NHA Exam Accommodations: How to Request Them Without Losing Your Test Date

Last verified: August 11, 2026 · By the Castleport Test Prep Editorial Team · How we verify · Found an error?

The short answer

NHA exam accommodations are available for documented disabilities and qualifying medical conditions under the ADA. Register for your exam first, then submit NHA's accommodations form with your documentation, and allow 30 days for review. Approved extra time is 150% of standard time. If you're testing through PSI, don't book a date until NHA approves you.

Now the part that costs people their exam date: if you're approved for anything other than extra time, your at-home testing option disappears. A reader, a private room, permission to eat or take medication — any one of those and remote is off the table. Third-party candidates must test on-site at a PSI center; candidates testing through a school or employer may remain there only if the institution confirms it can administer the approved modification.

Three things change your answer: which exam you're taking (150% is a different number of minutes for all eight), what you're asking for (extra time only, or something more), and where you'll test (an existing approval will not be applied at a new venue unless you notify NHA Compliance in writing).

We read all of it so you don't have to — the Candidate Handbook, NHA's Help Center, the forms hub, all nine test plans, the CBCS-specific update that corrects a stale handbook parenthetical, and the federal rule that governs testing companies. Here's the whole map.

Castleport Test Prep is an independent exam-prep publisher. We verify official exam claims against current handbooks, test plans, and policy pages, version-control material changes, and log corrections publicly.

This page is for you if

• You're taking the CCMA, CPT, CET, CMAA, CBCS, CEHRS, CPCT/A, or ExCPT and you have a documented disability or medical condition
• You had an IEP or 504 plan and you're not sure it still counts
• Your college disability office gave you accommodations and you assumed they carry over
• You need medically necessary access to food, medication, blood-glucose supplies, or disability-related breaks during a two- or three-hour exam
• Your exam is close and you just learned this is a separate process

This is not the page for you if

• You want the exam translated, or you want extra time because English is your second language. NHA does not treat that as a disability. We say so plainly below so you don't burn 30 days finding out.
• You just need to register. Start at NHA's certification portal — then come back here before you pick a date.
• You already tested and want to decode your score report. That's a different question and a different page.

One thing before you scroll

The planner asks only what changes your route: exam, test location, requested accommodation categories, registration status, exam date and time, and the type of documentation you have. It does not ask for your name, NHA Account ID, diagnosis details, or documents. The component makes no network requests and does not save your responses.

Everything on this page about NHA's process is free, and none of it requires buying anything from us. Accommodations are an official process. NHA decides. We're just the ones who read every document and put them in one place.

How do you request NHA exam accommodations?

Answer capsule: To request NHA exam accommodations, first complete your NHA exam registration, then submit NHA's Request for Accommodations Form with supporting documentation from a qualified professional, an IEP, or a 504 plan. NHA recommends allowing 30 days for review. Candidates testing through a third-party provider should not schedule an exam date until NHA approves the request and sends scheduling instructions.

There's a required order here, and the easy mistake is the middle step.

You register first. You request second. You schedule last.

That's backwards from how registration normally feels. The usual flow nudges you to apply and immediately grab a date. Do that, then ask for accommodations, and you may have to move the appointment you just booked — and moving a PSI appointment inside 24 hours forfeits your fee.

NHA's current Help Center says the candidate must have completed exam registration before submitting the request. It adds the second half — third-party candidates should not schedule a date and time until the accommodation is approved and Compliance has sent special instructions.

The eight steps, in order

Where the form actually is — and which link to use

This tripped us up, so it will trip you up.

On August 11, 2026 we found NHA linking an accommodations form from three places, and they don't all point to the same form:

Use the form linked from NHA's forms hub. That is our editorial recommendation, not an NHA-stated canonical designation: on August 11, 2026, the forms hub and Get Certified page both pointed to Form A, while the FAQ article pointed to Form B.

Already submitted through the other link? Don't submit twice. Email compliance@atitesting.com and ask them to confirm they have it.

Next step: Open NHA's accommodations forms hub — the accommodations form is the first link on the page.

Which route are you on? (This decides almost everything)

Answer capsule: NHA candidates test in one of three ways: at an authorized institution such as a school or employer, at a PSI testing center, or through PSI Live Remote Proctoring at home. The request form is the same for all three, but scheduling rules, who confirms delivery, and which accommodations can actually be provided differ by route.

Here's the distinction that saves people the most grief: PSI is the provider. Remote is the mode. PSI can deliver every accommodation NHA approves — but not every accommodation can be delivered remotely. Those are two different sentences, and mixing them up is how candidates end up at a laptop on exam morning with no accommodation attached.

