Finding time to navigate the NBCRNA CPC Program isn’t anyone’s idea of a good time. To make matters worse, an abundance of misinformation only adds to the confusion.

If you want to understand the CPC Program once and for all, you’ve come to the right place. We’ll also answer the most common questions that land in our inbox and dispel the myths we see perpetuated on social media. Let’s do this!

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The 4 C’s of the CPC Program

The CPC Program supports lifelong learning for CRNAs. It consists of two 4-year cycles that repeat every 8 years. If this sounds overwhelming, you’re not alone. Let’s break it down piece by piece.

the 4 C's of the CPC Program

CPC Core Modules

Core Modules on CPC timeline

Core Modules keep your clinical practice up-to-date with the evidence-based practice trends. They avoid the lag time it typically takes for new evidence to appear in the textbooks. The modules address the four domains of Nurse Anesthesiology practice:

  1. Airway Management
  2. Applied Clinical Pharmacology
  3. Physiology & Pathophysiology
  4. Anesthesia Equipment & Technology

You’ll also earn Class A credits by completing the Core Modules – this is the NBCRNA’s way of letting you “double-dip.” This means that the more credits you earn from your Core Modules, the fewer Class A credits you’ll have to buy elsewhere (cha-ching!)

Who sells the CPC Core Modules, and what do they cost?

Only CE providers officially recognized by the NBCRNA can offer Core Modules. These CE vendors undergo a rigorous (and expensive) application process over and above the AANA application for Class A credits.

Although all vendors jump through the same hoops to obtain approval, NOT all Core Modules are created equally. When you’re considering which ones are best for you, we recommend asking the following questions:

  • What’s the quality of the content (i.e., is there an expert team behind the product)?
  • How can I consume the content (video, audio, PDF, all three)?
  • Is there prompt customer support if I need help?
  • What’s the cost-per-credit?

Most CE vendors offer all four Core Modules at a cost of around $299.

⚠️  Although vendors may charge similar prices, some give you fewer Class A credits. This is a sneaky way to make you pay a higher cost-per-credit.

APEX gives you 23 Class A credits, so you can knock out over 1/3rd of your entire Class A credit requirement when you complete our Core Modules.

Here’s the complete list of Core Module providers officially recognized by the NBCRNA. One vendor offers a Core Module in non-surgical pain management, but you only have to do it if you hold the Non-Surgical Pain Management (NSPM) credential.

When do I have to complete my Core Modules?

You must complete all four Core Modules EVERY 4-year cycle. We’ve seen several myths circulating on social media, so let’s clear these up once and for all.

Myth #1 → You can’t take the CPC Assessment until you finish all four modules (this is false). The truth is you can take the Core Modules before or after you take the CPCA.

Myth #2 →You only have to complete the Core Modules every other cycle (this is false). Here’s the history…

When the NBCRNA introduced the CPC Program in 2016, they said Core Modules were optional during the first cycle. This led some CRNAs to believe that Core Modules would always be optional in the first half of every 8-year cycle. In reality, the “optional” period only applied to CPC cycles ending on or before July 31, 2021.

Here’s the bottom line – Core Modules are required for everyone in every 4-year cycle.

How can I consume the Core Module content?

The answer depends on the vendor you choose. What would you like best? Video to get an immersive experience? Audio to learn on the go? PDFs you can read between cases? In-person on your vacation? Not all vendors offer all of these options.

We know you’re pressed for time. That’s why we give you three convenient ways to complete your Core Modules that don’t require you to use vacation days. Click each link for a quick demo:

  1. Video
  2. Audio
  3. PDF

Do I have to take a post-test with the Core Modules?

Sadly, yes. The NBCRNA has stringent rules about this that differ from other AANA-approved Class A credits:

  • You must answer ten questions for every hour of Class A credit (most other AANA-approved courses only require 5).
  • If you fail a post-test, you can’t review the answers (most other AANA-approved courses let you review your failed tests).
  • Even if you complete your modules at an in-person event, you still have to take a post-test on a computer.

