CNA Certification in Texas: 100-Hour Training

How to become a CNA in Texas: a 100-hour state training minimum, the Prometric competency exam — verified from Texas Health and Human Services Commission (HHSC).

Source-verified

Requirements below are drawn from Texas Health and Human Services Commission (HHSC) — Long-term Care Regulation, Credentialing Branch (Nurse Aide Registry) (official site) and last verified August 14, 2026. Boards change fees and rules often — confirm before acting.

Requirements at a glance

What the credential is: A state-issued certificate backed by a state-run registry. HHSC states it plainly: 'Texas Health and Human Services (HHSC) maintains a registry of all nurse aides who are certified to provide services in nursing facilities and skilled nursing facilities licensed by the agency.' The operator is HHSC itself — not a Board of Nursing and not a private contractor. HHSC's Credentialing Branch handles 'Issuing and continuing nurse aide registrations, including oversight of nurse aide testing development and administration' and 'Approving and monitoring nurse aide training and competency evaluation programs', while a separate Credentialing and Registry Enforcement unit enters findings of abuse, neglect and misappropriation. The exam is contracted out but the credential is not: 'HHSC is contracted with Prometric to develop, score and report the results of the Nurse Aide Examination required for certification.' Applications, certificates, renewals and status all live in HHSC's own licensure system, TULIP (Texas Unified License Information Portal), which nurse aides have used since July 5, 2023.
The standard route — train, then test: HHSC calls this the Traditional Nurse Aide Route: 'Applicant successfully completes a state-approved nurse aide training program (60 hours of classroom and 40 hours of clinical) or the HHSC computer-based training (CBT) 60-hour online classroom training and 40 hours of clinical training with a state-approved nurse aide training and competency evaluation program.' The applicant then files a New Nurse Aide by Examination application in TULIP; the training program's director must approve the training in TULIP before the candidate can register for the exam; Prometric handles scheduling and testing; and on passing both exams 'Exam scores are electronically sent to TULIP from the Prometric system. HHSC staff issue the certificate.'
No minimum education requirement: HHSC answers this directly in its Nurse Aide Registry FAQs: 'Do I have to have a high school diploma or GED to become a certified nurse aide? Neither the federal regulation nor state rule imposes a minimum education requirement for nurse aides.'
Background check and registry screening: Approval to test rests on three things, in HHSC's own list: 'Successfully completing the training. Successful background check based on requirements in Texas Health and Safety Code 250.006. Student not listed on the Employee Misconduct Registry.' Training programs must screen before enrolment as well: 'NATCEPs are required to check both the Employee Misconduct Registry and the Nurse Aide Registry and to conduct a criminal history background check for all applicants. Applicants found to be listed on the EMR, or who are listed on the NAR in "revoked" status, or who have a criminal history that would bar employment in a HHS-licensed facility or agency are prohibited from enrolling in a nurse aide training program.' On the non-training routes (reciprocity, out-of-state training, military training, RN/LVN graduate or student, closed program, retest after expiry) the applicant must additionally 'Complete a criminal history check through the Texas Department of Public Safety Crime Records division for all last names the applicant has had. There is a fee for each check.' HHSC publishes a list of convictions barring nurse aide employment and points to Texas Health and Safety Code 250.006 for the offences.
Routes that skip the training but not the exam: HHSC lists five, each filed in TULIP under a different Eligibility Route: OUT-OF-STATE TRAINING — completed the training portion of an approved NATCEP in another state in the last 24 months without testing or being placed on a registry there; NURSE AIDE WITH EQUIVALENT MILITARY TRAINING — after July 1, 1989, 'successfully completed military training of 100 hours or more that's equivalent to civilian nurse aide training'; RN/LVN GRADUATE — after July 1, 1989, completed a state-accredited RN or LVN school without being licensed in Texas (or holding a licence since revoked); RN/LVN STUDENT — currently enrolled in a state-accredited school of nursing in any state, having demonstrated basic nursing skills competency under the school's curriculum; and TRAINING PROGRAM CLOSED — completed an approved Texas NATCEP in the past two years but the program has since closed. All five still require the written/oral and clinical skills exams.
The one route that skips the exam too: Request for Waiver of Nurse Aide Training and Competency Evaluation, for an applicant who 'completed a nurse aide training program prior to July 1, 1989, and has continued to work as a nurse aide every two years since the training was completed.' It requires Form 5507 plus an Employment Verification (Form 5506-NAR) for every two-year period worked since training, a DPS criminal history check, the training certificate or transcript, photo ID and Social Security card. No exam step appears in HHSC's process for this route — the certificate is issued on document review.
Where the clinical hours may be performed: HHSC names the permitted clinical sites: 'a nursing facility licensed or exempt from licensure under Texas Health and Safety Code, Chapter 242; a licensed intermediate care facility for an individual with an intellectual disability or related condition licensed under Texas Health and Safety Code, Chapter 252; a type B assisted living facility licensed under Texas Health and Safety Code, Chapter 247; a general or special hospital licensed under Texas Health and Safety Code, Chapter 241; or a hospice inpatient unit licensed under Texas Health and Safety Code, Chapter 142.' Clinical hours may be done in a LABORATORY setting only in two circumstances: 'no appropriate and qualified clinical site is located within 20 miles of the location of the NATCEP', or HHSC has determined that facility-based clinical training poses a health or safety risk because of a federal or state disaster declaration.
Facilities barred from running a training program: HHSC: 'A facility may not provide NATCEP training if, within the previous two years, it: Operated under a waiver under 42 United States Code, relating to the services of a registered nurse; Has been subject to an extended (or partial extended) survey under 42 USC; Has been assessed a civil money penalty of not less than $5,000; Has been subject to denial of payment or appointment of temporary management.' This matters to candidates because it is why some employers cannot train their own aides.