Built from the NHA Candidate Handbook (rev. 06/01/2026) and NHA's Help Center accommodations article, both read August 11, 2026.

Next step: Not sure which route you're on, or what it means for your dates? Build your route-specific plan in the planner at the top of this page. It asks for no name, NHA Account ID, diagnosis details, or document upload; the component makes no network requests and saves no responses.

How long should you allow for approval?

Answer capsule: NHA recommends submitting an accommodation request at least 30 days before a scheduled exam date, and says requests are reviewed in the order received. NHA's Help Center adds that it strives to complete a review within about two weeks of submission, but states that timelines vary based on the request and the documentation provided.

Plan on 30 days. Treat two weeks as luck.

Neither NHA document sets a hard cutoff. Nowhere does NHA say a late request gets refused. So if you're already inside the window, the answer isn't "give up" — it's "submit now and start working the phone."

Two details that soften the panic:

Rescheduling at your school costs nothing. NHA's Help Center is explicit — there's no penalty or additional cost for rescheduling an on-site exam when an approved accommodation requires it. The 24-hour cliff and the forfeited fee apply to third-party PSI appointments, not to your school's roster.

And the federal standard is on your side about speed. The Department of Justice's own guidance for testing companies says an entity must respond in a timely manner, that the process should respond in time for applicants to register and prepare, and that failing to act in a timely manner while also demanding unnecessary documentation could amount to a denial of equal opportunity. That's DOJ technical assistance, last updated February 28, 2020 — not a stick you get to swing, but a reasonable thing to reference politely in an email if you're being left hanging.

Next step: Get your recommended submit-by date — the planner counts backward 30 days from your exam date and tells you where you actually stand.

What documentation does NHA require?

Answer capsule: NHA requires either a letter from an objective professional qualified to diagnose the condition, or an IEP or acceptable 504 plan. Whichever is submitted, it must identify the specific diagnosis, explain how the condition limits testing under standard conditions, give diagnosis details if the condition is temporary, and name the specific accommodation required. A diagnosis alone does not establish the need for an accommodation.

NHA lists two primary documentation routes. You may also include relevant supporting evidence.

Option A — a professional letter. From a physician or health care professional qualified to diagnose your condition and give an opinion on whether you need an accommodation. "Objective" means it can't be you, and it can't be a relative.

Option B — an IEP or an acceptable 504 plan. Send the whole thing, not a page from it.

Either way, four elements have to be inside the document:

Four requirements the handbook doesn't mention

These live only in NHA's Help Center. Meet them anyway — Compliance reviews against them.

• A DSM classification code, if the diagnosis is mental or emotional. Omitting it can delay the request because the Help Center requires it even though the handbook does not mention it.
• Letterhead, a signature, and a date on the professional's letter.
• The entire IEP or 504 plan, not an excerpt.
• Documentation preferred within the last five years — with older material still accepted for review.

That last one may save you from paying for a new evaluation

Here is the current split:

If you have a four-year-old evaluation and you were about to book a new one, ask NHA before you pay. Four years falls inside NHA's preferred five-year window, and the Help Center says older paperwork may still be reviewed. Send what you have and let Compliance tell you if it needs more.

What the DOJ says about how much paperwork is fair

This is the most reassuring primary-source context on this page.

The Department of Justice publishes technical assistance for testing companies, and it's unusually direct. Four points, all from that guidance:

• Documentation requests must be reasonable and narrowly tailored to the accommodation you asked for. If one or two documents are enough to show the disability and the need, a testing entity should generally work from those and not ask for more.
• Proof of past accommodations in similar test settings is generally sufficient to support the same request now. If you had extended time on the SAT, that's meaningful evidence here.
• A history of academic success does not mean you don't have a disability. Straight quote in substance: someone with a learning disability may achieve a high level of academic success and still be substantially limited, because of the extra time and effort it takes them. If you've been told "but you did fine in school," this paragraph exists for you.
• Never had a formal accommodation before? You can still qualify. DOJ's own examples include a student with post-concussion syndrome who never had accommodations, and a student with ADHD and anxiety who only ever got informal help — extra time at lunch, finishing after school. Both may be entitled to accommodations on a high-stakes exam.

DOJ also says testing entities should defer to a qualified professional who actually evaluated you, and that a professional's choice not to include one specific test score shouldn't sink a request when the documentation as a whole shows the disability and the need.

Source: ADA.gov, "ADA Requirements: Testing Accommodations," originally issued September 8, 2015, last updated February 28, 2020. It's DOJ technical assistance — informal guidance, not binding law — and we're a prep publisher, not a law firm. But it's public, it's short, and it's worth reading before you assume you need to spend money.

