    OCCUPATIONS CODE
    TITLE 3. HEALTH PROFESSIONS
    SUBTITLE B. PHYSICIANS
    CHAPTER 156. REGISTRATION OF PHYSICIANS
    SUBCHAPTER A. RENEWAL AND REGISTRATION
    Sec. 156.001.  REGISTRATION REQUIREMENTS AND PROCEDURES.  (a)  Each person licensed to practice medicine in this state must register with the board every two years.  The initial registration permit shall be issued with the license.  The board by rule may adopt a system under which licenses expire on various dates during the year.(b)  Except as provided by Section 156.002, the application for registration must be accompanied by a registration permit fee in an amount set by the board regardless of whether the person is practicing medicine in this state.(c)  A license holder may renew the registration permit by submitting to the board, on or before the expiration date of the registration permit, the required renewal application and registration renewal fee.  Each registration permit renewal application must include:(1)  the license holder's name, mailing address, and, if one is available, address for receipt of electronic mail;(2)  the primary place at which the license holder is engaged in the practice of medicine;  and(3)  other necessary information as prescribed by board rule.(d)  If the license holder is licensed to practice medicine by another state or country or by the uniformed services of the United States, the registration renewal application must include a description of any investigation the license holder knows is in progress and any sanction imposed by or disciplinary matter pending in the state, country, or service regarding the license holder.(e)  In addition to the information required by Subsection (c), a license holder shall submit to the board with the registration permit renewal application information not reported on a license application or a previous permit renewal application relating to a felony conviction, a conviction for a Class A or Class B misdemeanor, or a deferred adjudication for a felony offense or Class A or Class B misdemeanor offense for:(1)  Medicare, Medicaid or insurance fraud;(2)  the Texas Controlled Substances Act or intoxication or alcoholic beverage offenses;(3)  sexual or assaultive offenses; and(4)  tax fraud or evasion.(f)  The board may not adopt a rule requiring maintenance of certification by a license holder for the license holder to be eligible for an initial or renewal registration permit.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.027(p), eff. Sept. 1, 2001;  Acts 2003, 78th Leg., ch. 202, Sec. 12, eff. June 10, 2003.Amended by: Acts 2005, 79th Leg., Ch. 269 (S.B. 419), Sec. 1.26, eff. September 1, 2005.Acts 2007, 80th Leg., R.S., Ch. 880 (H.B. 1973), Sec. 4, eff. June 15, 2007.Acts 2017, 85th Leg., R.S., Ch. 1121 (S.B. 1148), Sec. 5, eff. January 1, 2018.

    Sec. 156.0015.  CRIMINAL RECORD CHECK.  (a) In addition to the information required by Section 156.001, a  license holder shall submit to the board with the registration permit renewal application a complete set of fingerprints. The board shall submit to the Department of Public Safety each set of fingerprints received under this section for the purpose of completing the criminal record check described by Section 155.008. (b)  The board may suspend or refuse to renew the registration of a license holder who fails to submit a complete set of fingerprints under this section. (c)  This section does not apply to a license holder who previously submitted a complete set of fingerprints:(1)  as part of an application for a license; or(2)  as part of a previous application to renew a registration permit under this section.
    Added by Acts 2023, 88th Leg., R.S., Ch. 827 (H.B. 1998), Sec. 8, eff. September 1, 2023.

    Sec. 156.002.  EXEMPTION FOR CERTAIN PHYSICIANS.  (a)  The board by rule may exempt a retired physician from the registration permit fee requirement.(b)  A physician licensed by the board whose only practice is voluntary charity care, as defined by board rule, is exempt from the registration permit fee requirement.(c)  A retired physician whose only practice is voluntary medical care for a disaster relief organization is exempt from the registration permit fee requirement.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.027(q), eff. Sept. 1, 2001;  Acts 2003, 78th Leg., ch. 202, Sec. 13, eff. June 10, 2003.Amended by: Acts 2005, 79th Leg., Ch. 246 (H.B. 655), Sec. 4, eff. May 30, 2005.Acts 2005, 79th Leg., Ch. 1096 (H.B. 2158), Sec. 1, eff. September 1, 2005.

