Short on CME hours at Texas renewal: what the 30-day rule does and doesn't do

Key facts: short on CME at Texas renewal

Deficiency remedy

"Any CME deficiency can be remedied within 30 days after registration renewal due." (22 TAC §161.35(c)(1))

Registration grace

30 days after expiration to renew the permit (Occ. Code §156.004(b))

After grace

$75 penalty (TMB), $150 after 90 days; canceled at 1 year (TMB renewal page; Occ. Code §156.005)

CE Broker

Online renewal blocked until CE is reported and status is Complete (renewals on or after Sept. 1, 2026) (TMB renewal page; TMB CE Tracking)

Exemptions

Request through CE Broker at least 30 days before renewal is due; one registration period at most (22 TAC §161.35(d); TMB CE page)

Carry forward

Up to 48 excess credits, next period only; required topics can't be carried (22 TAC §161.35(c)(2)-(3))

Permit vs practice

A registration permit doesn't entitle you to practice unless CME requirements are met (Occ. Code §156.007(b))

Last verified October 17, 2026. Not affiliated with TMB or CE Broker.

Two different 30-day clocks get mixed up here, and neither one opens online renewal. If your CE Broker status says Not Complete because of an entry problem rather than missing hours, start with why CE Broker says Not Complete. This guide is for when you really don't have the hours.

Is there a grace period for Texas CME?

Yes, two separate clocks run. TMB rules let you remedy a CME deficiency within 30 days after renewal is due, and Texas law gives a 30-day grace period to renew the registration permit itself. Neither changes CE Broker. Online renewal still won't open until your CE Broker status shows Complete.

What should I do first if I'm short on hours?

Start by confirming what's actually missing, because a Not Complete status can come from an entry error rather than missing hours. Then count formal hours separately, take accredited courses that issue a certificate right away, report each one in CE Broker with its certificate, and renew as soon as your status shows Complete, ideally before your expiration date.

1. Check what's actually missing. Compare CE Broker's Requirements tab with your course history, and rule out entry errors with the Not Complete troubleshooting guide.
2. Count formal hours separately. At least 24 of your 48 credits must be formal, including 2 ethics hours, plus opioid and human trafficking hours only when they're due in your cycle.
3. Take accredited courses that issue a certificate right away. See where to find Texas CME and ethics CME options.
4. Report each course in CE Broker with its certificate.
5. Renew as soon as your status is Complete, ideally before your expiration date. Past it, you're in the 30-day grace period, and penalties apply after that (late renewal, day by day).
6. If something outside your control caused the gap, such as illness or deployment, look at exemptions. The rule sets a deadline of at least 30 days before renewal is due.

Can I renew now and finish CME within 30 days?

Not online in practice. Since September 1, 2026, TMB requires all CE reported in CE Broker before renewal, and online renewal is blocked until the status is Complete. TMB's pages don't explain how the 30-day remedy works with that block, so call TMB Registrations at 512-305-7030 before you rely on it.

Can I practice while I make up missing CME?

Texas law says a registration permit doesn't entitle you to practice unless you've met the CME requirements, and practicing after the 30-day grace period on an unrenewed permit counts as practicing without a license. If your permit has expired or your hours are short, talk to TMB before you see patients. This isn't legal advice.

Do hours I take late count for this period or the next?

TMB's rule allows the remedy but doesn't spell out how make-up credits are assigned between periods. What it does say: only up to 48 excess credits carry forward, only to the next period, and required topics such as ethics can't be carried forward. Ask TMB Registrations how your make-up hours will be applied.

Can I get an exemption instead?

Possibly, if you have a qualifying reason: catastrophic illness, military service over a year outside Texas, residence outside the US for over a year, or other good cause. Requests go through CE Broker, are reviewed case by case, must come at least 30 days before renewal, and can't exceed one registration period.

Board certification or recertification within the last 36 months, current MOC or OCC, or recent residency can satisfy the hours (alternate compliance), but none of them cover human trafficking. See exemptions and alternate compliance.

What if I'd rather stop practicing?

Retired status exempts you from registration, the registration fee and CME, but you can't practice medicine or engage in clinical activities in Texas. You must request it before your permit expires, and Texas has no inactive status. Emeritus retired and voluntary charity care are the other options. See retired, emeritus and charity care status.