NHA CMAA Exam Prep 2026: The Current Blueprint, the Real Pass Rate, and a Free Study Plan

By the Castleport Test Prep Editorial Team · Last verified: August 13, 2026

Here's the short version of NHA CMAA exam prep. The exam puts 135 questions in front of you — 110 that count and 25 that don't — and gives you 2 hours and 15 minutes. You pass with a scaled score of 390 out of 500. In 2025, NHA reported 10,848 CMAA exam administrations, and 63.24% resulted in a pass.

That last number is the one people get wrong. The CMAA has a reputation as the easy NHA exam, the "front desk" one. It isn't. It has the second-lowest pass rate of NHA's eight certification exams, and it sits 18.49 points below the clinical CCMA. More than a third of 2025 CMAA exam administrations did not end in a pass.

The good news is that this exam is beatable in a way a lot of exams aren't, because NHA publishes exactly what's on it — right down to numbered statements — and almost nobody reads that far. We did. We counted every one of them. What we found changes where you should spend your hours, and we built a free tool at the top of this page that turns it into a schedule with your actual test date on it.

Your CMAA exam at a glance

Every figure above comes from NHA's current CMAA test plan, Candidate Handbook, 2025 pass-rate report, and product change log.

🛠 Build your CMAA study plan free

The builder doesn't split your time evenly across the seven domains. It uses NHA's scored-question share as the main driver, then applies a smaller adjustment from the number of task and knowledge statements in each domain — a syllabus-density count we had to build ourselves. More on that in a second, because it's the single most useful thing on this page.

Is this the right page for you?

Yes, if you're:

• Taking the NHA CMAA (Certified Medical Administrative Assistant) exam — the administrative one
• A first-timer who finished a course and doesn't know how to allocate study time
• Retaking after a fail, holding a score report with Above / Near / Below on it
• Trying to work out which of the conflicting numbers you've read online is actually current

No, and here's where to go instead:

• You're taking the CCMA — that's the clinical medical assistant exam, a different test with a different blueprint. Go to our CCMA exam hub.
• You haven't picked a credential yet — start with CMA vs. CCMA vs. RMA.
• You're looking for leaked or "real" exam questions — we don't publish those and we won't link to sites that claim to. NHA's Testing Rules of Conduct treat memorizing or reproducing exam content as theft of intellectual property, and the penalties run to invalidated scores and revoked credentials. It isn't worth it.

Who we are, and one thing we should tell you up front

Castleport Test Prep is an independent exam-prep publisher. For this page, we checked every official claim against the current NHA Candidate Handbook, CMAA test plan, annual pass-rate reports, and product change log, and dated that verification.

Here's the admission: we don't currently sell anything for the CMAA. No study guide, no question bank, no course. There's nothing on this page for you to buy, which means we have no reason to talk this exam up or talk it down. If you want a paid practice test, NHA sells its own study guide and practice assessment, and NHA's handbook says plainly that buying them isn't required and doesn't guarantee a passing score. That's a fair description and we'll stand behind it.

What we do have is the free builder above, the counting work below, and a habit of reading the source documents.

Castleport Test Prep is an independent publisher of exam preparation materials and is not affiliated with, endorsed by, approved by, or connected to the National Healthcareer Association (NHA), any testing vendor, licensing board, or certification body. Exam and credential names are used descriptively for identification only. Castleport does not claim ownership of third-party names or marks.

Before you spend money on anything

The current national blueprint and your test date control the study plan. State rules decide whether the credential fits the work you plan to do; they do not change what appears on NHA's national exam. Use the free builder above to allocate the hours you actually have, NHA to confirm eligibility and the current fee, and the responsible state authority to confirm any practice requirement before you spend anything.

What's actually on the NHA CMAA exam?

NHA divides the CMAA exam into seven domains and publishes exactly how many scored questions each one is worth. Communication and Professionalism and Patient Encounter are the two biggest at 21 questions each; Foundational Knowledge is the smallest at 10. The four largest domains together account for 75 of the 110 scored questions — 68.2% of your score.

That much you can get from NHA's summary outline, and most study sites reprint it. But the summary outline is page one. Underneath it, NHA publishes a detailed outline that breaks each domain into numbered task statements (things you have to be able to do) and knowledge statements (things you have to know). The CMAA test plan says items may require recall and critical thinking tied to a knowledge statement, a task statement, or both. The handbook separately says every exam question must address a specified task on the test plan. Because Foundational Knowledge contains knowledge statements but no task statements, the safe study scope is the full detailed outline — both kinds of statement.

Almost nobody reads that far. So we counted them.