Legal basis

Texas Health and Human Services Commission (HHSC) — Long-term Care Regulation, Credentialing Branch (Nurse Aide Registry) administers certified nursing assistant licensing in Texas. Every figure below is verified against the board’s own official pages and dated. Who must personally hold a credential — the contractor, the business, or the individual worker — is set out under Requirements.

What it’s called

Texas uses ‘certified nurse aide (CNA)’ and ’nurse aide’ interchangeably in its own materials — the registry is the Nurse Aide Registry, the training programs are Nurse Aide Training and Competency Evaluation Programs, and the candidate bulletin is headed ‘TEXAS CERTIFIED NURSE AIDE’. ‘Certified nursing assistant’ is the common national term for the same credential and is what most job postings say; Texas does not use it in its rules or on its pages. What Texas issues is a CERTIFICATE, not a licence — 26 TAC 556.9 is titled ‘Certificate of Registration, Nurse Aide Registry, and Renewal’ — so ‘Texas CNA license’ is a folk term. ‘STNA’ (State Tested Nursing Assistant) is Ohio’s term, not Texas’s. Do not confuse the CNA with the Texas MEDICATION AIDE, a separate HHSC credential with its own registry, or with a nurse aide TRAINEE, who may work in a nursing facility for up to four months while enrolled in a NATCEP but is not certified. TULIP (Texas Unified License Information Portal) is the state’s licensure system, not a credential.

License types & fees

Type	Notes	Who Its For
Certified Nurse Aide (CNA) — nurse aide certificate, listed in Active status on the Texas Nurse Aide Registry	Texas issues an actual certificate, not merely a registry entry — HHSC writes that after the exam 'HHSC staff issue the certificate' and 'The certificate can be printed from TULIP', and the governing rule is titled 'Certificate of Registration, Nurse Aide Registry, and Renewal' (26 TAC 556.9). But the certificate on its own does not make a person employable; the REGISTRY STATUS does. HHSC: 'your employability depends upon the current status of your certification. If you are not in "Active" status on the Nurse Aide Registry, you are not employable, even if you have a copy of your certificate.' No state application or certification fee is published on any HHSC nurse aide page — see fees.	A person who wants to work as a nurse aide in a nursing facility or skilled nursing facility licensed by HHSC.
Nurse aide in training (uncertified, time-limited)	Not a credential, but the one lawful way to do the work before certification. HHSC: 'People who currently are enrolled in a NATCEP may work up to four months in a nursing facility. The facility must terminate anyone who is not on the registry within that time.'	A person currently enrolled in a Texas-approved Nurse Aide Training and Competency Evaluation Program (NATCEP) who is already working in a nursing facility.
Medication Aide — a SEPARATE Texas credential, not covered by this record	HHSC's Long-term Care Credentialing unit runs the Medication Aide (MA) program alongside the Nurse Aide Registry, NATCEP and Nursing Facility Administrator programs under one credentialing call centre (512-438-5800). It is a distinct credential with its own registry and its own rules; nothing in this record describes it.	Not covered here.

