Texas opioid CME: who needs it, how often, and what counts

Key facts: Texas opioid CME

Hours

2 formal (Category 1 or 1A) (Occ. Code §156.055(a); 22 TAC §161.35(a)(2)(C))

Who

Physicians who designate a direct patient care practice at renewal (§156.055(a))

First two renewals

Required in each of the first two renewal periods, with 2 hours within 1 year of license issuance (§156.055(b))

After that

2 hours every 8 years (every 4th renewal) (§156.055(c); TMB CME Hours Chart)

TMB's example

Done for 2024, exempt 2026, 2028 and 2030, due again 2032 (TMB CE page)

Counts toward

Ethics/professional responsibility and your 24 formal hours (TMB CE page; §156.055(d))

Carry forward

No (§161.35(c)(3); TMB CME Hours Chart)

Alternate compliance

Board certification, MOC or residency "MIGHT" cover it, depending on the board (TMB CME Hours Chart)

No direct patient care

CE Broker attestation waives opioid and human trafficking (CE Broker exemptions)

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

Do Texas physicians need opioid CME every renewal?

No. Physicians in direct patient care need 2 formal hours in each of their first two renewal periods, with the first 2 hours finished within a year of license issuance. After that, the requirement drops to 2 hours every 8 years, which is every fourth renewal. TMB's example: completed for 2024, exempt 2026 through 2030, due again in 2032.

TMB's own example row: done for a 2024 renewal, exempt 2026, 2028 and 2030, due 2032 (TMB CE requirements). The other rows are calculated from Tex. Occ. Code §156.055(b)–(c), the same logic the tracker uses. CE Broker's Texas overview describes the same schedule: "Required for your 1st and 2nd renewals, then every 8 years (4 cycles)" (CE Broker).

Why older pages say "every renewal." TMB's former rule required 2 opioid hours from every physician each renewal. The current rule only points to the statute, which limits it to direct patient care and uses the staggered schedule above (TMA, Texas Medicine, Mar./Apr. 2026). A separate transition clause had physicians licensed on January 1, 2021 complete 2 hours in each of their next two renewal periods; it expired January 1, 2026 (§156.055(g)).

Who counts as providing direct patient care?

TMB defines direct patient care as "any in-person or real-time audio or visual communication with a patient or a patient's legal medical decision-maker for the purpose of evaluation, treatment, diagnosis, directly testing or ordering of tests, or reviewing or interpreting of test results." If that describes your practice, the opioid requirement applies. If it doesn't, the no-direct-patient-care attestation in CE Broker removes both opioid and human trafficking.

TMB adds that it can't judge individual practices by specialty, and "if unsure, the Board suggests assuming it applies" (TMB Quick FAQs). In CE Broker the attestation is listed as "Attestation of Not Practicing Direct Patient Care in the Cycle" (CE Broker exemptions).

What topics must Texas opioid CME cover?

The 2 hours must cover pain management best practices and alternatives such as physical therapy and psychotherapy, plus safe prescribing of opioids and other controlled substances. That includes standards of care, spotting drug-seeking behavior, talking with patients about opioid prescriptions, and prescribing and monitoring controlled substances. TMB lists these topics on its CE page.

TMB's list (TMB CE requirements):

• Best practices, alternative treatment options, and multimodal approaches to pain management, which may include physical therapy, psychotherapy and other treatments
• Safe and effective pain management related to prescribing opioids and other controlled substances, including standards of care, identifying drug-seeking behavior, and communicating with patients about the prescription
• Prescribing and monitoring of controlled substances

Where can I get free opioid CME in Texas?

TMA says its Education Center is free to TMA members and includes courses toward the TMB opioid requirement. Whatever course you choose, check that the course is formal Category 1 or 1A and covers TMB's required topics. TexasCMELog's CME providers page lists current options with costs as each provider lists them.

TMA's Texas Medicine reported in July/August 2026 that the Education Center catalog, free to members through a TMA Insurance Trust grant, includes offerings in the "two hours in pain management and the prescription of opioids" category (TMA). A single course may carry fewer than 2 credits, so check the credit count on each one. See opioid courses on our Find CME page.

Does opioid CME count toward my Texas ethics hours?

Yes. TMB says pain management and opioid prescribing CME may also fulfill the 2-hour medical ethics and professional responsibility requirement. Report it in CE Broker under Pain Management and the Prescription of Opioids, and CE Broker can apply it to ethics automatically. The same hours also count toward your 24 formal credits and 48 total.

Sources: TMB CE requirements (FAQ); TMB Quick FAQs; CE Broker opioid article. More: Texas ethics CME.

Can I carry extra opioid hours to my next Texas renewal?

No. Texas rule 22 TAC §161.35(c)(3) bars carrying forward the required formal topics, which include pain management and opioid prescribing. Extra general credits, up to 48, can carry to the next registration period only. CE Broker's Texas overview says excess hours from these topics can bank only as general formal hours, not toward the topic itself.

CE Broker's wording: excess hours from ethics, pain management and human trafficking "can only bank as general Formal Category 1 or 1A hours" (CE Broker Texas overview; 22 TAC §161.35(c); TMB CME Hours Chart).

Do board certification, MOC or residency cover the opioid requirement?

Maybe. TMB's CME hours chart says board certification within 36 months, current MOC or OCC, and residency or fellowship "might" cover the opioid requirement, depending on the specialty board. They do cover ethics and most general hours. If your board's program doesn't include qualifying pain management content, take the 2 hours when they're due.

Source: TMB CME Hours Chart. None of these cover human trafficking.

How do I report opioid CME in CE Broker?

In CE Broker, click Report CE and choose Pain Management and the Prescription of Opioids. Enter the date, course name, provider and hours from your certificate, attach the certificate, and submit. The course appears in Course History right away. If opioid shows as lacking after you report it, check that you used that exact category rather than general Formal Category 1.

Sources: CE Broker: Report CE; TMB Quick FAQs. We couldn't confirm how a live Basic account shows opioid CME in a renewal where it isn't due. If yours lists it as required and you believe it isn't, ask CE Broker support before you take an extra course. Still Not Complete? See why CE Broker says "Not Complete". Step-by-step: How to report CME in CE Broker.

Pain clinics and other prescribers

Pain management clinic medical directors must make sure all clinic personnel, including themselves, complete 10 hours of pain management CME each renewal (22 TAC §172.3). TMB's CE page says opioid hours may count toward those 10 hours, but the statute says the §156.055 hours "may not be used to satisfy any education required by board rule for certified pain clinic personnel" (§156.055(e)). The statute controls over TMB's web guidance, so don't count opioid hours toward the 10 pain clinic hours. Our CME tracker doesn't count them either.

Related: Texas human trafficking CME · February 28, 2027 checklist · full Texas CME requirements.