PA license renewal and NCCPA certification: CME requirements explained

Most confusion about PA renewal comes from mixing up two separate systems. Your state license is what lets you practice. It is issued by a state board, and only that board can renew, restrict or revoke it. Your NCCPA certification is what lets you use the PA-C credential. It is a national board certification issued by NCCPA (the National Commission on Certification of Physician Assistants), which is a private certifier that is not a licensing authority.

The two are linked because most states use NCCPA in some way. New York, for example, requires you to pass the PANCE, NCCPA's entry exam, before it will license you. California, Texas and Florida go further and let current NCCPA certification stand in for most or all of the general CME hours at renewal. But the link only runs so far. A state can still require topic-specific courses that NCCPA does not, and NCCPA has its own deadlines that no state board will remind you about.

NCCPA's certification maintenance runs on a 10-year cycle made up of five two-year CME cycles. In each two-year cycle, every certified PA must:

• Earn and log 100 CME credits, of which at least 50 must be Category 1. The rest can be Category 2, and NCCPA sets no maximum on Category 2.
• Log the credits and pay the certification maintenance fee by 11:59 p.m. Pacific Time on December 31 of the year your certification expires.

NCCPA states plainly that if the CME requirements are not met by the deadline, certification will lapse. Because so many states rely on certification, a lapse can quickly turn into a state renewal problem too.

A simple planning pattern

Spread the work instead of loading it into December of the expiration year. One simple approach is to aim for about 25 Category 1 credits a year and log Category 2 as it happens. Upload certificates when you finish an activity, not two years later when the email links have expired.

To keep certification beyond the 10-year cycle, a PA has to pass a recertification exam before year 10 ends. There are two routes. Both are built on the same content blueprint and both cost $350.

NCCPA adopted PANRE-LA after a two-year pilot. Its appeal is that it spreads testing over time and teaches as it goes. The trade-off is that it starts earlier, so you need to decide in year 7, not year 9. Check your exact eligibility window in your NCCPA record before deciding.

Each year NCCPA randomly selects PAs to audit the Category 1 credits they have logged. If you are selected you are told by email and mail and have about six weeks to respond with certificates of completion or transcripts that show an accreditation statement from an approved sponsor.

• A first failed audit puts you into a second audit, without affecting certification at that stage.
• Not meeting the second audit, including any fees, by your expiration date means certification lapses.
• Falsified documentation or repeated failures can lead to NCCPA disciplinary action, including suspension or revocation. NCCPA's disciplinary policy lists failing a CME audit and making knowingly false statements to NCCPA among its grounds.

The practical lesson is integrity in logging. Only log what you completed, in the category it genuinely belongs to, and keep the evidence for each credit. Our guide to PA board complaints and NCCPA discipline explains what happens when certification problems overlap with a state case.

Your state license sits on top of certification. Here is how four large states handle PA renewal, as stated on each board's site in October 2026.

California: no grace period

The Physician Assistant Board renews licenses every 24 months and is clear that there is no grace period: once your license expires you cannot practice. A one-time waiver of the CME requirement is available for health reasons, military service or undue hardship, but you must apply at least 60 days before expiration.

Texas: certification does not cover everything

Texas presumes that a currently certified PA has met the formal and informal hours, but the board lists the topic-specific courses separately in its PA CME chart. Read that chart, because the human trafficking and opioid hours come from approved sources. Texas also carries forward up to 80 excess hours for up to two years, and mandatory CE tracking through CE Broker begins on September 1, 2026.

Florida: fixed expiration date and board-approved topics

All Florida PA licenses expire at midnight Eastern Time on January 31 of each even year. Florida points PAs to board-approved providers listed in CE Broker for its required topic courses, so check a provider's approval before you enroll for the medical errors or controlled substance hours.

New York: a different agency for discipline

The State Education Department licenses and registers New York PAs, but complaints about PAs go to the Department of Health's Office of Professional Medical Conduct (OPMC). That split matters only if something goes wrong; for renewal, NYSED is the office to watch.

