CNT Course Policies and Procedures

Thank you for your interest in the CCAHM Clean Needle Technique Course. Prior to registering, please review the following information. For questions not addressed here, see the Frequently Asked Questions page or contact the office.

Click on one of the topics below to learn more:

Acceptance into a CNT Course
Candidate Demographic Information
Certificate of Completion
Challenging Exam Content, Administration, or Results
Cheating Policy
Course Completion Time Limit
Disability Accommodations
Disciplinary Action
Exam Results
Eligibility Requirements and Prerequisites
Foreign Language
Pass Rate
Repeated Failed Exams
Switching Written or Practical Exam Dates and Times/Missed Exams
Switching Written or Practical Exam Languages
Technology Requirements
Withdrawing from a CNT Course


Acceptance into a CNT Course: 

Read thoroughly to understand the registration approval process.

  1. After submitting an online registration request, you will receive an email with instructions to submit required  eligibility documentation.
  2. If your documentation is complete and you are eligible for the course, you will receive an approval email (within about 1 week after your initial online registration request. If you don't receive an approval, contact the office.)
  3. The course content and additional information about how to prepare for the exams will appear in your CCAHM portal once your registration has been approved (login required)


Candidate Demographic Information: 

Please keep your physical and email addresses updated in your CCAHM portal. Be sure that the first and last name in your CCAHM profile match the first and last name on your government issued photo ID. 

NOTE: The name in your profile is the name will be used for your certificate of completion and all requested CNT verification. 

Certificate of Completion: 

Upon successful completion, candidates may state that they hold a certificate in Clean Needle Technique as administered by the CCAHM, but may not state that they are certified in acupuncture, herbal medicine, or any other modality as a result of completion of the CNT course.  Candidates shall not use acronyms or subtitles after their names to reference the CNT certificate; neither will the CNT certificate include any acronyms or subtitles after candidates' names.  


Challenging Exam Content, Administration, or Results: 

Any questions or comments about exam content, administration, or results must be submitted in writing to the CCAHM office within ten days after the exam date. The process for challenging exam content, administration, or results is outlined below. 

Initial Challenge of:

Examination Content: If you believe there is an error in a particular question or have comments about other specific aspects of exam content, submit your concern in writing to the CCAHM office within ten days after the exam date. Include your name, email address, exam date and time, and a description of the specific question(s). 

Examination Administration Conditions: Should you experience any environmental difficulties during the administration of the exam, submit a written communication to the CCAHM office within ten days of your exam date. 

Examination Results: Submit a written communication to the CCAHM office within ten days of receiving your results. Your written challenge should include your name, email address, exam date and time, and an explanation as to why you are challenging your exam results. 

Resolution of Challenge: The CCAHM office will evaluate and investigate all challenges and promptly issue a written response to the candidate disclosing the results of the evaluation and investigation.

Appealing Examination Decisions: You may appeal the CCAHM's response by sending written justification for the appeal to the chair of CNT Committee (appeals should be addressed to "Chair, CNT Committee"). The CCAHM office must receive the appeal request within 10 days following CCAHM’s response to the the initial challenge. On receipt of a written request for an appeal, the office will immediately forward the request to the chair of the CNT Committee. 

Final Decision by CNT Committee Chair: Within 10 days after receipt of a written request for an appeal, the chair shall: (1) make a decision concerning the merits of the appeal or (2) refer the appeal to the CNT Committee. The decision of the CNT Committee chair will be provided in writing by the office to the candidate. If the chair refers the appeal to the CNT Committee, the committee shall meet to consider the appeal and promptly communicate their final decision in writing to the candidate. 



Cheating Policy:

Any candidate who is suspected of cheating during the administration of the CCAHM Clean Needle Technique (CNT) written or practical exams shall be immediately referred for Disciplinary Action.

