How to Get Your CNA Certification in Texas (TX): 2026 Guide

If you want to work as a Certified Nurse Aide in Texas, this guide walks you through every step — from picking an HHSC-approved training program to scheduling your Prometric skills and written exam, to landing on the Texas Nurse Aide Registry and keeping your certification active. Texas contracts with Prometric to deliver the state competency exam, and unlike many states, the certification here is officially called "Certified Nurse Aide" (CNA). This guide covers the 100-hour training requirement, Prometric's exam structure, what the combined test costs, where the major testing hubs are, and how to renew on the 24-month cycle.

Texas CNA at a glance

• State credential: Certified Nurse Aide (CNA), listed on the Texas Nurse Aide Registry
• Oversight: Texas Health and Human Services Commission (HHSC)
• Test vendor: Prometric
• Training hours: 100 total (60 classroom + 40 clinical)
• Exam format: 60-question written (or oral) + 5-skill hands-on evaluation
• Exam fee: approximately $125 written / $135 oral
• Registry validity: 24 months
• Renewal requirement: 24 hours of continuing education per renewal cycle

Who oversees CNA certification in Texas

CNA certification in Texas is administered by the Texas Health and Human Services Commission (HHSC). HHSC approves nurse aide training programs, oversees the Texas Nurse Aide Registry, and sets the competency exam standards that Prometric administers. The registry is the database employers check before they onboard you — once you pass both exam portions, HHSC adds you to the registry and your listing serves as your official proof of certification in Texas.

If you move to Texas from another state, change your name, need to verify your current status, or want to apply for reciprocity, you go through HHSC. The same office handles renewal paperwork and processes the training-program approvals you'll want to confirm before you enroll in any school.

Training programs in Texas

Texas requires a 100-hour state-approved nurse aide training program before you're eligible to sit for the Prometric exam. The 100 hours break down into 60 hours of classroom instruction and 40 hours of supervised clinical practice — usually completed in a nursing home or hospital setting. This is more than the federal OBRA minimum of 75 hours, so Texas programs are slightly more comprehensive than the baseline.

Programs are offered across the state at community colleges, technical schools, nursing facilities, and private career schools. Tuition generally runs $800 to $1,800 depending on the provider, plus you'll want to budget separately for supplies, scrubs, watch with a second hand, textbooks, and the exam fee itself. Programs typically run 4 to 8 weeks of full-time study, with part-time and evening options for working adults.

When choosing a program, confirm two things before you enroll: (1) that the program is currently approved by HHSC, and (2) that it has a track record of graduates passing the Prometric exam on the first attempt. Approved programs are listed through HHSC's regulatory services division — your training certificate must come from an approved provider or you won't be eligible to test. For a refresher on what your training should cover, see our study guides.

The Texas CNA exam: Prometric details

Texas contracts with Prometric to deliver the nurse aide competency exam. The exam has two parts:

1. Written or Oral Knowledge Test — 60 multiple-choice questions covering the role of the nurse aide, basic nursing skills, resident rights, communication, safety, and infection control. The oral version is available for eligible candidates and includes the same content with audio narration. The oral exam carries a small surcharge over the written version.
2. Clinical Skills Evaluation — 5 randomly assigned skills performed on a live actor or mannequin while a Prometric Nurse Aide Evaluator watches. You'll be graded on technique, hand hygiene, resident rights, and safety throughout.

You register for both parts through Prometric's Texas nurse aide portal. Many Texas regional test sites schedule the written and skills portions on the same day, but some candidates take them on separate dates depending on site availability. The general workflow:

1. Complete your HHSC-approved 100-hour training program.
2. Submit your application to Prometric and pay the exam fee.
3. Receive your Eligibility Notice (ATT) by email.
4. Schedule your exam session at a Prometric regional test site.
5. Pass both portions within the allowed attempt window.
6. HHSC lists you on the Texas Nurse Aide Registry.

Lead time varies by site — popular locations like Houston and Dallas can book out a few weeks, especially during summer and post-graduation intake cycles. Book your session as soon as you receive your ATT.

How much does the Texas CNA exam cost?

Texas keeps its nurse aide exam costs on the lower end of the national scale, but exact figures shift occasionally and Prometric's fee table is the only authoritative source. As a general guide:

• Written + skills combined — ~$125
• Oral + skills combined — ~$135
• Retest fee (per portion) — Charged if you fail and need to re-attempt

Budget separately for:

• Training program tuition — typically $800 to $1,800 depending on the provider
• Training supplies — scrubs, closed-toe non-slip shoes, watch with a second hand, textbooks
• Background check — some training programs require one before clinical placement
• BLS / CPR certification — only if your program requires a separate card beyond what's built in
• Renewal CE costs — 24 hours of continuing education per 24-month cycle

Total out-of-pocket cost from enrollment to certified typically lands in the $1,200 to $2,500 range, depending on the program you choose and whether you pass on the first attempt. Compare at least three HHSC-approved programs in your area before committing — community college and technical school programs are often the most affordable.

