefore owes the 15 hours. A CRNA without prescriptive authority owes none. |
| Opioid / controlled-substance prescribing | 4 | One-time; by the end of the first full CE reporting period after 2019-01-01 or the first full reporting period after initial licensure, whichever is later. Counts toward the ARNP CE. | Any ARNP 'licensed to prescribe opioids' who prescribes an opioid in Washington — reaches a CRNA with prescriptive authority who prescribes opioids (including intra-/post-operative orders). Chronic-pain-management specialists have further CE under WAC 246-840-493. |
| Health equity continuing education (incl. implicit bias) | 2 | annual (2 hrs within the 12 months before each RN renewal; first due by the second full reporting period after initial licensure or the 2026 renewal, whichever is later) | All nurses incl. CRNAs (via the RN license; hours count toward the 8 RN CE hours) |
| RN continuing competency: 96 active practice hours + 8 CE hours | 8 | annual | All RN licensees incl. CRNAs |
Tracking: Self-attestation at renewal (ARNP every 2 years on birthday; RN annually); copy of NBCRNA recertification emailed to nursing@doh.wa.gov; documentation retained and produced on Board audit. Not CE Broker.
Anesthesiologist Assistants (CAA)
Set by the Washington Medical Commission — separate from the physician rules above, with its own hours and topics.
General CE: 'An anesthesiologist assistant must complete 200 hours of continuing education every four years as required in chapter 246-12 WAC' (WAC 246-921-125(4)); the 4-year review period begins at the second renewal after initial licensure. In lieu of the 200 hours the commission accepts current NCCAA certification or NCCAA maintenance-of-competency compliance (246-921-125(5)). License renews every 2 years on the birthday.
NCCAA recertification is accepted in place of state CE. Current NCCAA certification or NCCAA MOC accepted in lieu of 200 hrs. 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
| Topic | Hours | Timing | Applies to |
|---|---|---|---|
| Suicide assessment, treatment and management | 6 | One-time, by end of first full CE reporting period | All AAs |
| Health equity | 2 | Every 4 years | All AAs |
Tracking: Attestation at renewal; commission may audit (WAC 246-921-125(4)).
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 Washington'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)
- Total met alternatively via AMA PRA or ABMS board certificate/MOC.
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 Washington 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.