CNT Online Course Overview

Successful completion of the Council's Clean Needle Technique (CNT) course is one of the requirements for certification by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), as well as a licensing requirement in most states.

Administered by the Council as a one-day in-person class format since 1990, the COVID-19 pandemic required suspension of the Council's in-person CNT classes, beginning in March 2020. In response, the Council approved a proposal to transition the CNT course to a fully-online format and the redevelopment team worked tirelessly to complete the initiative as quickly as possible. 

Online CNT Course Format

Part 1: Self-Paced Online Course Modules and CNT Manual Study

After registering and being approved for the course and written exam, candidates will access the CNT course content through their online portal. The online course features a series of self-paced online video lecture modules and quizzes covering about 8 hours of content which must all be completed prior to the date of the written exam. Exam preparation should also include at least 15 hours of reading and studying the CNT Manual in addition to completing the online modules. 

Part 2: Live-Proctored Online Written Exam*

Following completion of all modules, a live-proctored 60 multiple-choice question online written exam will be administered. When registering for the course, candidates will select their preferred date and time of their written exam. This is not the date of the course, as all coursework must be completed independently by the candidate prior to the exam date. CNT written exams are typically held the first or second Saturday and Sunday of each month, with two sessions available each day. Please see the "CNT Exam Schedule" page (linked below) to see what dates and times are currently being offered for the next few months. 

Part 3: Online Practical Exam*

After passing the written exam, candidates will register for and complete a 1-on-1 online practical exam** that will be administered by an experienced Council examiner. Practical exams are typically held approximately one week after the written exam dates on various days and at various times for about two weeks. The schedule may vary slightly to accommodate holidays. Candidates do not need to take their practical exams immediately after completing the written exam, however as of January 1, 2023 all coursework and exams must be completed within one year of initial CNT registration. For more information, please visit our Policies and Procedures page. 

*NOTE: The number of available exam dates for both the written and practical exams will be limited, based on proctor and examiner availability.

**Candidates registering as acupuncture assistants will be required to have a licensed acupuncturist present during their practical exam who will complete the needling portion of the exam.

Exam Scoring

Written Exam

Each scored item on the written exam is worth one point. To pass the CNT written exam, candidates must have a final score of 39 points or higher (out of 50 scored items). 

Practical Exam

A candidate must receive a minimum total score of 37 with no zeros to pass the practical exam. If a candidate receives a score of zero at any time during the practical exam (including in the set up of their travel kit), this will result in an automatic failure and the candidate will be required to retake the practical exam at another time. 

2025 Online CNT Course and Exam Fees

Beginning in January 2024, the fees for the CNT online course and exams will be changing. Exams scheduled in January 2024 and beyond will follow the fee structure below. This adjustment reflects our dedication to maintaining the highest standards of excellence in acupuncture and herbal medicine education, certification, and safety. 

CNT Exam Schedule

CLICK HERE to view the current CNT exam schedule.

CNT Course Technical Standards 

Completion of the Clean Needle Technique (CNT) program is also dependent on essential, non-academic abilities and characteristics that require a minimum physical and cognitive capacity.  Those essential abilities and characteristics are also known as technical standards. Candidates should download and review the CNT Course Technical Standards (link below) before enrolling in the course and exams. 

CLICK HERE to download and review the CNT Course Technical Standards (PDF)

NEXT: Review Minimum Technology Requirements

IMPORTANT: The CNT Review Course: Acupuncture Safety course is NOT a substitute for the CNT online course. The CNT Review Course can only be used for California board and/or NCCAOM professional development/continuing education credits.