Short answer
- Complete a state-approved nurse aide training program. Federal rules require at least 75 hours, including 16 hours of supervised practical training (42 CFR 483.152). 27 of the 46 states that publish a figure require more; Missouri requires the most, 175 hours.
- Pass your state’s competency exam, usually a written (or oral) test and a skills test. Where states publish a total, it ranges from $60 (Alaska) to $216 (Hawaii), with a median of $135.
- Get listed on the state nurse aide registry. You must be on it to work in a nursing home (BLS).
- Keep it active, usually by working at least 8 paid hours as a nurse aide every 24 months. Some states ask for far more.
“CNA license” is the common phrase, but what you actually get is a listing on your state’s nurse aide registry. The steps are the same everywhere; the hours, fees and renewal rules are not. This guide explains the steps and then lists the rules for all 50 states and DC, taken from the state agencies and their testing vendors on September 22, 2026. Always confirm with your state’s registry before you enroll; programs and fees change.
Step 1: Training
A state-approved nurse aide training program has to “consist of no less than 75 clock hours of training” and “include at least 16 hours of supervised practical training,” meaning you practice tasks on real people under the direct supervision of an RN or LPN. You also need at least 16 hours of instruction before any direct contact with a resident, covering communication, infection control, safety and emergency procedures, residents’ independence and residents’ rights (42 CFR 483.152).
States can add to that minimum, and most do:
| Minimum training hours | States (of 46 with a published figure) |
|---|---|
| 75 (the federal minimum) | 19 |
| more than 75 | 27 |
| highest | Missouri 175, California 160, Alaska 140, Virginia 140, Maine 130 |
How long does CNA training take? The program hours set the pace. A 75-hour program can fit into a few weeks of full-time classes; a 160- or 175-hour program takes longer. Schools set their own schedules, so ask the program for its calendar. Training tuition is set by the school and isn’t part of the exam fees below.
Step 2: The competency exam
After training you take your state’s competency exam. In most states it has two parts: a written or oral knowledge test and a skills test where you perform tasks in front of an evaluator. States contract the exam out to vendors such as Credentia, Prometric, Headmaster (D&S Diversified Technologies) or run it themselves. The state tables below show who runs it in your state and what it costs.
A few states work differently: in Idaho, South Dakota and Washington the skills part happens inside the training program, and in Minnesota, North Dakota and Oklahoma the test sites set their own fees.
Step 3: The registry
Passing the exam puts you on the state nurse aide registry. The Bureau of Labor Statistics puts it plainly: nursing assistants who pass “are placed on a state registry. They must be on the state registry to work in a nursing home” (BLS). Employers check the registry, and you can look yourself up using the registry link for your state below.
If you later move, you’ll apply to the new state’s registry. See our CNA reciprocity guide for the rules in each state.
Step 4: Keeping your certification active
Most states renew every two years and ask for proof of paid nurse aide work, typically at least 8 hours in the 24-month period. The exceptions are where people get caught out:
- Much higher work requirements: Vermont (400 hours in two years), New Hampshire and Utah (200 hours), Alaska (160 hours), Delaware (64 hours), Michigan and Nevada (40 hours).
- Continuing education on top: for example California (48 hours of in-service training per two years), Texas and Florida (24 hours), Michigan (12 hours a year), Rhode Island and South Dakota (12 hours a year).
- Yearly renewal: Virginia and Washington.
- No renewal cycle at all: Illinois and Nebraska keep you active as long as you do paid nurse aide work at least once every 24 months; Iowa’s certification doesn’t expire.
If your certification lapses, many states require you to retake the exam, and some require retraining.