The Castleport CMAA Blueprint Audit

On August 13, 2026, we went through NHA's current CMAA test plan line by line and counted every numbered statement in the detailed outline. The result:

45 task statements + 101 knowledge statements = 146 published statements across 110 scored questions.

To be clear about what that number is and isn't: 146 is not the number of questions on the exam, and NHA doesn't publish it as an exam statistic. It's our count of the numbered statements in NHA's PDF — the size of the syllabus, not the size of the test. We recounted it twice and the numbers held.

Dividing published statements by scored questions gives you something genuinely useful that nobody else publishes: how granular each domain's published outline is relative to its scored weight. We call it the syllabus-density index. It is not a difficulty score, a time estimate, or an NHA statistic.

What this table tells you that the standard one doesn't

Medical Law has the densest published outline. It carries 1.47 published statements per scored item — 22.5% more statement density than Foundational Knowledge. It's 15.5% of the scored exam and 17.1% of the detailed outline. That does not prove each statement takes the same amount of time or that the domain is 22.5% harder. It does tell you not to leave HIPAA, consent, mandatory reporting, OSHA, and compliance until the final three days.

Foundational Knowledge has the least dense published outline. It's the only domain in the current plan with zero task statements — 12 knowledge statements and nothing else. That makes it a clean place for terminology and definition drilling. It does not make the domain pure recall: NHA says items may require both recall and critical thinking, including items tied to knowledge statements.

Patient Encounter is a high-weight domain with relatively low statement density. It carries 21 scored questions — tied for the largest domain — across 26 published statements. That makes it efficient to cover early, not automatically easy.

Four domains carry more than two-thirds of the scored exam. Communication (21), Patient Encounter (21), Medical Law (17), and Scheduling (16) add up to 75 of 110 questions. Billing, Logistics, and Foundational Knowledge together are the other 35.

The builder uses scored-item share for 75% of its base allocation and statement share for 25%. That keeps the official exam weighting in control while preserving the extra signal in the 146-statement audit.

Turn these seven weights into hours on your calendar → Build my CMAA study plan

How hard is the CMAA exam, really?

NHA reported a 63.24% CMAA pass rate across 10,848 exams administered in 2025. That's the second-lowest of NHA's eight certification exams and 18.49 points below the CCMA. It's an aggregate rate for exam administrations in a calendar year, not a prediction for any individual candidate — NHA doesn't break it down by first attempt versus retake, or by training program.

Here is where we can show you something you can't get anywhere else. NHA publishes each year's pass rates in a separate annual PDF and doesn't join the years into one CMAA series. We pulled four of them and lined them up.

The Castleport CMAA Pass-Rate Ledger, 2022–2025

Exam counts, pass rates and active certification counts are NHA's published figures. The pass and fail counts are ours — pass rate applied to exams administered, rounded to the nearest whole exam.

Read that column top to bottom and you get the real story, which is more interesting than "it got harder":

The published pass rate fell, then levelled. It dropped 8.74 points between 2022 and 2024, then ticked back up 0.56 points in 2025. Anyone telling you the published rate is still in freefall is working from the 2024 file.

But it levelled off at a hard number. Across those four years, 38,468 CMAA exams were administered and roughly 12,915 of them did not end in a pass. That's more than one in three sittings.

And 2025 had the highest administration count in this four-year window. Its 10,848 exams were up 15.5% from 2024. The reports establish volume and pass rate; they do not establish why either changed.

Where the CMAA sits among NHA's eight exams

Two things jump out. The CMAA is seventh of eight, clearing last place by 0.49 points. And the gap to the CCMA — the exam everyone assumes is the harder one because it involves needles and vitals — is 18.49 points. It was 18.70 points in 2024. The same large gap appears in both annual reports.

What the pass rate can't tell you

Be careful with it, in both directions. NHA's table counts examinations administered, not people — if you sit it twice, you're in there twice. Several study sites report the exam count as a headcount; it isn't one. And NHA publishes no split between first attempts and retakes, no breakdown by training program, and no "hardest domain." A 63.24% aggregate administration rate is not a 63.24% chance that you pass. The report does not isolate preparation, attempt number, or program quality.

See what the current blueprint says your week should look like → Build my CMAA study plan

What score do you need to pass — and why it isn't a percentage

You need a scaled score of 390 or higher on NHA's 200–500 scale. A scaled score is not a percentage of questions correct: NHA weights questions by difficulty so that 390 means the same level of ability no matter which version of the exam you happen to sit. Dividing 390 by 500 does not tell you how many questions you can miss.

This is the most misunderstood fact about the CMAA, and it gets published wrong constantly. Let's define the terms properly, because the words matter.

