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

Tennessee has two physician licensing boards. MDs are licensed by the Tennessee Board of Medical Examiners (rules chapter 0880-02); DOs are licensed by the Tennessee Board of Osteopathic Examination (rules chapter 1050-02). Both require 40 hours every two years, including 2 hours of Tennessee-specific controlled substance prescribing, but they accept different credit.

The short version

Requirement	MD (Board of Medical Examiners)	DO (Board of Osteopathic Examination)
Total CME	40 hours in the 24 months before renewal	40 hours in the 24 months ending on your expiration date
Accepted credit	AMA PRA Category 1 from an ACCME-accredited sponsor, or AAFP Prescribed	AOA Category I-A, II-A or I-B; ACCME-approved; or AAFP Prescribed
Credit limit	None	No more than 20 hours of AOA Category I-B
Controlled substance prescribing (within the 40)	2 hours every renewal, unless exempt	2 hours every renewal, unless exempt
License expires	Last day of your birth month, every two years	Same

How many hours, and what kind

MDs

Rule 0880-02-.19(1)(a): "All licensees must complete forty (40) hours of continuing medical education courses during the twenty-four (24) months that precede licensure renewal." Under rule 0880-02-.19(3), the hours must be awarded by an ACCME-accredited sponsor and designated AMA PRA Category 1, or designated as AAFP Prescribed credit, or designated by the AOA as meeting its prescribed-credit criteria. Because the rule requires both an ACCME-accredited sponsor and one of those designations, confirm with the Board before counting AOA credit from a sponsor that is only AOA-accredited.

Reviewing disciplinary cases for the Department earns one hour per hour of review, up to 10 hours per renewal period. The Board's FAQ says licensees in good standing in an ACGME-approved residency or fellowship can receive up to 20 hours of credit for each year of training with a letter from the program director, but must still complete the 2 prescribing hours.

DOs

Rule 1050-02-.12(1)(a): "During the twenty-four (24) month period ending on the licensee's expiration date, all licensees must complete forty (40) hours of courses approved by the Board in Category I-A, II-A and/or I-B continuing medical education as defined by the American Osteopathic Association." No more than 20 of the credits should be AOA Category I-B. Under rule 1050-02-.12(2), courses also count if approved by the ACCME (or a state medical association the ACCME recognizes), or designated as AAFP Prescribed credit. The Board's FAQ says preceptors in AOA-approved programs earn one Category I-B credit per hour, up to half of the required hours.

For both boards, a course counts only once in a calendar year, however many times you take it. Hours do not carry over.

When your license expires

Both boards use the Division of Health Related Boards' biennial birthdate system. The renewal due date "is its expiration date which is the last day of the month in which a license holder's birthday falls" (rules 0880-02-.09 and 1050-02-.07), every two years. You can renew online at apps.tn.gov/hlrs.

Your CME window is the 24 months ending on that expiration date. The MD FAQ gives an example: for an October 31, 2024 expiration, the 40 hours must be earned between November 1, 2022 and October 31, 2024. Both boards used to accept CME counted by calendar year in audits; for licenses expiring on or after January 1, 2025, you must show CME for the renewal cycle itself. The DO Board's FAQ (2016) still describes the calendar-year method; the current rule controls.

The required topic

Controlled substance prescribing — 2 hours, every renewal

T.C.A. 63-1-402 and both boards' rules require, unless you are exempt, at least 2 of the 40 hours on controlled substance prescribing. The education "must include instruction in the Department's treatment guidelines on opioids, benzodiazepines, barbiturates, and carisoprodol" and may cover topics such as addiction and risk management tools.

The MD Board's FAQ adds that the course must award AMA Category 1 or AAFP Prescribed credit and must be Tennessee-specific: "We cannot accept any prescribing course, unless it specifies on its face that it includes the Tennessee-specific content." The Board links a list of courses that attest to meeting the requirement.

Exempt under T.C.A. 63-1-402(c): providers practicing at a registered pain management clinic, and MDs or DOs board certified by the ABMS, AOA or ABPS in pain management, anesthesiology, physical medicine and rehabilitation, neurology or rheumatology. The DO Board's 2016 FAQ lets DOs without a DEA registration who do not prescribe take a general prescribing-practices course instead; the current rule text applies the controlled substance wording to all licensees, so confirm with the Board if this applies to you.

Federal requirement

The federal DEA requires a one-time 8-hour 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. It is a federal requirement, separate from Tennessee's rules.

Your first renewal

Both boards exempt you only for the calendar year in which your license is issued, and only if you were licensed in the same calendar year you passed USMLE Step 3 (MDs) or the NBOME, COMLEX or USMLE Step 3 (DOs). The rules do not say how the 40 hours apply when your first renewal comes less than 24 months after licensure. Plan on the full requirement and confirm with the Board.

Reporting and audits

By signing the renewal application you affirm that you met the requirement. The Department of Health audits licensees and may ask in writing for proof. Keep independent documentation, such as certificates, provider letters or AAFP records, for four years from the end of the calendar year in which you earned the CME.

If an MD is short of hours, the Board's policy imposes a civil penalty of $100 per missing Category 1 hour, the missing hours and ten penalty hours, through a public Agreed Citation. The DO Board has a similar penalty policy. Either board may waive CME for illness, disability or other hardship if you ask in writing before the renewal period ends and before you renew. Retired and inactive licenses do not need CME.

Checklist before you renew

1. Find your expiration date: the last day of your birth month, every two years.
2. Count 40 hours earned in the 24 months ending on that date (DOs: no more than 20 in AOA Category I-B).
3. Check that 2 of the hours were a Tennessee-specific controlled substance prescribing course, unless you are exempt.
4. Keep documentation for four years after the end of the year you earned it.
5. Renew by the last day of your birth month.

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