Which States Do Not Require the Nurse Practitioner Certification Exam?

While now is the time of year when NP program graduates are studying like mad in preparation for the national nurse practitioner certification exam, there are a few states that don’t require NPs to take this test. Most states have long mandated that nurse practitioners carry a national certification in addition to a state license but a few locales have yet to make the change. Which states don’t require nurse practitioners to hold national certification?

I’ve covered this topic before, but since my last post state laws have changed so I thought it would be a good idea to revisit the subject. To date, these four states do not require NPs to be nationally certified.

1. California

Nurse practitioners practicing in California may be able to get by without taking the national certification exam. NPs can become licensed in California one of three ways. The first way mirrors requirements for other states in which the prospective NP completes a nurse practitioner program, then becomes certified by taking and passing a national certification exam. The second and third methods of becoming licensed to practice in California do not require national certification.

Graduates of a nurse practitioner program “which conforms to the Board of Nursing’s educational standards” in the State of California may obtain a state license to practice by submitting verification that the NP program was completed along with official transcripts from the school. No national certification exam required.

Prospective nurse practitioners who did not complete a nurse practitioner program in the State of California may become certified without taking the national exam by submitting a number of documents to the Board of Nursing. These documents include verification of completion of an NP program, official transcripts, curriculum and course descriptions for the NP program, verification of clinical experience as a nurse practitioner, and verification of clinical competency as an NP from both a nurse practitioner and physician.

While it seems attractive to avoid taking the dreaded nurse practitioner certification exam, practicing without a national certification can be a pitfall. California’s Medicaid program requires that NPs are nationally certified for billing purposes. Naturally, most employers are looking to hire nurse practitioners eligible to be paid by Medicaid so taking shortcuts when it comes to becoming certified could make finding a job difficult.

2. New York

Despite it’s tendency toward passing regulations, New York is among the few states that do not require nurse practitioners to hold a national certification. In order to receive a license to practice as an NP in New York, nurse practitioners must only hold a New York license to practice as a Registered Professional Nurse (RN) and meet education requirements.

Education requirements may be completed in a few ways. First, aspiring NPs may simply graduate from a nurse practitioner program registered by the New York State Education department. In contrast, NPs completing their education outside of the state will need to take a national certification exam and become certified through a national organization in order to practice in New York. Graduates of NP programs prior to 1989 have unique licensure requirements depending on their amount of clinical experience, none of which require taking the national certification exam.

Similar to California, nurse practitioners electing not to take the national certification exam in New York may run into some obstacles in their practice. To participate the state’s Medicaid program certification by a national certifying body is required. Not participating in New York’s Medicaid program can preclude nurse practitioners from a significant number of job opportunities.

3. Kansas

Nurse practitioners seeking a license to practice in Kansas do not need to obtain national certification. They must only complete a nurse practitioner program approved by the state and hold a Kansas RN license. The Kansas Board of Nursing recognizes both in-state and out-of-state NP programs. Approved programs must be listed in the United States Department of Education database and meet certain curriculum requirements.

Although it may be tempting to bypass taking the national certification, as in other states certification by a national certifying body gives nurse practitioners a better job outlook in Kansas.

4. Indiana

In Indiana, nurse practitioners are not required to take the national certification exam. Rather, NPs practice under their RN license and must also complete an approved nurse practitioner program.

Like in other states, Medicaid, Medicare, and most health insurance companies require national certification for reimbursement. So, obtaining national certification is almost essential in finding a job despite the state’s requirements.

Do you live in a state that does not require nurse practitioners to take the national certification exam? Do you plan to become nationally certified regardless?

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