How Hard Is the NHA CET Exam? 70.45% Pass Rate, 390/500 Cut Score

As of November 2026, about 7 in 10 National Healthcareer Association (NHA) Certified EKG Technician (CET) exams end in a pass. NHA’s 2025 pass rate report (revised January 9, 2026) lists a 70.45% pass rate across 23,429 CET exams administered in 2025, up from 69.66% across 19,241 exams in 2024. NHA counts examinations administered and does not separate first attempts from retakes, so the rate is a share of exams, not of people. The passing standard is a scaled score of 390 on NHA’s 200 to 500 scale, shared by all NHA exams. The CET has 120 items in 2 hours: 100 scored items plus 20 unscored pretest items you cannot identify, which works out to 1 minute per item. EKG Acquisition carries 44 of the 100 scored items, Safety, Compliance, and Coordinated Patient Care carries 32, and EKG Analysis and Interpretation carries 24. If you do not pass, NHA allows 3 attempts with at least 30 days between them, then a 1 year wait. Roughly 3 in 10 sittings do not pass, so the CET is a moderately selective exam, and the difficulty comes from breadth and pace rather than from any single topic.

Figures current as of November 2026, from NHA’s 2025 Pass Rates report (revised January 9, 2026), the CET Test Plan, and the NHA Candidate Handbook (updated October 5, 2026).

What the Published Pass Rates Show

NHA publishes an annual pass rate table covering all of its exams. For the CET, the table lists the number of exams administered, the percentage passing, and the number of currently active certifications. It does not separate first attempts from retakes, so the rate is a share of exams, not a share of people. If retakes are counted as separate exams, a candidate who fails once and passes on a second try appears as one failed exam and one passed exam.

The CET sits about 7 points below the CPT and about 11 points below the CCMA in 2025, so among the three it is the hardest by NHA’s own published rates. The CET rate moved less than 1 point between 2024 and 2025 while the number of exams grew from 19,241 to 23,429, which suggests the exam is stable rather than getting easier or harder. NHA also reports 40,366 currently active CET certifications as of December 31, 2025.

What a 390 Scaled Score Means

NHA scores every exam on a 200 to 500 scale and sets the passing score at 390 for all of its exams. NHA does not publish the number of correct answers that corresponds to 390 on the CET, so converting it to a percentage would be a guess, and this guide does not offer one. What the Candidate Handbook does say is that the score report posts to your NHA account and shows your score, a pass or fail result, and diagnostic information for each major content area of the exam. If you fail, that content area feedback is the most useful data you get, since it shows which of the three domains cost you the most.

Where the Difficulty Comes From

The CET test plan is based on a 2017 job analysis, and as of November 2026 NHA’s current test plan still carries that date. It splits the 100 scored items across three domains.

Breadth across three skill sets. EKG Acquisition is the largest domain at 44 items. It covers equipment upkeep, verifying machine settings, skin preparation, patient positioning, electrode and lead placement for several test types, and finding and fixing artifacts on a tracing. The Safety, Compliance, and Coordinated Patient Care domain adds 32 items on privacy rules, infection control, scope of practice, communication, vital signs, stress testing and ambulatory monitor instruction, electronic records, and recognizing cardiopulmonary compromise. Together those two domains account for 76 of the 100 scored items, so a candidate who studies only rhythms leaves most of the exam uncovered.

Rhythm analysis in a smaller slice. EKG Analysis and Interpretation is the smallest domain at 24 items, but it is where heart rate calculation, interval measurement, arrhythmias, heart blocks, and ischemia patterns live. Each of those items asks you to read a tracing or apply a measurement, which takes longer than recalling a definition.

Pace. At 120 items in 120 minutes, you have 1 minute per item, with no way to identify which 20 items are the unscored pretest questions. All NHA exams run in a single continuous session, so you cannot pause and return later.

Candidates arrive trained. NHA requires a high school diploma or GED (the training pathway also accepts candidates scheduled to earn one within 18 months) plus evidence of at least 10 EKGs performed on live individuals, as of November 2026. The two pathways are an EKG training program completed within the last 5 years, or supervised EKG work experience of 1 year within the last 3 years or 2 years within the last 5 years. That means the 70.45% rate comes from people who have already handled the equipment, not from newcomers. Plan your study time against the 44, 32, and 24 item split above rather than evenly across topics.

How and Where You Take It

Per NHA, the CET is taken at your school, at a PSI testing center, or through Live Remote Proctoring (LRP) from a location you choose. NHA selects the LRP provider for you at registration, and LRP requires internet service that supports Voice over Internet Protocol (VoIP) plus a compatible computer. Score reports for exams taken at PSI or through LRP post to your NHA account within 48 hours; exams taken at your institution show a preliminary report immediately, which NHA stresses is not final. NHA lists the exam fee on its website store and in your account at scheduling, not in the Candidate Handbook, so confirm the current price there before you register. See also our guides to how much the CET exam costs and what to bring to the CET exam.

If You Do Not Pass

As of November 2026, the Candidate Handbook allows 3 attempts, with a minimum wait of 30 days between attempts. After a third non-passing attempt, you must wait 1 year. Each retake requires logging in to NHA as a returning candidate, scheduling again, and paying the full exam price. NHA also notes that retake exams are unlikely to be identical to the one you took, and that performance levels in a content area do not guarantee the same result on a retake. If you tested under an institution’s Pre-Externship Route, you have 90 days from the exam date to finish the externship and have your institution notify NHA, or the score is voided and you must retake the exam. For wait periods and attempt limits, see our guide to what happens if you fail the CET exam.

The fastest way to learn whether you are on track is to measure it. Try a free CET practice test to see which of the three domains needs work, then get full access to CET practice questions weighted to the 44, 32, and 24 item split.

Frequently Asked Questions

What is the pass rate for the NHA CET exam?

NHA’s 2025 pass rate report lists a 70.45% pass rate for the Certified EKG Technician (CET), based on 23,429 exams administered in 2025. The 2024 report lists 69.66% across 19,241 exams. NHA’s figures count all exams administered, not only first attempts.

What score do you need to pass the CET?

A scaled score of 390 on a 200 to 500 scale. NHA uses the same 390 passing score for all of its exams and does not publish a raw count of correct answers for the CET.

How many questions are on the CET exam?

120 items in 2 hours: 100 scored items and 20 unscored pretest items. The scored items are split 44 for EKG Acquisition, 32 for Safety, Compliance, and Coordinated Patient Care, and 24 for EKG Analysis and Interpretation.

How many times can you retake the CET?

As of November 2026, you can take it 3 times, with at least 30 days between attempts, then you must wait 1 year after a third non-passing attempt. Every retake requires re-registering and paying the full exam price.

Sources

• NHA, 2025 Pass Rates for NHA Examinations (revised January 9, 2026)
• NHA, 2024 Pass Rates for NHA Examinations (revised January 8, 2025)
• NHA, Certified EKG Technician (CET) Test Plan
• NHA, Candidate Handbook (updated October 5, 2026)
• NHA, Certified EKG Technician (CET) certification page

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