• Raw score — the number of questions you actually got right. Out of 110 scored ones.
• Scaled score — NHA converts your raw score onto a fixed 200–500 range. Because different exam forms contain different questions, some forms are marginally harder than others. Scaling absorbs that difference so nobody is punished for drawing a tough form.
• Cut score — the minimum needed to pass, here 390. NHA sets it using a modified Angoff method: panels of subject-matter experts go through the exam question by question and judge whether a minimally qualified candidate would get each one right.

Because the conversion changes from form to form, NHA doesn't publish a raw-to-scaled table, and neither will we. Any site converting 390 into a percentage correct, or telling you exactly how many questions you can miss, is doing arithmetic that NHA's own scoring method says does not work. We'd rather tell you the honest thing: prepare to comfortably clear the standard, not to squeak past a number that doesn't exist.

What your score report actually shows

Whether you pass or fail, NHA posts a score report to your account with your scaled score, the pass/fail result, and a performance band for each of the seven content areas:

Three rules about those bands that trip people up:

1. "Near" is not a pass. People read it as "almost fine." NHA's handbook says the opposite in as many words.
2. You can't add the bands up. NHA says the performance categories and the overall score are calculated differently, so they will not reconcile and cannot be used to reverse-engineer your scaled score.
3. A band can show N/A. If a content area had five or fewer questions on your form, NHA leaves the band blank because the result is not considered reliable enough to report. The published CMAA allocation gives every domain at least 10 scored items, so this rule should not normally affect a standard CMAA content-area report.

That last rule belongs to NHA's own certification score report. It does not validate a third-party practice test, but it is a reason to treat tiny domain samples cautiously.

Which domain should you study first?

If you're retaking, start with any content area marked Below, then Near. If you're a first-timer, start with the two 21-question domains — Communication and Patient Encounter — and schedule Medical Law early because it has the densest published outline. Use Foundational Knowledge for focused terminology and definition drills, not as a guaranteed source of easy points.

Most study advice tells you to "focus on the heaviest domains," which sounds smart and is nearly useless, because the two heaviest domains on the CMAA are 21 questions each and you obviously can't skip the other five. Here's a sharper way to sequence it. Ask three questions in order.

1. Do you have a score report? If yes, it beats every general rule on this page. Any content area marked Below goes first, then Near. NHA is direct about this: spend considerable study time on the Below and Near areas, review the test plan, and make sure you understand every task in them.

Don't wipe the Above areas off your plan, though. NHA warns that Above is a range — it could mean you were comfortably clear or barely clear, and the report won't tell you which. And because a retake may use a different form with a different spread of difficulty, an Above result does not guarantee the same outcome next time. Our builder handles this by cutting Above domains to 75% of their normal time rather than to zero.

2. How many weeks do you have?

Under two weeks, front-load Communication and Patient Encounter, the two 21-question domains, and use short Foundational Knowledge blocks for terminology and definitions. You still cover all seven domains; you just stop pretending a short runway can give each one equal depth.

Four weeks or more, schedule Medical Law, Ethics, and Compliance early. At 1.47 published statements per scored item it has the densest outline, and it is full of things you can't safely improvise — HIPAA, consent types, mandatory reporting, OSHA, and Joint Commission requirements.

3. What do you do all day? If you already work a front desk, be honest about which parts of the blueprint your job never touches. Your role may reinforce Scheduling and Patient Encounter while leaving Billing and Revenue Cycle — revenue-cycle phases, payment models, aging reports, clearinghouses, and claim scrubbing — mostly untouched. Eleven questions is 10% of the scored exam. Audit the domain instead of assuming work experience covered it.

Get this sequenced against your real test date → Build my CMAA study plan

How long should you study for the CMAA exam?

NHA doesn't publish a required number of study hours for the CMAA, and any site quoting one is guessing. The number that matters is how you divide the hours you actually have, which depends on your test date, how recently you trained, and whether you're working from a score report.

We're not going to invent a universal hour count. What we can do is show you how to split whatever you've got.

How our builder allocates your time

Two Castleport judgments drive it, and you should be able to see both:

1. We blend official scored weight with published-outline density. NHA's scored-question share controls 75% of the base allocation. Castleport's statement share controls the other 25%. That keeps the exam's actual point distribution in charge while nudging time toward domains whose detailed outlines are denser. The 75/25 blend is our planning judgment, not NHA policy.

2. We adjust for what your score report says.

Then everything gets normalised back to the hours you actually said you have, with a floor so no domain drops off the plan. Those multipliers are our editorial judgment, not NHA policy. They reflect the handbook's direction to spend substantial time on Below and Near while continuing to review Above.