Where to take the test in Texas

Prometric operates regional test sites across Texas, with the highest density in the major metro areas. The state's most active testing hubs include:

• Houston — frequent testing across multiple sites in the metro area, including the suburbs. The Gulf Coast region's busiest testing market, with regular weekly availability.
• Dallas — regular sessions in Dallas proper and surrounding cities. The North Texas hub, with consistent scheduling throughout the year.
• Austin — periodic testing in Central Texas. Book early as availability is more limited than Houston or Dallas.
• San Antonio — scheduled through training programs and Prometric's regional calendar. South and Central Texas candidates often test here.
• Fort Worth — limited dates, but pairs with Dallas as part of the DFW testing region. Some candidates commute between the two for better availability.

If you don't live near one of these cities, Prometric's site locator shows additional regional test sites in places like El Paso, Corpus Christi, Lubbock, Amarillo, and the Rio Grande Valley — these often run on more limited monthly cadences, so call the site directly to confirm the next available date before you schedule. Some rural candidates drive 1–2 hours to reach the nearest active site.

Scheduling and what to bring on test day

When you schedule your Texas CNA exam through Prometric, you'll pick a date for the clinical skills evaluation first since it requires an evaluator and a partner volunteer. The written portion is usually scheduled shortly before or after the skills date. Many Texas candidates finish both parts in a single visit, but check your registration confirmation — if the site splits them, you'll need two separate appointments.

On test day, bring:

• A government-issued photo ID (driver's license, passport, or state ID). Your name must match the registration exactly.
• Your Prometric Eligibility Notice (ATT) — printed or digital.
• Proper clinical attire for the skills portion: scrubs (your school color is fine), closed-toe non-slip shoes, and a watch with a second hand. No artificial nails, per federal nursing home guidelines.
• A pen and any supplies your Eligibility Notice specifies.

Arrive 30 minutes early. Late arrivals are typically turned away and counted as a no-show, which uses one of your attempt attempts.

After you pass: Texas certification and renewal

Once Prometric reports your passing results, HHSC adds you to the Texas Nurse Aide Registry. Your registry listing is your proof of certification — most employers verify your status online through the HHSC Nurse Aide Registry before onboarding you.

Your Texas CNA certification is valid for 24 months. To renew, you must complete 24 hours of continuing education during the certification period. The CE requirement is a real one — Texas doesn't accept "worked enough hours" as a substitute, so you need to log the full 24 hours through an approved provider before you reapply. If you let your certification lapse, reinstatement typically requires retesting or re-training depending on how long it's been expired. Don't wait until the last month — track your CE hours through your employer or an approved continuing education provider well before your expiration date.

Common pitfalls specific to Texas

• The 100-hour training requirement is more than federal minimum. Texas requires 100 hours while federal OBRA only requires 75. Don't assume out-of-state training will transfer cleanly — confirm reciprocity eligibility with HHSC before you start a Texas program.
• The 24-hour CE requirement is strict. Texas requires 24 hours of continuing education every renewal cycle, not the 12 hours some other states accept. Track your CE hours from day one of your certification — finding approved CE late in the cycle is stressful and expensive.
• The oral exam costs more than the written. If you qualify for and choose the oral version, you'll pay an extra ~$10 over the standard written fee. Confirm your eligibility and the price difference before scheduling.
• Registry name-match issues cause real delays. HHSC's registry runs against your legal name. If your registration name, your driver's license, and your school records don't match exactly, you'll hit processing delays. Fix discrepancies before you apply.
• Renewal is your responsibility. Texas doesn't send robust reminders. The 24-month window passes quickly, and reinstating an expired certification is more expensive than just tracking your CE hours.

FAQ

How long does it take to become a CNA in Texas? Most students complete a 100-hour Texas-approved training program in 4 to 8 weeks of full-time study. After training, expect another 2 to 6 weeks for Prometric application processing and exam scheduling. Realistically, plan on 2 to 3 months from start to certified, assuming you pass on the first attempt.

How much does the Texas CNA test cost? The combined written + clinical skills exam runs about $125 through Prometric. The oral + skills combination is around $135. Budget separately for training tuition ($800 to $1,800), supplies, and 24 hours of continuing education for your first renewal.

Can I challenge the Texas CNA exam without training? In general, no — Texas requires completion of a 100-hour HHSC-approved training program before you're eligible to test. Reciprocity is available for out-of-state CNAs with active certifications, but the path requires a current registry listing from your prior state rather than a direct exam challenge. If you trained in another country or have nursing coursework, contact HHSC directly to discuss your eligibility before scheduling.

What happens if I fail the Texas CNA exam? You can retake the portion you failed. Prometric charges a retest fee per portion. There's no published three-strike lockout like Florida, but repeated failures without passing both portions within the eligibility window may require re-enrollment in training. Treat each attempt like it counts.

Do I need to renew my Texas CNA certification? Yes, every 24 months. Texas requires 24 hours of continuing education per renewal cycle through an approved provider. If you don't complete the CE requirement before your expiration date, your certification lapses and reinstatement requires retesting or re-training depending on how long it's been expired.

Practice questions for the Texas CNA exam are at /exam and clinical-skills walkthroughs are at /skills.