MOC points are credits that board-certified physicians in the United States must earn to keep their certification active. MOC stands for Maintenance of Certification, a program run by the American Board of Medical Specialties (ABMS) and its 24 member boards. Most specialties require physicians to earn at least 100 MOC points every five years through a combination of learning activities and quality improvement work.
How MOC Points Fit Into Certification
Board certification isn’t a one-time achievement. After passing their initial board exams, physicians enter a continuing certification cycle that requires them to demonstrate ongoing competence. MOC points are the currency of that system. Each point represents completed work in one of several categories: lifelong learning and self-assessment, medical knowledge, and improvement in medical practice.
The ABMS describes MOC as “a comprehensive process that incorporates our commitment to professionalism, lifelong learning and self-assessment, measures of knowledge, judgment, and skills, and ongoing improvement in medical practice.” In practical terms, this means physicians can’t simply renew their certification by paying a fee. They need to show they’re staying current and actively working to improve patient care.
How Physicians Earn MOC Points
There are two main categories of activities that generate MOC points, and physicians typically need to earn points in both.
Lifelong Learning (Part 2) covers educational activities: attending conferences, completing online courses, participating in grand rounds, reading and answering questions from medical journals, and working through case discussions. Over 3,000 accredited continuing medical education (CME) activities can count toward MOC points. Many of these offer dual credit, meaning the same activity satisfies both state CME license requirements and MOC point requirements simultaneously. When a physician completes one of these activities, the data transfers automatically to their certifying board, so there’s no extra paperwork.
Improvement in Medical Practice (Part 4) focuses on quality improvement. This can include participating in local or national quality improvement projects, running your own QI project at your practice, working toward Patient-Centered Medical Home recognition, completing online practice improvement modules, or contributing to medical education program improvements. The American Board of Pediatrics notes that physicians can often earn Part 4 credit for work they’re already doing through their institution or practice.
Point Requirements by Specialty
The total number of points required and how they break down varies by certifying board, though the structure is broadly similar.
The American Board of Internal Medicine requires at least 100 MOC points every five years, along with passing a knowledge assessment by a set deadline. The American Board of Pediatrics also requires 100 points per five-year cycle, split evenly: 50 from Lifelong Learning activities and 50 from Health Care Improvement activities. Pediatricians can roll over up to 25 excess Part 4 points from one cycle to the next, but Part 2 points don’t carry over.
Different activities award different numbers of points, and the value can vary significantly. A short online module might earn a handful of points, while a multi-month quality improvement project could earn substantially more. Physicians are encouraged to check their board’s online portfolio regularly to track progress.
What It Costs
Beyond the time investment of completing activities, physicians pay annual fees to maintain their certification. The American Board of Psychiatry and Neurology, for example, charges $175 per year for one certification, $240 for two, and $310 for three or more. These fees are separate from the cost of the educational activities themselves, many of which carry their own registration or course fees. If a physician’s certification lapses and they need to re-enter the program, the costs jump considerably. The same board charges $1,750 for re-entry with one certification and up to $3,100 for three or more.
What Happens if You Fall Behind
Missing your MOC point deadlines results in a lapsed certification. This can affect hospital privileges, insurance panel participation, and employment, since many healthcare organizations require active board certification.
Reinstating a lapsed certificate isn’t as simple as catching up on points. The American Board of Internal Medicine, for instance, requires physicians with lapsed certificates to pass two consecutive Knowledge Check-Ins within a two-year period, on top of meeting all other MOC requirements. The process can take years. One example from ABIM: a physician who passed a Knowledge Check-In in 2019 but only took the next one in 2021 had to wait until that second passing result to regain certified status. Another physician who passed once but failed the next attempt remained uncertified because the two passing results weren’t consecutive.
The key word is “consecutive.” A single failure resets the clock, and physicians may find themselves locked out of certification for an extended period while they attempt again.
CME Credits vs. MOC Points
These two systems overlap but aren’t identical. CME (Continuing Medical Education) credits are required by state medical boards to maintain your license to practice medicine. MOC points are required by specialty boards to maintain your board certification. You need both, but they serve different purposes: one keeps your license active, the other keeps your specialty credential active.
The good news is that many activities now count for both. A collaboration between ABIM and the Accreditation Council for Continuing Medical Education (ACCME) has made thousands of CME activities eligible for MOC credit. When you complete one of these dual-credit activities, the completion data transfers to your board automatically. Some activities earn points in a single category, while blended activities can earn both Medical Knowledge and Practice Assessment MOC points at the same time.