The PA exam (PANCE) explained: format, fee, passing score and the PA-C
Last checked October 16, 2026 · Sources: NCCPA Become Certified, PANCE blueprint (effective January 2025) and Maintain Certification; NCCPA Five Year First Time Taker Summary Report as published by Drexel University
The PA exam, the Physician Assistant National Certifying Examination (PANCE), is run by NCCPA. It has 300 multiple-choice questions in five 60-minute blocks, costs $550, and is passed at a scaled score of 350. NCCPA’s report puts the 2025 national first-time pass rate at 91%. Passing earns the PA-C, which you keep through a 10-year maintenance cycle ending in the PANRE or PANRE-LA.
PANCE format at a glance
| PANCE | |
|---|---|
| Questions | 300 multiple choice, in five blocks of 60 |
| Time | 60 minutes per block; 45 minutes of breaks and a 15-minute tutorial (6-hour appointment) |
| Fee | $550 |
| Where | Over 300 Pearson VUE test centers, year-round |
| Eligibility | Graduates of an ARC-PA accredited entry-level PA program |
| Attempt limits | Once per 90 days, three times per calendar year, six attempts within six years |
Source: NCCPA Become Certified page, checked October 16, 2026.
What’s on the PANCE
NCCPA’s blueprint, effective January 2025, sorts questions two ways: by medical content (94% of the exam) and by task. Cardiovascular is the largest system at 11%, followed by pulmonary at 9% and gastrointestinal/nutrition and musculoskeletal at 8% each; professional practice is 6%. On the task side, formulating the most likely diagnosis is 18%, and history taking and physical exam and clinical intervention are 16% each. Our 2025 PANCE blueprint page has the full breakdown.
From PA school to PA-C
NCCPA accepts applications from 180 days before your expected program completion date. Pay $550 when you apply.
The earliest test date is seven days after you complete your program; you then have a 180-day window to test.
Pass with a scaled score of 350 or more to earn NCCPA certification and the right to use PA-C.
Log 100 CME credits and pay a maintenance fee every two years, and pass the PANRE or PANRE-LA by the end of year 10.
Study strategy and tips
Plan by NCCPA’s 2025 blueprint: cardiovascular (11%), pulmonary (9%), and GI and musculoskeletal (8% each) make up over a third of the exam, and formulating the most likely diagnosis is the biggest task at 18%. Use question banks to practice the task angle of each topic, not just the facts.
Every content and task weight.
→Ten weeks built on the blueprint.
→Two IDs, breaks and test-center rules.
→Free NCCPA material and trials.
→Things that actually move your score
Spend the most time on the biggest systems and on diagnosis and management questions.
NCCPA's sample items come with critiques showing how questions should be answered.
Five 60-question blocks take stamina; practice full blocks at one question a minute.
45 minutes covers the whole day; decide your split before test day.
An NCCPA practice exam ($50) uses its own item banks; take one before you test.
Where candidates talk about the PANCE
r/physicianassistant is the busiest community for PA students and PAs, useful for study plans and exam-day reports. Much of what’s posted predates the 2025 blueprint and passing standard, so check weights and rules against NCCPA. Our PANCE community guide lists outdated claims to watch for.
Our PA exam guides
300 questions, $550, scoring and pass rates.
→First-time results by year, 95% to 91%.
→Exam fee, prep and keeping your PA-C.
→Timeline, the $550 application and scheduling.
→Ten weeks built on the 2025 blueprint.
→Two IDs, 45 minutes of breaks, banned items.
→2025 weights by system and task.
→The 10-year cycle, CME and the PANRE-LA.
→NCCPA's sample items and practice exams.
→Blueprint PA, UWorld and BoardVitals.
→Three head-to-head comparisons.
→From free NCCPA material to $259.
→Trials, group discounts, guarantees.
→NCCPA and Pearson VUE pages.
→Weighing other healthcare exams? See our guides to the FNP exam, USMLE and NCLEX, and our official NCCPA links.
Common questions about the PA exam
What is the difference between the PANCE and PANRE?
The PANCE certifies new PAs. After that, NCCPA certification runs on a 10-year cycle of five two-year periods: each period needs 100 CME credits and a maintenance fee, and by the end of year 10 you must pass a recertification exam, either the proctored PANRE or the longitudinal PANRE-LA.
What score do you need to pass the PANCE?
A scaled score of 350 on a 200 to 800 scale.
How much does the PANCE cost?
$550, paid when you apply, according to NCCPA.
How many times can I take the PANCE?
Up to six times within six years of completing your PA program, no more than once in any 90-day period or three times in a calendar year. If you run out, NCCPA says the only way to regain eligibility is to complete an accredited PA program again.
What is the PANCE pass rate?
91% for first-time takers in 2025, according to NCCPA’s five-year report; the five-year national average is 92%.
We first checked these sources on October 12, 2026 and rechecked them on October 16, 2026. MockTestPrep is independent and is not affiliated with NCCPA.