Phase mix

First attempt: 65% learning and organising, 25% retrieval and application, 10% timed mixed review. Retake: 35% targeted repair of weak content, 40% practice with rationale review, 25% timed mixed review.

The shift is deliberate, and it is Castleport's planning judgment. A first attempt gets more coverage time. A retake gets practice earlier because the score report gives you a better target than a generic first-pass sequence.

What each runway realistically buys you

The pacing number nobody publishes

135 questions. 135 minutes. Exactly one minute per question, with nothing left over for a leisurely second pass.

Practise at that speed. The strategy that works on a one-minute-per-question exam is simple: answer what you know, move on when a question stalls you, and use any remaining time to review. Don't burn four minutes on question 12 — that's four questions you may not reach. And remember that 25 of those 135 are pretest questions that don't count and are not marked in any way, so there's no point trying to spot them. Answer everything as if it counts, because you can't tell which ones do.

Map the time you actually have → Build my CMAA study plan

Five things the top CMAA guides get wrong

We checked four prominent free CMAA guides against NHA's current Candidate Handbook and test plan on August 13, 2026. Four of the five errors below could change a candidate's behaviour — one publishes the wrong passing score, and one sends candidates to the wrong testing company.

We're not doing this to score points. We're doing it because if you've been reading about this exam for a week, you have probably absorbed at least one of these, and you should know which of the numbers in your head to throw out.

Two more worth flagging, because they touch eligibility and money:

"Training programs must be approved by the National Healthcareer Association." They don't have to be. The handbook says a training program from an accredited or state-recognized institution or provider — plus registered apprenticeships and formal U.S. military medical training. A candidate reading the stricter version might conclude they're ineligible when they aren't.

A fixed exam fee of $117 or $129. Both figures are currently published on major sites. The handbook contains no dollar amount at all — it routes you to the NHA store. More on that below.

We'll re-check these each quarter and remove any entry that gets corrected. Verified against NHA's Candidate Handbook (rev. 06/01/2026) and CMAA test plan on August 13, 2026.

Am I eligible to take the CMAA exam?

Most candidates need a high school diploma or recognised equivalent, plus one qualifying pathway: a training program completed within the past five years, a registered apprenticeship, formal U.S. military medical training, an employer-training or pre-externship route, or supervised work experience — one year within the last three, or two years within the last five. A separate provisional route lets eligible candidates test up to 12 months before high-school or equivalency graduation. NHA makes the eligibility decision, not your school and not us.

Pathway 1 — Training, within the past five years

Any one of: a training program in the field from an accredited or state-recognised institution or provider; an apprenticeship registered under U.S. Department of Labor guidelines; formal medical services training from any branch of the U.S. military; or one of the two early-testing routes below.

If your completion date falls outside NHA's five-year window on the date you register, Pathway 1 is closed to you and you'll need another qualifying route. That's a cut-off, not a guideline.

Pathway 2 — Work experience

One year of supervised work experience in the last three years, or two years in the last five. It has to be in the health field the exam covers.

A separate route for instructors

An instructor at an institution associated with NHA can qualify through a separate route. NHA requires a current state-recognised teaching certificate or teaching licence, or at least three years of full-time teaching in healthcare or health science; plus a current healthcare licence, certification or registration, or at least two years of relevant or commensurate allied-health work experience. The instructor must meet any program-specific requirements, register individually, and test at PSI or by Live Remote Proctoring — not at the instructor's own institution. An instructor who proctored that same exam in the prior six months cannot sit for it. Once registered for that exam, the instructor cannot proctor it again until certified.

The two deadlines that can void a passing score

This is the part almost nobody publishes, and it's the highest-stakes thing in this section. Both early-testing routes let you sit the exam before you've finished your program — but your certificate is held until the rest is done, and there's a clock.

Two things to sit with. First, the clock runs from the exam date, not from when you finish coursework. Second — and this is the trap — the requirement isn't just that you finish. Your employer or school has to notify NHA. If the paperwork sits on someone's desk past the deadline, a passing score can be voided through no fault of yours. If you're on either route, put the deadline in your phone the day you test, and chase the notification yourself.

One thing the CMAA doesn't require

There's no hands-on performance prerequisite. The CPT requires evidence of 30 venipunctures and 10 capillary sticks on live people; the CET requires 10 EKGs. The CMAA requires neither. Its certification exam is multiple choice and can still test recall and critical thinking tied to the published task and knowledge statements.

Still in high school?

