Biennial License Renewal

PURPOSE: This rule establishes the licensure renewal require ments. (1) A license shall be renewed biennially contingent upon the licensee completing the required hours of continuing educa tion as defined in section (2)— (A) For the purpose of this regulation one (1) hour of con tinuing education shall consist of at least fifty (50) minutes of instruction or study; (B) A chiropractic physician issued a license within one (1) year of graduation from an approved chiropractic college shall be exempt from the continuing education requirements until the end of the first biennial licensure cycle following initial license issuance; and (C) A chiropractic physician at least sixty-five (65) years old and licensed in this state for at least thirty-five (35) years shall complete at least twenty-four (24) hours of formal continuing education biennially as defined in section (4) of this rule. The remaining biennial hours of continuing education shall be waived. (2) Every two (2) years (hereinafter referred to as biennially) and prior to the expiration date of a license, a licensee shall complete forty-eight (48) hours of continuing education as defined in sections (3) and (5) of this rule. If a licensee is unable to complete the required biennial continuing education, prior to the expiration date of the license, the licensee may submit a written request to the board for an extension in order to comply with the continuing education requirement and shall pay the required late continuing education fee. (3) At least twenty-four (24) hours of the required forty-eight (48) hours of continuing education shall be earned by attend ing formal continuing education programs, seminars, and/or workshops that have been approved by the board, with twelve (12) of the twenty-four (24) formal hours to be in actual physical attendance. (A) A licensee shall obtain the required formal continuing education hours from no less than two (2) of the following formal categories: 1. Diagnostic imaging (X ray); 2. Differential or physical diagnosis or both; 3. Recordkeeping and/or Subjective Objective Assessment Plan (SOAP) notes; 4. Principles, techniques, and/or adjunctive procedures; or 5. Meridian Therapy/acupressure/acupuncture. (4) Twelve (12) of the formal continuing education hours in compliance with 20 CSR 2070-2.080(3) must be obtained by actual physical attendance not via the Internet. (5) The remaining required continuing education hours, which shall be deemed “general” continuing education hours, may be obtained from one (1) or more of the following areas: (A) Continuing education programs, seminars, and/or workshops approved by the board pursuant to 20 CSR 20702.080(3); (B) Continuing education programs, seminars, and/or workshops related to the practice of chiropractic and not approved by the board for formal continuing education hours; (C) Attending relevant professional meetings. Such meetings can be international, national, regional, state, or local and must be related to the practice of chiropractic; (D) Reading scholarly material relating to the practice of chiropractic to include books, journals, periodicals, and articles whether printed, provided via the Internet, or other electronic means; (E) Writing articles for scholarly publications such as books, national or international journals, and periodicals. Articles must be relevant to the practice of chiropractic; and (F) Chiropractic physicians teaching an approved post graduate course may receive continuing education credits for teaching the course providing the instructor’s name was submitted with the course content when requesting approval of the course. (6) Chiropractic physicians who are faculty members at a CCE–accredited college may receive up to a maximum of forty-eight (48) hours biennially of continuing education credit for teaching or attending course(s) at a CCE-accredited chiropractic college: (A) The areas of study shall be in compliance with 20 CSR 2070-2.080(3); (B) For the purpose of this rule, the faculty member must either teach or attend a course at a CCE-approved chiropractic college for a minimum of four (4) clock hours as defined in 20 CSR 2070-2.080(3); (C) Any remaining continuing education study required for licensure renewal may be obtained by teaching or attending course(s) relevant to chiropractic provided by a CCE-approved chiropractic college; and (D) The chiropractic college shall be responsible for submit ting course(s) to the board for approval and for verifying atten dance by the teacher or faculty member. (7) Chiropractic physicians who teach continuing education approved by the board may receive up to a maximum of four (4) hours per year of continuing education credit for teaching board-approved courses as defined in 20 CSR 2070-2.080(3)(A). (8) Chiropractic physicians certified by the board in Meridian Therapy/acupressure/acupuncture (MTAA) or insurance consulting who teach continuing education approved by the board may receive up to twelve (12) hours biennially of continuing education for teaching courses pursuant to 20 CSR 2070-2.031 MTAA or 20 CSR 2070-4.010 insurance consulting. (9) A licensee acting as an associate examiner for Part IV of the national examination administered by the National Board for Chiropractic Examiners (NBCE) is eligible to receive a maximum of ten (10) hours of continuing education as follows: (A) Four (4) hours of formal continuing education; (B) Six (6) hours of general continuing education; and (C) To obtain the continuing education, the associate examiner must attend the orientation and administer the Part IV examination for the day(s) scheduled. (10) If the licensee pays the continuing education penalty fee for continuing education credits earned late, those hours shall be applied to the requirements to renew the license and not be applied to the next renewal cycle. A licensee who has failed to obtain and document the requisite number of continuing education credits shall be subject to disciplinary action by the board at the board’s discretion, pursuant to the authority granted in section 331.060, RSMo. (11) A licensee shall be responsible for maintaining all documentation