Next step: Check your packet against the four required elements — the planner lists the requirements and likely gaps to check based on the document type you select, and prints as a filing checklist.

Does an IEP, a 504 plan, or a college disability letter count?

Answer capsule: NHA accepts an IEP or an acceptable 504 plan in place of a professional letter, provided it contains the required diagnosis, limitation, and accommodation details. A college disability office approval does not transfer: NHA's Help Center states that schools and proctors have no authority to add extra time to an NHA exam and that the request must be reviewed and applied by NHA Compliance.

IEP or 504 plan: yes, with a wrinkle in the wording.

The handbook frames the IEP route around being a high school student, and says the IEP has to be actively in place or have been active at graduation. It allows an acceptable 504 plan if the plan contains all the required information. NHA's Help Center lists "an IEP or acceptable 504 Plan" with no student-status qualifier at all.

The two documents don't line up. Our read: if you graduated recently and your plan was active then, the handbook's own wording covers you. Further out than that, submit it as supporting evidence and ask Compliance whether it satisfies NHA's documentation route or whether a qualified-professional letter is needed.

College disability approval does not transfer automatically. Even where accommodations have been reviewed by an institution, NHA's governance and exam security require the request to be reviewed and applied by NHA directly, and proctors and schools have no authority or ability to add additional time to NHA's exams.

Your disability office letter is not worthless. Proof that you received similar testing accommodations is meaningful supporting evidence under DOJ guidance. The letter may satisfy NHA's professional-letter route only if its author is an objective qualified professional and it contains every required element above.

But evidence isn't a request. You still have to file with NHA. If the disability office letter is all you've got and it does not meet NHA's letter requirements, ask for the underlying provider documentation or a compliant letter from a qualified professional.

What does extended time actually give you?

Answer capsule: NHA's Candidate Handbook states that candidates approved for extra time receive 150% — one and a half times — the standard allotted time for their exam. If more than 150% is needed, the supporting documentation must specifically state how much time is required and why. Approval remains case by case.

Here's the rule. And here's the calculation NHA does not publish in one place: what 150% actually equals for your exam.

NHA doesn't put its time limits in the handbook. They live in nine separate test plan PDFs, written in four different formats — "3 hours," "2 hours," "2 hours + 15 minutes," "125 minutes." So we opened all nine on August 11, 2026 and did the arithmetic.

Your accommodated clock, by exam

Item counts and standard times read directly from NHA's published test plans, August 11, 2026. The 150% rule is from the Candidate Handbook, rev. 06/01/2026. The 150% column, time gained, and per-question figures are Castleport calculations from those published values — arithmetic on official numbers, not estimates. All nine plans are linked from NHA's Certification Prep page.

Three things that table tells you and nothing else will

1. NHA builds almost every exam at exactly one minute per question. Seven of the nine plans give you 1.00 minute per presented question — and that counts pretest items, which you can't identify and which don't affect your score. Extended time moves you to 90 seconds.

That reframes the conversation with your doctor. The question isn't "do I need extra time." It's: do I reliably finish a careful read of a multiple-choice question in under 90 seconds? That's a concrete pacing fact to bring to your provider; it is not NHA's approval standard and it is not a substitute for professional evaluation.

2. Two exams break the pattern, in opposite directions. CBCS gives 1.44 minutes per presented item — the roomiest standard clock in this set. Do not infer that the extra time is for code-book lookup: NHA's CBCS FAQ and product-update page say coding manuals have not been permitted since September 24, 2024 because the information needed for each coding item is provided with the question. The 2026 handbook still contains a stale parenthetical suggesting CBCS materials are allowed; the CBCS-specific update is newer and more specific. ExCPT sits at 1.08. If you're taking either, your baseline time pressure is genuinely different from a CCMA candidate's.

3. For CMAA and CEHRS, 150% doesn't land on a whole minute. CMAA works out to 202.5 minutes. CEHRS to 187.5. NHA publishes the 150% rule but no rounding rule — we looked in the handbook, the Help Center, and all nine test plans. If you're taking either exam, ask PSI Accommodations to confirm your exact clock when they call. That half-minute isn't something to discover on exam day.

Need more than 150%? The handbook allows it, but your documentation has to state how much time and why. Don't let your provider write "extended time" and leave it there. If you need double time, the letter should say double time and explain the reason.

Can you request a calculator, a reader, or other aids?

