Physician Assistant and Nurse Practitioner CME/CE Requirements by State (2026)
Continuing education rules for physician assistants and nurse practitioners are set in two layers: a national certification standard (NCCPA for PAs; AANP or ANCC for NPs) and a separate state license-renewal requirement that varies widely. This guide covers all 51 jurisdictions — All 50 U.S. states plus the District of Columbia — with hours, cycles, and topic mandates for each.
A note on terms: The acronym is CME (Continuing Medical Education) for PAs and CE/CNE (Continuing Education / Continuing Nursing Education) for NPs. Users sometimes search 'CEM' but the correct term is CME/CE.
National certification, before any state rules
Every PA and NP first answers to a national certifying body. Most state boards build on top of this — and some accept it in place of separate state hours entirely.
100 CME credits every 2 years (at least 50 Category 1), plus a recertification exam (PANRE or the take-at-home PANRE-LA) by year 10. Credential: PA-C.
Two routes. AANP: 100 contact hours of advanced CE (including ≥25 pharmacology hours embedded in the 100) PLUS ≥1,000 clinical practice hours in the NP role during the 5-year period ANCC: 75 CE hours over 5 years including 25 pharmacotherapeutics, plus one professional-development category. The two totals are different — do not conflate them.
All DEA-registered practitioners with Schedule II–V authority (MDs/DOs, NPs, PAs, dentists, and other prescribers EXCEPT veterinarians) must attest, at new registration or first renewal on/after the effective date, to ≥8 hours of training on treatment/management of patients with opioid or other substance use disorders. In effect since June 27, 2023. It is federal and one-time, so it is not repeated per state below.
Find your state
Every state has two requirement pages — one for physician assistants, one for nurse practitioners. Search, filter by topic or certification rule, and sort by hours, then click either profession’s cell to open its full breakdown: board, mandates, sources, and confidence.
Select a state’s PA or NP cell to open its full requirements page — board, mandate list, sources, and confidence.
Opens that profession’s full state page Accepts national certification in lieu of state hours Logs its own state hours
Where the rules cluster
States where current NCCPA certification satisfies PA CME
In these states a PA who keeps NCCPA certification active does not separately log state CME hours (topic mandates may still apply).
States requiring implicit-bias or health-equity CE
A growing list mandate implicit-bias, cultural-competency, or health-equity training for PAs and/or NPs.
Recent & upcoming changes
DEA MATE Act one-time 8-hour SUD training in effect for all DEA registrants
Self-assessment CME (+50%) and PI-CME (first 20 doubled) shifted from required to optional-but-weighted; PANRE-LA made the permanent longitudinal recert alternative
Renewal Handbook reissued (75 CE / 25 pharmacotherapeutics + one professional development category); no numeric change to hours
Online CE Log removed; NPs now self-attest and retain documentation; expanded definition of qualifying practice hours
Geriatrics CE rule — PAs/NPs with >25% patients age 65+ must complete ≥20% of mandatory CE (NP: ≥6 of 30 hrs) in geriatric/dementia/older-patient care (B&P §3524.6)
Health equity CE (2 hrs/renewal, incl. implicit bias) phased in for PAs (WMC) and ARNPs (WABON) (RCW 43.70.613)
PA CME changed to 50 AMA Category 1 hours per two calendar years (every 2 years)
PAs/APRNs authorized to prescribe hydrocodone/oxycodone must complete 1 additional hour every 2 years on appropriate ordering/use
One-time 1-hour Alzheimer's/dementia training added before first renewal
Board of Medical Practice rule with detailed controlled-substance CME content
Controlled-substance/opioid awareness training rule updated
Statutory 2-hour opioid CME requirement tied to controlled-substance registration expired (medical side)
MSBML updated its CME reporting requirements, but these apply only to MD/DO physicians and do not change PA requirements (unchanged: 100 hrs per 2 years, 50 Category 1, or current NCCPA certification).
PA CME rule OAC 4730-1-06 amended (100 hrs/2 yr; ≥12 pharmacology hrs for prescribers)
One-time implicit bias and structural racism training required at the first license renewal on or after the effective date (Health Occupations Article §1-225). Applies to all Maryland health practitioners, including NPs and PAs.
Holding current national certification will fully satisfy the NP CE requirement (pain management + cultural competency topics still required)
All nurses must complete the new mandatory child-abuse training curriculum (adds implicit bias + virtual-setting identification)
23 states have joined the PA Licensure Compact (as of March 2026), with legislation pending in about a dozen more. No state is issuing compact privileges yet — they're projected to become available in early 2027. This is a licensure development, not a CE change.
Five states have enacted the APRN Compact (Delaware, North Dakota, South Dakota, Utah, Wyoming), but it is not active yet and the activation threshold differs across sources (NCSBN cites 10 states). NPs still need individual state licenses; projected activation is 2026–2027 at the earliest.
Colorado's HB24-1153 requires physicians (MD/DO) to complete 30 CME hours, with documentation required starting the 2027 renewal cycle. It does not currently apply to PAs or NPs — worth monitoring for possible future expansion.
Frequently asked questions
How many CME hours do physician assistants need?
To maintain NCCPA certification, PAs must earn 100 CME credits every 2-year cycle, of which at least 50 must be Category 1. Individual states may require additional or alternative CME; some states accept current NCCPA certification in lieu of separate state CME hours.
How many continuing education hours do nurse practitioners need?
National recertification requires either 100 CE hours including 25 pharmacology hours over 5 years (AANP, plus 1,000 practice hours) or 75 CE hours including 25 pharmacotherapeutics hours over 5 years (ANCC). Each state board of nursing then sets its own license-renewal CE, which varies from no state hours to 50+ hours per cycle, often with required pharmacology hours.
Do PAs still need state CME if they maintain NCCPA certification?
It depends on the state. Many states (e.g., Connecticut, Vermont, Mississippi, Idaho, Alaska, Hawaii) accept current NCCPA certification in lieu of a separate state CME hour count. Others (e.g., Texas, Missouri, Kansas) require their own state CME hours regardless of NCCPA status. Most states still impose topic-specific mandates such as opioid or controlled-substance CE on top of certification.
What is the DEA MATE Act 8-hour training?
Effective June 27, 2023, the Medication Access and Training Expansion (MATE) Act requires all DEA-registered prescribers with Schedule II–V authority—including PAs and NPs—to attest to a one-time 8 hours of training on treating and managing patients with opioid or other substance use disorders. It can be satisfied cumulatively across past and present trainings, by certain board certifications, or by recent graduation from a qualifying program.
Which states require implicit bias CE for PAs and NPs?
As of 2026, states with implicit bias or health-equity CE mandates affecting PAs and/or NPs include California, Illinois, Michigan, Washington (health equity), Maryland (one-time implicit bias), and Nevada (cultural competency/implicit bias for NPs). Requirements and effective dates vary.
Sources & references
National certification and federal sources are listed below. Each state’s licensing-board source is linked on its individual PA and NP requirements page.
- DEA / SAMHSAsamhsa.gov/substance-use/treatment/statutes-regulations-guidelines/mate-act
- DEA / SAMHSAdea.gov
- PA Licensure Compactnccpa.net/activation-of-pa-licensure-compact
- PA Licensure Compactaapa.org/advocacy-central/pa-licensure-compact
- APRN Compactnurselicenseguide.com/aprn-compact