If you're scheduled to graduate from an accredited high school, GED program, or another equivalency program recognised by your state, and you meet the remaining eligibility requirements, you can sit the exam up to 12 months before graduation and receive a Provisional Certification — a placeholder. It expires 12 months after your exam date, it cannot be renewed or reinstated, and if it lapses before you convert it to a full certification, you retake the exam. Schedule accordingly.

And a separate checklist entirely

NHA certification and your state's rules for practising are two different things. The handbook is explicit: NHA's eligibility requirements are separate and distinct from any state law, regulation or rule, and NHA certification does not guarantee you meet state requirements. Check with the oversight body in the state you plan to work in.

Confirm your pathway with NHA directly → Check CMAA eligibility on nhanow.com

How much does the CMAA exam cost?

NHA charges an examination fee for every attempt, but the current Candidate Handbook publishes no dollar figure — it directs candidates to the fee shown at checkout on nhanow.com. Third-party sites currently list $117 and $129; we're not publishing either as fact, because the amount you're charged at NHA's checkout is the only one that governs.

We looked for a figure to give you. The handbook's exact instruction is to go to Shop, pick your profession, and click the certification exam icon — that's where the applicable fee lives. It isn't in the document.

So instead of guessing, here's what we can tell you that's actually useful.

The published numbers disagree. As of August 13, 2026, two prominent CMAA guides list $117 and another lists $129. They can't both be right, and neither is NHA. Treat both as unverified.

Your fee may not be your fee. If you're testing through a school or employer that's an NHA partner, the exam may be bundled into tuition or sponsored outright. Ask before you pay anything.

You have a two-hour payment window. Once you apply for the exam, the handbook gives you two hours to complete payment. Miss it and your application is voided and you start over. Don't begin the application from a phone in a parking lot.

Refunds barely exist. The handbook states that a refund is offered if NHA, PSI or an LRP provider cancels your exam date and you don't reschedule — and that there are no other circumstances under which refunds are offered. Not illness, not a change of plans. Rescheduling, not refunding, is your lever.

What a retake actually costs you

Every retake is the full price — there's no discounted second attempt. Whatever the fee turns out to be, multiply it before you decide you're ready.

Get the current fee from the source → Open NHA's official CMAA application route

What test day actually looks like

All CMAA exams are multiple choice and proctored. PSI testing centres and Live Remote Proctoring are computer-based. Computer-based testing is available at institutions too, but NHA's current institution-resource page still links an official paper-exam manual, so an institution may use computer-based or paper delivery. Ask your site which format it scheduled.

You will not be allowed to bring materials in. But you are given something to work with at every venue, which is the opposite of what several study sites claim.

Rules that apply everywhere:

• Government-issued photo ID. Verified before you enter. If the address doesn't match what you registered with, bring proof of address like a current utility bill.
• Calculator rule depends on delivery. On a computer-based exam, NHA allows the built-in exam calculator; your own calculator and your computer's calculator are prohibited. NHA's current paper-exam proctor guide prohibits calculators on paper exams.
• No reference materials. The CBCS exam is the only NHA exam with a written-materials carve-out. The CMAA has none.
• Devices are out — phones, tablets, e-readers, cameras, MP3 players, pagers, radios, watches, AI glasses, earbuds, headphones, electronic translators and personal calculators. (Yes, AI glasses are named in the 2026 handbook. That tells you something about where proctoring is heading.)
• One continuous session. You cannot stop and come back later.
• Only one person out of the room at a time during an in-person exam, and no talking, no materials, no devices while you're out.

The break rule deserves a second look if you're choosing a venue. Under standard Live Remote Proctoring rules there are no breaks — 135 minutes in the chair, on camera. In person, a necessary break may be allowed under the handbook's conditions, and the clock keeps running. If you need a break or another change for a documented disability, request an accommodation before scheduling.

What happens if you don't pass?

NHA requires a minimum 30-day wait before your next attempt, and you get three attempts. After a third unsuccessful attempt you must wait one year before testing again, and each attempt after that carries the same one-year wait. Every retake requires re-registering and paying the full exam price.

If you just failed, take the pressure off for a second: roughly one in three CMAA sittings ends this way. It's a common outcome on this exam, not a verdict on you.

The retake ladder

Attempt 1 → 30-day minimum wait → Attempt 2 → 30-day minimum wait → Attempt 3 → if unsuccessful, 1 year → Attempt 4, and one year for each repeated failure after that.

Two practical notes. Thirty days is a minimum, not a target — if your score report shows two content areas Below, thirty days of real work is a tight but reasonable turnaround; three weeks of avoidance and a week of panic is not. And you must re-register and pay the full price each time; there's no reduced retake rate.

