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
Pass Rate
Payments/Payment Disputes
Repeated Failed Exams
Switching Written or Practical Exam Dates and Times/Missed Exams 
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. 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 of your 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:

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: 

Please visit the Accommodations page of our website for more information. 


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 completed a hands-on 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/POCA Trained Auricular Acu-Technicians*

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 60 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. 

Candidates will be given access to their final scores for each of the six steps of the practical exam after receiving their exam results. However, CCAHM will not provide additional individualized feedback 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.



2024 Online CNT Course and Exam Fees

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. 

Course / Exam   Fee
 English Course and Written Exam $170
 English Practical Exam  $85
 Retake Exams (up to two times) $85




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. 



Payments/Payment Disputes:

Payments are processed electronically via Payflow Pro, a secure online payment gateway used to process payments via credit card, debit card, and PayPal. When submitting your payment, the system will perform an authorization to check that the funds are available. This will look different for each candidate depending on how their bank is set up. It may mean that while the funds have not been withdrawn form the account, they are placed on a "hold" until the payment is either processed. However, the payment will not be fully complete until it has been processed and approved by CCAHM office staff. Before approving payments, we can adjust them to be less than the original amount (as is the case with retake fees), but not more. 

When the payment is posted to your account, it will display as "CCAHM" or "COUNCILCOLLEGESAHM" on your statement. 

If you encounter any issues or have any questions about a charge, please contact us before filing a dispute with your bank or PayPal. Dispute cases are a lengthy and time-consuming process that may take 70 or more business days to resolve. 

If a dispute case is initiated, CCAHM reserves the right to deactivate your account until the dispute has been resolved. Once an account is deactivated, candidates will not be able to register for any additional courses or exams and will lose access to all previously purchased courses and already issued CCAHM certificates. CCAHM will not submit verification of course completion to any entities while a dispute case is open. 

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/session*, 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 $85.

*Joining the wrong Zoom session for Practical Exams will count as a missed exam. When you are granted access to the Practical Exam Schedule and Zoom links page, please be sure to click on the correct one


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 not be issued a refund and will be required to pay a retake fee of $85 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.