Chiropractic CE Requirements by State

No two states set chiropractic continuing education the same way. Among the jurisdictions we have verified, the annual states run from 12 hours a year (Arizona, Montana) to 24 (Arkansas, California); the biennial states from 20 hours (New Hampshire) to 40 (Florida); New York asks for 36 hours every three years; and Connecticut counts 48 hours over a two-year monitoring period. The totals are only half of it. Each board also sets required topics, caps on online or distance hours, and its own reporting window, and those details are what trip up a DC who holds licenses in several states.

The list below comes from the verified records behind our state license pages, each built from the statute, the board's rule, or an archived copy of the board's own page. Boards change CE rules more often than most licensing rules, so confirm with the board before a renewal.

Which states renew every year?

• Alabama: 18 board-approved hours a year, including two on the Alabama practice act and rules (four in the first renewal year); no more than one third by distance learning. Renew by September 30 (Ala. Admin. Code r. 190-X-2-.11).
• Arizona: 12 board-approved credits each calendar year; renew before the end of the birth month (A.R.S. § 32-923; Ariz. Admin. Code R4-7-801).
• Arkansas: 24 board-pre-approved hours from the preceding 12 months, no more than 12 by distance learning, certificates sent with the renewal; renew by December 31 (the board's continuing education and renewal pages).
• California: 24 hours a year, at least 2 in ethics and law and 4 in history and physical examination, adjusting or manipulation technique, or billing and coding; no more than 12 by distance learning (16 CCR § 361). Renewal is annual (16 CCR § 370).
• Connecticut: licenses renew every year in the birth month, but CE is counted over a two-year period: 48 contact hours with mandatory topics the Department of Public Health lists, plus a veterans' mental health course (the department's chiropractic CE page).
• Montana: 12 hours a year, no more than two in philosophy or practice management, no carryover; renew between July 1 and September 1 (Mont. Admin. R. 24.126.2103).
• New Mexico: 16 board-approved hours of 60 minutes each per July-to-June year, with at least 10 percent of renewals audited and records kept for three years (16.4.10.8 NMAC). Advanced practice registrants add 10 hours (16.4.15.10 NMAC); see New Mexico's advanced practice registration.
• Texas: 16 hours a year, with the reporting year starting on the first day of the birth month. At least 4 hours must be Board-required courses taken live, including 3 on the board's rules, ethics and documentation, plus 1 hour of risk management. No more than 10 hours a year may be non-live online courses. A DC first licensed on or after September 1, 2012 must complete 8 hours in Medicare coding and documentation by the second renewal (22 Tex. Admin. Code § 73.1). The license itself renews every two years in the birth month (§ 72.14).

Which states renew every two years?

• Alaska: 32 hours per biennium, including 8 in diagnostic imaging, 2 in coding and documentation, 2 in ethics and boundaries and 2 in CPR; up to 16 online (12 AAC 16.290).
• Colorado: 30 hours per renewal period, at least 4 in recordkeeping and documentation, no carryover, plus current healthcare-provider CPR. Licenses expire October 31 of odd-numbered years (3 CCR 707-1).
• Delaware: 24 hours per biennium, at least 3 in ethics, recordkeeping or risk management; up to 12 asynchronous online hours and 6 hours of carryover. Licenses expire June 30 of even-numbered years (24 Del. Admin. Code 700).
• District of Columbia: 24 approved hours in the two years before expiration on December 31 of even-numbered years; the first renewal after licensure by exam is exempt (D.C. Board of Chiropractic regulations).
• Florida: 40 contact classroom hours each biennium, including 3 in risk management (2 of them on Florida's laws and rules), 6 in record keeping, documentation and coding, and 2 in ethics and boundaries. All hours may be online attendance courses if they are live or include a way to ask the instructor questions. Acupuncture-certified DCs take 4 acupuncture hours inside the 40 (Fla. Admin. Code R. 64B2-13.004; § 460.408, Fla. Stat.).
• Nebraska: 36 hours per 24 months, at least 4 in technical skills and 4 in listed practice issues; independent study cannot count toward the mandatory hours. Licenses expire August 1 of even-numbered years (172 NAC 29-006).
• Nevada: 36 board-approved hours in the 24 months before renewal for licensees in active Nevada practice; licenses renew by January 1 of odd-numbered years (NRS chapter 634). Dry needling certificate holders add 4 hours (NAC 634.3668).
• New Hampshire: 20 hours per renewal from ACA, ICA, PACE or chiropractic college sources (N.H. Admin. Code Chi 404.01). The statute words the 20 hours as completed within one year before renewal, so keep certificates dated inside that window.
• New Jersey: 30 credits of 50 minutes each per biennium, including at least 2 in New Jersey law and rules on ethics or recordkeeping and 2 in nutrition (N.J.A.C. 13:44E-1A.5).

Which state uses a three-year cycle?

New York: registration renews every three years with 36 contact hours of approved CE per period, prorated at one hour per month for a shorter period. New licensees by exam are exempt for their first period; licensees by endorsement are not (NYSED Office of the Professions, chiropractic CE questions and answers). That last point catches DCs who move to New York by endorsement and assume a new licensee grace period.

What differs besides the hours?

Read side by side, five details cause most CE problems for multi-state licensees:

• Reporting windows. Texas starts the CE year on the birth month; New Mexico runs July to June; Arkansas counts the preceding 12 months; New Hampshire's statute looks at the year before renewal even though renewal is biennial. One course can fall inside one state's window and outside another's.
• Mandatory state-law hours. Alabama, Florida, New Jersey and Texas each require hours on their own laws or rules. Those hours rarely count anywhere else.
• Online limits. California and Arkansas cap distance learning at 12 hours, Texas caps non-live online at 10 hours a year, Alaska at 16 per biennium, and Florida allows all hours online if the format is interactive.
• Specific topics. Alaska's 8 imaging hours, New Jersey's 2 nutrition hours, Colorado's 4 documentation hours and Texas's 8 Medicare coding hours for newer licensees have no equivalent in most other states.
• Approval. Some boards approve courses themselves, some accept PACE or national bodies, and Arkansas wants pre-approval. A course approved in one state is not automatically approved in another.

How do I survive a board CE audit?

Most boards accept an attestation at renewal and check later, so the certificates matter more after the renewal than before it. New Mexico selects at least 10 percent of renewals for audit and requires CE records to be kept for three years after the cycle in which they were earned (16.4.10.8 NMAC). Texas requires a licensee to send written verification from each course sponsor for any years the board requests, and treats a failure to send it as failing to meet the CE requirement (22 Tex. Admin. Code § 73.1(m), (n)). Florida does not allow a course to be repeated for credit within the same biennium (Fla. Admin. Code R. 64B2-13.004(3)(c)), and Colorado and Montana allow no carryover, while Delaware allows six hours. Keep certificates by state and by cycle, and keep them longer than the shortest retention period you are subject to.

How do I plan CE across several licenses?

1. List every license with its renewal date, cycle and CE window.
2. Book the state-specific hours first: law and rules courses, required live courses, and topic requirements such as imaging or nutrition.
3. Fill the remaining hours with courses approved in as many of your states as possible, usually PACE-approved courses where the boards accept PACE, and check the online caps of the strictest state.
4. Keep certificates by state in one place. Audits, such as New Mexico's 10 percent, can arrive after the renewal.
5. Recheck each board's rule a few months before each renewal.

Our post on keeping several licenses current covers the calendar side. Our Annual Renewal & CE Compliance service ($299 per license, per year) tracks each license's renewal date, CE window and required topics and files the renewals; course fees and board fees are separate.