How to actually use your score report

Your report gives you a band for each of the seven content areas. Use it in this order:

1. Everything marked Below goes to the front of your plan. NHA's guidance is to spend considerable study time there and to go back to the test plan and work through every task in those areas.
2. Then Near — and remember NHA says Near is not satisfactory. Treat it like a fail in that domain, because that's what it is.
3. Don't delete the Above areas. Above is a range. You might have been well clear or barely clear, and the report won't say. NHA specifically warns against excluding them.
4. Don't expect the same exam form. A retake may use a different form and a different spread of item difficulty. A band you earned last time is not a guarantee for the next form.
5. Don't try to add the bands up to reconstruct your score. They're calculated differently. It won't work.

If you think the score is wrong

You can request a hand rescore in writing within 60 days of your exam date — NHA may charge a fee, and the determination is final. You can also file an appeal of your final score on NHA's official Appeals form within 30 days of the exam date. Decisions come in writing only. Those two windows are different lengths and both run from your exam date, so if you're going to act, act early.

Rebuild your plan around your score-report bands → Open the builder in retake mode

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Need the exact 30-day or one-year date, rescore window, and appeal deadline? Use our NHA exam retake policy guide.

When do you get your CMAA results?

If you take a computer-based exam at an institution, a preliminary score report is available immediately when you finish. If you test at a PSI centre or by Live Remote Proctoring, the handbook says within 48 hours. For a paper exam at an institution, NHA's current-linked paper proctor guide says results are posted about three business days after NHA receives the exam booklets. Your final score report is posted to your NHA account.

The word doing the work there is preliminary. NHA is direct that preliminary results are not final results, and that if you show a preliminary report to an employer or a regulatory agency as evidence you passed, you do so at your own risk. Exam data gets analysed for anomalies and scoring errors; if something turns up, the exam is rescored and you're told whether the rescore changed your outcome.

So: celebrate immediately, but wait for the final result in your NHA account before you update anything official. And note that a passing score isn't automatically a certificate if you're on the employer-training or pre-externship route — see those deadlines above. For the complete result timeline and score-report decoder, use our NHA exam results guide.

Rescheduling and accommodations: the rules nobody reads

You can move your exam date without repaying to a new date within six months of the original scheduled date. NHA's current handbook does not publish a one-reschedule limit. If you're testing with PSI or a remote proctor, you must cancel or reschedule at least 24 hours ahead or you forfeit the fee. Accommodation requests should be submitted with documentation about 30 days ahead.

Rescheduling

That 24-hour rule is the one that costs people money. If you wake up ill on exam morning, you are already inside the window.

Accommodations

Accommodations are available for documented disabilities under the ADA. A few specifics worth knowing before you start:

• Allow about 30 days for review. Requests are handled in the order received.
• Extra time defaults to 150% — one and a half times the standard limit, so 202.5 minutes instead of 135. If you need more than that, your documentation has to state how much and why.
• Documentation means a letter from an objective physician or qualified professional — not you, not a relative. High school students can use an active IEP, or a 504 plan if it contains the required information.
• Submitting isn't approval. Decisions are case by case.
• Live Remote Proctoring may not be available with certain approved accommodations; you may be routed to a PSI centre or your institution.
• Language is not a disability under this policy. The exam is administered in English only, it won't be translated, and interpreters are not permitted for translation.

For the documentation checklist, timing sequence, and venue limits, use our NHA exam accommodations guide.

Is the CMAA exam changing in 2026?

As of August 13, 2026, the live CMAA exam is still built on NHA's 2021 job analysis, the version that launched September 12, 2023. NHA's published product change log lists no newer CMAA certification-exam launch.

Here's the honest read on that. We're not going to manufacture urgency about a version change NHA hasn't listed — no countdown, no "beat the change." The practical consequence runs the other way and it's good news: you're not racing a published blueprint change, so you can plan against the current test plan today.

The 2023 launch date is worth one note, though. NHA described the transition as having minimal impact on exam topics and content areas. But 2024 was the first full calendar year under the current exam, and it produced the lowest pass rate in our four-year table. We're flagging the timing because it's a real coincidence in the data. We're not claiming it's the cause — NHA has published no explanation, the 2025 recovery complicates any simple story, and we're not going to invent one.

When the plan does change, we'll update this page rather than spin up a new dated URL, and we'll publish a side-by-side of what moved.

CMAA or CCMA? Make sure you're studying the right exam

CMAA is the Certified Medical Administrative Assistant — the administrative, front-office credential. CCMA is the Certified Clinical Medical Assistant, a separate credential with a clinical scope and a completely different blueprint. The acronyms are one letter apart and the exams are not interchangeable.

