(a) Physician assistants licensed under the Physician Assistant Licensing Act shall register biennially and pay a fee. A physician assistant may, on notification from the board, renew an unexpired license by submitting the required form and documents and by paying the required renewal fee to the board on or before the expiration date of the permit. The fee shall accompany the required form which legibly sets forth the licensee's name, mailing address, business address, and other necessary information prescribed by the board.
(b) Continuing Medical Education. As a prerequisite to the biennial registration of a physician assistant's license, 40 hours of continuing medical education (CME) are required to be completed.
  (1) At least 20 hours are to be from formal courses:
    (A) that are designated for Category I credit by a CME sponsor approved by the American Academy of Physician Assistants; or
    (B) approved by the board for course credit.
  (2) As part of the 20 formal hours required, a course in human trafficking prevention approved by the executive commissioner of the Texas Health and Human Services Commission must be completed.
  (3) The remaining hours may be from Category II composed of informal self-study, attendance at hospital lectures, grand rounds, case conferences, or by providing volunteer medical services at a site serving a medically underserved population, other than at a site that is the primary practice site of the license holder, and shall be recorded in a manner that can be easily transmitted to the board upon request.
  (4) A physician assistant shall receive one credit of continuing medical education for each hour of time spent up to 6 hours per year, as required by paragraph (1) of this subsection based on participation in a program sponsored by the board and approved for CME credit for the evaluation of a physician assistant's competency or practice monitoring.
  (5) A physician assistant must report on the biennial registration form if she or he has completed the required continuing medical education during the previous year.
  (6) A licensee may carry forward CME credit hours earned prior to registration which are in excess of the 40 hour biennial requirement, except that excess credits may not be applied to requirements set forth under paragraph (2) of this subsection, and such excess hours may be applied to the following years' requirements. A maximum of 80 total excess credit hours may be carried forward and shall be reported according to whether the hours are Category I and/or Category II. 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 biennial registration following the period during which the hours were earned.
  (7) A physician assistant may request in writing an exemption for the following reasons:
    (A) catastrophic illness;
    (B) military service of longer than one year's duration outside the United States;
    (C) residence of longer than one year's duration outside the United States; or
    (D) good cause shown on written application of the licensee that gives satisfactory evidence to the board that the licensee is unable to comply with the requirement for continuing medical education.
  (8) Exemptions are subject to the approval of the licensure committee of the board.
  (9) An exemption under paragraph (8) may not exceed two years but may be renewed biennially, subject to the approval of the board.
  (10) This section does not prevent the board from taking disciplinary action with respect to a licensee or an applicant for a license by requiring additional hours of continuing medical education or of specific course subjects.
  (11) 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 the board.
  (12) Unless exempted under the terms of this section, a physician assistant licensee's apparent failure to obtain and timely report the 40 hours of CME as required and provided for in this section shall result in nonrenewal of the license until such time as the physician assistant obtains and reports the required CME hours; however, the executive director of the board may issue to such a physician assistant a temporary license numbered so as to correspond to the nonrenewed license. Such a temporary license shall be issued at the direction of the executive director for a period of no longer than 90 days. A temporary license issued pursuant to this subsection may be issued to allow the physician assistant 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.
  (13) A physician assistant, who is a military service member, may request an extension of time, not to exceed two years, to complete any CME requirements.
  (14) A physician assistant must provide a complete and legible set of fingerprints to the board, unless fingerprints were already submitted with their initial license application or a previous renewal request.
(c) Falsification of an affidavit or submission of false information to obtain renewal of a license shall subject a physician assistant to denial of the renewal and/or to discipline pursuant to the Act, §§204.301-204.303.
(d) If the renewal fee and completed application form are not received on or before the expiration date of the permit, the fees set forth in Chapter 175 of this title (relating to Fees and Penalties) shall apply.
(e) The board shall not waive fees or penalties.
(f) The board shall stagger biennial registration of physician assistants proportionally on a periodic basis.
(g) Practicing as a physician assistant as defined in the Act without a biennial registration permit for the current year as provided for in the board rules has the same force and effect as and is subject to all penalties of practicing as a physician assistant without a license.
(h) Expired Biennial Registration Permits.
  (1) If a physician assistant's registration permit has been expired for less than one year, the physician assistant may obtain a new permit by submitting to the board a completed permit application, the registration fee, as defined in §175.2(2) of this title (relating to Registration and Renewal Fees) and the penalty fee, as defined in §175.3(2) of this title (relating to Penalties).
  (2) If a physician assistant's registration permit has been expired for one year or longer, the physician assistant's license is automatically canceled, unless an investigation is pending, and the physician assistant may not obtain a new permit.
  (3) A person whose license has expired may not engage in activities that require a license until the licensed has been renewed. Practicing as a physician assistant after a physician assistant's permit has expired 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 as a physician assistant without a license. The Board interprets §204.156 of the Act to provide the exclusive sanction that may be imposed by the board for practicing medicine after the expiration of the permit.
(i) A military service member who holds a physician assistant license in Texas is entitled to two years of additional time to complete any other requirement related to the renewal of the military service member's license.
(j) The physician assistant board may refuse to renew a license if the licensee is in violation of a physician assistant board order.

Source Note: The provisions of this §185.6 adopted to be effective January 12, 1996, 21 TexReg 109; amended to be effective October 22, 1996, 21 TexReg 9831; amended to be effective May 5, 1997, 22 TexReg 3654; amended to be effective September 15, 1997, 22 TexReg 8998; amended to be effective December 23, 1997, 22 TexReg 12492; amended to be effective September 21, 2000, 25 TexReg 9218; amended to be effective November 3, 2002, 27 TexReg 10027; amended to be effective June 29, 2006, 31 TexReg 5105; amended to be effective August 9, 2009, 34 TexReg 5133; amended to be effective May 5, 2011, 36 TexReg 2728; amended to be effective September 26, 2016, 41 TexReg 7484; amended to be effective July 19,2018, 43 TexReg 4747; amended to be effective September 8, 2019, 44 TexReg 4729; amended to be effective December 31, 2020, 45 TexReg 9523