The Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC) certification exam measures the entry-level clinical knowledge and skills needed to provide advanced psychiatric and mental health care across the lifespan. The current ANCC exam contains 175 questions covering scientific foundations, advanced practice skills, diagnosis and treatment, psychotherapy, and ethical, legal, and culturally responsive care.
What Happened to the Adult Psychiatric-Mental Health NP Exam?
The former Adult Psychiatric-Mental Health Nurse Practitioner certification is no longer available for initial certification. ANCC now lists that credential as renewal only.
New candidates seeking psychiatric-mental health nurse practitioner certification take the current:
Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification — PMHNP-BC
This is the current ANCC board certification examination for new PMHNP candidates.
The current certification was formerly known as the Family Psychiatric-Mental Health Nurse Practitioner certification and covers psychiatric-mental health care across the entire lifespan rather than adults alone.
If you already hold the retired Adult PMHNP certification: ANCC still allows you to renew it. The exam information on the rest of this page applies to new candidates taking the current Across the Lifespan PMHNP-BC certification exam.
What Is the PMHNP-BC Certification?
The Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) certification is administered by the American Nurses Credentialing Center (ANCC).
The certification is designed for advanced practice nurses prepared to assess, diagnose, and treat psychiatric and mental health conditions in patients ranging from infancy through older adulthood.
PMHNP practice can include psychiatric assessment, diagnosis, psychopharmacology, psychotherapy, crisis intervention, health promotion, patient education, and collaboration with other healthcare professionals.
Who Is Eligible for the PMHNP-BC Exam?
To qualify for initial PMHNP-BC certification, you must meet ANCC’s current licensure, graduate education, coursework, clinical, and psychotherapy-training requirements.
RN License
You must hold a current, active RN license in a U.S. state or territory or the legally recognized professional equivalent in another country.
PMHNP Graduate Education
You must complete a Psychiatric-Mental Health Nurse Practitioner Across the Lifespan:
Master’s degree
Post-graduate certificate
Doctor of Nursing Practice (DNP)
The program must meet ANCC’s current accreditation requirements through CCNE, ACEN, or CNEA.
2026 post-graduate certificate rule: For post-graduate certificate applicants, ANCC now requires the post-graduate APRN certificate program itself to meet the applicable accreditation requirement. Accreditation of a related master’s or DNP program cannot be substituted for accreditation of the certificate program.
Required APRN Core Courses
Your graduate program must include separate, comprehensive courses in:
Advanced physiology/pathophysiology across the lifespan
Advanced health assessment of human systems using advanced assessment techniques
Advanced pharmacology, including pharmacodynamics, pharmacokinetics, and pharmacotherapeutics
The program must also include health promotion or maintenance and differential diagnosis and disease management using pharmacologic and nonpharmacologic interventions.
Clinical and Psychotherapy Training
Your PMHNP program must include:
500+
Faculty-supervised clinical hours in the PMHNP role and population.
2+ modalities
Clinical training in at least two psychotherapeutic treatment modalities.
ANCC currently requires at least 500 faculty-supervised clinical hours. Work experience does not substitute for the required program clinical hours.
PMHNP-BC Exam Format
The exam contains 175 questions. Of these, 150 contribute to your score and 25 are unscored pretest questions.
Pretest questions are being evaluated for possible use on future exams. They are mixed throughout the examination and cannot be identified, so treat every question as though it is scored.
What’s on the PMHNP-BC Exam?
The current ANCC test content outline became effective April 28, 2023 and contains five major domains.
| Content Domain | Scored Questions | Weight |
|---|---|---|
| Scientific Foundation | 33 | 22% |
| Advanced Practice Skills | 41 | 27% |
| Diagnosis and Treatment | 33 | 22% |
| Psychotherapy and Related Theories | 17 | 11% |
| Ethics, Legal Principles, and Cultural Care | 26 | 17% |
The displayed percentages total 99% because ANCC rounds the individual domain percentages.
Scientific Foundation – 22%
This domain contains 33 scored questions and covers the scientific knowledge underlying advanced psychiatric practice.
Topics include:
Advanced pathophysiology
Advanced pharmacology
Advanced psychopharmacology
Neurodevelopment
Neuroanatomy and neurophysiology
Psychogenomics, including gene-drug interactions and heritability
Advanced physical assessment
Advanced Practice Skills – 27%
This is the largest individual domain, with 41 scored questions.
You should be prepared to apply skills involving:
Clinical interviewing and motivational interviewing
Health promotion and disease prevention
Selecting and interpreting mental health screening tools
Mental status examinations
Psychiatric emergency management
Psychoeducation
Recovery and resilience promotion
Risk assessment
Selecting and interpreting substance-use screening and withdrawal-assessment tools
Know common screening tools in context. The current outline specifically identifies examples such as the PHQ-9, GAD-7, Vanderbilt ADHD scales, AUDIT, DAST, CIWA, and COWS. Be prepared to recognize when a tool is appropriate and how its results affect the next clinical step.
Diagnosis and Treatment – 22%
This domain contains 33 scored questions.
Topics include:
DSM-5-TR diagnostic criteria
Complementary and alternative treatments
Diagnostic and laboratory test selection and interpretation
Diagnosis and differential diagnosis
Evidence-based medication dosing and treatment selection
Selecting appropriate psychotherapy
Psychopharmacologic and general pharmacologic management and monitoring
Psychotherapy and Related Theories – 11%
This domain contains 17 scored questions.
