Recent changes to CDL testing and medical standards affect when and how you can renew
Commercial driver's license rules have shifted in several states over the past two years, mostly around medical certification timing and what the Federal Motor Carrier Safety Administration (FMCSA) accepts as proof of a valid medical exam. The biggest change: many states now allow you to renew your CDL medical certificate through a telehealth visit with a certified medical examiner, rather than requiring an in-person appointment. Some states have also extended the validity period of medical certificates from two years to three years for certain drivers, though this varies by state and by your age.
If you hold a CDL or are planning to get one, the practical effect is that your renewal timeline and cost may have changed since you last went through the process. This guide covers what has shifted, which states have made changes, and what you need to know before your next renewal or initial process.
Key Takeaways
- Medical certificate validity periods now range from two to three years depending on your state and age, so check your state's DMV website before scheduling an exam.
- Telehealth medical exams are now permitted in most states, though you still need a certified FMCSA medical examiner and must provide proof of identity and vehicle inspection during the visit.
- The FMCSA updated its list of approved medical conditions and medications in 2023, which may affect whether you can renew or whether you need additional documentation from your doctor.
- CDL renewal fees and testing requirements have not changed federally, but some states have added online components to the written test or changed the order in which you take the written and skills tests.
- Your state's CDL manual has been updated to reflect new rules around hours of service and electronic logging devices (ELDs), so review it before taking the written exam even if you have held a CDL for years.
Telehealth medical exams: what you can and cannot do remotely
You can now complete the initial consultation and most of the medical history review with a certified FMCSA medical examiner over video in most states. However, the examiner still needs to see certain things in person or through specific methods during the call. Blood pressure must be taken by you at home using a device that displays a digital reading, or you can visit a local clinic or pharmacy to have it measured and provide the examiner with the result. Vision testing can be done remotely using a standardized online tool that the examiner will direct you to, or you can have it done at an optometrist's office and provide the results.
The examiner will still need to review your medical history, current medications, and any conditions that might affect your ability to drive safely. You will need to provide a government-issued ID during the video call, and some states require you to show proof of vehicle ownership or registration. After the exam, the examiner submits the Medical Examination Report (Form MCSA-5875) to the FMCSA database, and your state DMV pulls it from there when you renew your CDL. The entire process typically takes one to two weeks from exam to approval, though this varies by how quickly your state processes the paperwork.
Medical certificate validity: two years or three, depending on your state and age
The FMCSA allows states to issue medical certificates valid for either two or three years. Most states have adopted the three-year option for drivers under 65, while drivers 65 and older typically receive two-year certificates. However, some states still issue only two-year certificates regardless of age, and a few issue three-year certificates to all drivers. Check your state's DMV website or call their CDL section to confirm what applies to you before scheduling your medical exam.
Your medical certificate expiration date is separate from your CDL expiration date. You can renew your CDL at the DMV without a current medical certificate, but you will not be able to drive commercially until you have submitted a new medical certificate to the FMCSA. If your medical certificate expires before your CDL does, you must renew the medical certificate before your next commercial drive. Some drivers schedule their medical exam renewal about 60 days before expiration to allow time for processing.
Updated medical conditions and medication restrictions
The FMCSA updated its Medical Examination Report form and guidance in 2023 to clarify which conditions automatically disqualify you from holding a CDL and which require additional documentation from your doctor. Conditions affecting your cardiovascular system, vision, hearing, and ability to control a vehicle are the most commonly reviewed. If you have diabetes, heart disease, sleep apnea, or take certain medications for mental health conditions, you may need a letter from your doctor stating that your condition is stable and does not impair your driving ability.
The updated list also specifies which medications require a medical examiner's review before approval. Some blood pressure medications, certain pain relievers, and some allergy medications can affect your ability to drive safely. If you take any prescription medication regularly, bring a complete list to your medical exam, including the dosage and how long you have been taking it. The examiner will determine whether each medication is acceptable or whether you need additional documentation from your prescribing doctor.