    Sec. 156.003.  STAGGERED RENEWAL SYSTEM.  (a)  The board by rule may adopt a system under which registration permits expire on various dates during the two-year registration period.(b)  For the registration period in which the expiration date is changed, registration permit fees shall be prorated.  On renewal of the registration on the new expiration date, the total registration permit fee is payable.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.027(r), eff. Sept. 1, 2001;  Acts 2003, 78th Leg., ch. 202, Sec. 14, eff. June 10, 2003.

    Sec. 156.004.  NOTICE OF EXPIRATION.  (a)  At least 60 days before the date on which a physician's registration permit expires, the board shall send to each physician at the physician's last known address according to the board's records:(1)  a registration permit renewal application notice; and(2)  a renewal notice for the physician's registration with the Department of Public Safety under Subchapter C, Chapter 481, Health and Safety Code.(b)  The board shall provide for a 30-day grace period for renewing the registration permit from the date of the expiration of the permit.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.027(s), eff. Sept. 1, 2001;  Acts 2003, 78th Leg., ch. 202, Sec. 15, eff. June 10, 2003.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 956 (H.B. 1803), Sec. 6, eff. January 1, 2014.

    Sec. 156.005.  RENEWAL OF CERTAIN REGISTRATION PERMITS.  (a)  If a person's registration permit has been expired for 90 days or less, the person may renew the permit by submitting to the board the required registration renewal application, the registration renewal fee, and a $75 penalty fee.(b)  If the person's registration permit has been expired for longer than 90 days but less than one year, the person may renew the permit by submitting to the board the required registration renewal application, the registration renewal fee, and a $150 penalty fee.(c)  If the person's registration permit has been expired for one year or longer, the person's license is automatically canceled, unless an investigation is pending, and the person may not renew the registration permit.(d)  A physician whose license is automatically canceled may obtain a new license by complying with the requirements, fees, and procedures for obtaining a new license.  The board may issue a new license without examination to a person whose license is automatically canceled for less than two years.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.027(t), eff. Sept. 1, 2001;  Acts 2003, 78th Leg., ch. 202, Sec. 16, eff. June 10, 2003.

    Sec. 156.006.  EMERGENCY CONTACT INFORMATION.  (a)  Each license holder shall submit to the board telephone numbers, fax numbers, and e-mail addresses, if available and as appropriate, that the board may use to contact the license holder in an emergency.(b)  A license holder who receives an initial registration permit shall provide the information required under Subsection (a) not later than the 30th day after the date the permit is issued.  Each license holder who applies to renew a registration permit shall submit the information required under Subsection (a) with the renewal application.(c)  A license holder shall report to the board any change in the information required under Subsection (a) not later than the 45th day after the date of the change.(d)  The information provided by a license holder under this section is confidential and is not subject to disclosure under Chapter 552, Government Code.  The board may not publish, release, or make available information provided by a license holder under this section except as provided by Subsection (e).(e)  In the event of a public health emergency declared or invoked by the governor, the Department of State Health Services, or a federal agency, the board may publish, release, or make available information provided by a license holder under this section for the sole purpose of disseminating information to:(1)  a license holder;(2)  a designated city, county, state, or federal public health or emergency management official; or(3)  the Federation of State Medical Boards.
    Added by Acts 2009, 81st Leg., R.S., Ch. 1345 (S.B. 292), Sec. 1, eff. September 1, 2009.