We're raising this because it goes wrong more often than you'd think — including on published guides. One of the CMAA articles we reviewed for this page has two section headings that read "CCMA" on a page about the CMAA.

That pass-rate row is the fastest way to check yourself. If you've been reading that "the exam has an 81% pass rate and it's very manageable," you've been reading about the CCMA. Different exam. Come back here.

Still deciding between credentials rather than preparing for one? CMA vs. CCMA vs. RMA is the page for that decision.

Which NHA CMAA exam prep option should you use?

There's no required study material for the CMAA. NHA's handbook states that purchasing preparation materials is not required to sit the exam and does not guarantee a passing score. What matters is that whatever you use covers the current seven-domain test plan and includes active practice, not just reading.

Here's a fair comparison of what's realistically available, including what we don't offer.

That last row is the honest answer to "should I buy the Castleport CMAA guide" — there isn't one to buy. If and when we publish one, we'll say so here and you'll be able to see exactly what's in it. Until then, this page and the builder are what we've got, and they're free.

One habit worth more than any product: after every practice question, read the rationale even when you got it right. Guessing correctly and knowing are different states, and only one of them survives a different exam form.

What we actually verified

Verified August 13, 2026 by the Castleport Test Prep Editorial Team. We read these documents directly rather than citing other prep sites:

• NHA Candidate Handbook, revision dated 06/01/2026 — eligibility pathways, the 180-day and 90-day voiding deadlines, scaled scoring and the 390 standard, Above/Near/Below band definitions and the N/A rule, the retake ladder, rescheduling and the 24-hour rule, refund policy, accommodations and the 150% time rule, testing rules by venue, the built-in calculator allowance, results timing, rescore and appeal windows, recertification and reinstatement.
• NHA CMAA Test Plan (2021 job analysis) — 110 scored and 25 pretest questions, 2 hours 15 minutes, the seven domains and their question counts, and every numbered task and knowledge statement, which we counted by hand: 45 tasks, 101 knowledge, 146 total.
• NHA Annual Pass Rate reports for 2022, 2023, 2024 and 2025 — the 2025 report is dated revised 01/09/26. All exam counts, pass rates and active certification counts in our tables are NHA's. The pass and fail counts are our arithmetic and are labelled as approximate.
• NHA's CMAA certification page, certification-prep page, Testing Best Practices page and product change log — to verify the official delivery routes, results timing, current prep offerings, the conflicting CMAA mobile-flashcard statements, and that the published log lists no newer CMAA certification-exam launch.
• NHA's current institution-resource page and linked paper-exam proctor guide — to verify that paper delivery remains supported at institutions, the paper calculator rule, and the paper-result timeline.
• Four competing CMAA guides, checked claim by claim against the handbook, on the same date.

What we did not publish, and why: no Castleport exam-fee figure (the handbook contains no dollar amount and the official CMAA product price was not directly verifiable from a stable public product page); no invented raw-score or percentage equivalent of the 390 scaled score (the 78% claim appears only so candidates know why it is invalid); no first-attempt versus retake pass rates (NHA doesn't break them out); no definitive claim that CMAA mobile flashcards are or are not available (NHA's current public pages conflict); no testimonials (we have no verified CMAA customer, and we won't borrow someone else's).

Frequently asked questions

Is 390 on the CMAA exam the same as 78%?

No, and this is the most common misconception about CMAA scoring. 390 is a scaled score on a 200–500 range, not a percentage of questions answered correctly. NHA weights questions by difficulty so that 390 represents the same ability level no matter which exam form you sit, which is exactly why it can't be restated as a share of questions. Dividing 390 by 500 does not produce a valid target, and NHA publishes no conversion between raw and scaled scores.

How many questions can I miss and still pass?

There's no published answer, and anyone giving you a specific number is estimating. Because the raw-to-scaled conversion varies by exam form, NHA doesn't publish a conversion table. Prepare to clear the standard comfortably rather than aiming at a threshold that doesn't exist.

How many questions are on the CMAA exam?

135 are presented: 110 scored and 25 unscored pretest questions. Only the 110 count toward your result. You can't tell which are which, so answer all of them as if they count.

How long is the CMAA exam?

2 hours and 15 minutes — 135 minutes for 135 questions, or exactly one minute each.

What's the CMAA pass rate?

NHA published a 63.24% pass rate for 2025 across 10,848 exams administered. That's second-lowest among NHA's eight certification exams. The three prior years were 62.68% (2024), 69.02% (2023) and 71.42% (2022).

Is the CMAA exam open book? Can I use a calculator?

