Certified Cardiovascular Knowledge Examination

The CCKE Registration for the May 2 – 5 Exam is Open!
Select the Apply Now button to begin the registration process.

Scores are available in the Exam HUB for Nov. 2023 examinees. For additional questions, email ccke-nppa@acc.org.

Apply Now for the May CCKE
Apply Now for the Sept. CCKE
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(for approved applicants and previous CCKE examinees only)

Access the Professional Associate Recommendation for my application here!

Do you plan to take the CCKE this May? Please review the CCKE application instructions before submitting your application materials and the CCKE exam checklist for tips on how to prepare.

Demonstrate your clinical knowledge and commitment to cardiovascular excellence by taking and passing ACC's Certified Cardiovascular Knowledge Examination (CCKE). Your successful participation allows you to:

  • Validate your clinical knowledge
  • Uphold standards of excellence in patient care
  • Demonstrate your commitment to optimizing cardiovascular care and outcomes
  • Achieve recognition with colleagues and patients
  • Earn credit towards your path to becoming an FACC and AACC
  • Strengthen professional accomplishments for career advancement & enhance professional reputation
  • Contribute your expertise and ability to provide excellence in patient care as a member of the CV team

Click the arrows below to learn more about the exam.

The CCKE is a comprehensive test of your clinical cardiovascular knowledge and is designed for a more experienced NP or PA clinician; it is not intended for someone newly out of training. To be eligible to participate, you need to have accrued a minimum of 2,000 hours in cardiovascular medicine in the last 3 years, with a portion of that time spent in direct cardiovascular patient care.

What Do I Need to Submit When I Apply For the CCKE?

As part of the online application, you will:

  • Submit your current license with date of expiration.
  • Provide information about your cardiovascular medicine experience.
  • Submit a professional associate recommendation using one of the two template options below.

For any questions regarding the application process, please email us at ccke-nppa@acc.org.

  • Validate your eligibility for participation in the Program by reviewing the list above.
  • Apply for the Program online and submit proof of eligibility. You'll learn if your application has been accepted in approximately 4 – 6 weeks.
  • Prepare for your exam.
  • Verify that your system is compatible with ACC's exam delivery system by taking a brief sample exam and reviewing the resources in the CCKE Exam Hub.
  • Take the exam.
  • Learn your score 1 – 2 months after the exam.
  • Celebrate your success!

The Certified Cardiovascular Knowledge Examination is administered online twice a year during a four-day testing window. The exam may be taken from your home or office; there is no need to travel to a testing center. You will have 7.5 hours to answer CCKE questions. There is an optional 24 hours offered which can be taken between sections. During the testing window, the exam is available 24 hours a day and remains open until 11:59 p.m. ET on the last day.

To take the CCKE, you must have:

  • A private space that is free from disruptions for the time allotted for the assessment.
  • Reliable internet access.
  • The devices and browsers outlined in the table below:
  Do Use Do NOT Use
Device Laptop
Browser Chrome
Internet Explorer

The Certified Cardiovascular Knowledge Examination is developed, evaluated, and approved by subject matter experts and psychometricians to ensure that it provides a fair and reliable estimate of proficiency.

Prior to the exam, questions are written by cardiovascular NP and PA experts trained in effective question writing. The questions undergo a rigorous review process to ensure that each question is fair, clinically accurate, and relevant. The questions are also aligned to the 2020 ACC Clinical Competencies for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine document which identifies the knowledge and skills necessary for NPs and PAs practicing in cardiovascular medicine. The questions selected for inclusion on the examination must be of good quality and meet statistical and content specifications.

Following each exam administration, questions are evaluated based on their statistical properties. Questions that do not meet statistical criteria are reviewed by a committee prior to scoring the exam. Any question deemed as flawed or inappropriate is removed from scoring. The final scoring of the exam is based on the number of questions that have been accepted as suitable.

Reliability is the extent to which the CCKE consistently measures the core components of cardiovascular medicine. The reliability of the examination can be affected by the uniformity of the questions, the length of the exam, as well as the quality of questions. The reliability of the CCKE will be estimated using internal consistency methods such as Cronbach's alpha once we have gathered sufficient data.

Candidates who pass the Certified Cardiovascular Knowledge Examination will be listed on ACC's website for a minimum of five years, as well as receive a certificate of completion. To continue to be listed after five years, candidates will need to demonstrate continuous competency. More details will be provided on ACC's website.