    Sec. 156.007.  ISSUANCE OF REGISTRATION PERMIT.  (a)  On receipt of a registration renewal application and all required fees, the board, after ascertaining from the records of the board or from other sources considered reliable by the board that the applicant is a physician in this state and meets all other requirements for registration, shall issue to the applicant a registration permit certifying that the applicant has filed the application, has paid the registration permit fee for the registration period, and has completed the requirements for registration.(b)  The filing of the registration renewal application, the payment of the required fees, and the issuance of the permit do not entitle the permit holder to practice medicine in this state unless:(1)  the permit holder has been previously licensed as a physician by the board, as prescribed by law;(2)  the license to practice medicine is in effect;(3)  the permit holder has met the continuing medical education requirements;  and(4)  the permit holder has submitted a current complete physician profile.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.027(u), eff. Sept. 1, 2001;  Acts 2003, 78th Leg., ch. 202, Sec. 17, eff. June 10, 2003.

    Sec. 156.008.  PRACTICING MEDICINE WITHOUT REGISTRATION PROHIBITED.  (a)  Practicing medicine after the expiration of the 30-day grace period under Section 156.004 following expiration of a registration permit that has not been renewed for the current registration period as provided by this subchapter has the same effect as, and is subject to all penalties of, practicing medicine without a license.(b)  In a prosecution for the unlawful practice of medicine, the receipt showing payment of the registration fee required by this chapter does not constitute evidence that the receipt holder is lawfully entitled to practice medicine.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2001, 77th Leg., ch. 753, Sec. 1, eff. June 13, 2001;  Acts 2003, 78th Leg., ch. 202, Sec. 18, eff. June 10, 2003.

    Sec. 156.009.  INACTIVE STATUS.  The board may adopt rules and set reasonable fees relating to placing license holders on inactive status.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2003, 78th Leg., ch. 202, Sec. 19, eff. June 10, 2003.

    Sec. 156.010.  REFUSAL FOR VIOLATION OF BOARD ORDER.  The board may refuse to renew a registration permit issued under this chapter if the license holder is in violation of a board order.
    Added by Acts 2017, 85th Leg., R.S., Ch. 567 (S.B. 674), Sec. 3, eff. September 1, 2017.

    SUBCHAPTER B. CONTINUING MEDICAL EDUCATION REQUIREMENTS
    Sec. 156.051.  REPORTING PROGRAM;  RULES;  EXEMPTION.  (a)  The board by rule shall adopt, monitor, and enforce a reporting program for the continuing medical education of license holders.  The board shall adopt and administer rules that:(1)  establish the number of hours of continuing medical education the board determines appropriate as a prerequisite to the registration of a license under this subtitle;(2)  require at least one-half of the hours of continuing medical education established under Subdivision (1) to be board approved;  and(3)  adopt a process to assess a license holder's participation in continuing medical education courses.(b)  In approving continuing medical education hours under Subsection (a)(2), the board shall consider the standards of:(1)  the American Medical Association adopted by that association for its Physician's Recognition Award;  or(2)  the American Osteopathic Association.(c)  The board shall permit the hours that are not subject to board approval under Subsection (a)(2) to consist of self-study or equivalent self-directed continuing medical education according to guidelines determined by the board.(d)  This section does not apply to a license holder who is exempt by rule from paying the registration fee under Section 156.002(a).
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2003, 78th Leg., ch. 202, Sec. 20, eff. June 10, 2003.

    Sec. 156.052.  PRESUMPTION OF COMPLIANCE FOR CERTAIN LICENSE HOLDERS.  A license holder is presumed to be in compliance with the requirements of this subchapter if, during the 36 months preceding the date of the required registration, the license holder 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.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2003, 78th Leg., ch. 202, Sec. 21, eff. June 10, 2003.

    Sec. 156.053.  TEMPORARY EXEMPTION.  (a)  The board may temporarily exempt a license holder from the continuing medical education requirement on the basis of:(1)  catastrophic illness;(2)  military service outside this state for longer than one year;(3)  medical practice and residence outside the United States for longer than one year;  or(4)  good cause shown on the written application of the license holder that provides evidence satisfactory to the board that the license holder is unable to comply with the requirement.(b)  A temporary exemption granted under Subsection (a) may not exceed one year but may be renewed.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.  Amended by Acts 2003, 78th Leg., ch. 202, Sec. 22, eff. June 10, 2003.

