Texas Medical Board and the Medical Practice Act

Rules and statutes governing the practice of medicine in Texas.

Physician licensure and CME requirements, the complaint process, electronic death registration, the treatment of and prescribing for pain, the Prescription Monitoring Program (PMP), and more.





Texas Medical Board Announcements, Contact Information, Rules, and News

The Texas Medical Board (TMB) is the state agency charged with keeping Texas patients safe through the licensure and regulation of Texas physicians. The Board consists of 12 physician members and seven public members appointed for six-year terms by the Governor and confirmed by the Texas Senate. Board business includes interviewing licensure candidates, considering disciplinary matters, and adopting procedural rules.

COVID-19 IMPORTANT ANNOUNCEMENTS (updated July 2, 2020)

Suspension of Elective Surgeries and Procedures in Hospitals in Harris County - Effective June 26, 2020
Gov. Abbott Issues Executive Order GA-27 Expanding Hospital Capacity - this executive order is aimed squarely at preserving hospital capacity and does not apply to ambulatory surgical centers or physicians' offices. See below TMA links for more details. (6/25/20)
From the Texas Medical Association (TMA) - Governor Suspends Most Elective Hospital Surgeries in State's Largest Counties (6/25/2020)
From the Texas Medical Association (TMA) President -TMA Statement Regarding Governor's COVID-Fighting Orders (6/25/2020)

Requirements Concerning COVID-19 Minimum Standards of Safe Practice - Effective May 1, 2020
TMB Adopts Emergency Rule Related to Gov. Abbott's Executive order GA-19 (4/30/2020)
The below notice/sign must be posted in each public area and treatment room of the office, practice, or facility (other than hospitals) -
----TMB's Notice and Compliance Requirements Concerning COVID-19 Minimum Standards of Safe Practice (updated 5/6/2020)
The TMB has answers to FAQs - TMB FAQs Regarding COVID-19 Minimum Standards of Safe Practice (updated 5/6/2020)
From the Texas Medical Association (TMA) - Share this poster with patients even before they arrive at your practice (also can be printed and posted) (5/12/2020)
From the Texas Medical Association (TMA) - TMA has issued a white paper on the TMB's minimum standards for safe practice rule. (updated 5/13/2020)
From the Texas Medical Association (TMA) - What if my patient refuses to wear a mask? (5/13/2020)
From the Texas Medical Association (TMA) - TMA has published FAQs - How do I comply with TMB's safe practice standards? (5/14/2020)

Chronic Pain Patients -  Waiver now extended until Sept 2 - with documentation requirements and determination guidance - Effective July 1, 2020
TMB Extends Emergency Rule Related to Issuance of Prescriptions (updated 7/1/2020)
TMB FAQs Regarding Telemedicine During Texas Disaster Declaration for COVID-19 Pandemic - question #9 on prescribing updated; #6 discusses the requirements for documenting a telemedicine visit. (updated 7/1/2020)
Note: All prescribers must still check patients' PMP history prior to prescribing certain controlled substances. See more info on the PMP mandate, 
From the Texas Medical Association (TMA) - How to Prescribe Controlled Substances Under COVID-19 Waivers (updated 7/2/2020)

Telemedicine -
TMB FAQs Regarding Telemedicine During Texas Disaster Declaration for COVID-19 Pandemic (updated 7/1/2020)
Gov. Abbott Waives Certain Regulations for Telemedicine Care in Texas (3/17/2020) 
For telemedicine resources and more, please refer to our Telemedicine web page.

Supervision of PAs and APRNs and PIT Permit Holders -
From the Texas Medical Association - Regulations on Residents and Fellows Waived to Increase Health Care Staffing (4/13/2020)
Gov. Abbott Eases Regulations on Physicians-in-Training (PIT) to Increase Health Care Capacity in Texas (4/11/2020)
TMB FAQs Regarding Supervision - PAs, APRNs - During Texas Disaster Declaration for COVID-19 Pandemic (4/7/2020)
Gov. Abbott Waives Certain Regulations to Expand Healthcare Workforce During COVID-19 Response (4/5/2020)

Licensing -
Gov. Abbott Fast-Tracks Licensing for Out-of-State Medical Professionals (3/14/2020)
Licensing Overview - COVID-19 Disaster Response
License Renewals - COVID-19 Disaster Response - License Renewal Extensions
Physician License Retirement Options - COVID-19 Disaster Response - Retired Physicians Returning to Active Status 
From the AMA for senior and retired physicians - Senior Physician COVID-19 Resource Guide (4/1/2020)