Who does NOT need this license — exemptions

Texas’s carve-outs are narrow, and only two are unconditional. (1) THE FOUR-MONTH TRAINING WINDOW: ‘People who currently are enrolled in a NATCEP may work up to four months in a nursing facility. The facility must terminate anyone who is not on the registry within that time.’ This is the only published way to do nurse aide work in a Texas nursing facility without being on the registry, and it expires by its own terms. (2) SETTING: the registry requirement reaches nursing facilities and skilled nursing facilities — HHSC ‘maintains a registry of all nurse aides who are certified to provide services in nursing facilities and skilled nursing facilities licensed by the agency.’ Note carefully what this record does NOT claim: no HHSC nurse aide page read on 2026-08-14 states whether a hospital, home health agency, assisted living facility or other setting may employ an uncertified aide, so no such claim is made here; those settings appear in HHSC’s nurse aide material only as approved CLINICAL SITES for training, which is a different question. Everything else Texas offers is a WAIVER OF TRAINING, not an exemption from certification — the out-of-state training, equivalent military training (100+ hours after July 1, 1989), RN/LVN graduate, RN/LVN student and closed-program routes all still end in both exams, and even the pre-1989 waiver still ends in a certificate and a registry listing. Two hard bars run the other way: a person listed on the Employee Misconduct Registry, listed in ‘revoked’ status on the Nurse Aide Registry, or carrying a criminal history that bars employment in an HHSC-licensed facility ‘are prohibited from enrolling in a nurse aide training program’ at all, and a revoked registry finding for abuse or misappropriation is permanent.

Fees

NO STATE CERTIFICATION FEE IS PUBLISHED. Not one dollar figure for applying for, issuing or renewing a Texas nurse aide certificate appears on HHSC’s Nurse Aide Registry page, its Become a Certified Nurse Aide page, its Renew or Make Changes page, its NAR Credentialing FAQs, its NATCEP page or its In-Service Education page — all six read on 2026-08-14. What a candidate actually pays: EXAM FEES, paid to Prometric at scheduling by credit card or voucher — Written Test $31; Oral Test $41 (‘Oral includes Reading Comprehension Exam’); Clinical Skills Test $89 — the same schedule applying to ‘Newly Trained, Lapsed, or Re-tester’ candidates. ‘Testing fees are nonrefundable and nontransferable.’ RESCHEDULING — ‘$25 fee if you reschedule 5-29 days before your test. If you reschedule less than 5 days before your test you will lose your test fee and be considered a no show… There is no charge for rescheduling 30 or more days before your appointment.’ A no-show or late arrival costs the full exam fee again; a state-side cancellation for weather or a major incident is rescheduled ‘without additional cost’. DPS CRIMINAL HISTORY CHECK — required on every route except the standard train-then-test route; HHSC says only ‘There is a fee for each check’ and does not publish the amount, and the amount is not stated on any HHSC nurse aide page read. TRAINING COST — set by whichever approved NATCEP the trainee uses and not published by HHSC; the state’s own 60-hour classroom CBT is explicitly free.