This exam will be offered twice in 2024:

Exam Dates Application Deadline
May 2 – 5 Monday, April 22
Sept. 19 – 22 Monday, Sept. 9

The CCKE is available 24 hours a day during the dates noted above and will be available until 11:59 p.m. ET on the last day.

Once you start the exam, you have 31.5 hours within a four-day window to take the CCKE.

With 3 minutes available for each 30-question section, you may take up to 1.5 hours per section; 7. 5 hours to complete the exam. You have an optional 24 hours of break time which can be divided and taken after any section. Therefore, you can plan for 31.5 hours during the four-day window to complete the exam.

The CCKE window is open for four full days. The exam will open on Thursday, May 2, at 12:01 a.m. and remain available until Sunday, May 5 at 11:59 p.m.

As you prepare for the exam, review, and print the CCKE Tutorial (Coming Soon).

Application Fee $25

Exam Registration Fee

  Year One Discounted Fee
Member $299
Nonmember $399

CCKE Refund Policy:

Prior to the first day of the exam window, you may cancel your CCKE registration at any time and receive a refund.

  • CCKE cancellations made within 21 days of the exam will be subject to a $50 administrative fee.
  • Once the exam opens, no refunds will be issued.

All CCKE cancellations must be sent in writing to ccke-nppa@acc.org.

Deferrals are not available with the CCKE. If you have already registered for an exam and need to choose a different date, please submit a cancellation request as noted above and register for a future exam.

This exam is designed to evaluate your knowledge and clinical judgment in areas where a cardiovascular specialist should demonstrate a high level of competency. Most questions are based on patient scenarios. Exam questions are designed to require you to draw from a variety of sources to reach the correct conclusion, including training, education, practical experience in the health care environment, as well as textbooks and scholarly journal articles.

Overview of the Exam

  • The Certified Cardiovascular Knowledge Examination consists of 150 multiple-choice questions covering the field of cardiovascular disease. You have up to 7.5 hours to answer the exam questions. Many examinees finish the exam in 4 – 5 hours.
  • All questions are designed to test your clinical judgment with patient vignettes.
  • Once you start the exam, you will have a total of 7.5 hours to answer questions. The CCKE has 5 sections that consist of 30 questions. You have 3 minutes per question or 1.5 hours per section. You are allocated 24 hours of break time that can be taken between the exam sections.
  • The exam is delivered online so you can take it from your home or office; you do not need to visit a testing center.

This exam covers the field of cardiovascular medicine. The list below shows the specific topics that are covered and their relative weight on the exam:

Medical Content Category % of Exam
Acute Coronary Syndromes 13%
Adult Congenital Heart Disease 5%
Ambulatory and Consultative Cardiology Care 9%
Cardiac Arrhythmias and Electrophysiology 11%
Cardiovascular Disease Prevention 9%
Critical Care Cardiology 2%
Heart Failure 14%
Pericardial Disease 5%
Stable Ischemic Heart Disease 8%
Valvular Heart Disease 9%
Vascular Medicine 6%
Core Competencies 9%
TOTAL 100%

To prepare for the CCKE, download and print the CCKE blueprint and review the additional details about each medical content category.

This exam covers the field of cardiovascular medicine. The exam will cover some of the clinical competencies outlined in the 2020 ACC NP/PA Competency Document.

2020 ACC Clinical Competencies for Nurse Practitioners and Physician Assistants in Adult Cardiovascular Medicine: A Report of the ACC Competency Management Committee | Journal of the American College of Cardiology (jacc.org)

To prepare for the CCKE, download and print the CCKE blueprint and review the additional details about each medical content category.

Looking for a study tool for the CCKE? Have you considered ACCSAP – ACC's Adult Clinical Cardiology Self-Assessment Program, which provides a comprehensive overview of the field of cardiovascular medicine and includes 600+ self-assessment questions. Typically sold as a 5-year subscription, ACCSAP is now available as a one-year subscription to NP/PAs looking for a study tool for the CCKE.

  • To learn more about ACCSAP and/or purchase a 5-year subscription, visit ACC.org/ACCSAP
  • Note: ACCSAP offers enough credits and MOC points in Medical Knowledge for all your licensing and certification requirements (CME/MOC/AAPA/CNE credit).
  • To purchase a one-year subscription*, please call ACC's Member Care team at 800-253-4636

*The one-year ACCSAP subscription is available to NPs/PAs who have completed the application, signed the legal agreement, and paid the CCKE application fee.

