The short answer
There are now two separate things to track. Certification applications (turning a passed exam into board certification) require, among other documentation, 15 AMA PRA Category 1 credits devoted specifically to echocardiography within your pathway's window. Ongoing maintenance changed completely in July 2024: the ten-year recertification exams are gone, replaced by MOCE - an annual program for Diplomates - and MOTE for Testamurs. Echo-specific CME remains the fuel for staying current either way.
Who the NBE is, in one paragraph
The National Board of Echocardiography is a physician-led non-profit, established in 1996, that develops and administers the field's competence examinations: the ASCeXAM for adult echocardiography, the Advanced and Basic PTEeXAM for perioperative transesophageal echo, and the CCEeXAM for critical care echo. Passing an exam makes you a Testamur; completing the certification application - training or practice documentation, case volumes, and the CME requirement - makes you a Diplomate, which is what "NBE board certified" means. Certification is offered at levels from transthoracic-only through comprehensive (transthoracic + TEE + stress).
The 2024 change nobody told you about
For two decades, maintaining NBE status meant a recertification exam (ReASCE, RePTE, or ReBasic PTE) taken around your ten-year anniversary. That system is gone: as of July 2024, the recertification exams are no longer administered. In their place:
| Your status | Old system (pre-July 2024) | Current system |
|---|---|---|
| Diplomate (board certified) | Recert exam in years 8-10 of a 10-year cycle | MOCE - Maintenance of Certification in Echocardiography, an annual program |
| Testamur (passed exam, not yet certified) | Same recert exam to keep Testamur status | MOTE - Maintenance of Testamur in Echocardiography, until Diplomate status is achieved |
MOCE is deliberately lighter-touch than an exam: annual participation, completable on a mobile app or in a browser, with enrollment windows and fees published each cycle. The trade is obvious once you see it: instead of a decade of nothing followed by a high-stakes exam, you owe the board a little attention every year. Which, not coincidentally, is the same shape as a daily-case CME habit.
Which track applies to you
- You're a current Diplomate: enroll in MOCE annually. Missing enrollment has consequences for your certified status.
- You're a Testamur working toward certification: maintain status via MOTE while you assemble the certification application (below). Applications are reviewed by the Certification Committee twice a year, and incomplete applications wait for the next review.
- You passed an exam long ago and let everything lapse: re-entry generally runs through the current initial exam - see our ASCeXAM guide or PTEeXAM guide depending on your discipline.
- You haven't sat an exam yet: the exam comes first; the CME requirement below is for the certification application after you pass.
The certification application: where the 15 credits live
To convert Testamur status into board certification, the application pathways require:
- A current, valid license to practice medicine (or letter of good standing)
- Valid Testamur status during the application period
- 15 AMA PRA Category 1 credits devoted specifically to echocardiography, earned within the preceding window - the NBE's pathway pages cite windows of two years (initial certification pathways) and three years (the legacy recertification pathways)
- Documented case experience via notarized letters from your fellowship or hospital/practice covering the specified period and volumes for your certification level.
Three details in the CME line disqualify common mistakes. "AMA PRA Category 1" means the activity must come from an ACCME-accredited provider - vendor lunch talks and unaccredited webinars don't count. "Devoted to echocardiography" is the trap for anesthesiologists and cardiologists who earn plenty of CME anyway: MOCA credits, general board review, ACLS - none of it qualifies unless the content is echo-specific. And the window anchors to your application, not the calendar: credits earned before it opened don't count, however excellent they were.
Documentation habit worth adopting now: download the PDF certificate the day you complete any activity and keep one folder for the application window. Applications stall over lost certificates far more often than over missing credits - and the Certification Committee only meets twice a year, so a stalled application can cost you six months.
Meeting the CME requirement without rearranging your life
Fifteen echo-specific credits is a small number with a specific shape, and the three standard routes each fit a different temperament. Conferences cover it in one trip - an ASE review course alone carries more than the full requirement - at the highest cost per credit once travel and lost clinical days are counted. Question banks and self-assessment products (BoardVitals' echo activity, EchoSAP) bundle the credits into one purchase you grind through at your own pace. And daily case platforms break the requirement into 0.25-credit units: one real echo case a day, four questions, credits banked on the spot - the entire 15-credit requirement is 60 completed cases, and the habit that clears it also happens to be continuous interpretation practice, which is what the requirement was always a proxy for.
Under the annual MOCE regime, the daily-case route arguably fits best of the three: a yearly obligation is easier to meet from a standing habit than from an annual scramble. We've reviewed the leading daily-case platform hands-on - read the full eEcho review - and compared it against the question banks and conferences in our TEE CME comparison. If you're against a deadline instead, the last-minute CME guide has the realistic compressed timelines.
Frequently asked questions
Does the NBE still have a ten-year recertification exam?
No. The ReASCE, RePTE, and ReBasic PTE were retired in July 2024. If you were mid-cycle when the change landed, your transition terms are defined in the NBE's MOCE materials.
Do fractional credits (0.25 per case) really count?
Yes. Fractional AMA PRA Category 1 credits from accredited point-of-care activities total normally on certificates - sixty cases at 0.25 equals 15.0 credits, full stop.
Does my MOCA or state-license CME overlap with this?
In one direction. Echo-specific Category 1 credits count toward MOCA totals and most state requirements, so a well-chosen echo activity does double duty. The reverse isn't true: general MOCA credits never become echo credits.
Where do I confirm current policy?
Only at the source: echoboards.org, and specifically the MOCE pages and the current handbook for your certification track. This guide was checked against the NBE's published materials in August 2026; the board revises policy - as the 2024 overhaul proved - and your application will be judged by their current text, not anyone's summary of it, including ours.