What Constitutes Cheating: Cheating on the written or practical exam includes but is not limited to:

  1. using books, notes, photographic or electronic devices of any kind, including cameras, smart watches, translation devices, etc. during the written or practical exam;
  2. using any writing instrument for the written exam;
  3. using headphones or ear buds during the written or practical exam unless prior permission has been obtained from CCAOM to allow assistive devices;
  4. possessing any CCAOM exam-related materials;
  5. reading questions out loud during the written exam;
  6. leaving the exam room;
  7. allowing others to enter the exam room;
  8. obscuring cameras or face;
  9. attempting to access other web pages, applications, etc.;
  10. using multiple screens;
  11. playing music;
  12. disconnecting from the proctored written exam video chat for more than ten minutes and failing to answer a call/text from the proctor after disconnecting
  13. discussing exam content at any time after taking the written exam
  14. any other behavior deemed odd or suspicious by the exam proctor or examiner. 

Notification of Charge of Cheating:

Following notification of suspected cheating by the exam proctors and examiners, the office shall promptly investigate the charge by reviewing video recording of the candidate’s exam along with notes submitted by the proctor or examiner. After the initial investigation, if a candidate is found to be in violation of the CNT Cheating Policy the candidate will be referred for Disciplinary Action and notified in writing by the office.  





All candidate CNT course records are permanently and securely maintained and verification is always available upon request. No information will be released without the express written authorization of the candidate. Payment information is not stored and all CCAHM systems and processes are PCI compliant.


Course Completion Time Limit (Effective starting January 1, 2023):

CNT candidates will have one year from the date of course approval to complete all CNT requirements. Those candidates who do not successfully complete both their written and practical exams within that timeframe will be required to start the process again, including retaking already completed course modules and exams at the current fees. 


Disability Accommodations: 

CCAHM is committed to access and inclusion in its program and services as part of a broad effort to encourage the admission and retention of students with disabilities in accredited acupuncture and herbal medicine programs. Students are encouraged to access all the resources available to them, including applying for disability accommodations.

To be eligible for accommodations, a student must have a documented disability as defined by the Americans with Disabilities Act (under the ADA or ADAAA). Early communication is critical to successful implementation of effective and timely accommodations. Accommodations cannot be provided retroactively; therefore, we strongly advise applying for accommodations 3 to 4 weeks before your anticipated/scheduled testing date.

Reasonable accommodations are determined as part of a holistic evaluation of submitted documentation, any history of accommodations, and the CNT program requirements.

Examples of documentation include, but are not limited to:

  1. Student self-report of how their disability impacts them, their perceived need for accommodations, and their functional limitations in the academic environment
  2. Educational records of prior accommodations
  3. Proof of accommodations on previous standardized exams (ACT, SAT, licensing exams, etc.)
  4. Statement on letterhead from a healthcare professional or licensed provider outlining a diagnosis or the impact of a disability
  5. Medical records, evaluations, or diagnostic reports

Requesting Accommodations:

  • Step 1: Register for the Online CNT Course and written exam 
  • Step 2: If after reviewing the Course OverviewMinimum Technology Requirements, Policies and Procedures, and CNT Course FAQs, you determine that you require accommodations to fully participate in the Clean Needle Technique online course modules and/or exams, please upload supporting documentation on the Disability Accommodation Upload Form (requires account login).
  • Step 3: As part of the interactive process, once your documentation has been received, it will be assessed by an external ADA Compliance Consultant in a timely manner. Recommendations for approved accommodations will be provided to CCAHM.
  • Step 4: You will receive an email from CCAHM outlining your approved accommodations and any request for additional information.

ADA Accommodations Appeals Process:
CCAHM engages in the interactive process with candidates as part of determining and providing reasonable accommodations. The interactive process requires both CCAHM and the candidate to participate in good-faith communication to clarify, substantiate, and implement an accommodation request. If a candidate refuses or fails to participate in this process, CCAHM will not have the information necessary to fully execute accommodations. 