Answer capsule: NHA's Candidate Handbook states that candidates may use the calculator built into the exam software and may not use a personal calculator or the computer's calculator. Other aids — a reader, adaptive equipment, or a specific device — may be requested with documentation, and any electronic device approved under an accommodation is subject to inspection by the proctor.

Start with the surprise: there's already a calculator in the exam.

The current handbook says NHA allows you to use the built-in exam calculator as needed during your exam, and that you may not use your own calculator or open your computer's calculator app. If you were going to request a calculator only because you need ordinary arithmetic support, try the built-in tool first. If your disability requires a different device, display, or input method, request that accommodation and explain why the built-in tool does not work for you.

If you need something different from the built-in tool — a specific adaptive calculator, a large-display device, something tied to a visual or motor limitation — that's a real accommodation request, and your documentation should explain why the built-in one doesn't work for you.

Worth knowing how DOJ frames calculators generally: a basic calculator may be an appropriate accommodation when the ability to do arithmetic is secondary to what the exam is measuring, and likely isn't appropriate when computation is precisely what's being tested. Whether that reasoning applies to your request is for NHA to decide, case by case.

The other aids, and the rules attached to them

Never bring unapproved equipment to a test center. An unapproved device isn't a gray area — it's a Testing Rules of Conduct problem, and those have consequences well beyond a bad test day.

Can you take an NHA exam at home with accommodations?

Answer capsule: Extended time alone does not close the Live Remote Proctoring option; at-home testing may remain available through NHA and PSI's scheduling instructions. If anything else is approved, at-home testing is unavailable. Third-party candidates must use a PSI test center; candidates testing through an authorized institution may remain there if the institution confirms it can administer the modification.

The handbook puts it gently — Live Remote Proctoring "may not be available to you if you are approved for certain accommodations."

The Help Center draws the actual line, and it's sharp.

Source: NHA Help Center, "Does NHA provide special accommodations?", read August 11, 2026.

Why the rule exists — and this next part is our reading, not NHA's stated reason: the handbook's Testing Rules of Conduct say no person other than you may be in the room during a remote session at any time, and that no breaks are allowed at all during a remote session. A reader is another person in the room. A break is a break. The same rules that make remote testing secure make most accommodations impossible to deliver remotely.

That's a real cost and we're not going to dress it up. If getting to a test center is itself your barrier — you don't drive, you're rural, travel is hard because of the same condition you're documenting — put that in writing when you submit. DOJ's regulation for testing entities contemplates alternative accessible arrangements where accessible facilities are unavailable. NHA may say no; you still need to ask for the barrier you actually have.

Already booked remote? Move it now, not later. At least 24 hours before the appointment, you can reschedule without repaying the fee and choose a new date within six months of the original scheduled date.

Will extra time show up on your certificate?

Answer capsule: NHA's public verification tool shows certification status and certification number and does not disclose exam scores or failed attempts. NHA does not publish whether accommodated results carry any internal annotation. Separately, Department of Justice guidance states that flagging policies — annotating scores to indicate an exam was taken with an accommodation — that impede individuals with disabilities are prohibited by the ADA.

We're putting this section in because it's the fear people don't say out loud: if I ask for this, will an employer find out?

Two facts, from two sources:

NHA's public verification tool doesn't show scores at all. The handbook says NHA is required by its accreditor to let the public verify credentials, and that the tool shows your certification status and certification number — and that NHA does not disclose failed attempts or your exam score on it. An employer using that public tool sees the fields NHA says it displays: certification status and certification number.

And "flagging" is squarely addressed in federal guidance. DOJ's testing accommodations guidance says testing entities should report accommodated scores the same way they report scores generally, must not decline to report scores for test-takers receiving accommodations, and that flagging policies which impede people with disabilities from fairly competing are prohibited by the ADA. DOJ's stated reason is exactly the fear you have: flagging announces a disability, implies the score isn't deserved, and discourages people from exercising their rights.

What we could not find: any NHA statement, either way, describing how accommodated results are annotated internally. We're not going to invent one. What we can tell you is what NHA's own verification tool shows the public, and what the federal guidance says about flagging. If this specific question is what's stopping you, ask NHA Compliance directly and get the answer in writing.

What happens after NHA approves your request?

Answer capsule: NHA Compliance sends written approval with route-specific scheduling instructions. Candidates testing with PSI should expect a call from the PSI Accommodations Department at the phone number in their NHA account within 48 hours of PSI being notified, and the Candidate Handbook advises candidates to call PSI before exam day if they have not received verbal confirmation that accommodations are in place.

Approval is not the finish line. Approval is a document. Your accommodation still has to get attached to a specific appointment, at a specific location, in a specific system.

