The United States Geological Survey (USGS) National Seismic Hazard Model (NSHM) is the scientific foundation of seismic design regulations in the United States and is regularly updated to consider the best available science and data. The 2018 update of the conterminous US NSHM includes major changes to the underlying ground motion models (GMMs). Most of the changes are motivated by the new multi-period response spectra requirements of seismic design regulations that use hazard results for 22 spectral periods and 8 site classes. In the central and eastern United States (CEUS), the 2018 NSHM incorporates 31 new GMMs for hard-rock site conditions (VS30=3000m/s)(VS30=3000m/s), including the Next Generation Attenuation (NGA)-East GMMs. New aleatory variability and site-effect models, both specific to the CEUS, are applied to all median hard-rock GMMs. This article documents the changes to the USGS GMM selection criteria and provides details on the new CEUS GMMs used in the 2018 NSHM update. The median GMMs, their weights, epistemic uncertainty, and aleatory variability are compared with those considered in prior NSHMs. This article further provides implementation details on the CEUS site-effect model, which allows conversion of hard-rock ground motions to other site conditions in the CEUS for the first time in NSHMs. Compared with the 2014 NSHM hard-rock ground motions, the weighted average of median GMMs increases for large magnitude events at middle to large distance range, epistemic uncertainty increases in almost all situations, but aleatory variability is not significantly different. Finally, the total effect on hazard is demonstrated for an assumed earthquake source model in the CEUS, which shows an increased ring of ground motions in the vicinity of the New Madrid seismic zone and decreased ground motions near the East Tennessee seismic zone.