For Experienced Dialysis Technicians Functioning in Varied Roles

Certified Clinical Hemodialysis Technician - Advanced® (CCHT-A®)

Current CCHT Certificants, NNCCs FailSafe policy protects you. If you take, but do not pass the CCHT-A examination, NNCC will grant recertification of your CCHT credential automatically.

Three Easy Steps to Certification

  • Five (5) years of continuous employment and a minimum of 5,000 hours as a clinical dialysis technician.
  • 30 contact hours of continuing education relevant to the practice of a hemodialysis technician, within the previous three years.
    It is recommended but not required that continuing education be approved by one of the following:
    • Organizations accredited by the American Nurses' Credentialing Center — Commission on Accreditation (ANCC-COA), the credentialing body of the American Nurses Association.
    • The American Association of Critical-Care Nurses (AACN).
    • The Council of Continuing Education.
    • California, Florida, Iowa, Kansas, or Ohio State Boards of Nursing*
      • For example: The National Association of Nephrology Technicians/Technologists, which is an approved provider through the California State Board of Nursing.
  • Current national certification as a CCHT, CHT or CCNT.

*Please be aware that although programs may meet requirements set forth by other state boards of nursing, they may not meet the Nephrology Nursing Certification Commission criteria.

The applicant must be in compliance with federal and state regulations of the practice of hemodialysis patient care technicians. Applicants must meet the training and experience requirements of the CMS Conditions for Coverage for End Stage Renal Disease Facilities and of the state in which they practice.

The CCHT-A exam contains 150 questions and must be completed in 180 minutes. A correct response rate of no less than 70% is required to pass the exam.

Download the Exam Application Forms

Standard Fees

Fee Name Amount
Exam Fee
CBT 90-day Extension
Exam Rescheduling
Exam Application Processing Fee (Non-refundable, included in exam fee)
Expedited Review
Late Fee
Incomplete Application Fee
Returned Check/Cancelled Payment Fee
Duplicate Wallet Card or Certificate
Certification Validation Letter (Except to State Boards of Nursing)
  • Download our Certification Preparation Guide.
  • Determine the content of the examination from the test blueprint.
  • Read the test specifications to determine which content areas have the most "weight," because those will have the highest number of questions.
  • Review the exam reference list to familiarize yourself with material that will be included on the test.
  • Focus on areas with which you are least familiar.
  • Take the Online Practice Exam (see info below)
  • Learning strategies:
    • attend a certification review course - check with your local chapter regarding upcoming opportunities or locations may be listed on the ANNA site.
    • systematically review a nephrology nursing reference:
      • Core Curriculum for the Dialysis Technician
      • Kidney School™
      • NCS 2009 Hemodialysis Review Course
      • Kallenbach, J., Gutch, C., Stoner, M., Corea, A. Review of Hemodialysis for Nurses and Dialysis Personnel, 8th Ed. St. Louis: Mosby.
    • participate in a study group.
    • spend a day with a colleague working in an area you need to learn about.
  • Listen to the directions given prior to the examination and follow them exactly.
  • Caution: Test preparation websites offering alternative and/or shortcuts to test preparation should be avoided. Exam content is confidential and is not shared with any individuals involved in test preparation activities. "Tricks of testing" and "short cut methods for test preparation" are specifically avoided when creating this exam. We test candidates on content and not on their "test taking skills." If you have any questions about the best methods to prepare please call us at 888.884.6622. Our goal is that each exam candidate best use their time and money to reach the end result of demonstrating their excellence in nephrology patient care through certification.

The purpose of this test is to allow eligible candidates for the CCHT-A examination to practice with a test similar in content and format developed using the same process as that used in the actual CCHT-A test development. However, no questions on the CCHT-A practice exam will be on the actual CCHT-A exam.

The CCHT-A practice exam contains 50 questions and has 90-minute time limit. The fee for the exam is $30 per attempt. All questions should be answered; you will not be penalized for guessing. Once the CCHT-A practice exam is completed, all questions and rationale for the correct response will be displayed for review. Taking the CCHT-A practice exam is not required and does not guarantee a similar result on the CCHT-A exam.

