The National Certification Examination (NCE) is the board exam you must pass to become a CRNA. It is a computer adaptive test of 100 to 170 questions, with a 3-hour time limit, run by the NBCRNA.
In 2025, 90.5% of first-time takers passed. Here is how the exam works, what it costs and what happens if you need to retake it.
NCE format
| Feature | NCE |
|---|---|
| Questions | 100 to 170, including 30 unscored pretest questions |
| Scored questions | 70 minimum, 140 maximum |
| Time limit | 3 hours |
| Test type | Variable-length computerized adaptive test |
| Question types | Multiple choice, multiple correct response, calculation, drag and drop, hotspot, graphics |
| Going back | Not allowed once you answer |
| Where | Pearson test centers, plus select US military bases abroad for active duty |
A calculator is available on screen for complex calculation items. Calculation answers must be typed as numbers.
How the adaptive test ends
After each answer, the computer estimates your ability and picks the next question. The test stops when one of these happens:
- you are clearly above the passing standard, any time between 100 and 170 questions
- you are clearly below it, in the same range
- you reach 170 questions, and the decision rests on your final ability estimate
- you reach 3 hours, and you fail if you have not answered at least 100 questions
In 2025, 70% of first-time takers passed in the minimum number of questions. About 12% went to the maximum length.
A long test does not mean you failed. Of all first-time takers, 7.7% passed at the maximum length and 4.6% failed there.
What the NCE covers
The NBCRNA content outline has four domains:
| Domain | Weight | Examples |
|---|---|---|
| Basic sciences | 20% | Anatomy, physiology, pathophysiology, pharmacology, applied chemistry and physics |
| Equipment, instrumentation and technology | 20% | Anesthesia delivery systems, airway equipment, monitoring, infusion devices |
| General principles of anesthesia | 35% | Preoperative assessment, fluids, positioning, airway management, regional anesthesia |
| Anesthesia for surgical procedures and special populations | 25% | Surgical and diagnostic anesthesia, complications, special populations |
The current outline applies to exams given on or after January 2, 2024. The NBCRNA also publishes a bibliography of reference texts.
Passing standard
The NBCRNA updated the NCE passing standard on July 1, 2026, after a routine review. The content and format did not change.
Eligibility
To take the NCE, you must:
- Hold a current, unrestricted RN license in every state where you have an active license.
- Complete a COA-accredited nurse anesthesia program within the previous two calendar years.
- Have your program submit your academic and clinical record, which it must do within 30 days of completion.
- Submit an application, photo and required attestations through the NBCRNA portal.
Once approved, you have 90 days to take the exam. Pearson usually books appointments at least two weeks ahead, so schedule early.
NCE fees
| Fee | 2026 | 2027 |
|---|---|---|
| NCE application | $1,310 | $1,335 |
| NCE retake | $1,150 | $1,175 |
The 2026 NCE fee includes the $160 MAC Check enrollment fee for your first recertification cycle. No refund is given if you cannot schedule before your 90-day window closes.
Pass rates
From the NBCRNA's 2025 annual report:
| Group | 2025 pass rate | 5-year average (2021 to 2025) |
|---|---|---|
| First-time takers | 90.5% (2,980 of 3,294) | 86.6% |
| Repeat takers | 62.3% (307 of 493) | 59.6% |
First-time pass rates were 89.3% in 2024 and 84.9% in 2023. Pass rates were higher for younger candidates in 2025: 93.0% for those under 30 and 78.0% for those 40 and over.
Program pass rates vary too. In Everything CRNA's School Finder data (October 2026), the median program reports 91.7%. See CRNA schools with the highest NCE pass rates.
Results
You get a preliminary pass or fail report when you leave the test center. Passing candidates then receive an electronic notice with instructions for printing their certification documents.
If you pass, you do not get a score. The NBCRNA says employers and others often misuse score data. If you fail, your report shows a total scaled score and a scaled score for each of the four domains.
Retake rules
If you fail, you must reapply, submit a retake application and pay the retake fee. Allow up to five business days for processing.
The key limits:
- You may take the NCE up to four times in each of the two years after you complete your program.
- You must pass within two years of your official completion date.
- If you do not pass in that window, you must complete another full accredited program to become eligible again.
How to prepare
- Take the SEE seriously. In 2025, 84.4% of NCE takers said the SEE helped them prepare. See the SEE exam.
- Study from the content outline. Weight your time toward general principles, the largest domain at 35%.
- Use question banks and review courses. See our SRNA recommendations.
- Practice adaptive pacing. Aim for steady, careful answers, since you cannot go back.
- Book your date soon after you are approved. Your 90-day window starts when eligibility is issued.
After you pass
You become a CRNA and can apply for your state APRN license and credentialing. See APRN credentialing and your state board of nursing.
New CRNAs then maintain certification through the NBCRNA's Maintaining Anesthesia Certification (MAC) program, which has replaced the CPC program. CRNAs renewing in 2026 and 2027 still complete their CPC renewal requirements.
FAQ
How many questions are on the NCE?
Between 100 and 170, including 30 unscored pretest questions. You will not know which questions are pretest items.
How long is the NCE?
You have up to 3 hours.
How much does the NCE cost?
$1,310 in 2026 and $1,335 in 2027. Retakes cost $1,150 in 2026.
How many times can you take the NCE?
Up to four times in each of the two years after you finish your program. You must pass within those two years.
What is the NCE pass rate?
In 2025, 90.5% of first-time takers passed.
Sources
- NBCRNA: NCE resources
- NBCRNA: National Certification Examination Handbook (revised January 14, 2026)
- NBCRNA: NCE and SEE content outline
- NBCRNA: NCE passing standard update
- NBCRNA Annual NCE and SEE Report, Calendar Year 2025
- NBCRNA fee schedule (2026 and 2027)
- NBCRNA: MAC program
- NBCRNA: CPC program
- Everything CRNA School Finder data (October 2026), compiled from program websites and admissions-office correspondence