State-by-state requirements
Jump to your region: Northeast (CT, ME, MA, NH, NJ, NY, PA, RI, VT) · Midwest (IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI) · South (AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV) · West (AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY)
Northeast
| State | Minimum training hours | Exam provider | Exam fee (total) | Renewal | Official source |
|---|---|---|---|---|---|
| Connecticut | 100 | Prometric | $125 | Every 2 years; one 8-hour paid shift; free | registry |
| Maine | 130 | not named by the state | not published | Every 2 years; 8 hours; free | registry |
| Massachusetts | 75 | Headmaster | $100 | Every 2 years; 8 consecutive paid hours | registry |
| New Hampshire | 100 | Excel Testing | $200 | Every 2 years; 200 hours + 24 CE hours; $66 | registry |
| New Jersey | 90 | PSI (written) + Headmaster (skills) | $84 | Every 2 years; 7 paid hours + background check; $36 | registry |
| New York | 100 | Prometric | $115 | Every 2 years; 7 paid hours; $40 (paid by employer) | registry |
| Pennsylvania | 80 | Credentia | $135 | Every 2 years; one 8-hour paid day | registry |
| Rhode Island | 120 | Credentia | $165 | Every 2 years (June 30); 8 work hours + 12 in-service hours a year; $35 | registry |
| Vermont | 75 | Excel Testing | $200 | Every 2 years; 400 hours (50 days); $65 | registry |
Midwest
| State | Minimum training hours | Exam provider | Exam fee (total) | Renewal | Official source |
|---|---|---|---|---|---|
| Illinois | 120 | SIU Carbondale (written only) | $85 | No renewal; inactive after 24 months without paid work | registry |
| Indiana | 75 | Ivy Tech | $100 | Every 2 years; 8 hours; free | registry |
| Iowa | 75 | Headmaster (written); community colleges (skills) | $165 | No expiration; 8 paid hours in 2 years keeps you active | registry |
| Kansas | 90 | state test (KDADS) | not published | Every 2 years; 8 hours in 2 years | registry |
| Michigan | 75 | Headmaster | $175 | Every 2 years; 40 paid hours + 12 CE hours a year; $40 | registry |
| Minnesota | 75 | Headmaster (fees set by test sites) | not published | Every 2 years; 8 paid hours; free | registry |
| Missouri | 175 | Headmaster | $135 | Every 2 years; 8 consecutive paid hours; $20 | registry |
| Nebraska | 75 | state-approved test sites | not published | No renewal; stays active with paid work within 24 months | registry |
| North Dakota | 75 | Headmaster (fees set by test sites) | not published | Every 2 years; 8 paid hours; free | registry |
| Ohio | 75 | Headmaster | $120 | Every 2 years; 7.5 consecutive paid hours (or 8 within 48 hours) | registry |
| South Dakota | 75 | Headmaster (knowledge test); skills in training | not published | Every 2 years; 12 paid hours + 12 in-service hours a year | registry |
| Wisconsin | 75 | Headmaster | $144.7 | Every 2 years; 8 paid hours under RN or LPN supervision | registry |
South
| State | Minimum training hours | Exam provider | Exam fee (total) | Renewal | Official source |
|---|---|---|---|---|---|
| Alabama | not verified | Credentia | $135 | Every 2 years; 8 paid hours in 24 months in listed settings | registry |
| Arkansas | 90 | Headmaster | $125 | Every 2 years; 8 paid hours in 24 months | registry |
| Delaware | not verified | Prometric | $115 | Every 2 years; 64 paid hours + 24 CE hours | registry |
| District of Columbia | 125 | Credentia | $165 | Every 2 years; 8 paid hours + 24 CE hours | registry |
| Florida | 120 | Prometric | $155 | Every 2 years; 24 in-service hours; lapses after 24 months without paid work; $50 | registry |
| Georgia | 85 | Credentia | $130 | Every 2 years; 8 paid hours under nurse supervision; free | registry |
| Kentucky | 75 | KCTCS | $135 | Every 2 years; 8 paid hours | registry |
| Louisiana | 80 | Prometric | $125 | Every 2 years; 8 paid hours | registry |
| Maryland | 100 | Credentia or Headmaster | $130 | Every 2 years; 16 paid hours; $40 | registry |
| Mississippi | not verified | Headmaster | $135 | Every 2 years; 8 consecutive paid hours | registry |
| North Carolina | 75 | Credentia | $140 | Every 2 years; 8 paid hours under RN supervision; free | registry |
