- The CHHA exam has 125 scored items plus 25 unscored pretest items, in three hours.
- You need a scaled score of 575 out of 200-720 to pass.
- Direct Client Care is the largest of the six domains - prioritize it in review.
- Testing is closed book with no scratch paper; mental math and memorization matter.
Exam Snapshot: The Numbers You Must Memorize
Before you touch a single practice question, lock in the raw mechanics of the CHHA exam. These are the facts test-day nerves make you forget, so drill them until they're automatic.
| Detail | Fact |
|---|---|
| Administering body | National Center for Competency Testing (NCCT) |
| Scored items | 125 |
| Unscored pretest items | 25 |
| Time allowed | 3 hours |
| Question format | 92% four-option multiple choice; 8% drag-and-drop, multi-select, hotspot |
| Passing score | 575 on a 200-720 scale |
| Exam fee | $70 |
| Remote proctoring fee | $44 when applicable |
If any of these numbers feel unfamiliar, pause and review the CHHA Study Guide 2026: How to Pass on Your First Attempt before moving on - this cheat sheet assumes you already understand the exam's basic shape.
The Six Domains at a Glance
Every scored item on the CHHA exam maps to one of six content areas. Memorizing the names and relative weight of each domain helps you triage your remaining study time.
Domain 1: Infection Prevention
Standard precautions, hand hygiene, PPE use, and preventing transmission in the home setting.
Domain 2: Direct Client Care
The largest category on the exam. Vital signs, observation, reporting changes, and hands-on care tasks.
Domain 3: Client Safety and Transfers
Body mechanics, fall prevention, safe transfer techniques, and emergency response basics.
Domain 4: Activities of Daily Living
Bathing, grooming, feeding, toileting, and mobility support that promotes client independence.
Domain 5: Special Populations
Care considerations for pediatric, geriatric, cognitively impaired, and terminally ill clients.
Domain 6: Law and Ethics
Scope of practice, client rights, confidentiality, and reporting obligations.
Because Direct Client Care carries the heaviest weight, it deserves proportionally more of your remaining review sessions. For a domain-by-domain content breakdown with sample scenarios, see the CHHA Exam Domains 2026: Complete Guide to All 6 Content Areas.
Registration and Fee Mechanics
Money and logistics trip up more candidates than content does. Keep these facts straight:
- The base exam fee is $70, paid to NCCT.
- If you test via live remote proctoring instead of an authorized test site, expect an additional $44 remote-testing fee.
- Testing happens either at NCCT-authorized physical test sites or through live remote proctoring - you choose the format at registration.
- There is no walk-in testing; you must register and schedule in advance.
A complete cost breakdown, including training and renewal expenses beyond the exam fee itself, is available in CHHA Certification Cost 2026: Complete Pricing Breakdown. If you're still finalizing your test date, cross-check the CHHA Exam Dates 2026: Testing Windows, Deadlines & Scheduling page for scheduling windows.
Key Takeaway
Budget for $70 minimum, and add $44 if you plan to test remotely rather than at a physical site - decide your testing format early so there are no surprises at checkout.
Eligibility Pathways Cheat Sheet
NCCT offers three distinct routes into the CHHA exam. Know which one applies to you before you register.
- Education pathway: Completion of an NCCT-authorized home health aide training program.
- Experience pathway: Verified recent home health aide work - either six months or 1,040 hours with multiple clients, or one year or 2,080 hours with a single client, completed within the previous five years.
- Military pathway: Qualifying recent U.S. military training in a comparable role.
The experience route's hour requirements are the detail most candidates get wrong - mixing up the "multiple clients" threshold with the "one client" threshold. For a full walkthrough of documentation and verification steps, read CHHA Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Question Format and Testing Rules
Content knowledge alone isn't enough - you need to know how questions are delivered and what's off-limits in the room.
- 92% of items are traditional four-option multiple choice.
- 8% of items use drag-and-drop, multi-select, or hotspot formats - these require you to physically interact with the screen, not just click a bubble.
- The exam includes 25 unscored pretest items mixed in with the 125 scored items, so you won't know which questions count.
- Testing is closed book.
- No scratch paper is permitted, including for vital sign math or unit conversions.
- You have three hours total to complete all 150 items.
The no-scratch-paper rule catches people off guard on questions involving temperature conversions or intake/output math - practice doing that arithmetic mentally or on-screen before test day. If you're wondering whether the exam's difficulty matches its reputation, the How Hard Is the CHHA Exam? Complete Difficulty Guide 2026 article breaks down exactly where candidates tend to lose points.