Exam

Two exams, both required: a Clinical Skills test and a Written test (which may instead be taken in Oral form). CLINICAL SKILLS — ‘The Clinical Skills test is a timed test. You will be scored on five skills. While performing three assigned skills, you will also be scored on two additional skills - Handwashing and Indirect Care.’ Indirect Care covers resident rights, communication with the resident, resident safety and comfort, and infection control. ‘To pass the Clinical Skills test, you must pass all five skills.’ Each test form carries its own time limit depending on the skill combination, stated on the instruction card. The test runs in a clinical laboratory ‘with someone acting as a resident or with a mannequin’, and the exact checklist the evaluator uses is published in advance. WRITTEN — ‘The Written Test consists of 60 multiple-choice questions… You will have 90 minutes to take the test.’ ORAL — the written test may be taken orally, with questions read aloud and replayable; ‘All candidates testing by way of Oral Exam are required to also pass a Reading Comprehension exam.’ LANGUAGE — ‘The Texas Nurse Aide Clinical Skills Exam is offered in English only, however, the Competency Exam is offered in English and Spanish. Translators are not permitted, and translation dictionaries may not be used.’ Both tests ‘are written so as not to exceed a sixth-grade reading level, as required by the Texas Competency Evaluation Program.’ ATTEMPTS — HHSC: ‘People who fail either the skills or the written/oral examination may re-test twice. People who don’t pass after three attempts must go through the training again before being allowed to take the test again.’ The candidate bulletin states the same limit and adds the deadline: ‘Pass the Clinical Skills exam and Written or Oral exam within 24 months of completing your training.’ DELIVERY — written/oral exams are offered at computer-based testing centres, regional testing sites, in-facility testing sites, and by live remote proctoring; clinical skills exams are offered only at regional testing sites and in-facility testing sites. These exam details come from the Texas CNA Candidate Information Bulletin published by Prometric on the page HHSC itself links; the attempt limit is corroborated independently by HHSC’s own FAQ.

Renewal & continuing education

Every 24 months, and it is renewed on WORK, not on a fee. HHSC’s FAQ: ‘Once I am certified, how often do I have to renew? You must contact the Nurse Aide Registry and verify your employment at least every two years to remain in active status.’ Renewal may be filed ‘beginning three months prior to the expiration date on the certificate.’ Two ordinary routes exist: the nurse aide files a Certified Nurse Aide Renewal Application in TULIP with a completed Employment Verification (Form 5506-NAR), or the employer files a Nurse Aide Facility Staff Renewal on the aide’s behalf and acknowledges both the employment and the in-service education. Either way the aide (or the employer) must confirm no Employee Misconduct Registry entries and no disqualifying criminal convictions. A fifth route exists for military applicants: ‘This application applies to military service member, military veteran, or military spouse applicants who are certified and hold an Active or Expired CNA certificate in Texas. They must complete 24 hours of continuing education. These applications are prioritized.’ Separately, a military spouse stationed in Texas who holds an active certificate in another state can be issued a Texas certificate ‘for three years, as long as the applicant maintains active status in the other state’ — a three-year term rather than two, and the applicant chooses between that waiver and ordinary reciprocity. Name changes and address changes are filed in TULIP and are not part of renewal. 24 hours of in-service education every two years, with mandated dementia content. HHSC quotes the rule verbatim on its Nurse Aide In-Service Education page: ‘Effective September 1, 2013, a nurse aide renewing a certification must complete at least 24 hours of in-service education every two years that includes training in geriatrics and the care of residents with a dementia disorder, including Alzheimer’s disease’ (26 TAC 556.9). The same sentence is repeated on the renewal page for every renewal route. WHERE THE HOURS CAN COME FROM: ‘requirements can be fulfilled through a nursing facility or an approved Nurse Aide Training and Competency Evaluation Program’, and ‘All approved NATCEPs are eligible to offer in-service education.’ HHSC also publishes free computer-based in-service modules of its own — a six-module set (Texas Long-term Care Overview, Resident Rights, Quality of Resident Care, Infection and Infection Control, Dementia Disorders, Resident Care for Dementia-related Conditions) where ‘Each course satisfies 2 hours toward the 2-year requirement of 24 hours’ and ‘CNAs get 2 hours of credit for each course, as long as they score a minimum of 70% and have a copy of the learning certificate’ — plus a separate five-module Infection Control for Nurse Aides series that HHSC describes as satisfying an ANNUAL in-service requirement. The aide keeps the certificates: ‘To document successful course completion, participants must print a copy of the course certificate available at the end of the training and keep the certificate for documentation purposes.’ The state’s free 60-hour classroom CBT for new trainees does NOT count: ‘The course will not satisfy the 24 hours of in-service education and is only for those interested in becoming a certified nurse aide.’

How to apply

Applications are handled by Texas Health and Human Services Commission (HHSC) — Long-term Care Regulation, Credentialing Branch (Nurse Aide Registry). Start at the official application page .