Do these four things:

1. Read the approval email properly and follow its route-specific scheduling instructions. Don't assume an existing booking was quietly updated.
2. Save it. The email, the appointment confirmation, and the documentation you sent. Screenshot them.
3. Confirm verbally. Testing with PSI, expect their Accommodations team to call the number in your NHA account within 48 hours of notification. Testing at your school, ask your testing coordinator to confirm out loud that the modification is set up.
4. If nobody's called, call them.

About that phone number

NHA currently publishes two different numbers for the PSI Accommodations team:

Both were published by NHA on August 11, 2026. Notice what's identical: extension 6750. The Help Center makes a point of it — entering the extension when prompted is what connects you to the Accommodation Team rather than general support.

NHA does not identify one as preferred. Use either published number with extension 6750; if one does not connect, try the other.

What if your accommodation isn't applied on exam day?

Answer capsule: NHA publishes dedicated forms for exam-day problems. Its forms hub hosts an Incident Form and, separately, a Remote Proctoring Event Review Form, alongside the accommodations form and the appeals form. Candidates who experience a testing irregularity should also raise it with the proctor or testing provider at the time it occurs.

This is the scenario that keeps people up at night: you did everything right, and the timer on your screen says 180 minutes instead of 270.

Say something immediately. Before the exam starts if you can, during it if you must. Tell the proctor. A problem raised in the room is a different conversation than a problem raised a week later.

Then use NHA's own forms. Its forms hub hosts four things candidates actually need:

Bookmark that hub now, before exam day. It puts all four candidate forms on one official page.

Two score-challenge clocks from the handbook, both counted from your exam date, not your result date: a hand-rescoring request must be received within 60 days, and an appeal of a final exam score within 30 days. NHA does not publish either clock as the deadline for reporting an accommodation incident.

Do accommodations carry over to your next exam or a retake?

Answer capsule: NHA's Help Center states that an approved accommodation is valid for a full year — 365 days — unless it was approved for a temporary disability or medical condition, and that it applies automatically to additional exams within that window. A new request form is generally not required unless the candidate needs different or additional accommodations, or more than a year has passed.

Good news first: stack your credentials and your accommodation comes with you — unless the approval was for a temporary condition. CCMA, then CET, then CPT — inside 365 days, no new form in the ordinary case. NHA publishes that rule in its Help Center article.

Now the trap, from the same article. Compliance must be told if you change where you test, or the approved accommodations will not be applied to the new exam. NHA's own example: your venue moves from your school or employer to third-party testing.

Nothing about that sentence is loud. You can hold a valid approval, change venue for a completely normal reason — you graduated, your school stopped offering the exam, you moved — and arrive at a PSI center with nothing applied to the new appointment because Compliance was not notified.

The email NHA wants

Four items, exactly. Send it to compliance@atitesting.com.

1. Your name
2. Your NHA Account ID
3. The city and state that match your NHA account
4. A statement that you're testing at a different location and want your previously approved accommodations provided to the new administrator

You don't need to redo the form unless you want different accommodations or it's been more than a year.

Retaking the same exam? The Help Center adds two specifics. Same institution both times — check with them beforehand that the accommodations will still be available. PSI both times — call the Accommodations team to confirm they carry over to the new attempt.

Next step: Generate your venue-change email — the planner formats it with all four required fields so nothing gets bounced.

What if you test at your school?

Answer capsule: When a candidate tests at an authorized institution, NHA's Help Center states that communication begins between the candidate and NHA, and that once a request is tentatively approved, NHA's Compliance Team emails the institution contact to verify the institution can administer the exam with the accommodations. The candidate is notified of approval only after the institution confirms.

Your school sits inside the approval chain, and it can be the bottleneck.

Three things follow from that:

• "Tentatively approved" is a real state you might be sitting in. If your review seems stuck, it may be waiting on your school, not on NHA.
• Name the right contact on the form. NHA emails whoever you list. Name someone who answers email and has authority over test administration — usually a program director or testing coordinator, not necessarily your instructor.
• Your school's admin can chase it. The Help Center gives them compliance@atitesting.com for status questions.

And here's a line worth reading twice if you're worried about privacy: if you'd rather NHA contact only you, leave the school-contact fields blank. That's NHA's own instruction in the handbook. That controls who NHA contacts during the request; if you plan to test at the institution, NHA's Help Center says the institution still must confirm it can administer the modified exam before final approval.

If your school can't administer the exam with your accommodations, you may need to move to PSI — and at that point the venue-change rule above kicks in.

