Pain Management

Providers of pain management services in Alabama are required to register with the Board.

What are "Pain Management Services"?

The provision of pain management means:

  • A physician practice which advertises or holds itself out to the public as a provider of pain management services (medical services that involve the prescription of controlled substances in order to treat chronic non-malignant pain by a physician who treats pain); OR
  • A physician practice that dispenses opioids; OR
  • A physician practice in which any of the providers of pain management services are rated in the top three percent (3%) of practitioners who prescribe controlled substances in Alabama in Schedules II, IIN, III, IIIN and IV, determined by the Alabama Prescription Drug Monitoring Database on an annual basis.

Registration and Renewal

All physicians who provide pain management services (see definition above) must obtain annually from the Board a pain management registration. Pain management registrations expire on Dec. 31 of each year and are renewed in the same manner and during the same period as licenses and ACSCs (Oct. - Dec.). The renewal fee is $100.

How to Register

You should first thoroughly review Board Rules Chapter 540-X-19

  • Login to the Licensee Portal.
  • Scroll down to Apply for PM; click Apply PM
  • When your registration is complete, print registration certificate and receipt at the Licensee Portal 
  • Fees:
    • First location: $100
    • Additional locations: no additional charge
    • IMPORTANT:  Application fees are non-refundable.

The following are required for pain management services registration:

  • A completed application.
  • Proof of a current Drug Enforcement Administration (DEA) registration.
  • Proof of an Alabama Controlled Substance Certificate (ACSC).
  • Proof of current registration with the Alabama Prescription Drug Monitoring Program (PDMP).
  • The disclosure of any controlled substances certificate or registration denial, restriction or discipline imposed on the registrant, or any disciplinary act against any medical license of the registrant.
  • Payment of the initial registration fee (non-transferable/non-refundable) ($100.00).
  • A certification listing the current name of the physician who serves as the medical director.
  • The physical address of each location where pain management services are provided.
  • A list of all physicians who work at the practice location, including the name of the physician who will serve as the medical director.

Should you Register?

  • Do you treat chronic non-malignant pain?
    If NO, you do not need to register.
    If YES, proceed to the following question.
  • Do you advertise or hold yourself out as providing treatment for patients with chronic non-malignant pain?
    If YES, you should register.
    If NO, proceed to the following question.
  • Does the ultimate user (patient) physically leave your medical practice with an opioid?
    If YES, you should register..
    If NO, please proceed to the following information.

The Board will determine, on an annual basis, the top 3% of prescribers of Schedule II, IIN, III, IIIN and IV controlled substances and inform them of the registration requirement.

Physicians who meet ANY of the above criteria are required to register with the Board annually.

Please note, these rules do not apply to the treatment of acute pain. Physicians are encouraged to be involved in the appropriate care of acute pain.

Board Requirements

Pain Management Services must be provided at a location owned and operated by:

  • One or more physicians licensed in Alabama; or
  • A business entity registered with the Alabama Secretary of State; or
  • A governmental entity or body, or political subdivision, including state universities and schools.

Each practice must be under the direction of a medical director who is a physician with a current, unrestricted Alabama medical license, ACSC, and DEA registration and who has had certain training or is board certified.

Every registrant is required to register with the Department of Public Health's Prescription Drug Monitoring Program.


The rules do not apply to:

  • A hospice program as defined by and licensed by the Alabama Department of Public Health, or any physician while performing work or providing pain management services for that program; or
  • A facility maintained or operated by the United States or any of its departments, offices or agencies, or any physicians while performing work for that facility.
  • A physician may petition the Board for an exemption for working at a particular entity.