Additional Resources -
From the AMA - Ethics Guidance During a Pandemic - An Overview 
From the AMA - AMA Code of Medical Ethics - Guidance in a Pandemic
From the ABIM - American Board of Internal Medicine coronavirus updates 
From the ABMS - American Board of Medical Specialties Statement Regarding Continuing Certification During COVID-19

Contact the TMB - contact info with addresses, department mail codes, phone numbers.
Rules and Regulations - Most current TMB Laws and Rules, the Proposed Rule Changes, and FAQs for Licensees.
Newsroom - TMB Bulletins and Press Releases of recent rule changes, disciplinary action, new licenses issued, and other information.


Texas Medical Practice Act

The Texas Medical Practice Act, or Texas Occupations Code, Title 3 Health Professions, is where the state statutes are written that govern the practice of medicine and define the limits and responsibilities of medical practice in Texas.

Other sections of the Texas Constitution and Statutes include the Health and Safety Code and Family Code.


Texas Register and Texas Administrative Code

The Texas Register is a weekly publication from the TX Secretary of State that serves as the journal of state agency rule-making, including those involving the TMB.

After adoption, these actions are codified into the Texas Administrative Code, Title 22 Examining Boards, Part 9 Texas Medical Board, known as the TMB Rules.


Texas Physician Health Program (TXPHP)

This state program serves physicians affected by substance use disorders, physical illnesses and impairment, or psychiatric conditions through a recovery program. The TXPHP is covered under TMB rules Chapter 180. For more information, refer to the TXPHP website.


Physician TMB Profile

The public is able to access any Texas physician’s TMB profile and look up licensure, specialty, medical school of graduation, graduate medical education, practice address, hospital privileges, and more. Physicians should periodically review their TMB profile to ensure their information is accurate and current.


Complaint Processes

Information on the TMB's processes for handling complaints and enforcement procedures.

Notices: For patients and the public: For physicians:

Electronic Death Registrar - TxEVER

A physician who would ever be called upon to sign a death certificate must be registered with TxEVER, the Department of State Health Services (DSHS) Texas Electronic Vital Events Registrar. To enroll, see the TxEVER Welcome page and click on the User Enrollment link.

The medical certification of an electronic death certificate must be completed not later than five days after receiving it Health and Safety Code 193.005(b).
If a physician does not complete the death certificate within the required time frame, a complaint could be filed with TMB and disciplinary action could be taken. For information from the TMB.


Licensure, CME Requirements, DEA Registration, and more

Renewing a medical license, CME requirements, changing an address, retirement options, DEA information, and more.

CME: Licensure: Additional information:
  • Change of address
  • Name change request form
  • Retirement options - TMB provides licensure options for physicians who are retiring from medical practice. Note: The TMB allows retired physicians to use either a home address or a PO Box for the personal mailing address; however, PO Boxes are not allowed to be used as a 'practice' address.
  • Controlled Substances Registration (CSR) - The requirement to hold a CSR was eliminated in 2016, and the state will NOT replace it with another process. However, physicians must still maintain a current federal DEA registration.
  • DEA registration - For Drug Enforcement Administration (DEA) new and renewing registration online forms. Note: The DEA does not allow the use of PO Boxes for the registration address. A PO Box may only be used as an additional contact address.
  • DEA contact information including local offices.
  • Scam targeting DEA registrants - A TMB alert regarding criminals claiming to be DEA agents or TMB employees.
  • Ordering Prescription Forms - The Texas State Board of Pharmacy is responsible for issuing the Official (CII) Prescription Forms. To learn about electronic prescribing, including the e-prescribing of controlled substances, see our e-prescribing page.
  • KSTAR Physician Assessments - Through TAMHSC-Rural and Community Health Institute, these assessments are designed to help physicians who want to re-enter practice, have a perceived practice issue, or are under medical board order and need an assessment to demonstrate their knowledge base.

Pain Management Treatment and the Prescription Monitoring Program (PMP)

The treatment of pain is a vital part of the practice of medicine. Chapter 170 Prescription of Controlled Substances defines acute and chronic pain, sets forth minimum requirements for the treatment of chronic pain, and describes the requirement to check the Texas Prescription Monitoring Program.