CDL written test updates: new content on hours of service and electronic logging
Most states have updated their CDL written test to include new questions about electronic logging devices (ELDs) and changes to hours-of-service rules that took effect in 2023. The test now covers how to use an ELD, what to do if your ELD malfunctions, and the updated rules for when you can and cannot drive based on your hours worked. If you have held a CDL for several years, these questions may cover material that was not on the test when you originally obtained your license.
Your state's CDL manual has been updated to reflect these changes, and you should review the sections on hours of service and vehicle inspection before taking the written test. Some states have also added online practice tests to their DMV website, which can help you prepare. The written test itself is still administered at your local DMV office in most states, though a few states now offer it online if you meet certain requirements. Check your state's DMV website for the current testing format and any new requirements.
Skills test and road test changes by state
The federal skills test for CDL has not changed, but some states have adjusted the order in which you take the written test, the pre-trip inspection test, and the road test. A few states now require you to pass the written test before scheduling the pre-trip inspection test, while others allow you to take them in either order. Some states have also added a waiting period between passing the written test and taking the skills tests, typically 24 to 48 hours, to allow time for processing.
The road test itself remains the same: you will drive a commercial vehicle through a predetermined route while an examiner observes and scores your performance on starting, stopping, turning, backing, and lane changes. The test typically takes 30 to 45 minutes. However, some states have changed the locations where the test is administered or the types of vehicles used, so contact your local DMV to confirm where and when you can schedule your test. Wait times for skills tests vary widely by state and season, ranging from a few weeks to several months in high-demand areas.
Renewal fees and documentation you will need
Federal CDL renewal fees have not changed, but state fees vary. Most states charge between $50 and $150 for a CDL renewal, with additional fees if you are adding or removing endorsements. Some states charge extra for the medical certificate processing or for taking the written test. Check your state's DMV website for the exact fee and whether you can pay online or must pay in person.
When you renew, you will need your current CDL, proof of identity, proof of residency, and your FMCSA medical certificate (Form MCSA-5875). If you are renewing by mail in states that allow it, you will need to provide copies of these documents. If you are renewing in person, bring the originals. Some states require a new photograph for each renewal, while others use the photo from your previous CDL. If you are adding a new endorsement, such as hazmat or tanker, you will need to pass the written test for that endorsement and may need additional background checks or training documentation.
Frequently Asked Questions
Can I do my medical exam entirely over video, or do I have to go somewhere in person?
Most of the exam can be done over video, but you will need to have your blood pressure measured and recorded, either at home with a digital device or at a clinic. Vision testing can also be done remotely using an online tool. Some states may require you to visit a clinic for these measurements, so check with your state's DMV before scheduling your telehealth exam.
How long is my medical certificate good for after I get it?
Two or three years, depending on your state and age. Most states issue three-year certificates to drivers under 65 and two-year certificates to drivers 65 and older, but this varies. Your state DMV website will tell you which applies to you. Your medical certificate expiration is separate from your CDL expiration, so you may need to renew one before the other.
Do I have to take the written test again if I already have a CDL?
Not for a standard renewal. You only need to take the written test if you are adding a new endorsement, if your CDL was suspended or revoked, or if your state requires a new test after a certain number of years. Check your state's renewal requirements, as some states do require periodic retesting.
What happens if my medical condition disqualifies me from getting a medical certificate?
You cannot legally drive a commercial vehicle without a valid medical certificate. Some conditions may be temporary or manageable with treatment, so ask the medical examiner whether you can reapply after a certain period or with additional documentation from your doctor. If the condition is permanent, you may need to downgrade to a regular driver's license or explore non-driving roles in the transportation industry.
How long does it take to get my CDL after I pass all the tests?
Once you pass the written and skills tests, your state DMV will issue your CDL at the office or mail it to you within one to two weeks, depending on your state. However, you cannot drive commercially until your medical certificate is also on file with the FMCSA, which can take an additional one to two weeks after your medical exam. Plan for a total of three to four weeks from the time you pass your tests to the time you can legally drive commercially.