Domain-by-Domain Must-Know Facts
This section condenses the highest-yield content inside each domain so you can do a rapid final pass.
Infection Prevention Essentials
- Correct sequence for donning and removing PPE.
- Hand hygiene timing around client contact, meal prep, and toileting.
- Disinfection vs. sterilization distinctions for home equipment.
Direct Client Care Essentials
- Normal ranges and correct technique for vital signs.
- Recognizing and reporting changes in condition promptly.
- Accurate, objective documentation language.
Client Safety and Transfers Essentials
- Proper body mechanics to protect both aide and client.
- Gait belt use and safe transfer sequencing.
- Fall-risk identification and environmental hazard checks.
Activities of Daily Living Essentials
- Promoting independence rather than doing tasks for the client.
- Safe bathing, dressing, and feeding techniques.
- Skin integrity checks during ADL assistance.
Special Populations Essentials
- Adjusting communication and care approach for dementia or cognitive impairment.
- Pediatric and geriatric-specific safety considerations.
- End-of-life and hospice care basics.
Law and Ethics Essentials
- Scope-of-practice boundaries for a CHHA versus licensed nursing staff.
- Client rights, confidentiality, and mandatory reporting duties.
- Documentation as a legal record.
Final-Week Review Schedule
If your test date is close, don't try to relearn everything. Instead, sequence your remaining days around domain weight and personal weak spots.
Direct Client Care + Infection Prevention
- Review vital sign ranges and PPE sequencing
- Run timed practice sets focused on these two domains
Client Safety and Transfers + ADLs
- Rehearse transfer steps and body mechanics verbally
- Review ADL independence-promotion language
Special Populations + Law and Ethics
- Review scope-of-practice boundaries
- Study end-of-life and cognitive-impairment scenarios
Full Mixed Review
- Take one full-length timed practice exam without scratch paper
- Skim this cheat sheet once more before sleep
This kind of short-cycle spaced review works because it front-loads the domain that carries the most scored items (Direct Client Care) while still giving every domain dedicated attention before test day. For a longer-range version of this plan, see the full CHHA Study Guide 2026: How to Pass on Your First Attempt.
Recertification Rules
Passing the exam is only the start - CHHA status must be actively maintained.
- Active status renews annually.
- CHHA-only recertification requires six continuing-education contact hours plus a $40 fee per cycle.
- If you miss recertification for five consecutive years, the credential becomes invalid and you'll need to requalify from scratch.
Key Takeaway
Set a recurring annual reminder for your CE hours and $40 renewal fee - letting five consecutive years lapse means starting the entire certification process over.
Who Hires CHHAs
Understanding the job market helps contextualize why each domain matters. Home health agencies, hospice organizations, private-duty care companies, and some assisted living settings all look for the CHHA credential when screening candidates. Employers value it because it signals verified competency across infection control, safe transfers, and daily-living assistance - not just completed training hours.
If you're evaluating whether this credential fits your career goals, compare the CHHA Salary Guide 2026: Complete Earnings Analysis against the CHHA Certification Cost 2026: Complete Pricing Breakdown to weigh the investment, and read Is the CHHA Certification Worth It? Complete ROI Analysis 2026 for a fuller picture. Once certified, browse CHHA Jobs to see how the credential translates into openings.
For newcomers still asking foundational questions, resources like What Is CHHA?, CHHA Meaning, and CHHA Training fill in the background before you dive into exam-specific prep.
Before test day, run through a few more full simulations on our practice test site so the 125-item, three-hour pacing feels routine rather than stressful. And if you haven't already reviewed how the scoring scale converts to a pass/fail outcome, revisit CHHA Passing Score 2026: Exactly What You Need to Pass one more time.
Frequently Asked Questions
The exam contains 125 scored items and 25 unscored pretest items, for a total of 150 questions, with three hours allowed to complete them.
You need a scaled score of 575 on NCCT's 200-720 scale.
No. The CHHA exam is closed book and no scratch paper is permitted, so calculations must be done mentally or on-screen.
Active CHHA status renews annually and requires six CE contact hours plus a $40 fee. If you miss recertification for five consecutive years, the credential becomes invalid.
Direct Client Care is the largest content category on the exam, so it should receive the largest share of your remaining review time, followed by whichever domain feels weakest on practice tests.