of continuing education compliance for the previous and current biennial licensure cycles. In the event the licensee is selected for a compliance audit, the licensee shall provide the required documentation of compliance within sixty (60) days of the written request from the board. Failure to comply with a board audit or other request for such documentation shall be a basis for disciplinary action against the licensee, pursuant to section 331.060, RSMo. (12) If a licensee requires a waiver or an extension of time to complete the continuing education requirements, a written request, explaining the reason for the request for an extension, must be submitted to the board in advance of the license expiration date. Any extension of time to complete the continuing education requirements or waiver of the continuing education requirements shall be granted solely at the discretion of the board and based upon terms and conditions deemed appropriate by the board. (13) A Missouri licensed chiropractor that practices in another state and is not practicing in Missouri may use the approved continuing education hours required of the state in which they practice for biennial renewal of the Missouri license, without prior approval by the board. If the state in which the chiropractic physician is practicing does not have continuing education requirements for renewal or licensure reinstatement, the out-of-state chiropractic physician must earn the requisite number of continuing education hours required in Missouri as defined in sections (2), (3), and (5) of this rule. (14) Within two (2) years of the expiration date, a license may be reinstated upon submission of the following: (A) A completed reinstatement form available from the board; (B) Renewal and reinstatement fees as defined in 20 CSR 2070-2.090(1)(B) and (D); and (C) Proof of compliance with continuing education requirements pursuant to sections (2), (3), and (5) of this rule. If licensed in another state and not practicing in Missouri, the continuing education required to maintain the license in that state may be used in lieu of meeting the requirements of 20 CSR 2070-2.080(2), (3), and (5). (15) A license that is expired or inactive for more than two (2) years and less than five (5) years from the expiration or inactive date may be reinstated upon submission of the following: (A) A completed reinstatement form available from the board; (B) Reinstatement fee as defined in 20 CSR 2070-2.090(1)(D); (C) A criminal history background check from the Missouri State Highway Patrol’s approved vendor(s) for both the Missouri State Highway Patrol and Federal Bureau of Investigation. Any fees for the background check are the applicant’s responsibility; and (D) Proof of compliance with 20 CSR 2070-2.080(2), (3), and (5). If licensed in another state and not practicing in Missouri, the continuing education required to maintain the license in that state may be used in lieu of meeting the requirements of sections (2), (3), and (5) of this rule. (16) A license that is expired or inactive for more than five (5) years and the applicant is not licensed in another state, the following shall be submitted: (A) A completed reinstatement form available from the board; (B) Reinstatement fee as defined in 20 CSR 2070-2.090(1)(D); (C) A criminal history background check from the Missouri State Highway Patrol’s approved vendor(s) for both the Missouri State Highway Patrol and Federal Bureau of Investigation. Any fees for the background check are the applicant’s responsibility; (D) An official transcript from a Council on Chiropractic Education accredited chiropractic college documenting com pletion of the following: 1. Four (4) semester hours in chiropractic clinical reasoning; 2. Four (4) semester hours clinical diagnosis; and AND INSURANCE 3. Four (4) semester hours of diagnostic imaging; and (E) Completion of the jurisprudence examination regarding Missouri statutes and regulations; with a minimum composite score of seventy-five percent (75%) on the jurisprudence examination. (17) Prior to the expiration date of the license, an application for renewal of the license shall be postmarked and sent via regular or overnight mail to the state board office, or electronically renewed by the licensee. The licensee shall verify the number of continuing education hours completed during the renewal cycle on the renewal form mailed to the board office or submitted online. (18) A license may be placed on inactive status upon submission of a written request and payment of the required fee pursuant to 20 CSR 2070-2.090(1)(C). AUTHORITY: sections 331.050 and 331.100.2, RSMo 2016.* This rule originally filed as 4 CSR 70-2.080. This version of rule filed Dec. 17, 1975, effective Dec. 27, 1975. Rescinded and readopted: Filed Dec. 9, 1981, effective March 11, 1982. Rescinded and readopted: Filed July 9, 1982, effective Nov. 11, 1982. Amended: Filed Sept. 12, 1983, effective Jan. 13, 1984. Amended: Filed Dec. 10, 1984, effective April 11, 1985. Amended: Filed April 10, 1986, effective July 11, 1986. Amended: Filed Aug. 14, 1986, effective Nov. 13, 1986. Amended: Filed April 18, 1990, effective June 30, 1990. Amended: Filed April 30, 1991, effective Oct. 31, 1991. Amended: Filed July 7, 1992, effective Feb. 26, 1993. Amended: Filed July 22, 1993, effective Jan. 31, 1994. Amended: Filed March 4, 1994, effective Aug. 28, 1994. Amended: Filed Dec. 18, 1995, effective June 30, 1996. Amended: Filed July 23, 1998, effective Feb. 28, 1999. Amended: Filed April 14, 2000, effective Oct. 30, 2000. Amended: Filed July 31, 2003, effective Jan. 30, 2004. Amended: Filed April 1, 2005, effective Oct. 30, 2005. Moved to 20 CSR 2070-2.080, effective Aug. 28, 2006. Rescinded and readopted: Filed June 27, 2007, effective Jan. 30, 2008. Amended: Filed Aug. 15, 2008, effective Feb. 28, 2009. Amended: Filed Aug. 27, 2009, effective Feb. 28, 2010. Amended: Filed March 29, 2019, effective Oct. 30, 2019. Amended: Filed Dec. 12, 2025, effective July 30, 2026. *Original authority: 331.050, RSMo 1939, amended 1945, 1947, 1969, 1981, 1987, 1999, 2001, 2004, and 331.100, RSMo 1939, amended 1949, 1969, 1980, 1981, 2008, 2013.