You might be wondering, “if I can’t review a failed post-test, how do I know the questions are fair?” All Core Module providers must review their post-test statistics and submit the data to the NBCRNA. This process eliminates the “bad” questions, ensuring the post-tests you take are fair. Additionally, most vendors give you up to three chances to pass each post-test.

Myth #3 → If I complete my Core Modules at an in-person event, I won’t have to take a post-test (this is false). Unlike other live events where you can skip the post-test, the NBCRNA isn’t going to let you off easy. So, if the Core Module live event provides 15 Class A credits, you’ll still have to answer 150 questions on a post-test.

Myth #4 → If I pass the CPC Assessment, I don’t have to complete the Core Modules (this is false). The CPCA and Core Modules are two separate things. You have to do both – not one or the other!

➡️  Sign up for Core Modules from APEX.

CPC Assessment

CPCA on CPC puzzle timeline


Like the Core Modules, the CPC Assessment (CPCA) covers the four domains of nurse anesthesiology practice. Here’s the breakdown:

  1. Airway Management
  2. Applied Clinical Pharmacology
  3. Physiology & Pathophysiology
  4. Anesthesia Equipment & Technology

Unlike the Core Modules that teach the latest evidence, the CPCA is more of a test of book knowledge. The questions focus on clinical concepts that all CRNAs should know regardless of their practice settings. In theory, a CRNA working in a GI clinic should perform as well as a CRNA working at a tertiary care center.

These NBCRNA resources will help you get more familiar with the CPCA:

Myth #5 → The Core Modules are a review course for the CPCA (this is false). According to the NBCRNA, “Core Modules were NOT designed as a CPC Assessment preparation tool.” Having said this, you can expect some overlap between the two.

How much does the CPCA cost, and what kind of questions will I get?

Here’s an quick overview: the average cost is around $295, the assessment takes 3 hours to complete, and there are 150 questions comprised of multiple choice and multiple response (i.e. select 2)

How do I schedule the CPCA?

You must take the CPCA during your second 4-year cycle (i.e., every other 4-year cycle). You can take it at a testing center or at home with a remote proctor. Which is better is a matter of personal preference, so here are two resources to help you decide:

  1. Online through Pearson VUE
  2. In-Person at a Pearson VUE Center

Ready to schedule your CPCA? Log into the NBCRNA portal to determine eligibility and schedule your test.

You must schedule the CPCA through the NBCRNA (not a CE vendor).

Myth #6 → You can take the CPCA any time during your second 4-year cycle (this is false… mostly). You can take the CPCA anytime in the first 3.5 years of your second 4-year cycle (i.e., every 8 years). Why is this? By taking the CPCA at least 6 months before your cycle ends, you’ll have enough time to earn your remediation credits if you don’t meet the passing standard (otherwise, your license might lapse).

Update 8/2/22 → The CPCA is now available year-round, so you can schedule when it’s best for you (so long as it’s at least 6 months before your recert date).

Update 8/2/22 → The NBCRNA now provides a preliminary score report right after you complete the CPCA (it used to be a 90-day wait). You’ll get an official score report 1 – 2 business days after the NBCRNA verifies and finalizes your results.

The NBCRNA says that all CRNAs must take the CPCA at least once in its “current form.” We know they’re currently investigating alternatives, and we’ll post an update as soon as we hear something.

You should contact the NBCRNA if you have questions about the CPCA:

What happens if I “fail” the CPC Assessment?

Myth #7 → You can lose your license if you “fail” the CPCA (this is false). The CPC Assessment is NOT a pass/fail exam. Instead, it’s an assessment. Think of the CPCA as a tool to measure your knowledge of anesthesia practice.

If you’ve been a CRNA for a while, you know this wasn’t always the case. In fact, the CPCA was initially a high-stakes exam, where no pass = no practice. The CRNA community pushed back, and the NBCRNA changed the “exam” to an “assessment.” 

What happens if I don’t meet the performance standard in any of the four CPC domains?

You’ll get one attempt to meet the performance standard (you can’t take it again to get a higher score).

If you don’t meet the performance standard in any of the four domains, you’ll need to complete at least 1 additional Class A credit beyond the required 60. Let’s look at an example. A CRNA who scores below the passing standard in airway management and clinical pharmacology will need at least 1 Class A credit in each of these areas for a total of 62 Class A credits in that 4-year cycle.

