CNA certification: exam fees, training hours and who pays

The federal floor every state builds on

Nurse aide training is one of the few licensing requirements written into federal law. Under 42 CFR 483.152, a state-approved training program must run at least 75 clock hours and include at least 16 hours of supervised practical training, meaning hands-on work under the direct supervision of a registered or licensed practical nurse. States may ask for more and many do. Colorado and Tennessee stay at 75 hours. Pennsylvania (80), Maryland (100), South Carolina (100), Arizona (120), Virginia (140), California (160) and Missouri (175) set higher minimums. Missouri's 175 hours combine classroom instruction with supervised on-the-job training, and California's 160 hours split theory and supervised clinical work, with lab time not counted.

For Alabama, Georgia, Massachusetts, Michigan, Nevada, North Carolina, Ohio, Utah and Wisconsin, no state hour figure could be read on an official page, so the calculator shows the federal floor of 75 hours. At 20 hours a week, 75 hours take about 4 weeks and 175 hours about 9.

Who pays for training and testing

The same federal section limits what a nursing facility can charge. Section 483.152(c)(1) says that an aide who is employed by a facility, or who has received an offer of employment from one, on the date the training program begins may not be charged for any portion of the program, including textbooks and other required course materials. A parallel rule in section 483.154 covers the competency evaluation, the exam itself, for aides employed or offered a job on the day the evaluation begins.

For everyone else, section 483.152(c)(2) applies: if a person who was neither employed nor offered a job becomes employed by, or receives an offer from, a facility within 12 months of completing a training program, the state must provide for reimbursement of the costs of completing the program, on a pro rata basis, for the period the person works as a nurse aide. The rule speaks of the state providing for reimbursement; how each state organizes it is set by that state. Keep receipts for tuition, books and exam fees. The calculator adds a tuition field for the price a program quotes you, but if a facility sponsors your training that amount may be zero.

The competency exam: two parts, two prices

The exam is the one fee every priced state publishes. It has a knowledge part, written or read aloud as an oral version, and a skills part where an evaluator watches you perform care tasks. In Alabama, Arizona, California, Massachusetts, Missouri, Nevada, Ohio, South Carolina, Tennessee, Utah and Virginia, each part has its own price, and a candidate who fails one part pays to retake only that part. Colorado, Georgia, Maryland, Michigan, North Carolina, Pennsylvania and Wisconsin sell both parts as one first-attempt package. In California, for instance, the written exam costs $40 in the northern region, with a separate skills fee, and Missouri $32 for the knowledge exam.

Credentia administers the exam in Alabama, California, Colorado, Georgia, Maryland, North Carolina, Pennsylvania, South Carolina, Tennessee and Virginia; Headmaster in Arizona, Massachusetts, Michigan, Missouri, Nevada, Ohio and Wisconsin. The vendor matters only because it publishes the handbook with the fees and retake rules for your state. California adds a Live Scan background check: the Department of Justice fee is $32 on paper cards, and the Live Scan operator adds its own rolling fee, which no state page sets.

Staying on the registry

Registry renewal is rarely a large fee. Georgia charges nothing to renew, and both Georgia and California tie renewal to paid work as an aide during the period. For most states here the renewal fee field is empty because no fee was found on an official page. South Carolina lists $35 every 2 years and Virginia $30, though Virginia's registry vendor describes the initial certification as valid for two years while the regulation shows an annual fee. Minnesota and New York are not priced: Minnesota (exam fee set by each test site), New York (fee read on a 2016 form). The licensing time page compares how long the CNA path takes against other trades.