CDL Changes Medical Certification Requirements

All CDL holders must comply with federal motor carrier safety regulations and provide information about the type of commercial vehicle operation they drive in, or expect to drive in, with their CDL. Depending on the type of operation, some drivers will also be required to obtain a qualified medical examiner certificate to obtain a “certified” medical status as part of their driving record, as required by state and federal law (see Section 302.768, RSMo, and 49 CFR Section 383.71).

Changes to federal regulation and state law require the Department of Revenue to receive and post to the commercial driver record electronically transmitted medical examiner certificate information from the National Registry of Certified Medical Examiners. Additionally, the Department has a responsibility to send notification to a driver regarding any change in medical certification status; pending downgrade due to expiration of the medical certificate, a determination of an unqualified status and resulting downgrade; or other notice from the registry for a voided or rescinded medical certificate. More information on the driver’s part of this requirement can be found at https://www.fmcsa.dot.gov/registration/commercial-drivers-license/medical.

Any person applying for or renewing a CDL must self-certify by responding that they operate in one of the following commercial operation categories:

1. Non-excepted interstate (NI). Operates or expects to operate in interstate commerce, and is subject to and meets the qualification requirements under 49 CFR Part 391, and is required to obtain a medical examiner’s certificate by 49 CFR 391.45.
2. Non-excepted intrastate (NA). Operates or expects to operate in intrastate commerce and is required to meet Missouri’s current medical requirements.
3. Excepted interstate (EI). Operates or expects to operate in interstate commerce, but engages exclusively in transportation or operations excepted under 49 CFR 390.3(f), 391.2, 391.68, or 398.3 from all or parts of the qualification requirements of 49 CFR Part 391, and is not required to obtain a medical examiner’s certificate by 49 CFR 391.45.
4. Excepted intrastate (EA). Operates or expects to operate in intrastate commerce but engages exclusively in transportation or operations that are excepted from all or parts of Missouri’s medical requirements.

CDL holders who certify to category 1 or 2 above (non-excepted interstate or non-excepted intrastate) must have an unexpired, qualified medical examiner certificate on file in the medical registry at the time of application for issuance of a new, renewal, upgrade, downgrade or replacement of a CDL.

As of June 23, 2025, a driver required to have a commercial driver license or commercial learner’s permit under 49 CFR 383, who has a driver record reflecting a current medical examiner certificate documenting compliance with the physical qualification requirements of Part 391, no longer needs to carry a copy of the medical examiner certificate when operating.