A physician licensed in California, Texas, and Minnesota is, on paper, the same doctor. On the renewal calendar, she is three different people. California wants 50 AMA PRA Category 1 credits every two years. Texas wants 48 every two years, half of them formal Category 1. Minnesota wants 75 over three years. Same medical degree, three separate clocks, three sets of fine print.
That is the first thing to understand about physician continuing medical education in this country: there is no national requirement. The federal government does not set a CME total. State medical boards do, and they rarely agree. If you want to see how wide the spread runs, the short answer to how many hours you actually need is "open your state's page and read it," because the number lives there and almost nowhere else.
The common currency: AMA PRA Category 1
Most state boards count CME in AMA PRA Category 1 Credits. Think of it as the dollar of physician CME. An accredited provider designates an activity for a certain number of Category 1 credits, you complete it, and you claim those credits. The accreditation chain runs through the ACCME (or a state medical society), which is why checking that a provider is actually accredited matters before you spend a dime. A polished website is not accreditation.
Category 2 is the looser bucket — self-directed reading, teaching, unstructured learning you log yourself. Some states let a portion of your total come from Category 2; many do not count it at all. If the difference is fuzzy, what counts as Category 1 and what doesn't walks through it, and the categories post covers the full taxonomy.
Hour totals are only half the story
The number of credits is the headline. The mandated topics are the part that trips people up. States bolt on required subjects, and they almost never advertise them loudly.
- California layers a one-time 12-hour pain management course and an implicit bias component onto its 50 hours.
- Texas requires 2 hours of medical ethics, staggered opioid/pain CME, and human trafficking training on a rotating schedule, per the Texas Medical Board.
- New York sets no general hour total at all but mandates a child abuse course, infection control every four years, and pain management CME for controlled-substance prescribers.
New York is the cleanest example of why "how many hours" is the wrong first question. Zero general hours, three required courses. Miss the infection control refresher and your perfect hour count means nothing. The pattern repeats with opioid and controlled-substance CME, implicit bias, and the one-time-versus-recurring distinction that decides whether a course you took in 2019 still counts.
Cycles do not line up either
Two years is common but far from universal. Minnesota runs three-year cycles. Several states tie expiration to your birth month rather than a calendar date, which means your deadline and a colleague's can be months apart even in the same state. And the date your CME is due is not always the date your license expires — see why those two dates diverge. Getting that wrong is one of the most common mistakes that cost clinicians.
State CME and specialty board CME are different animals
If you maintain board certification, you are already doing MOC — and some states accept it. Minnesota, for instance, takes ABMS Maintenance of Certification in lieu of its 75-credit total. Others give you no such credit, so you end up doing both. The overlap is real but incomplete, which is the whole point of specialty board CME versus state CME. Do not assume one satisfies the other.
One physician, several licenses, several plans
Doctors who hold licenses in multiple states — common with telehealth and locum work — face the version of this problem that grows fast. Each license is its own requirement with its own deadline. Physicians who licensed through the Interstate Medical Licensure Compact sometimes assume the compact pooled their obligations; it did not. The IMLC speeds up licensing, but each state keeps its own CME clock. If you carry several, the realistic move is a separate plan per license rather than one tangled spreadsheet.
Where to start
Pull up the actual requirement for your state before you buy a single course. Our physician CME requirements by state page lays out each board's total, mandated topics, and cycle length, and the full requirements index covers every profession. If your state has its own quirks — say California or Texas — read that page line by line.
If you would rather not assemble it yourself, that is what we do. We read your board's current rules, map your exact hours and mandated topics to your renewal month, and hand you a plan for a flat $99 per license renewal. We don't grant CME credit and we never touch your board portal — we just make sure you know precisely what to earn and by when. See how the flat fee works or tell us your state and renewal date.
Need help figuring out your CME?
Stop guessing what CME you need. Tell us your license type, state, and renewal date, and we'll map exactly which continuing-education hours and mandated topics you need — and by when. Flat $99 per plan.