Texas State Board of Medical Examiners
166.1 Physician Registration.
(a) Each physician licensed to practice medicine in Texas shall register with the board, submit
a current physician profile, and pay a fee. A physician may obtain a registration permit ("permit") by
submitting the required form and by paying the required registration fee to the board on or before the
expiration date of the permit. The fee shall accompany a written application which sets forth the licensee's
name, mailing address, primary practice site, and address for receipt of electronic mail if available.
(b) The board shall stagger initial registrations of newly-licensed physicians proportionally.
(c) The board shall provide notice to each physician at the physician’s last known mailing
address according to the records of the board at least 30 days prior to the expiration date of the registration
permit and shall provide for a 30-day grace period for payment of the registration fee from the date of the
expiration of the permit.
(d) Within 30 days of a physician's change of mailing or practice address or professional name
from the addresses or professional name on file with the board, a physician shall notify the board in writing
of such change and submit additional documentation if requested.
(e) Approximately half of all permits issued to license holders that expire between January 1,
2005 and December 31, 2005 shall remain in effect for a one-year period; the other half shall remain in
effect for a two-year period. All permits issued to license holders that expire on or after January 1, 2006
shall remain in effect for two-year periods.
166.2. Continuing Medical Education.
(a) As a prerequisite to the registration of a physician's permit a physician must complete 24
hours of continuing medical education (CME) every 12 months. CME hours must be completed in the
(1) At least 12 hours every 12 months are to be from formal courses that are:
(A) designated for AMA/PRA Category 1 credit by a CME sponsor
accredited by the Accreditation Council for Continuing Medical Education or a state medical society
recognized by the Committee for Review and Recognition of the Accreditation Council for Continuing
(B) approved for prescribed credit by the American Academy of Family
(C) designated for AOA Category 1-A credit required for osteopathic
physicians by an accredited CME sponsor approved by the American Osteopathic Association;
(D) approved by the Texas Medical Association based on standards
established by the AMA for its Physician's Recognition Award; or
(E) approved by the board for medical ethics and/or professional
responsibility courses only.
(2) At least one of the 12 formal hours of CME which are required by paragraph (1)
of this subsection must involve the study of medical ethics and/or professional responsibility. Whether a
particular hour of CME involves the study of medical ethics and/or professional responsibility shall be
determined by the organizations which are enumerated in paragraph (1) of this subsection as part of their
(3) The remaining 12 hours for the 12-month period may be composed of informal
self-study, attendance at hospital lectures or grand rounds not approved for formal CME, or case
conferences and shall be recorded in a manner that can be easily transmitted to the board upon request.
(b) A physician must report on the registration permit application if she or he has completed
the required CME during the previous year.
(1) A licensee may carry forward CME credit hours earned prior to a registration
report which are in excess of the 24-hour annual requirement and such excess hours may be applied to the
following years requirements.
(2) A maximum of 48 total excess credit hours may be carried forward and shall be
reported according to the categories set out in subsection (a) of this section.
(3) Excess CME credit hours of any type may not be carried forward or applied to a
report of CME more than two years beyond the date of the registration following the period during which
the hours were earned.
(4) A licensee under a two-year permit who timely registers may apply CME credit
hours retroactively to the preceding year’s annual requirement, however, those hours may be counted only
toward one registration period. A maximum of 24 hours may be applied retroactively.
(c) A licensee shall be presumed to have complied with this section if in the preceding 36
months the licensee becomes board certified or recertified by a specialty board approved by the American
Board of Medical Specialties or the American Osteopathic Association Bureau of Osteopathic Specialists.
This provision exempts the physician from all CME requirements, including the requirement for one hour
involving the study of medical ethics and/or professional responsibility, as outlined in subsection (a)(2) of
this section. This exemption is valid for one registration period only.
(d) A physician may request in writing an exemption or the following reasons:
(1) catastrophic illness;
(2) military service of longer than one year's duration outside the state;
(3) medical practice and residence of longer than one year's duration outside the
United States; or
(4) good cause shown submitted in writing by the licensee, that gives satisfactory
evidence to the board that the licensee is unable to comply with the requirement for CME.
(e) Exemptions are subject to the approval of the executive director or medical director and
must be requested in writing at least 30 days prior to the expiration date of the permit.
