Missouri physician (MD and DO) CME requirements for license renewal

This guide covers physicians licensed by the Missouri State Board of Registration for the Healing Arts, which licenses both MDs and DOs as "physicians and surgeons." One rule, 20 CSR 2150-2.125, sets the CME requirement for both degrees.

The short version

Requirement	Hours	How often	Who
Total CME	50	Every two-year reporting period (January 1 of an even year to December 31 of the next odd year)	Every MD and DO
Health benefits of nutrition (within the 50)	1	Every reporting period, from the rule change effective June 30, 2026	Every MD and DO
Accepted credit	AMA PRA Category 1, AAFP Prescribed, AOA 1-A or 2-A	—	Every MD and DO

The current reporting period runs from January 1, 2026 to December 31, 2027.

How many hours, and what kind

RSMo 334.075 says the Board may not renew a license unless the physician has met its minimum CME requirements. Under 20 CSR 2150-2.125(1), each licensee "shall complete and report at least fifty (50) hours of continuing medical education every two (2) years." The hours must be:

• accredited by the AMA as Category 1;
• AAFP Prescribed credit (the rule calls it "the American Academy of Family Practice Prescribed Credit"); or
• accredited by the AOA as Category 1-A or 2-A.

AMA PRA Category 2, AOA Category 1-B and AOA Category 2-B are not named, so do not count them toward the 50. The rule applies to every licensee, so MDs can count AOA credit and DOs can count AMA or AAFP credit.

There is a shorter route: if you complete 40 hours and every course includes a post-test of the material, you are treated as compliant. Those 40 hours must all be AMA Category 1 or AOA Category 1-A (2.125(1)(A)).

You are also treated as compliant for the period if you:

• obtained American specialty board certification or recertification during the reporting period (2.125(6));
• spent at least 60 days of the period in an AMA- or AOA-approved internship or residency (2.125(7)); or
• spent at least 60 days in a fellowship at an approved teaching institution that counts as advanced training (2.125(8)).

Hours do not carry over from one reporting period to the next.

The new nutrition hour

The Board amended the rule effective June 30, 2026. It now says: "A total of at least one (1) hour, within the required fifty (50) hours, must pertain to the topic of the health benefits of nutrition." The hour is part of the 50, not extra.

The change took effect halfway through the current January 1, 2026 to December 31, 2027 reporting period. The rule text applies to the 50 hours you report for that period, and the Board has not published separate guidance. Plan to complete a nutrition hour by December 31, 2027, and confirm with the Board if you have questions about timing.

Missouri has no other topic-specific CME requirement for physicians in this rule. The federal DEA requires a one-time 8 hours of training on treating and managing patients with opioid or other substance use disorders (the MATE Act) when you first register or renew a DEA registration. That is a federal requirement, not a Missouri one.

When your license expires

The CME reporting period is the same for everyone: January 1 of each even-numbered year to December 31 of each odd-numbered year. Separately, the license itself is registered every year. The Board's rules call it annual registration (20 CSR 2150-2.050) and treat renewal fees as timely if received by January 31 (20 CSR 2150-2.001(17)). Renewal is online through the MOPRO system.

If you have not completed and reported the 50 hours by the end of the period, you may not practice until the Board grants an extension (2.125(1) and (4)). To ask for one:

• apply in writing before December 31, with a $50 fee and documentation of the illness or circumstances beyond your control;
• do not practice until the Board gives written authorization;
• finish the hours by February 28 and send proof by March 10.

An extension is not available two periods in a row, except for military service. Licensees called to active duty for 30 days or more get an extension; those on active duty for most of the period are exempt (2.125(5)).

Your first renewal

You do not need CME in the reporting period in which you are first licensed in Missouri, but only if you have never held a permanent license to practice the healing arts in Missouri or any other U.S. state (2.125(1)). If you were licensed in another state first, this exception does not apply. The rule does not prorate hours for a partial period, so confirm with the Board how many hours you need.

Reporting and audits

You attest on the renewal form, under penalty of perjury, that you completed the required hours (2.125(2)). Keep records documenting each activity, including title, dates, location, sponsor, category and hours, for at least three years after the reporting period (2.125(3)). The Board may audit, and you must respond promptly and completely.

Failing to complete and report the hours and then practicing without the Board's written permission is treated as the unauthorized practice of medicine (2.125(12)). To reinstate a license that lapsed for two years or less, you need 25 hours for each calendar year it was not current (2.125(11)).

Checklist before you renew

1. Count 50 hours of AMA PRA Category 1, AAFP Prescribed or AOA 1-A/2-A credit earned January 1, 2026 to December 31, 2027 (or 40 hours with post-tests, AMA Category 1 or AOA 1-A only).
2. Make sure one of those hours covers the health benefits of nutrition.
3. Finish by December 31, 2027. If you cannot, request an extension in writing before that date.
4. Attest at your license renewal, due by January 31.
5. Keep your records for three years after the period ends.

Requirements change. This guide was checked against the sources below in October 2026; confirm with the Board before you rely on it.