Tennessee

At a Glance

Category	Details
IMLC Member	Yes
FCVS	Accepted
NP Independent Practice	No
PA Independent Practice	No
Physician-Owned PC Allowed	No
Max NPs per Physician	No Limit
Max PAs per Physician	4

Licensure

Item	Cost
Initial License	$510
Renewal Fee	$400
Renewal Cycle	Biennial
Annualized Cost	$200
Controlled Substance Registration	No

Endorsement & Reciprocity

Not yet researched — whether this state offers license-by-endorsement or reciprocity, and its prerequisites, is being verified.

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APC Supervision

In-state requirement for supervising physicians: MD must be within “reasonable” distance. Once annual site (11 virtual, 1 in-person). Board advisory ruling, can take place for telehealth. Location for telehealth for site visit, can be a site mutually agreed upon. NP doesn’t have to b present.

Nurse Practitioners

NPs require physician supervision in Tennessee.

• Maximum NPs per physician: No Limit

Physician Assistants

PAs require physician supervision in Tennessee.

• Maximum PAs per physician: 4

CME & Training Requirements

Requirement	Details
Total CME	40 hours
Category 1 Minimum	40 hours
Cycle	Biennial
Opioid / SUD	2 hrs/cycle
DEA MATE Act	8 hrs one-time (federal)
Jurisprudence Exam	Not required

Fingerprint Requirements

Detail	Info
Required	Yes
FBI Check	Yes
Method	IdentoGO / Ink cards (FD-258)
Out-of-State Options	Contact board

Malpractice Insurance

• No general malpractice-insurance mandate for licensure was found; the only mandate located in Board rules is context-specific — physicians performing Level III office-based surgery must submit written verification of malpractice coverage as part of surgical-suite certification, not as a general licensure condition.

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Giving Up a License

• Status after lapse: lapsed (status changes to lapsed on the public licensure-verification page starting the day after the expiration date)
• Lapse consequences: A late renewal fee applies immediately after expiration. Practicing on an expired license is prohibited; a grace period of 60 calendar days is tolerated, but practicing 60 days-to-6-months on an expired license draws an Agreed Citation with a $1,000/month fine (reportable to the NPDB), and practicing 6+ months on an expired license triggers formal disciplinary referral with a mandatory reportable reprimand and civil penalties exceeding $1,000/month.
• Voluntary surrender: Available — Board rule provides a formal, non-disciplinary 'Licensure Retirement' (and a separate 'Inactivation' option for those actively practicing in another state) initiated by filing an affidavit; no fee to retire. Distinguished from disciplinary surrender.
• Reinstatement: Retirement/inactive-status reactivation requires the renewal/reinstatement/reactivation application, renewal fee, and 2 years of CME; retirement/inactivity over 2 years may require a competency interview, and over 5 years (or non-continuous out-of-state practice while inactive) may require passing the FLEX Special Purpose Examination. For a simple expired license (not retired), an application, notarized work history, and all fees are required, with expedited reinstatement if expired under 60 days.

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Quirks & Gotchas

Fees

• Application fee: $510 (MD) / $410 (DO)** - non-refundable, paid to the respective board.
• 90-day hard expiration clock**: The application expires 90 days from filing if all verifications have not been received. There is no grace period. If it expires, you pay the full fee again and start over. This is the single most common failure point.
• Most common causes of expiration: references failing to respond in time, and repeat FBI fingerprint card rejections.
• Fingerprinting via IdentoGO only** (TBI/FBI background check). Fee: ~$37.15. If you miss your scheduled appointment and do not reschedule within two weeks of the original date, you forfeit the fee and must re-register and repay.
• There is no separate “jurisprudence exam” publicly documented as a requirement for MDs/DOs the way Texas has one. The board rules and multiple sources do not list a physician-specific jurisprudence exam as a licensure step - this appears to be a non-requirement for physicians (unlike dentists or speech pathologists in TN, who do have one).

Exam Requirements

• All three USMLE steps must be completed within 10 years from the date the first step was passed. The board may grant waivers, but do not count on it.
• If any single USMLE step was failed more than 3 times, you must provide proof of ABMS board certification and active Maintenance of Certification before the application will be considered. This is a significant barrier for applicants with a rocky exam history.
• COMLEX/NBOME: 3 attempts per step, no 10-year time limit (unlike USMLE).

CME & Mandatory Training

• AMGs**: Minimum 1 year ACGME-accredited postgraduate training.
• IMGs: Minimum 3 consecutive years** in a single ACGME-accredited specialty. This is stricter than many states and catches IMGs off guard.
• 5-year gap rule**: If a physician has not been in active clinical practice for 5 or more years, the board may require a SPEX or COMVEX competency exam before licensure. Same applies after certain disciplinary actions.
• 40 Category 1 CME hours per 2-year renewal cycle** (renewal is in your birth month).
• Mandatory controlled substances CME: Minimum 2 of the 40 hours** must specifically cover controlled substance prescribing, including opioids, benzodiazepines, barbiturates, and carisoprodol, aligned with TN Department of Health treatment guidelines. Exemptions exist for ABMS/AOA board-certified specialists in pain management, anesthesiology, PM&R, neurology, and rheumatology.
• DEA one-time requirement (federal, not state)**: 8 hours on treating opioid/substance use disorders for all DEA-registered practitioners - triggered by any DEA registration or renewal on or after June 27, 2023. One-time only.
• No documented mandatory CME requirements for human trafficking, implicit bias, suicide prevention, or domestic violence were found in the current Tennessee rules - unlike many other states. This is notably absent.
• Physicians offering intractable pain treatment must complete specialized pain management CME beyond the standard 2-hour floor.

Application Requirements

• Visiting Faculty / Distinguished Faculty
• Administrative License

Privilege Tax

• Fully repealed effective July 1, 2022.** Was $400/year annually. Physicians were the first profession exempted, framed as COVID-era appreciation. Last payment obligation was June 1, 2022 for FY2021-22.
• No lingering obligation. It is gone for physicians.

Timeline

• Average processing: 12-14 weeks (3-4 months).
• If any adverse history questions are answered “yes,” processing extends while the board reviews documentation - no stated cap on how long this takes.
• Tennessee does NOT offer an expedited processing track through the board itself.

Interstate Medical Licensure Compact (IMLC)

• Tennessee participates. If you qualify, IMLC is dramatically faster than the standard route and bypasses most of the gotchas above.

Other Gotchas

• 2 physician reference letters** required, attesting to good moral character. References failing to respond is a top cause of the 90-day clock expiring.
• Telemedicine**: Tennessee no longer issues standalone telemedicine licenses. Only fully licensed MDs and DOs may practice telemedicine - no workaround.
• Foreign Medical School graduates**: Must comply with a separate TN BME Foreign Medical School Policy document; not all foreign schools are “approved.”
• Renewal is in the licensee’s birth month every 2 years - an unusual cadence vs. calendar-year renewal states. Easy to miscalculate when a new license will expire.
• Tennessee Board of Medical Examiners - TN.gov
• Rules of the Tennessee BME (November 2025 revision)
• Rules of the Tennessee BME (June 2025 revision)
• Tennessee Medical License Guide - MedicalLicensing.com
• Tennessee Medical License - Medical Licensure Group
• Tennessee Medical License - MedLicensePro

Researched from state board websites and regulatory sources. Verify with the board directly before applying.

Resources

• Tennessee Board of Medical Examiners
• FSMB State Licensure Directory
• Interstate Medical Licensure Compact

Sources

Data compiled from state medical board websites, FSMB, and regulatory filings.

Have a correction or update? Let us know.