If, after an initial assessment from the ADA Compliance Consultant, it is determined that more information is necessary to approve an accommodation request, candidates  will receive detailed information on what question(s) must be answered by any newly submitted documentation. Ongoing communication with CCAHM constitutes an appeal of the initial assessment. Many candidates  are capable of providing the required information without obtaining additional medical or academic documentation. The interactive process is an opportunity to provide clarification not contained in the initial accommodation request and/or resolve any concerns or misunderstandings. 

Please be aware that documentation outlining history or diagnosis of disability may not have sufficient information regarding the nature of accommodations required specifically on the CNT course or examinations. Documentation on prior academic accommodations may demonstrate a need for accommodations without outlining what modifications are required in the CNT learning and testing environment. A candidate’s initial request may be approved, but feedback may still be required for accommodations to be successfully arranged. It has been CCAHM’s experience that quick and effective resolution occurs when all parties engage in open communication during this process.



Please contact CCAHM if you require accommodations as part of applying for disability accommodations or have additional questions regarding application requirements. CCAHM understands the collaborative and ongoing nature of providing access and welcomes feedback on your experience in the accommodation process.


Disciplinary Action:

Candidates who are suspected to be in violation of any CCAHM Policy may be subject to investigation and disciplinary action depending on the nature of the violation. Disciplinary action may include, but is not limited to, one or more of the following:

  • A written warning indicating what further action will be taken if the violation occurs again
  • Invalidated CNT exam results necessitating a retake of the exam and additional exam fees
  • Temporary suspension from the CNT course and exams
  • Notification to the candidate’s school and/or state licensing body of the violation that occurred
  • Permanent dismissal from the CNT course and exams

Notification of CCAHM Violation and Disciplinary Action:
Following notification of a suspected violation of CCAHM Policy, the office shall promptly investigate the charge by reviewing the evidence provided by the examiner, proctor, or other individual issuing the charge.  After the initial investigation, if a candidate is found to be in violation of CCAHM Policy the candidate will be notified in writing by the office.  

Appealing CCAHM Disciplinary Action:
Candidates who wish appeal the disciplinary action taken by CCAHM as a result of policy violation must appeal to the CNT Committee Chair by submitting a written request to the office addressed to “Chair, CNT Committee.” The appeal must be emailed within 10 days of receiving the initial written notice of violation. 

The office will immediately forward the written appeal to the chair of the CNT Committee. Within 10 days after receipt of the appeal, the chair shall: (1) make a decision concerning the merits of the appeal or (2) refer the appeal to the CNT Committee.

The decision of the CNT Committee chair will be provided in writing by the office to the candidate. If the chair refers the appeal to the CNT Committee, the committee shall meet to consider the appeal and promptly communicate their final decision in writing to the candidate.



Eligibility Requirements and Prerequisites:

All individuals in the following categories are eligible for the CNT course:

  • Currently enrolled acupuncture students who have at least begun a needling techniques course
  • Graduates of an acupuncture and/or herbal medicine program or college
  • Candidates for the NCCAOM examinations
  • Individuals currently enrolled in a state or NCCAOM approved tutorial program*
  • Licensed Acupuncturists*
  • Other licensed healthcare professionals legally authorized to practice acupuncture in the United States*
  • NADA detoxification specialists*

Candidates are required to provide documentation of their eligibility when registering for the CNT course and exams. For more information about what documentation is required for each eligibility criteria, see "Step 2: Gather your Documentation" on our Register for the Online CNT Course page. 

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 the CNT Course Technical Standards (PDF)

 *applies only to candidates in the United States




All course attendees must complete both an online live-proctored 55 multiple-choice question written exam and an online real-time practical exam, which consists of demonstrating proper needling technique based on verbal instructions.  Only candidates who pass the written exam will be allowed to register for the practical exam.

Written and practical exams for the CCAHM CNT Course are recorded to ensure security, discourage misconduct and assure quality. No recording will be completed without candidate knowledge and consent. Recordings are confidential and will be viewed only by individuals authorized by the CCAHM. All viewers are bound by CCAHM standards and policies. CCAHM will not provide access to exam recordings to candidates.