ACC offers numerous resources to set you up for success!

Candidate Score

Candidate scores are determined by the number-correct formula where a correct response will count as one and an incorrect response will count as zero.

While ACC strongly recommends that candidates attempt to answer every question, failure to complete every question does not immediately imply you did not pass the exam and there is no penalty for guessing.

Passing Score
What's the Passing Score for This Exam?

The passing score is determined based on the results of a content-based standard-setting study by a panel of subject matter experts followed by review and final approval by ACC's Certification Governance Work Group.

The standard-setting study is conducted by cardiovascular subject matter experts invited by ACC to participate as a standard setting panelist. Panelists are representative of U.S. NPs/PAs and reflect diversity in age, geographic location, and years of experience.

ACC uses the standard setting method known as the modified-Angoff. Under the guidance of a psychometrician, selected panelists review each question to determine the basic level of knowledge or skill that is expected. The recommended passing score is based on the panel's estimated difficulty ratings for each exam question. The recommended passing score from the standard-setting study is then reviewed and approved by ACC's Certification Governance Working Group. The passing score for the exam represents the minimum score needed to identify individuals with an acceptable level of knowledge and skill.

Passing the Exam

The CCKE is a criterion-referenced test meaning that exam outcomes are a result of comparing a candidate's score to the passing score standard. If the candidate's score is equal to or higher than the passing score, then the candidate has passed the exam. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.

Score Report

A score report showing the candidate's score and the passing score will be available 1-2 months after the examination test window. ACC will notify candidates by email when scores are available.

Refund /Cancellation Policy

  • The CCKE application fee of $25 is nonrefundable.
  • The CCKE registration fee is refundable if you request a refund at least 30 days prior to the exam. Alternatively, you may defer your registration fee for up to two testing windows.
  • The exam registration fee allows you to take one (1) CCKE exam. If you did not pass the exam and wish to take it a second time, you may apply to retake the exam. Contact us at ccke-nppa.com@acc.org for more information.

The answer to this question depends on how you define those terms. Please refer to the table below to learn more about the CCKE:

Definition of Board Certification / Credential CCKE
The process by which a healthcare professional demonstrates a mastery of advanced knowledge and skills through written, practical, or simulator-based testing. Yes
A formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a specialty to promote optimal health outcomes. Yes
A process of assessing the academic qualifications and clinical practice history of the provider. No
Something that is offered by an organization called a "Board" or a "Certification Center". No
A license to practice. No

At the present time, the CCKE does not offer specific credentials, although we are exploring it for the future based on your feedback. In the meantime, the CCKE does offer:

  • A digital badge
  • Pathway to AACC and FACC – see ACC Membership website for additional information.

Additional FAQs

The American College of Cardiology provides reasonable accommodations to examinees with documented needs for special accommodation. Examinees wishing to request accommodation should submit a completed request form and supporting documentation at least 60 days prior to the exam date. Submit requests to ccke-nppa@acc.org.

Your exam fee covers the cost of one exam; if you take the exam a second time, you will need to pay a second fee.

You may take the exam multiple times, but not consecutively. If you take the November 2023 exam and do not pass, then you must skip the Spring 2024 exam and try again in the fall. If you take the Spring 2024 exam and do not pass, then you must skip the Fall 2024 exam and take the following exam in 2025.

ACC will release pass/did not pass information and score reports 2-3 months after the exam.

The passing score is determined based on the results of a content-based standard-setting study by a panel of subject matter experts followed by review and final approval by ACC's Certification Governance Work Group.

For information regarding group applications and registration please fill out the form below and submit Brenda Hindle at bhindle@acc.org. Application fees will be waived for groups of 3 or more applicants from the same institution that are registered at the same time.

* A passing score on the Certified Cardiovascular Knowledge Examination (the "Program") solely demonstrates that a medical professional has met the particular standards and criteria of the Program. Neither the American College of Cardiology Foundation, nor the Program itself, guarantees or warrants anything beyond a medical professional's ability to meet such standards or criteria. A passing score is not a license to practice medicine, nor is it a substitute for formal medical training. The American College of Cardiology Foundation makes no representations, warranties, or guarantees as to, and has and assumes no responsibility for the proper performance of medical services or care provided by those individuals who achieve a passing score under the Program.