(f) A temporary exemption under subsection (d) of this section may not exceed one year but
may be renewed, subject to the approval of the board.
(g) Subsection (a) of this section does not apply to a licensee who is retired and has been
exempted from paying the registration fee under §166.3 of this title (relating to Retired Physician
(h) This section does not prevent the board from taking board action with respect to a licensee
or an applicant for a license by requiring additional hours of CME or of specific course subjects.
(i) The board may require written verification of both formal and informal credits from any
licensee within 30 days of request. Failure to provide such verification may result in disciplinary action by
(j) Physicians in residency/fellowship training or who have completed such training within
six months prior to the registration expiration date, will satisfy the requirements of subsections (a)(1) and
(2) of this section by their residency or fellowship program.
(k) Unless exempted under the terms of this section, a licensee's apparent failure to obtain and
timely report the completion of the required number of hours of CME on his or her registration application
as provided for in this section shall result in the denial of the registration permit until such time as the
physician obtains and reports the required CME hours. The executive director of the board may issue to
the licensee a temporary CME license numbered so as to correspond to the nonrenewed license. Such a
temporary CME license shall be issued upon receipt of a written request and fee for the license made prior
to the expiration of the 30-day grace period for registration at the direction of the executive director for a
period of no longer than 60 days. A temporary CME license issued pursuant to this subsection may be
issued to allow the physician who has not obtained or timely reported the required number of hours an
opportunity to correct any deficiency so as not to require termination of ongoing patient care.
(l) The fee for issuance of a temporary CME license pursuant to the provisions of this section
shall be in the amount specified for temporary licenses under §175.1 of this title (relating to Fees).
(m) CME hours which are obtained during the 30 day grace period after the expiration of the
licensee’s permit or while under a CME temporary license to comply with the CME requirements for the
preceding year as a prerequisite for obtaining a registration permit, shall first be credited to meet the CME
requirements for the previous year. Once the previous year's CME requirement is satisfied, any additional
hours obtained shall be credited to meet the CME requirements for the current year.
(n) A false report or false statement to the board by a licensee regarding CME hours
reportedly obtained shall be a basis for disciplinary action by the board pursuant to the Medical Practice
Act (the "Act"), TEX. OCC. CODE ANN. §§164.051-.053. A licensee who is disciplined by the board for
such a violation may be subject to the full range of actions authorized by the Act including suspension or
revocation of the physician's medical license, but in no event shall such action be less than an
administrative penalty of $500.
(o) Administrative penalties for failure to timely obtain and report required CME hours may
be determined by the Disciplinary Process Review Committee of the board as provided for in §187.40 of
this title (relating to Administrative Penalties).
(p) Unless exempted under the terms of this section, failure to obtain and timely report the
CME hours on a registration permit application shall subject the licensee to a monetary penalty for late
registration in the amount set forth in §175.2 of this title (relating to Penalties). Any temporary CME
licensure fee and any administrative penalty imposed for failure to obtain and timely report the 24 hours of
CME required for a registration permit application shall be in addition to the applicable penalties for late
registration as set forth in §175.2 of this title (relating to Penalties).
166.3. Retired Physician Exception. The registration fee shall apply to all physicians licensed by the
board, whether or not they are practicing within the borders of this state, except retired physicians.
(1) To become exempt from the registration fee due to retirement:
(A) the physician's current license must be active and not under an order with
the board or otherwise have a restricted license; and
(B) the physician must request in writing on a form prescribed by the board
for his or her license to be placed on official retired status.
(2) The following restrictions shall apply to physicians whose licenses are on official
(A) the physician must not engage in clinical activities or practice medicine in
(B) the physician may not prescribe or administer drugs to anyone, nor may
the physician possess a DEA or Texas controlled substances registration; and
(C) the physician's license may not be endorsed to any other state.
(3) A physician whose license has been placed on official retired status must obtain
the approval of the board before returning to active status by submitting a written request to the attention of
the Permits Department of the board which indicates the following:
(A) the physician's Texas medical license number;
(B) current mailing address;
(C) proposed practice location;
(D) intended type of medical practice;
(E) length of retired status;
(F) any other medical licenses held;
(G) any condition which adversely affects the physician's ability to practice
medicine with reasonable skill and safety;
(H) any current specialty board certifications; and,
(I) any formal or informal continuing medical education obtained during the
period of retired status.