Where NHA's own two documents disagree

Answer capsule: NHA publishes accommodation rules in both its Candidate Handbook and a Help Center article, and the two differ on several material points, including documentation age, DSM code requirements, letterhead requirements, approval validity, remote testing eligibility, and the PSI Accommodations phone number.

This table is the reason this page exists. We read both documents in full on August 11, 2026 and mapped every difference we could find.

Why this matters more than it sounds. The handbook is the dated candidate-facing policy document most sites quote, while the Help Center carries several operational requirements that are absent from it. A candidate who follows only the handbook can miss the DSM code, letter format, 365-day carryover, and venue-change rules. CBCS shows the reverse problem: the handbook contains a stale exception, while the newer CBCS-specific FAQ and product update state the current exam rule.

The accommodation rules that aren't in the accommodations section

Answer capsule: Several NHA rules that determine how an accommodated exam is administered appear outside the Candidate Handbook's Accommodation Request section, primarily in its Testing Rules of Conduct. These include rules on eating and drinking, breaks, who provides reader assistance, electronic devices, and how proctors enforce time limits.

NHA's Accommodation Request section runs about a page and a half. But the rules that decide what your exam day actually looks like are filed several pages later, under Testing Rules of Conduct, outside the section a candidate would naturally read first.

If you need medically necessary or guaranteed breaks, altered break conditions, or permission to eat or medicate, request that accommodation and put it in your documentation. For an ordinary in-person bathroom exception, the handbook lets the proctor permit a break under specific conditions, and the time still counts against your exam clock. Remote sessions allow no breaks. DOJ's guidance names permission to bring and take medication during an exam — using diabetes and blood-sugar monitoring as its example — as a testing accommodation.

What the ADA actually requires

Answer capsule: 28 CFR § 36.309 applies to private entities that offer certification examinations. It requires documentation requests to be reasonable and limited to the accommodation requested, requires considerable weight be given to past accommodations and to IEP or Section 504 plan accommodations, requires a timely response, and lists extended time and auxiliary aids among required modifications.

We're a prep publisher, not a law firm, and none of this is legal advice. But you're entitled to know the framework, because it's public and short.

The current eCFR text contains four provisions that matter to you:

• § 36.309(b)(1)(iv) — documentation requests must be reasonable and limited to the need for what you asked for.
• § 36.309(b)(1)(v) — the entity gives considerable weight to documentation of past accommodations in similar testing situations, and to accommodations provided under an IEP or a Section 504 plan. This is the legal backdrop to NHA accepting IEPs and 504s, and the reason your college disability letter is still worth sending as supporting evidence.
• § 36.309(b)(1)(vi) — the entity responds in a timely manner.
• § 36.309(b)(2) and (b)(3) — required modifications may include changes in the length of time permitted, and appropriate auxiliary aids must be provided unless doing so would fundamentally alter what the exam measures or create an undue burden. The listed examples include qualified readers for individuals with visual impairments or learning disabilities, transcribers, interpreters, and Braille or large print.

On the cost question

NHA's handbook says the cost of excessive accommodation requirements is borne by the candidate. Separately, 28 CFR § 36.301(c) says a public accommodation may not impose a surcharge on an individual with a disability to cover the costs of measures — including auxiliary aids — required to provide nondiscriminatory treatment.

We are not telling you those two statements conflict in your case, and we can't. Whether a specific charge is a prohibited surcharge or a cost for something beyond what the ADA requires is a legal question that turns on facts we don't have.

What we will say plainly: if you're quoted a cost for your accommodation, that's the moment to ask NHA Compliance in writing what the charge covers — and to keep the answer. If you want to go further, the DOJ runs an ADA Information Line at 800-514-0301 (TTY 1-833-610-1264), and you may want your own legal advice.

Regulation text read from eCFR § 36.309, August 11, 2026; Title 28 current as of August 10, 2026.

What NHA will not accommodate

Answer capsule: NHA's Help Center states that the ADA does not consider English as a second language a disability or medical condition, and that NHA does not provide accommodations for ESL candidates. The Candidate Handbook states the exam is written and administered in English, that exams will not be translated, and that interpreters are not permitted in the exam room for the purpose of translating the exam.

Two clear no's, stated up front so you don't lose 30 days.

English as a second language. Both documents agree. The handbook adds that a lack of facility with English isn't considered a disability, exams aren't translated, and interpreters aren't permitted for translation purposes.

Read that last clause carefully, though. The handbook lists a sign language interpreter as an accommodation that may be granted, for audio or spoken components. The prohibition is on translation, not on interpretation for a hearing disability. Different requests, different answers.