    Sec. 156.054.  AUTHORITY OF BOARD TO REQUIRE ADDITIONAL HOURS.  This subchapter does not prevent the board from taking disciplinary action with respect to a license holder or license applicant by requiring additional hours of continuing medical education, including education in specific course subjects.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

    Sec. 156.055.  CONTINUING EDUCATION IN PAIN MANAGEMENT AND PRESCRIPTION OF OPIOIDS.  (a)  A physician licensed under this subtitle who submits an application for renewal of a license that designates a direct patient care practice must complete, in accordance with this section, not less than two hours of continuing medical education regarding safe and effective pain management related to the prescription of opioids and other controlled substances, including education regarding:(1)  reasonable standards of care;(2)  the identification of drug-seeking behavior in patients; and(3)  effectively communicating with patients regarding the prescription of an opioid or other controlled substance.(b)  A physician must complete the hours required by Subsection (a) in each of the first two renewal periods following the issuance of the physician's initial registration permit under this chapter, with two of those hours to be completed not later than the first anniversary of the date of issuance. (c)  After the period described by Subsection (b), a physician must complete not less than two hours of continuing medical education described by Subsection (a) every eight years.(d)  The hours required by this section may be completed in any continuing medical education activity approved by the board, including medical ethics or professional responsibility education, and may be counted toward the hours of continuing medical education completed to comply with Section 156.051(a)(2).(e)  The hours required by this section may not be used to satisfy any education required by board rule for certified pain clinic personnel. (f)  The board shall adopt rules to implement this section.(g)  Notwithstanding Subsections (b) and (c), a physician who on January 1, 2021, holds a license to practice medicine under this subtitle shall complete not less than two hours of continuing medical education described by Subsection (a) in each of the two renewal periods occurring after that date.  This subsection expires January 1, 2026.
    Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.Amended by: Acts 2019, 86th Leg., R.S., Ch. 818 (H.B. 2454), Sec. 1, eff. September 1, 2019.

    Sec. 156.056.  CERTAIN VOLUNTEER SERVICES.  (a)  In this section, "practice serving a medically underserved population" has the meaning assigned by Section 157.051.(b)  The board by rule shall permit a license holder to complete half of any informal continuing medical education hours required under this subchapter by providing volunteer medical services at a practice serving a medically underserved population other than a site that is a primary practice site of the license holder.
    Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.029(a), eff. Sept. 1, 2001.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 418 (S.B. 406), Sec. 10, eff. November 1, 2013.

    Sec. 156.057.  CONTINUING EDUCATION IN FORENSIC EVIDENCE COLLECTION.  (a)  A physician licensed under this subtitle who submits an application for renewal of a license to practice medicine and whose practice includes treating patients in an emergency room setting shall complete at least two hours of continuing medical education relating to:(1)  the provision of trauma-informed care to sexual assault survivors;(2)  appropriate community referrals and prophylactic medications;(3)  the rights of a sexual assault survivor under Chapter 56A, Code of Criminal Procedure, including the opportunity to request the presence of an advocate as defined by Section 420.003, Government Code, and a forensic medical examination;(4)  forensic evidence collection methods; and(5)  applicable state law pertaining to the custody, transfer, and tracking of forensic evidence.(b)  The board shall adopt rules to establish the content of continuing medical education relating to forensic evidence collection.  The content of the continuing medical education must conform to the evidence collection protocol distributed by the attorney general under Section 420.031, Government Code.  The board may adopt other rules to implement this section.(c)  The board may permit the continuing medical education under this section to be counted toward the hours of continuing medical education required by Section 156.051(a)(2).
    Added by Acts 2005, 79th Leg., Ch. 782 (S.B. 39), Sec. 1, eff. September 1, 2005.Amended by: Acts 2025, 89th Leg., R.S., Ch. 365 (H.B. 47), Sec. 17, eff. September 1, 2025.