| Oklahoma | 75 | state CareerTech program (fees set by test sites) | not published | Every 2 years; 8 paid hours (sworn statement); free | registry |
| South Carolina | 100 | Credentia | $140 | Every 2 years; 8 paid hours; $35 | registry |
| Tennessee | 75 | Credentia | $122 | Every 2 years; 8 hours | registry |
| Texas | 100 | Prometric | $120 | Every 2 years; paid work + 24 in-service hours | registry |
| Virginia | 140 | Credentia | $140 | Every year; paid work in the last 2 years; $30 | registry |
| West Virginia | 120 | PHD LLC | $140 | Every 2 years; 8 paid hours under RN supervision | registry |
West
| State | Minimum training hours | Exam provider | Exam fee (total) | Renewal | Official source |
|---|---|---|---|---|---|
| Alaska | 140 | Credentia | $60 | Every 2 years; 160 paid hours + 24 CE hours; $100 | registry |
| Arizona | not verified | Headmaster | $130 | not verified | registry |
| California | 160 | several approved vendors | not published | Every 2 years; paid work + 48 in-service hours | registry |
| Colorado | 75 | Credentia | $145 | 8 paid hours in 24 months (cycle not verified) | registry |
| Hawaii | 100 | Prometric | $216 | Every 2 years; 8 paid hours | registry |
| Idaho | 120 | Prometric (written); skills at training sites | not published | Every 2 years; 8 paid hours; free | registry |
| Montana | 75 | Headmaster | $97 | not stated on the state page | registry |
| Nevada | 75 | Headmaster (switching from Credentia) | $165 | Every 2 years; 40 hours + 24 CE hours; $50 | registry |
| New Mexico | 75 | Headmaster | $140 | Every 2 years; 8 consecutive paid hours; $25 | registry |
| Oregon | 105 | Headmaster | $106 | Every 2 years; no work hours; 2 CE hours every 4 years; $60 | registry |
| Utah | 100 | state exam (UNAR) | $110 | Every 2 years; 200 paid hours | registry |
| Washington | 108 | Credentia (knowledge test); skills in training | not published | Every year; no work-hour or CE rule; $95 | registry |
| Wyoming | not verified | Headmaster | $127 | Every 2 years (even years); 400 hours, 40 CE hours or a passed exam; $50 | registry |
“Not published” means the state or its vendor doesn’t publish the figure on its official pages, often because test sites set their own prices. Sources: the state registry, health department or board of nursing and the state’s testing vendor. The full dataset with a source for each value is behind these tables; where an official site blocked access, we used archived copies of the same page. Alabama’s training hours and most of Arizona’s rules could not be verified.
What the job pays
The BLS reports a 2025 median pay of $42,260 a year ($20.13 an hour) for nursing assistants and orderlies, about 1.56 million jobs, and 3% projected growth from 2025 to 2035 (BLS). If you’re thinking beyond CNA, our CNA vs LPN vs RN comparison shows the next steps.
Frequently asked questions
What is CNA certification?
It’s your listing on a state nurse aide registry after completing a state-approved training program and passing the state’s competency exam. It lets you work as a nurse aide, including in nursing homes.
How long does it take to become a CNA?
It depends on your state’s training hours (75 to 175 hours among states that publish a figure) and on the program’s schedule, plus the time to book and pass the exam.
How much does the CNA exam cost?
Among states that publish a total, from $60 in Alaska to $216 in Hawaii, with a median of $135. Training tuition comes on top.
Do I need to renew my CNA certification?
In most states, yes, every two years, usually with proof of at least 8 paid work hours. Virginia and Washington renew yearly; Illinois, Iowa and Nebraska work differently (see above).
Is a CNA certification valid in every state?
No. It’s a state credential. To work in another state you apply for reciprocity there.
How we checked this. We read the official page or candidate handbook for every state on September 22, 2026, and the federal rule in the Code of Federal Regulations. Each value in our dataset has a source link and a quote. Fees and rules change often; your state’s registry has the final word. Certificate Quest is not affiliated with any state agency, school or testing vendor and earns nothing from links on this page. This is general career information, not legal advice.