Anything that fundamentally alters the exam. Accommodations are provided to the extent they don't fundamentally alter the examination or cause undue burden to NHA, the test center, or the remote provider. How you take the exam can change. What it measures cannot.

And one honest boundary that isn't a no: an approved accommodation doesn't change the rules you're held to. Readers and interpreters are bound by the same Testing Rules of Conduct you are, and they can't help you answer.

What if you're denied, or you're out of time?

Answer capsule: NHA states that accommodation decisions are made case by case and that additional documentation may be requested based on individual need. NHA publishes a general Appeals Form, but neither the current handbook nor the form clearly says accommodation denials use that process. If you are denied, ask Compliance in writing for the correct review path and deadline.

First, a request for more paperwork is not a denial. NHA's Help Center says additional documentation may be requested depending on the individual need. Send it fast and keep the thread moving.

If you are actually denied, here's what NHA publishes:

• Decisions are case by case, based on what you submitted. One high-impact fixable problem is a document missing element (b) — the explanation of how the condition limits you under standard testing conditions.
• There is an official Appeals Form, hosted on the same forms hub as the accommodations form. The handbook describes the appeals process mainly around eligibility and attestation exceptions rather than accommodations specifically, so we won't tell you it definitely covers an accommodation denial. Ask Compliance in writing what your options are and reference the form.
• compliance@atitesting.com is the published inbox for you and for your school's administrator.

And if your exam is simply too close? If you cannot finish under standard conditions and approval will not arrive in time, rescheduling at least 24 hours before a PSI appointment protects the exam fee you already paid, as long as the new date is within six months of the original. Sitting and failing means a full-price retake and at least a 30-day wait before the next attempt. There is no discounted second attempt.

What we actually verified

Everything above was read from a primary source on August 11, 2026. Here's the list.

What we could not verify — stated plainly:

• How the fractional half-minute is rounded on CMAA (202.5) and CEHRS (187.5) accommodated clocks. No rounding rule published anywhere we looked. Confirm with PSI.
• Whether NHA annotates accommodated results internally. No NHA statement either way. We report only what its public verification tool shows.
• Whether NHA's general appeals process formally covers an accommodation denial. The handbook frames appeals around eligibility and attestation.
• Which PSI Accommodations number is current. Both are published by NHA right now.
• Which of the two live accommodation form URLs NHA considers canonical. NHA links both and does not label either one as canonical.

What we deliberately left out: exam fees, because this page does not answer the cost decision and the handbook does not publish one universal dollar figure; and pass rates, because they are not this page's subject and we will not repeat unsourced numbers from other sites.

NHA exam accommodations FAQ

Does NHA offer testing accommodations?

Yes. NHA's Candidate Handbook states that accommodations may be available to individuals with documented disabilities under the ADA, and that NHA provides reasonable testing accommodations to candidates whose documented disabilities or other qualifying medical conditions hinder their ability to test under standard conditions. Submitting a request does not guarantee approval; decisions are case by case.

Do I register before requesting accommodations?

Yes. NHA's Help Center says you must complete your exam registration before submitting the accommodation request. What you should not do is book a test date with PSI before your accommodation is approved.

How long does NHA take to approve accommodations?

NHA recommends allowing 30 days and reviews requests in the order received. Its Help Center adds that it strives to complete a review within about two weeks of submission, though timelines vary with the request and the documentation.

How much extra time does NHA give?

150% of standard time. That's 270 minutes instead of 180 for the CCMA; 180 instead of 120 for the CPT, CET, and CPCT/A; 202.5 instead of 135 for the CMAA; 187.5 instead of 125 for the CEHRS; 270 instead of 180 for the CBCS; and 195 instead of 130 for the ExCPT. If you need more than 150%, your documentation must state how much and why.

Can I use an IEP or 504 plan instead of a doctor's letter?

Yes, in the right circumstances. The handbook frames the IEP route around a high school student whose IEP is active or was active at graduation, and allows an acceptable 504 plan containing all the required elements. NHA's Help Center lists an IEP or 504 plan as a documentation option without that qualifier. Send the entire plan, not an excerpt.

Does ADHD, anxiety, or dyslexia automatically qualify?

No diagnosis automatically qualifies. NHA reviews case by case, and the documentation must explain how the condition limits your ability to test under standard conditions — not just name the condition. For a mental or emotional diagnosis, NHA's Help Center requires a DSM classification code in the documentation.

Can I request a calculator?

NHA's handbook says you may use the calculator built into the exam software and may not use a personal calculator or your computer's calculator. If you need a different or adaptive calculator because of a documented condition, request it with documentation explaining why the built-in tool doesn't work for you.