It's not open book — no reference materials are allowed, and the CBCS is the only NHA exam with a written-materials exception. On a computer-based exam, you may use the built-in exam calculator; personal calculators and your computer's calculator are prohibited. NHA's current paper-exam proctor guide prohibits calculators on paper exams. You'll be given scratch paper or a whiteboard depending on where you test.

Can I take the CMAA exam at home?

Yes, through Live Remote Proctoring, if your internet supports VoIP and your computer meets the remote proctor's requirements. Be aware that no breaks of any kind are permitted during an LRP session and nobody else may be in the room at any time.

How much does the CMAA exam cost?

NHA charges a fee for every attempt, but the Candidate Handbook doesn't publish a dollar amount. Use the current amount shown in your NHA account or at official checkout. School, employer, voucher, or partner sponsorship can change what you pay out of pocket.

How many times can I take the CMAA exam?

Three attempts, with a minimum 30-day wait between each. After a third unsuccessful attempt you wait one year before testing again, and each repeated failure after that carries another one-year wait. Every attempt requires re-registration and the full fee.

Do I need to finish a course to take the CMAA exam?

Not necessarily. Training within the past five years is one pathway; supervised work experience — one year in the last three, or two years in the last five — is another. Some candidates can test before finishing on-the-job training or an externship, but those routes carry 180-day and 90-day deadlines, and missing them voids a passing score. NHA also publishes a separate instructor route with its own qualification and testing-site rules.

Is CMAA the same as CCMA?

No. CMAA is the administrative credential; CCMA is the clinical medical assistant credential. Separate exams, separate blueprints, separate study material. Their 2025 pass rates differ by 18.49 points.

Is Quizlet or a free flashcard deck enough to pass?

For terminology, abbreviations, the "Do Not Use" list, and other compact facts, flashcards are genuinely efficient. They are not the whole plan: NHA says items may require recall and critical thinking tied to knowledge statements, task statements, or both. Use flashcards as one layer, then apply the material in original practice questions. NHA's public pages conflict on whether CMAA mobile flashcards are currently available, so verify inside your enrolled course before depending on the app.

Are sites offering "real" or "verified" CMAA exam questions legitimate?

No. NHA's Testing Rules of Conduct prohibit copying, memorising, soliciting, reproducing or disclosing exam content, and violations can mean invalidated scores, revoked credentials and a ban from future NHA exams. Legitimate practice questions are original items written to the published blueprint.

How long is a passing CMAA exam score valid?

NHA's June 1, 2026 handbook does not publish a separate general expiration period for an ordinary passing CMAA score once standard certification is awarded. It does publish two score-void deadlines before certification: 90 days for the pre-externship route and 180 days for the employer-training route. A provisional credential expires 12 months after the exam.

How long is the CMAA certification valid, and what does renewal require?

Two years from the issue date. During each two-year cycle you need 10 continuing education credits, where two hours of qualifying CE equals one credit. Excess credits don't roll into the next cycle, and NHA allows a one-month grace period. If it lapses, you can reinstate within one year with 15 CE credits plus recertification and reinstatement fees; after a year you retake the exam. Use our NHA certification renewal guide for the current fee and lapse-route details.

When should I request testing accommodations?

Allow around 30 days before your intended exam date. You'll need the NHA Request for Accommodations Form plus supporting documentation from an objective professional. Approved extra time defaults to 150% of the standard limit.

Primary sources

All read directly on August 13, 2026:

• NHA Candidate Handbook (rev. 06/01/2026)
• NHA CMAA Test Plan (2021 job analysis)
• NHA 2025 Annual Pass Rates (rev. 01/09/26)
• NHA 2024 Annual Pass Rates
• NHA 2023 Annual Pass Rates
• NHA 2022 Annual Pass Rates (rev. 08/04/2023)
• NHA CMAA certification page
• NHA certification-prep page
• NHA Testing Best Practices page
• NHA institution user resources
• NHA paper-exam proctor guide
• NHA product change log

Download our data: CMAA Blueprint Audit dataset (CSV) — all 146 statements counted by domain, with scored-item share and the syllabus-density index. CMAA Pass-Rate Ledger (CSV) — four official annual reports joined into one series. Free to use with attribution.

Castleport Test Prep is an independent publisher of exam preparation materials and is not affiliated with, endorsed by, approved by, or connected to the National Healthcareer Association (NHA), any testing vendor, licensing board, or certification body. Exam and credential names are used descriptively for identification only. Castleport does not claim ownership of third-party names or marks. This page is exam-preparation guidance, not legal, employment, medical, or licensing advice. NHA eligibility and state practice requirements are separate — confirm current requirements with NHA and the responsible authority in the state where you plan to work.

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