So the question remains, “Should I review for the CPCA or take it cold?” While some CRNAs won’t bother reviewing, others will use the CPCA as an opportunity to brush up on the basics. Let’s face it, if you don’t use it, you lose it. Refreshing the basics is part of lifelong learning, which is one way to maintain your status as an OR rockstar™.

APEX will give you free remediation credits if you don’t meet the passing standard on the CPCA. Just email us your scores, and we’ll give you access!

➡️  Sign up for Free CPCA remediation credits (1 credit for each domain)

Class A Credits

Puzzle graphic showing CPC timeline and highlighting Class A credits. CE credits are categorized as Class A and Class B. You must earn 60 Class A credits EVERY 4-year cycle.

CE credits are categorized as Class A and Class B. You must earn 60 Class A credits EVERY 4-year cycle.

What CE activities award Class A credits?

You can earn Class A credits from online courses, live meetings, webinars, and Core Modules. Activities that award Class A credits must meet two requirements:

  1. They’re prior approved by the AANA (i.e., they have an AANA prior-approval number)
  2. They include an assessment, such as a live discussion, simulation, or post-test.

You’ll get a certificate of completion when you earn Class A credits, and many CE vendors will report your credits directly to the AANA if you’re an active member. Be careful, though. While some vendors report daily, others may only report once a month and charge a fee if you need them sooner.

If you’re not an AANA member or your vendor doesn’t report to the AANA, you’ll need to report your credits yourself. This resource will guide you through the process.

Class B Credits

Puzzle graphic showing CPC timeline and highlighting Class B credits. You must earn 40 Class B credits every 4-year cycle.

You must earn 40 Class B credits EVERY 4-year cycle.

Alternatively, you can earn additional Class A credits (beyond your required 60) to satisfy your Class B requirement. For example, a CRNA who earned 70 Class A credits only needs to complete 30 (not 40) Class B credits to satisfy the 100 total credit requirement.

What CE activities award Class B credits?

This is a bit trickier. First, Class B credits aren’t prior approved by the AANA, nor do they include an assessment. You won’t get a certificate of completion, and vendors can’t report them for you. Therefore, it’s up to you to keep accurate records of your Class B credits.

Activities that count towards your Class B requirement include research, publishing, teaching, M&M conferences, anesthesia podcasts, and mission trips.

These resources will help:

  1. Activities that award Class B credit
  2. Class B credit reporting document (this is how you’ll report your Class B credits to the AANA)

Two-Year check-in

Halfway through each 4-year cycle, the NBCRNA wants you to check in with them. It’s a free and pretty quick process where you’ll:

  1. Validate your state license(s)
  2. Confirm your practice status
  3. Update your contact info
  4. Review your progress in the CPC Program

There is no fee for the two-year check-in, and you don’t have to provide evidence of any CE activities you’ve completed at this point.

Demonstrate CPC compliance

At the end of each 4-year cycle, you’ll log into the NBCRNA portal to:

  1. Complete your application, and pay the fee.
  2. Provide documentation of current licenses to practice anesthesia (state-specific).
  3. Show you completed all components of the CPC Program.
  4. Submit a record of anesthesia practice.

If you don’t demonstrate compliance by the deadline, you’ll have to pay extra fees. Depending on how late you are, you may also have to complete additional Class A credits (beyond your initial CPC requirement).

Anyone who isn’t CPC compliant for 4 years (or longer) must complete the NBCRNA reentry program.

CPC timeline

We covered a lot of ground, and now it’s time to put the pieces together. Here’s a timeline with a quick summary of everything you need to recertify. You can get your personalized timeline by logging into the NBCRNA portal.

Graphic showcasing Continuing Education requirements for CRNAs. These requirements include the core modules, Class A credits, Class B credits and CPC assessment.

Congratulations! If you made it this far, you can fancy yourself a CPC program expert!

Get started on your CPC requirements

Did you know APEX makes it easy to get everything you need for your entire CPC cycle? If you’re ready to get started, check our out CPC Core Modules.

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Updated 9/20/2022