Your credit card payment will be processed on-line and you will be granted immediate access to the CCHT-A Practice Exam. When entering the CCHT-A Practice Exam, the examinee will be presented with one question at a time with four responses to choose from. The examinee should select the single best response to that question and then select “NEXT” to save that answer and move to the next question, while still having the ability to come back to that question for further review.

When all questions are completed, the examinee should then choose to “END”. You will be presented with a “Test Summary” indicating which items have responses and which do not. When you are satisfied with your responses, select “Submit test”. A score will be given and each question with the selected response and rationale will be displayed. If you choose to take the exam at another time (for the same fee), the experience will vary but the questions will be the same.

To purchase the CCHT-A Practice Exam, please read the Terms of Agreement and click the appropriate button below.

I Have Read and Accept the Terms    I Don't Accept the Terms

Online Practice Exam

Fee Name Amount
Online Practice Exam

Core References

  • Centers for Medicare and Medicaid Services (CMS). End-Stage Kidney Disease Program Interpretive Guidance Version 1.1

    View Online

  • Kallenbach, J.Z. (2016). Review of hemodialysis for Nurses and Dialysis Personnel, 9th ed.  St. Louis, MO: Elsevier/Mosby.
  • Medical Education Institute, Inc. (2012). Core curriculum for the Dialysis Technician: A Comprehensive Review of Hemodialysis, 5th ed.  Madison, WI: MEI.

Emotional Preparation

  • Moderate anxiety is normal and may be helpful - you may be more alert and open to learning; however too much anxiety is detrimental and will interfere with learning and test-taking.
  • Study and prepare for the examination so that you feel confident.
  • Think positively - you possess a wealth of experience and the examination will allow you to demonstrate that knowledge.
  • Use anxiety-reducing strategies:
    • relaxation response.
    • guided imagery.
    • exercise.
    • prayer.
  • Even though some test takers may finish the exam early, use as much of the allotted time as you need to think through and answer the questions.

Physical Preparation

  • Get a good night's sleep.
  • Eat before the examination - those gray cells will have glucose available when you're answering questions.
  • Gather all the materials you need to take the test the night before the exam:
    • government-issued photo ID.
    • nursing license.
    • examination permit.
    • sweater or jacket in case the room is cool.
  • Allow plenty of time to arrive early.
  • If you are distracted by other candidates during the test or leaving to use the rest room, select a seat at the front of the room where you will be less likely to notice the other candidates.

Tips on Answering Examination Questions

  • Read the questions carefully and focus on key words in the question such as "first", "most likely", "most important", "best". These words are usually printed in boldface type to attract your attention.
  • As you read the question, anticipate the correct answer.
  • Read each of the four choices carefully. Even if the first option sounds correct, read all options before choosing the answer.
  • Do not "read into" the question. Answer the question based only on the information presented, even if you think the answer is too obvious or too easy.
  • Do not be afraid to change an answer. Research has shown that more often than not, test takers change answers to the correct one.
  • Do not spend too much time on any one question. Make a note of the questions of which you are uncertain and return to them later if you have time.
  • If you are unsure about one of the content areas, you may find it helpful to complete the other areas first and leave the problem area for last.

I am CCHT certified. Can I recertify as a CCHT-A?

No. The CCHT-A credential can only be obtained by taking and passing the CCHT-A certification examination.

What is the difference between the CCHT and the CCHT-A?

The CCHT-A is an advanced credential for technicians that are working in an advanced dialysis technician level of practice, ie. precepting new technicians, for a minimum of 5 years and 5000 hours.  The CCHT is an entry level certification credential.

How will I benefit from obtaining the CCHT-A certification credential?

The CCHT-A shows that you are working at an advanced level of practice and have proven your knowledge and skills by passing the CCHT-A examination. The biggest benefit of this credential may be personal satisfaction. There may be benefits offered by your employer for earning this credential, this would need to be discussed with your employer.