DOT physical exams, NRCME-certified.
Every CDL driver needs a current medical certificate (MCSA-5876) to perform safety-sensitive duty — 49 CFR 391.41. $119 flat at any National Registry of Certified Medical Examiners (NRCME) examiner in our network. Cert valid up to 24 months. Filed to the FMCSA National Registry within 24 hours of your exam.
- NRCME-listed certified medical examiner — the only credential FMCSA recognizes
- Full 49 CFR 391.43 exam: vision, hearing, BP, urinalysis, cardiovascular, neurological
- Medical Examination Report Form (MCSA-5875) completed at the visit
- Medical Examiner's Certificate (MCSA-5876) issued same-day
- Result filed to FMCSA National Registry within 24 hours
- Printable copy emailed to you for state DMV self-certification
Three categories. One exam.
49 CFR 391.43 specifies exactly what the medical examiner evaluates. The exam takes 30–45 minutes for a healthy driver — longer if specialty records are reviewed for a qualifiable condition like sleep apnea or controlled diabetes.
Vision & hearing
Vision: at least 20/40 acuity in each eye, with or without correction; 70-degree peripheral; ability to recognize standard traffic signal colors. Hearing: ability to perceive a forced whisper at 5 feet, with or without hearing aid. 49 CFR 391.41(b)(10–11).
Cardiovascular & BP
Blood pressure, pulse, heart sounds, peripheral circulation. BP up to 140/90 qualifies for a 24-month cert; 140/90–159/99 typically gets a 12-month; 160/100–179/109 gets 3 months while it's brought under control. 49 CFR 391.41(b)(6) + FMCSA Medical Advisory Criteria.
Med history & neurological
Medication list reviewed against disqualifying-substance criteria. Urinalysis screens sugar, protein, and blood. Neurological exam covers reflexes, balance, mental status. Sleep apnea, diabetes, and cardiac history qualifiable with documented compliance. 49 CFR 391.41(b)(1–9).
Schedule. Exam. Card in hand.
Most drivers walk in and walk out with the medical certificate the same visit. Three steps from the moment of order to the National Registry record.
Routed to NRCME examiner
Order through the portal. We match you with an NRCME-listed examiner near your ZIP — usually within 5–10 miles. Same-day or next-day appointments at most clinics. You bring photo ID, current med list, and any specialty records.
30–45 minute exam
Examiner runs the full 391.43 protocol — vision, hearing, BP, urinalysis, full body. Driver fills out the medical history portion of MCSA-5875 in the waiting room. Medication list and any specialty records reviewed at the visit.
MCSA-5876 issued + National Registry filed
Pass the exam, walk out with the medical certificate the same day. Examiner files the result to the FMCSA National Registry within 24 hours. We email you a printable copy for state DMV self-certification.
Most drivers get the full 24. Some don't.
A short cert isn't a fail — it's the examiner saying "qualified, but with documented compliance." These four conditions account for nearly every short-cert outcome. Bring the right paperwork up front and the cert length is usually as long as it can legally be.
Hypertension
BP up to 140/90 → 24 months. Up to 159/99 → 12 months. Up to 179/109 → 3 months while controlled. Bring your home BP log if recently started or adjusted on meds.
Sleep apnea
Diagnosed sleep apnea is qualifiable with a current CPAP compliance report (≥4 hours/night ≥70% of nights). Cert renews annually with the next compliance report. Bring the printout.
Insulin-treated diabetes
Insulin-treated diabetes has been qualifiable since 2018 with the FMCSA Insulin Exemption. Need recent A1C (under 10), blood-glucose log, and an ophthalmology evaluation within 12 months.
Stable conditions
Controlled hypertension, well-managed cholesterol, fully recovered from an isolated cardiac event with cardiologist clearance — all qualify for the full 24-month cert when documentation is current.
The fastest path to a 24-month cert is bringing the right paperwork on day one — sleep study + CPAP compliance for apnea, A1C + glucose log + eye exam for diabetes, BP log for new-on-meds hypertension. We email a checklist with your appointment confirmation.
How much does a DOT physical exam cost?
Member rate is $119 for the full exam and certificate. Specialty referrals (sleep studies, cardiac exams, lab work) when a condition warrants documentation are billed by the referring facility — we coordinate the referral but don't mark up the third-party visit.
Member rates shown. Examiner-direct pricing through the same NRCME network typically runs $130–$180 per exam.
Related pages
- Motor carrier compliance hub — every FMCSA requirement under one roof
- Driver qualification file management — the physical certificate is one of the required DQF items
- CDL driver onboarding — DQF Basic + physical bundle for new hires
- DOT drug testing overview — required separately at hire and randomly thereafter
- DOT random testing program — what comes after the physical and pre-employment screen
- SAP program — for drivers who fall out of qualification on a positive drug test
Frequently Asked Questions
How often do I need a DOT physical?
The standard DOT medical certificate is valid for up to 24 months. Certain conditions — controlled high blood pressure, sleep apnea on CPAP, insulin-treated diabetes — typically result in a shorter cert (3, 6, or 12 months) with documented compliance required at renewal. The medical examiner determines cert length based on 49 CFR 391.41 qualification standards.
What should I bring to my DOT physical appointment?
Valid photo ID, current eyeglasses or contacts, hearing aids if used, complete medication list with dosages, and any specialty records that affect qualification — sleep study + CPAP compliance report (if applicable), recent A1C and blood glucose log (if diabetic), cardiac stress test or echo (if you have a cardiac history). Bringing the records up front prevents a return visit.
Can I choose my own DOT physical location?
Yes. Every examiner in our network is listed on the FMCSA National Registry of Certified Medical Examiners (NRCME) — the only credential that makes a physical valid for DOT purposes. We route you by ZIP to the nearest NRCME-listed examiner. You can also search the National Registry yourself at nationalregistry.fmcsa.dot.gov if you prefer a specific clinic.
What conditions disqualify a CDL driver?
Per 49 CFR 391.41(b), absolute disqualifiers include uncorrected vision worse than 20/40, current alcoholism, current drug use including marijuana even where state-legal, and any condition that interferes with safe driving. Many conditions that look disqualifying on paper — diabetes, sleep apnea, hypertension, cardiac history — are qualifiable with documented treatment compliance and may receive shorter certs (3–12 months) instead of the full 24.
Can I drive while waiting for my new medical cert?
No. The cert must be in hand before any safety-sensitive duty after your prior cert expires — driving on an expired med card is a violation under 49 CFR 391.41(a). Schedule the physical at least 30 days before expiration. Most NRCME examiners issue the MCSA-5876 same-day at the appointment, and the result is filed to the National Registry within 24 hours.
Do I need to file the medical certificate with my state DMV?
Yes — most states require CDL holders to self-certify and submit the medical certificate (MCSA-5876) to the state licensing agency within a state-specific window (often 10–15 days). The examiner files to the FMCSA National Registry automatically within 24 hours; the DMV submission is a separate driver responsibility. We mail you a printable copy of the MCSA-5876 the day of your exam.
Med card up for renewal? Book it now.
30 days out is the right window — gives you room to handle any specialty referral without an expired-cert gap. Members track expirations automatically with 60 / 30 / 7-day reminders.