(4) The request of a physician seeking a return to active status whose license has been
placed on official retired status for two years or longer shall be submitted to the Licensure Committee of
the board for consideration and a recommendation to the full board for approval or denial of the request.
After consideration of the request and the recommendation of the Licensure Committee, the board shall
grant or deny the request subject to such conditions which the board determines are necessary to
adequately protect the public including but not limited to passage of the Special Purpose Examination
(SPEX), passage of the Medical Jurisprudence Examination, and/or passage of a specialty board
(5) The request of a physician seeking a return to active status whose license has been
placed on official retired status for less than two years may be approved by the executive director of the
board or submitted by the executive director to the Licensure Committee for consideration and a
recommendation to the full board for approval or denial of the request. In those instances in which the
executive director submits the request to the Licensure Committee of the board, the Licensure Committee
shall make a recommendation to the full board for approval or denial. After consideration of the request
and the recommendation of the Licensure Committee, the board shall grant or deny the request subject to
such conditions which the board determines are necessary to adequately protect the public including but
not limited to passage of the Special Purpose Examination (SPEX), passage of the Medical Jurisprudence
Examination, and/or passage of a specialty board certification examination.
(6) In evaluating a request to return to active status, the Licensure Committee or the
full board may require a personal appearance by the requesting physician at the offices of the board, and
may also require a physical or mental examination by one or more physicians or other health care providers
approved in advance in writing by the executive director, the secretary-treasurer, the Licensure committee,
or other designee(s) determined by majority vote of the board.
166.4. Expired Registration Permits.
(a) If a physician's registration permit has expired, the physician may register for a new permit
without monetary penalty during the first 30 days following expiration. If a physician's permit has been
expired for longer than 30 days, but less than 91, the physician may obtain a new permit by submitting to
the board a completed permit application, the registration fee, and a $75 penalty fee.
(b) If a physician's registration permit has been expired for longer than 90 days but less than
one year, the physician may obtain a new permit by submitting a completed permit application, the
registration fee, and a $150 penalty fee.
(c) If a physician's registration permit has been expired for one year or longer, the physician's
license is automatically canceled, unless an investigation is pending, and the physician may not obtain a
(d) Practicing medicine after the expiration of the 30-day grace period under subsection (a) of
this section without obtaining a new registration permit for the current registration period has the same
effect as, and is subject to all penalties of, practicing medicine without a license.
166.5. Relicensure Following Cancellation for Nonpayment of Registration Fee. To be relicensed
following cancellation for nonpayment, a physician must submit to reexamination and qualify under
§163.10 of this title (relating to Relicensure).
166.6. Exemption From Registration Fee for Retired Physician Providing Voluntary Charity Care.
(a) A retired physician licensed by the board whose only practice is the provision of voluntary
charity care to indigent populations shall be exempt from the registration fee. To qualify for and obtain
such an exemption, a physician must truthfully certify under oath, on a form approved by the board, and
received by the board at least 30 days prior to the expiration date of the permit, that the following
information is correct:
(1) the physician's practice of medicine does not include the provision of medical
services for either direct or indirect compensation which has monetary value of any kind;
(2) the physician's practice of medicine is limited to voluntary charity care for which
the physician receives no direct or indirect compensation of any kind for medical services rendered;
(3) the physician's practice of medicine does not include the provision of medical
services to members of the physician's family; and
(4) the physician's practice of medicine does not include the self-prescribing of
controlled substances or dangerous drugs.
(b) A physician who qualifies for and obtains an exemption from the registration fee
authorized under this section shall obtain and report continuing medical education as required under the
Act, §§156.051-.055 and §166.2 of this title (relating to Continuing Medical Education).
(c) A retired physician who has obtained an exemption from the registration fee as provided
for under this section, may be subject to disciplinary action under the Act, §§164.051-.053, based on
unprofessional or dishonorable conduct likely to deceive, defraud, or injure the public if the physician
engages in the compensated practice of medicine, the provision of medical services to members of the
physician's family, or the self-prescribing of controlled substances or dangerous drugs.
(d) A physician who attempts to obtain an exemption from the registration fee under this
section by submitting false or misleading statements to the board shall be subject to disciplinary action
pursuant to the Act, §164.052(a)(1), in addition to any civil or criminal actions provided for by state or
This chapter was last updated on January 9, 2005.