You should understand major psychotherapy and behavioral theories, including:
Cognitive behavioral therapy
Humanistic approaches
Interpersonal and behavioral approaches
Change theories
Developmental theories
Family theories
Developing and maintaining a therapeutic alliance, including empathy, boundaries, trauma-informed practice, and psychotherapy facilitation
Ethics, Legal Principles, and Cultural Care – 17%
This domain contains 26 scored questions covering professional responsibilities and patient-centered psychiatric care.
Topics include:
Patient rights and informed consent
Confidentiality, release of information, and duty to warn
Psychiatric-mental health nursing scope and standards
Cultural and spiritual competence
Social determinants of mental health and barriers to care
Equity, diversity, and inclusion
Ethical decision-making, involuntary treatment, capacity, and least-restrictive care
Patient advocacy and educational or disability accommodations
What Ages Are Covered?
Unlike the retired Adult-only certification, the current PMHNP examination covers psychiatric-mental health care across the lifespan.
How Much Does the PMHNP-BC Exam Cost?
| Applicant | Initial Fee |
|---|---|
| Nonmember | $395 |
| American Nurses Association Member | $295 |
| American Association of Nurse Practitioners Member | $340 |
| AANP Student Member | $290 |
| American Psychiatric Nurses Association Member | $220 |
| ISPN Member | $340 |
The listed application fees include a $140 nonrefundable administrative fee. Additional fees can apply for optional services.
How Do I Apply?
1. Confirm your eligibility.
Verify that your RN license, PMHNP program, graduate coursework, clinical hours, and psychotherapy training meet current ANCC requirements.
2. Submit the ANCC application.
Complete the initial certification application and pay the applicable fee.
3. Upload required documentation.
This includes licensure, clinical-hour documentation, and transcripts related to your APRN education.
4. Receive Authorization to Test.
After ANCC determines that you are eligible to test, you receive authorization and scheduling instructions.
5. Schedule with Prometric.
Select an available testing center and appointment during your authorization period.
Can I Test Before Graduation?
Possibly. ANCC may authorize a candidate to take the exam after all required coursework and faculty-supervised clinical hours are complete but before the degree or certificate is formally conferred.
However, passing the examination does not make you certified until ANCC receives and approves the final official transcript showing the qualifying degree or certificate was awarded.
How Long Is the Testing Window?
The current ANCC testing window is 120 days.
Once you receive authorization, you must schedule and complete the examination within your assigned testing period.
Where Is the PMHNP-BC Exam Taken?
ANCC certification examinations are offered year-round through Prometric testing centers.
Once you receive authorization to test, use the Prometric scheduling system to choose an available location, date, and time.
How Is the PMHNP-BC Exam Scored?
ANCC first determines your raw score based on the number of scored questions you answer correctly. The raw result is then converted to a scaled score with a maximum of 500.
Passing score: 350. You must earn a scaled score of at least 350 to pass the PMHNP-BC examination.
A score of 350 does not mean that you answered exactly 70% of the scored questions correctly. ANCC uses a scaled scoring process, so the reported score should not be treated as a percentage.
Examination results are reported as pass or fail. Candidates who do not pass also receive their scaled score and diagnostic information for the major content areas.
When Will I Get My Results?
You can access your examination result after completing the exam through Prometric’s score-reporting system. Prometric sends instructions for accessing the report after your examination.
Prometric then reports your result to ANCC within approximately 24–48 hours.
What If I Don’t Pass?
If you do not pass, you must wait at least 60 calendar days from the previous test date before taking the examination again.
You may take the same ANCC certification exam no more than three times during any 12-month period.
A retest requires a new application, applicable fees, and continued compliance with the eligibility requirements in effect when you reapply.
How Long Is PMHNP-BC Certification Valid?
PMHNP-BC certification is valid for five years.
To continue using the credential, you must maintain appropriate professional licensure and complete the ANCC renewal requirements in effect when your certification is due for renewal.
How Can I Prepare for the PMHNP-BC Exam?
The current exam emphasizes clinical application. You should be able to combine psychiatric assessment findings, diagnostic criteria, risk information, medications, psychotherapy principles, ethical considerations, and patient characteristics to make appropriate clinical decisions.
PMHNP Study Checklist
Review advanced pathophysiology, neuroanatomy, neurophysiology, neurodevelopment, and psychogenomics.
Know major psychotropic drug classes, indications, adverse effects, interactions, monitoring requirements, and serious reactions.
Practice mental status examinations, clinical interviewing, suicide and violence risk assessment, and psychiatric emergency management.
Review DSM-5-TR diagnostic criteria and practice differentiating conditions with similar presentations.
Know when common mental health, substance-use, and withdrawal assessment tools are appropriate.
Review major psychotherapy approaches, developmental theories, change theories, and family theories.
Study confidentiality, informed consent, duty to warn, involuntary treatment, capacity, professional boundaries, and patient rights.
Prepare for psychiatric care across the full lifespan rather than studying only adult disorders and treatment.
Complete timed practice so you are comfortable answering 175 questions within 3.5 hours.
PMHNP Study Resources
PMHNP-BC™ is a certification credential of the American Nurses Credentialing Center (ANCC). ANCC is not affiliated with StudyGuideZone or Mometrix Test Preparation and does not endorse these products or services.