Can I test remotely with accommodations?

Extended time alone does not close the at-home option; remote testing may remain available through NHA and PSI's scheduling instructions. Any approved accommodation beyond extended time closes Live Remote Proctoring. Third-party candidates then use a PSI test center; institution candidates may test there if the institution confirms it can administer the modification.

Will my college's disability accommodations transfer?

No approval transfers automatically. NHA's Help Center states that schools and proctors have no authority to add time to an NHA exam and that the request must be reviewed and applied by NHA Compliance. Send proof of prior accommodations as supporting evidence, but file the request with NHA.

Do accommodations carry over to a retake or another NHA exam?

NHA's Help Center says an approved accommodation is valid for a full year unless it was for a temporary condition, and applies automatically to additional exams in that window. You must file again for different or additional accommodations, or after a year.

What if I change from school testing to PSI?

Notify NHA Compliance in writing at compliance@atitesting.com with your name, NHA Account ID, the city and state on your account, and a statement that you're testing at a new location. Otherwise NHA says the approved accommodations will not be applied to the new exam.

Can I get accommodations for a temporary condition like surgery or a concussion?

NHA's wording covers documented disabilities or other qualifying medical conditions that hinder your ability to test under standard conditions. For a non-permanent condition, the documentation must include the date first diagnosed, roughly how long it lasts, and how it was diagnosed.

Can I eat, take medication, or check my blood sugar during the exam?

Only with prior approval. The rule sits in the handbook's Testing Rules of Conduct: eating or drinking isn't allowed unless necessary for a documented medical condition and you sought and received approval before the exam date. Request it explicitly.

Who do I contact about the status of my request?

NHA Compliance at compliance@atitesting.com. If your exam is with PSI and you're confirming that accommodations are attached, NHA publishes both 833.537.1330 and 800.537.1565 for its Accommodations Department — extension 6750 in both cases.

Does NHA accommodate English as a second language?

No. NHA's Help Center states the ADA does not consider ESL a disability or medical condition, and NHA does not provide accommodations for ESL candidates.

Are coding manuals allowed on the CBCS exam?

No. NHA's CBCS FAQ and product-update page say coding manuals have not been required or permitted since September 24, 2024; the information needed for each coding item is provided with the question. The contrary parenthetical that remains in the 2026 handbook is stale.

Do accommodations cost extra?

NHA's handbook says the cost of "excessive accommodation requirements" is borne by the candidate, using electronic communication equipment as its example. Separately, 28 CFR § 36.301(c) prohibits a public accommodation from imposing a surcharge on an individual with a disability to cover measures required for nondiscriminatory treatment. If you're quoted a cost, ask Compliance in writing what it covers.

What to do now

If you haven't submitted yet: run your answers through the planner at the top of this page, print the filing plan, and check your document against the four required elements before you send it. One high-impact fixable problem is a letter that names a diagnosis but never explains how it limits you under testing conditions.

When your packet is ready: open NHA's accommodations forms hub and use the accommodations form at the top. Bookmark that page — the Incident Form and Remote Proctoring Event Review Form live there too, and you'll want them if exam day goes sideways.

If you still need to register: you have to do that first. NHA's certification portal is the only place to do it, and you have to complete it yourself — parents, teachers, and school officials aren't permitted to register on your behalf.

And once your accommodation is confirmed, if you're taking the CCMA: take the free Castleport CCMA diagnostic. Twenty-five original questions written to the current NHA test plan, an instant score broken out by content area, full rationales on every item, no sign-up and no email wall. It tells you nothing about your accommodation — it gives you a directional top-level domain baseline and shows where to focus next, not a pass prediction. Taking one of the other seven NHA exams? We don't have a diagnostic for you yet, and we'd rather say so than sell you a link.

Disclosure

Castleport Test Prep sells its own exam preparation materials. Nothing on this page is required to request an accommodation or to sit an NHA exam, and we have not recommended a paid product anywhere above. Our practice questions are original items written to the published test plan — we do not have, use, or reproduce real exam content.

This page is study and process guidance. It is not legal, medical, or licensing advice. NHA decides every accommodation request case by case, and the official Candidate Handbook and NHA Compliance set the requirements — not this page. Confirm anything that affects your money or your test date directly with NHA.

Castleport Test Prep is an independent publisher of exam preparation materials and is not affiliated with, endorsed by, or approved by the National Healthcareer Association. Third-party organization, exam, credential, and product names are used only to identify the subjects discussed.

Prepare with proof.

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