Practicing in more than one state means meeting each state's rules separately. Our physician license renewal guide covers the same four states for MDs and DOs if you work alongside a supervising or collaborating physician and want to compare.

If you hold a DEA registration, a federal requirement applies on top of NCCPA and state rules. The Medication Access and Training Expansion (MATE) Act requires DEA-registered practitioners to finish 8 or more hours of one-time training on treating and managing opioid or other substance use disorders, and you confirm this on the DEA form the first time you register or renew after June 27, 2023 (that date included).

It is a one-time requirement, not a recurring one. It is also a self-attestation, which makes it a probity issue as much as a learning one: only check the box if you have done the training. The DEA's MATE Act FAQ explains what counts.

The AAPA House of Delegates voted in May 2021 to change the profession's title to “physician associate”. The vote did not change anyone's legal title by itself. Your title in law is whatever your state's statute and license say.

• States with statutory title change (as listed by AAPA in 2026): Alaska, Delaware, Iowa, Maine, New Hampshire and Oregon. Oregon was first, with HB 4010 signed in April 2024.
• Title recognition legislation: Kansas and Wisconsin.
• Everywhere else, including California, Texas, Florida and New York, the license is still issued to a “physician assistant”.

AAPA says the change does not alter scope of practice and that PAs should follow licensing board, employer and payer policies before using the new title. “PA” works in every state, which is why we use it on this site. NCCPA's own policies now refer to “physician assistant/associate” practice, and the credential is still PA-C.

Why this belongs on a renewal page: using a title your state has not adopted, on a badge, website or form, can raise a misrepresentation question. Check before you change your signature block.

None of the four states above sets a separate ethics hour for PAs, and NCCPA does not ask for a named ethics topic. But ethical lapses sit behind many of the grounds for discipline that boards list, and the profession has its own framework. The AAPA Guidelines for Ethical Conduct for the PA Profession are built on four core values:

1. Autonomy: patients decide about their own care, with information they can understand.
2. Beneficence: act in the patient's best interest.
3. Nonmaleficence: do no harm, and weigh risks honestly.
4. Justice: treat patients fairly and distribute resources fairly.

The Guidelines also cover topics that turn up in complaints: informed consent, confidentiality, conflicts of interest, sexual involvement with patients, impairment, and the team relationship with physicians. They are ethical guidance from a professional society, not law. Boards enforce the state practice act and rules, but they often look at the profession's own standards when judging conduct.

What they do offer is focused, self-paced learning on professional conduct, written for U.S. licensees and grounded in official sources. For US$89 and about 3 hours, a PA gets case-based checks, a 20-question final (16 correct, or 80%, to pass), a completion certificate and a guided reflective account. Courses PAs most often choose:

• Ethics for Licensed Health Professionals (3 hours, US$89): codes, frameworks and board expectations, including the AAPA four principles.
• Professionalism in U.S. Healthcare Practice (3 hours, US$89): conduct, team working, impairment and reporting duties.
• Informed Consent and Patient Communication (3 hours, US$89): disclosure, capacity and documentation of the discussion.
• Medical Record Documentation for Licensed Health Professionals (3 hours, US$89): what a defensible record looks like.
• Professional Integrity and Honesty for Licensed Health Professionals (3 hours, US$89): attestations, billing, and honest logging and declarations.

Browse the full list on the course catalogue.

1. Find your NCCPA expiration year and your cycle year (1 to 10) in your NCCPA record.
2. Count logged credits: at least 50 Category 1 and 100 in total before December 31 of the expiration year.
3. Keep every certificate with its accreditation statement in one folder, ready for an audit.
4. If you are in year 7 or later, decide between PANRE-LA and PANRE.
5. List each state license you hold, its expiration date and its topic courses.
6. Confirm whether each state accepts NCCPA certification for the general hours.
7. If you are DEA-registered, confirm the MATE Act training is done before you attest.
8. Check the title rules in your state before using “physician associate”.