Verify a license in Texas

Texas Health and Human Services Commission (HHSC), through its TULIP licensure system publishes a public license search , searchable by Program Type (a required selector: Correctional Medication Aide / Medication Aide / Nurse Aide / Nursing Facility Administrator / Preceptor — a search that does not select ‘Nurse Aide’ returns nothing), First Name, Last Name, Social Security Number, License Number, State, Mailing City, Mailing Zip/Postal Code or bulk file upload (First Name, Last Name and SSN required; ‘A maximum of 900 records are allowed using bulk search’). It covers Texas nurse aide certification status, and HHSC treats this lookup as the authoritative one: ‘Check Nurse Aide registry status. HHSC no longer provides written verification of certified nurse aides. This website will assist with verifying status.’ The same page carries HHSC’s assurance to employers: ‘Providers can verify nurse aide employability using the Employability Status Check Search. This website consolidates checks of the Nurse Aide Registry and other systems. Verifying a nurse aide’s status through the Employability Status Check Search is the equivalent of using the NAR and is considered in compliance with all applicable federal regulations and state licensure laws.’ The statuses it reports are the five HHSC defines: Active, Expired, Prospective, Revoked and Suspended. PRACTICAL LIMIT: the lookup runs entirely inside an interactive application, so the page arrives empty and only assembles itself once it has loaded in a normal web browser — a result cannot be bookmarked or linked to, and the search page is a JavaScript portal, so its fields do not appear in the served markup; the field list here was read from the fully rendered form on 2026-08-14. The search_by list above was read from that rendered form; re-check it in a browser if it matters, since a JavaScript portal can change its fields without changing its served markup. Prometric’s Texas nurse aide page points to the same HHSC system for CNA verification.

Records come from Texas Health and Human Services Commission (HHSC), through its TULIP licensure system’s own system. LicensingAtlas does not hold license records and cannot confirm any individual’s status — the date on this page refers to the requirements described above, not to anyone’s credential.

Frequently asked questions

How many hours of training does Texas require to become a CNA?

100 clock hours, split 60/40. HHSC states that ‘Each NATCEP must provide a minimum of 100 clock hours of training, including: 60 clock hours of classroom training that doesn’t involve direct resident care; 40 clock hours of hands-on resident care in a nursing facility.’ At least 16 of the classroom hours must be introductory training — communication and interpersonal skills, infection control, safety and emergency procedures including the Heimlich maneuver, promoting residents’ independence and respecting residents’ rights — completed before any direct client contact. That puts Texas 25 hours above the 75-hour federal minimum.

Can you do the classroom part of Texas CNA training online, and does it cost anything?

Yes, and the state’s own version is free. HHSC ‘has created a Computer Based Training (CBT) that nurse aide trainees can use to complete the 60-hour classroom training online… at their own pace.’ The clinical part cannot be done online: ‘Once a trainee finishes the CBT, they must complete the 40-hour clinical portion of the training with an approved NATCEP to qualify to take the CNA exam.’ HHSC is blunt about the price: ‘The CBT course is a free course. Anyone attempting to charge for this course or completing the course for someone else will be referred to HHSC Office of Inspector General.’ The CBT is pass/fail and produces a certificate of completion rather than a grade.

Who gives the Texas CNA exam, and what does it cost?

Prometric, under contract to the state — ‘HHSC is contracted with Prometric to develop, score and report the results of the Nurse Aide Examination required for certification.’ Fees are paid to Prometric at scheduling: $31 for the Written test, $41 for the Oral test (which includes a Reading Comprehension exam), and $89 for the Clinical Skills test. Those fees are ’nonrefundable and nontransferable’, and rescheduling costs $25 if done 5 to 29 days ahead, nothing if done 30 or more days ahead, and the whole fee if done inside 5 days. Texas HHSC itself publishes no application or certification fee on any of its nurse aide pages.

What is on the Texas CNA exam?

Two parts. The Written test is ‘60 multiple-choice questions’ with ‘90 minutes’ to complete it, and can be taken orally instead — in which case the candidate must also pass a Reading Comprehension exam. The Clinical Skills test is timed and scored on five skills: three assigned skills plus Handwashing and Indirect Care, the latter covering resident rights, communication, safety and comfort, and infection control. ‘To pass the Clinical Skills test, you must pass all five skills.’ The skills test happens in a clinical laboratory with a person acting as the resident or with a mannequin, and Prometric publishes the exact evaluator checklist in advance. The skills exam is English-only; the written competency exam is offered in English and Spanish.

How many times can you fail the Texas CNA exam?