For the treatment of acute pain, refer to the below info effective Sept. 1, 2019, regarding opioid prescribing limits.

The Texas Prescription Monitoring Program (PMP) is under the oversight of the Texas State Board of Pharmacy and monitors Schedule II through V controlled substance prescriptions. Physicians and other prescribers must set up a PMP account, use it to view and monitor their patients' prescription history for info that might indicate drug abuse, illicit activity, drug diversion, or doctor shopping, and check a patient's PMP history prior to issuing a new or refill prescription for certain controlled substances. Refer to the below info effective March 1, 2020, for a list of these substances.

A review of the patient's PMP prescribing history must be documented in the patient's medical record, which could include placing a copy of the PMP check in the patient's file. Chapter 170.9 describes when and under what circumstances a PMP check is required as well as exceptions to that requirement.

A PMP account also allows physicians to verify that their own prescribing records are accurate, and physicians who have delegated prescribing authority to PAs or APRNs may request from the PMP info on their prescribing activity as well.

The Texas Medical Association's on-demand webinar Texas Prescription Monitoring (PMP) Requirements: Who, What, When, and How covers the statutory requirements for checking the PMP and delineates how to use the PMP to determine a patient's risk for overdose, etc. It also discusses integrating a patient's PMP history with the practice's EHR. For more details and to register for this free recorded TMA webinar. Check the latest list of EHR vendors that are integrated with the PMP.

Effective Sept. 1, 2018:
  • Pharmacy Board issued new official prescription forms with advanced security features designed to help deter fraud.
Effective June 1, 2019: Effective Sept. 1, 2019:
  • Opioid Prescription Limits for Acute Pain - 2019 HB 2174 sets limits on the prescribing of opioids for acute pain. Opioid prescriptions for acute pain may not exceed a 10-day supply and cannot include any refills. However, the patient may see the practitioner in a follow-up appointment and receive another opioid prescription for up to 10 days, if needed. A follow-up appointment is required for each 10-day period of opioid prescriptions for acute pain. The 10-day limitation does not apply in the treatment of chronic pain, or as part of cancer, hospice, end-of-life or palliative care, or in the treatment of substance addiction. See Health and Safety Code 481.07636-481.0765. Refer also to the Resources section below for TMB's Aug 30, 2019 clarification. 
  • Delegated prescribing activity - 2019 SB 683 contains a provision authorizing physicians to request information on the prescribing activity of an individual to whom the physician has delegated prescribing authority. See Health and Safety Code 481.076.
  • Continuing Education - 2019 HB 2174 requires practitioners to complete CME related to approved procedures of prescribing and monitoring controlled substances and 2019 HB 3285 requires CME in best practices, alternate treatment options, and multi-modal approaches to pain management. These two formal hours of CME are to be completed within each license renewal period beginning with renewal on or after Sept. 1, 2020. Refer to the Resources section below for TMB's Feb 6, 2020 initial guidance. For complete CME requirements, see TMB's CME page.
Effective March 1, 2020:
  • Prescribers and pharmacists required to check the patient's PMP history prior to issuing or dispensing a new or refill prescription for an opioid, benzodiazepine, barbiturate, or carisoprodol. The date was formerly Sept. 1, 2019; however, the TX Legislature delayed the mandate until March 1, 2020, by passing 2019 HB 3284. See Health and Safety Code 481.0764-481.0765.
  • Refer to TX Admin Code Chapter 170.9 for details, requirements and exceptions regarding the Prescription Monitoring Program Check.
  • A copy of the PMP check may be placed in the patient's medical record to provide the required documentation that the PMP was checked and, based on that information, appropriate care was provided.
Effective Jan. 1, 2021:
  • Requirement for controlled substances to be prescribed electronically, except in certain circumstances described in 2019 HB 2174. See Health and Safety Code 481.075. To learn about electronic prescribing, including the e-prescribing of controlled substances, see our e-prescribing page.
  • Continuing Education - 2019 HB 2454 requires physicians practicing direct patient care to complete two hours of CME in safe/effective pain management and opioid prescribing by the next registration period. Refer to the Resources section below for TMB's Feb 6, 2020 initial guidance. For complete CME requirements, see TMB's CME page.
Resources:

Pain Management Clinics and Office-Based Anesthesia

Board rules, registration, inspections, FAQs, and forms.