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

Washington has two physician licensing boards with different CME rules. MDs are licensed by the Washington Medical Commission (WAC chapter 246-919). DOs are licensed by the Board of Osteopathic Medicine and Surgery (WAC chapter 246-853). Both also follow the Department of Health's general rules in WAC chapter 246-12.

The short version

Requirement	MD (Medical Commission)	DO (Osteopathic Board)
Total CME	200 hours every four years	150 hours every three years
Credit rules	All may be Category I; Categories II–V capped at 80 hours each	At least 60 hours Category 1; home study capped at 90
Instead of hours	AMA PRA award, recent ABMS certification, or maintenance of certification	Recent ABOMS/ABMS certification, maintenance of certification, AOA CME certificate, or AMA PRA award
Health equity (including implicit bias)	2 hours every four years	2 hours every four years
Suicide assessment, treatment and management	6 hours, one time	6 hours, one time
Opioid prescribing	1 hour, one time (if you prescribe opioids)	1 hour, one time (if you prescribe opioids)
License renewal	Every two years on your birthday	Every year on your birthday

The one-time trainings and the health equity hours count toward your total; they are not added on top.

How many hours, and what kind

MDs

WAC 246-919-430 gives four ways to meet the requirement at renewal:

1. 200 hours of CME every four years;
2. a current AMA Physician's Recognition Award in at least two of the four years before the renewal date;
3. becoming certified by an ABMS member board in the four years before renewal; or
4. meeting the maintenance of certification requirements of an ABMS member board at the time of renewal.

WAC 246-919-460 sets five categories:

• Category I: programs recognized as Category I credit and offered by an organization that meets ACCME standards (or those of the Washington State Medical Association). All 200 hours may be Category I. This is where AMA PRA Category 1 Credit™ fits.
• Category II: CME programs without accredited sponsorship, up to 80 hours.
• Category III: teaching physicians or other health professionals in an approved program, up to 80 hours.
• Category IV: published papers, book chapters and exhibits, 10 hours each, up to 80 hours.
• Category V: self-directed learning, such as journal reading, multimedia programs, board exam preparation and quality-of-care committees, up to 80 hours.

The Commission does not pre-approve courses; the category depends on the sponsor's accreditation (WAC 246-919-470). Residency or fellowship counts as 50 Category I hours per year of training.

AAFP Prescribed credit is not named. The AAFP is ACCME-accredited, so its activities may count as Category I, and Category II would cover them in any case up to 80 hours. AOA credit is not named in the MD rules either. If you rely on either for most of your hours, confirm with the Commission.

DOs

WAC 246-853-080 requires 150 hours every three years. You may meet it instead by certifying or recertifying with ABOMS or ABMS within the last six years, holding a current AOA certificate of excellence in CME, or holding a current AMA Physician's Recognition Award. A rule change effective August 30, 2026 (WSR 26-16-042) added a fifth option: meeting the maintenance of certification requirements of an ABOMS or ABMS member board at the time of renewal.

WAC 246-853-070 sets Washington's own categories, and the credits must be earned in the 36 months before the renewal application:

• Category 1, at least 60 hours. Category 1-A is formal programs from nationally recognized osteopathic or medical organizations, including the AOA and AMA, accredited schools and hospitals, specialty societies, CME institutes, government health agencies, residencies, and interactive online courses that assign credits. Category 1-B is preparing and presenting an original scientific paper; Category 1-C is teaching, up to 45 hours.
• Category 2. Home study (2-A: journal reading, audio programs and home study courses) up to 90 hours; scientific exhibits (2-B) up to 30; other programs (2-C) up to 30.

The Department of Health's page says "at least 60 hours must be category 1A"; the rule counts all of Category 1 toward the 60. AOA Category 1-A and AMA PRA Category 1 Credit™ both fit Washington's Category 1-A. AAFP Prescribed credit is not named, but programs of "specialty practice organizations" are Category 1-A, which appears to cover it; confirm with the Board.

Neither board lets hours carry over to the next cycle (WAC 246-12-230).

When your license expires

Every Washington credential expires on your birthday (WAC 246-12-030).

• MDs renew every two years on their birthday (WAC 246-919-990). The 200 hours are reported every four years, at every second renewal. The Commission's FAQ says hours count from your first renewal through your second renewal cycle.
• DOs renew every year on their birthday (WAC 246-853-990). The 150 hours are counted over the 36 months before the renewal at which you report them. The rules do not say which annual renewal that is, so confirm with the Board.

You can renew up to 90 days early. The fee must be received or postmarked by midnight of the expiration date, or a late fee applies.

The required topics

Health equity: 2 hours every four years

WAC 246-919-445 (MDs, effective January 1, 2024) and WAC 246-853-075 (DOs) require two hours of health equity training every four years, under the Department of Health model rules (WAC 246-12-800 to 246-12-830). The training must include implicit bias training to identify strategies to reduce bias during assessment and diagnosis. It must also end with an assessment or a document attesting attendance. The Department of Health lists free courses that meet the model rules. The hours count toward your total.

Suicide assessment, treatment and management: 6 hours, one time

WAC 246-919-435 (MDs) and WAC 246-853-065 (DOs) require a one-time training of at least six hours from the Department of Health's model list (RCW 43.70.442). It is due by the end of your first full CE reporting period after initial licensure. MDs with only brief or limited patient contact, or none, are exempt, as are residents on limited licenses.

Opioid prescribing: 1 hour, one time

To prescribe opioids in Washington, a physician licensed to prescribe them must complete a one-time course of at least one hour. For MDs it covers best practices in opioid prescribing or the Commission's opioid prescribing rules (WAC 246-919-875); for DOs it covers best practices and the current opioid prescribing rules (WAC 246-853-685). It is due by the end of your first full CE reporting period after initial licensure.

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 Washington's rules.

Your first renewal

• MDs: the Commission's FAQ (dated 2012) says you start accumulating hours at your first renewal, so the first 200-hour report comes four years later. The FAQ is old; confirm your first reporting date with the Commission.
• DOs: the rules set no first-renewal waiver and do not say when a new licensee first reports the 150 hours. Confirm with the Board.

For both, the suicide prevention and opioid prescribing trainings are due within your first full CE reporting period.

Reporting and audits

You sign a declaration of compliance at renewal (WAC 246-12-180); do not send certificates unless asked. Up to 25 percent of practitioners are audited at random after renewal. If you are selected, you have 60 days to send certificates or transcripts, or you may be disciplined (WAC 246-12-190 and 246-12-200). Keep records of attendance and a description of the learning for four years. The Commission's FAQ says that failing to report CME makes an MD renewal invalid.

Rule changes in progress

The Department of Health's 2026 rules agenda lists a Medical Commission review of WAC 246-919-010 through 246-919-520, which includes the MD CME rules. No change to the MD hours had been proposed when this guide was checked.

Checklist before you renew

1. Find your renewal date (your birthday) and whether this is a CME reporting year: every second renewal for MDs, the three-year count for DOs.
2. MDs: count 200 hours over four years (Category II–V capped at 80 each), or use the AMA PRA award, ABMS certification or maintenance of certification. DOs: count 150 hours over 36 months with at least 60 in Category 1, or use a certification option.
3. Confirm 2 hours of health equity training in the last four years.
4. Confirm you have completed the one-time suicide prevention (6 hours) and, if you prescribe opioids, opioid prescribing (1 hour) trainings.
5. Keep records for four years.

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