Exam Results:

The CNT course and exams are designed to ensure competence in the areas of cleanliness and safety in the acupuncture and herbal medicine field. The course is a pass/fail course. Candidates will be notified whether they passed or failed either exam via email within 10 business days of completion. 

A numerical score for the written exam will be automatically provided only to those candidates who do not pass. CCAHM will not disclose which exam items were answered incorrectly, nor will CCAHM grant access to exam items outside of the secure testing environment. Doing so would compromise exam integrity and validity. 

CCAHM will not provide individualized feedback or scores for practical exams. The purpose of the practical exam is to ensure that practitioners can safely administer acupuncture treatment. The exam itself is not a learning exercise/opportunity. Candidates should only schedule their practical exam once they feel they have a thorough understanding of Clean Needle Technique and can carry it out with minimal to no errors.


The fee for the English language online CNT course and written exam is $150. There is an additional fee of $50 for a foreign language written exam. The fee for the Chinese or Korean version of the online CNT course (with foreign language written exam included) is $200. There is also a $75 fee for the online examiner-administered practical exam, regardless of language requested. For eligible candidates, the retake fee is $75 for the written exam and $75 for the practical exam. 

Language of Course / Exam   Fee
 English Course and Written Exam     $150
 English Course with Chinese or Korean Written Exam     $200
 Chinese or Korean Course and Written Exam     $200
 Practical Exam (all languages)       $75

Foreign Language:

Some states may require completion of the CNT course in English. Be sure to check your state's licensing requirements before registering. To receive credit for completing the CNT course in English, the course and written exam must be completed in English. Please select the preferred written exam language when registering online.  



Individuals seeking NCCAOM certification must have completed a CCAHM CNT course within the six years prior to their application date for NCCAOM certification. Otherwise, the CNT course must be re-taken, unless the applicant has held a continuous license to practice acupuncture within the last three years before applying to NCCAOM for certification. Please contact the NCCAOM for more information about this policy.


Pass Rate:

About 86% of all candidates pass the CNT course (including written and practical exams) on the first attempt. 



Repeated Failed Exams: 

Candidates who do not pass the CNT written exam after three attempts will be required to repeat the full online CNT course, including all modules, quizzes and CNT Manual study. After the third failed attempt, repeating candidates will be charged the full registration fee and must spend a minimum of 30 days completing the course before they will be approved to take the exam again. Any candidate who does not pass on the fourth attempt may retake the exam at a reduced retake fee up to two more times before repeating the full course again. More information about the process for re-registering for the course will be provided to the candidate by the office. 


Switching Written or Practical Exam Dates and Times/Missed Exams:

Please contact the office as soon as possible. 


  1. Notify the CCAHM office by email that you would like to switch your exam date. Notification must be sent at least 24 hours before your exam date.
  2. A refund of your original exam fee will be issued, less a switch fee of $50. The switch fee is reduced to $25 for requests received 15 or more days before the initial written or practical exam date/time, or if there is a documented medical or other emergency.
  3. Log in to the CCAHM website, select your new exam date and time, and re-register. Candidates who are switching exam dates do not need to resubmit eligibility documentation. 

Missed Exams:

Candidates who are more than 5 minutes late to their exam will not be permitted to test. If you miss your exam time, or do not give 24 hours notice that you will miss your exam, you will not be issued a refund and you will be charged a retake fee of $75.


Switching Written or Practical Exam Languages: 

Please contact the office.  There may be a fee associated with switching your exam language. CCAHM will not be able to accommodate requests made less than 14 days prior to the exam date. 



Technology Requirements: 

Candidates are responsible for familiarizing themselves with the Minimum Technology Requirements for the CNT course and exams prior to registering. Candidates who are unable to complete their exams as a result of not meeting these requirements will be required to pay a retake fee of $75 in order to reschedule their exam. 


Withdrawing from a CNT Course:

Please contact the office as soon as possible. Due to the online nature of the course, refunds for withdrawing are not offered. In the case of a documented illness or other emergency that impacts your ability to complete the online course and/or your scheduled written or practical exam, notify the office immediately.