Three attempts on each part. HHSC: ‘People who fail either the skills or the written/oral examination may re-test twice. People who don’t pass after three attempts must go through the training again before being allowed to take the test again.’ There is also a deadline independent of the attempt count — the candidate bulletin requires passing both exams ‘within 24 months of completing your training.’

How do you renew a Texas CNA certificate?

By proving you worked, not by paying a fee. HHSC: ‘You must contact the Nurse Aide Registry and verify your employment at least every two years to remain in active status.’ Renewal can be filed by the aide (with a completed Form 5506-NAR employment verification) or by the employer on the aide’s behalf, and can start three months before the expiration date. On top of the work, ‘a nurse aide renewing a certification must complete at least 24 hours of in-service education every two years that includes training in geriatrics and the care of residents with a dementia disorder, including Alzheimer’s disease.’ HHSC offers free online in-service modules worth 2 hours each, requiring a 70% score and a printed certificate.

What happens if a Texas CNA certificate expires?

You test again. HHSC defines the status: ‘Expired – The nurse aide’s registration is expired. To renew registry status, the nurse aide must provide verification of qualifying employment. If the person is unable to verify employment, he or she will have to re-train and/or re-test.’ The trigger is having neither worked in a health care setting nor completed the 24 in-service hours in the 24 months since certification or last renewal. Two ways back exist and the aide chooses: retest only — a DPS criminal history check plus a Request to Retest for Nurse Aides in Expired Status filed in TULIP, then both exams again — or retrain and retest, meaning the full 100-hour program followed by both exams. While expired, the aide ‘is currently not employable as a nurse aide in a licensed nursing facility in the state of Texas.’

Can a CNA certified in another state work in Texas?

Yes, through reciprocity, and without retesting. HHSC: ‘Nurse aides that have an active certification in another state may transfer their certification to Texas’, and the eligibility test is being ‘currently on the nurse aide registry in another state that is in compliance with applicable federal laws.’ The applicant completes a Texas DPS criminal history check for every last name ever held, files a Request for Entry on the Texas Nurse Aide Registry through Reciprocity in TULIP, and uploads the criminal history results, the out-of-state certificate, photo ID and Social Security card — plus Form 5506-NAR if the other state’s certificate carries no expiration date. A military spouse stationed in Texas may instead take a waiver route that issues a Texas certificate ‘for three years, as long as the applicant maintains active status in the other state.’

Can you work as a nurse aide in Texas before you are certified?

Only briefly, and only while training. HHSC: ‘People who currently are enrolled in a NATCEP may work up to four months in a nursing facility. The facility must terminate anyone who is not on the registry within that time.’ Beyond that window, employability turns on registry status rather than on holding a certificate: ‘If you are not in “Active” status on the Nurse Aide Registry, you are not employable, even if you have a copy of your certificate.’

Do you need a high school diploma to become a CNA in Texas?

No. HHSC answers it directly: ‘Neither the federal regulation nor state rule imposes a minimum education requirement for nurse aides.’ What does gate entry is screening rather than schooling — training programs must check the Employee Misconduct Registry and the Nurse Aide Registry and run a criminal history check, and applicants on the EMR, in revoked status on the registry, or with a criminal history barring employment in an HHSC-licensed facility ‘are prohibited from enrolling in a nurse aide training program.’

How do you check whether a Texas CNA certificate is valid?

Through HHSC’s own online lookup, which has replaced letters entirely: ‘HHSC no longer provides written verification of certified nurse aides. This website will assist with verifying status.’ Employers get an equivalence guarantee: ‘Verifying a nurse aide’s status through the Employability Status Check Search is the equivalent of using the NAR and is considered in compliance with all applicable federal regulations and state licensure laws.’ The lookup reports one of five statuses — Active, Expired, Prospective, Revoked or Suspended. It runs inside an interactive application, so it has to be opened in a normal web browser and a result cannot be saved as a link.

See every license and certification LicensingAtlas covers in Texas.

Sources & verification

Last verified against these sources: August 14, 2026.

We re-fetch every cited source on a weekly schedule: see what changed at the agencies, or every correction we have ever made.

LicensingAtlas states licensing and certification requirements categorically from official sources. It is a reference, not legal or career advice, and requirements change frequently — confirm details with the issuing board before you act.