    Sec. 156.059.  CONTINUING EDUCATION IN TICK-BORNE DISEASES.  (a)  A physician licensed under this subtitle who submits an application for renewal of a license to practice medicine and whose practice includes the treatment of tick-borne diseases is encouraged to include continuing medical education in the treatment of tick-borne diseases among the hours of continuing medical education completed for purposes of rules adopted under Section 156.051(a)(2).(b)  The board shall adopt rules to establish the content of and approval requirements for continuing medical education relating to the treatment of tick-borne diseases.  In adopting rules, the board shall seek input from affected parties and review relevant courses, including courses that have been approved in other states.  Rules adopted under this section must provide for the identification and approval of accredited continuing medical education courses that represent an appropriate spectrum of relevant medical clinical treatment relating to tick-borne diseases.(c)  If relevant, the board shall consider a physician's participation in a continuing medical education course approved under Subsection (b) if:(1)  the physician is being investigated by the board regarding the physician's selection of clinical care for the treatment of tick-borne diseases; and(2)  the physician completed the course not more than two years before the start of the investigation.(d)  The board may adopt other rules to implement this section.
    Added by Acts 2011, 82nd Leg., R.S., Ch. 1092 (S.B. 1360), Sec. 2, eff. September 1, 2011.Added by Acts 2011, 82nd Leg., R.S., Ch. 1306 (H.B. 2975), Sec. 2, eff. September 1, 2011.

    Sec. 156.060.  CONTINUING EDUCATION REGARDING THE IDENTIFICATION AND ASSISTANCE OF TRAFFICKED PERSONS.  (a)  This section applies only to a physician who designates a direct patient care practice on an application for renewal of a registration permit.(b)  A physician licensed under this subtitle who submits an application for renewal of a registration permit must complete at least one hour of continuing medical education under this section regarding the identification and assistance of trafficked persons:(1)  in the first renewal period following the issuance of the physician's initial registration permit under this chapter; and (2)  if the board approves more than one course under Subsection (d), at least once in every third renewal period following the renewal period described by Subdivision (1).(c)  The hours required by Subsection (b):(1)  must be designated by the board as medical ethics or professional responsibility education; and(2)  may be counted toward the hours of continuing medical education required by Section 156.051(a)(2).(d)  The board shall adopt rules to implement this section, including rules to establish the content of and approval requirements for continuing medical education relating to the identification and assistance of trafficked persons.  In adopting rules, the board shall seek input from affected parties and review relevant courses, including courses that have been approved in other states.  Rules adopted under this section must provide for the identification and approval of accredited continuing medical education courses that represent an appropriate spectrum of relevant information relating to the identification and assistance of trafficked persons.
    Added by Acts 2019, 86th Leg., R.S., Ch. 796 (H.B. 2059), Sec. 2, eff. September 1, 2019.Amended by: Acts 2023, 88th Leg., R.S., Ch. 70 (S.B. 415), Sec. 1, eff. September 1, 2023.

    Sec. 156.061.  CONTINUING EDUCATION IN NUTRITION AND METABOLIC HEALTH.  (a)  A physician licensed under this subtitle who submits an application for renewal of a license to practice medicine must complete, in accordance with this section and rules adopted under this section, continuing medical education regarding nutrition and metabolic health.(b)  The board shall adopt rules to implement this section.  The rules must prescribe:(1)  the number of hours of the continuing medical education required by this section; and(2)  the content of the continuing medical education required by this section based on the nutritional guidelines recommended by the Texas Nutrition Advisory Committee under Chapter 119B, Health and Safety Code.
    Added by Acts 2025, 89th Leg., R.S., Ch. 1179 (S.B. 25), Sec. 10, eff. September 1, 2025.