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7 ways you can prepare for the NPTE

npte exam
6 minutes, 52 seconds

One of the final steps before graduating and starting your career as a physical therapist, potentially at a clinic like an Alliance Physical Therapy Partners (Alliance PTP) clinic, is taking and passing the NPTE. The NPTE is the National Physical Therapy Examination. It’s an evaluation process used by licensing authorities, and to become a licensed physical therapist or therapist assistant in the U.S., you must pass the examination. The NPTE is given by the Federation of State Boards of Physical Therapy. You must pass the NPTE to get your license to practice as a physical therapist or work as a physical therapist assistant. Licensing is managed by each individual state’s regulatory boards. 

Why do I need a license to practice physical therapy?

A state’s Board of Physical Therapy is responsible for safeguarding the health, safety and welfare of the citizens of their state. They help ensure this by requiring all who practice physical therapy in the state to be qualified to practice. Alliance PTP clinics are spread across the nation, and we can help you be prepared to meet the requirements of your Alliance PTP clinic’s state. The Board of Physical Therapy interprets laws, rules and regulations to set standards of practice to ensure patient care and professional conduct. The board also investigates allegations of violating rules and is responsible for disciplining those found guilty. 

In addition to passing the NPTE, each state may have its own exam you must also pass to become licensed in that state. It’s important to research the requirements for the state you plan to practice in. It’s illegal to practice physical therapy without a valid license.

I’m close to graduation. How do I get ready for the NPTE?

If you are attending a program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE), your school will be connected with the Federation of State Boards of Physical Therapy (FSBPT) and you will have access to a personalized journey map after you register for the exam. Before you register for the exam, you will also want to do the following to take the NPTE:

  • See what the requirements are to apply for your license in the state where you’ll practice
  • Complete an application for the state physical therapy license where you want to practice. 
  • Register and pay for the NPTE. The NPTE fee is currently $485. 
  • If you have a disability that is covered by the Americans with Disabilities Act (ADA), you may request testing accommodations if you need them. 
  • Get state licensing eligibility approval to take the NPTE. Once approved and notified, you can schedule an appointment with Prometric. It’s essential to schedule your exam appointment in the window of eligibility. If you don’t take the exam or withdraw your registration, you will be removed from the list and must start the process over. Current exam fees with Prometric are: $100.30 for a physical therapist, $82.60 for a physical therapist assistant, and $29.50 for the jurisprudence exam. 

The NPTE is offered quarterly. The FSBPT has the exam and other important dates for physical therapists and physical therapist assistants available for 2024, 2025 and 2026.

What topics should I study to be prepared for the NPTE?

The NPTE is a standardized exam that is used to assess your knowledge of and skills in physical therapy to become a licensed physical therapist in the United States. It’s a multiple-choice exam that covers a wide range of topics related to the practice of physical therapy. The topics covered on the exam include:

  • Cardiovascular and pulmonary systems.
  • Musculoskeletal system.
  • Neuromuscular and nervous systems.
  • Integumentary system.
  • Metabolic and endocrine systems. 
  • Gastrointestinal system.
  • Genitourinary system.
  • Lymphatic system.
  • System interactions.
  • Nonsystem items (equipment, devices, and technologies; therapeutic modalities; safety and protection; professional responsibilities; and research and evidence-based practice).

Over 60% of the NPTE covers the cardiovascular and pulmonary systems, musculoskeletal system, and neuromuscular and nervous systems. Excluding nonsystem items, each content area is divided into topics related to:

  • Physical therapy examination.
  • Foundations for evaluation, differential diagnosis, and prognosis.
  • Interventions. 

The NPTE format changed as of January 2024. It now has 225 questions. It previously had approximately 250 questions. Some questions may contain an image or a video; there may also be scenario-based questions. The test is allotted five hours to complete. It is given in five blocks of 50 items. Once a block is completed, you can’t go back to questions in the block. There is a 15-minute break scheduled after the second block. Additional breaks may be taken, but they will take away from the time available for the test.  

Scoring for the exam is 200 to 800. You must make a 600 or higher to pass. In 2023, the first-time pass rate was 84%.

Study strategies for NPTE success

The amount of time you need to spend studying and preparing to take the NPTE will depend on your learning style and background. Some students only need a few weeks to study and review while others feel they need longer to prepare. Most students may need several months to allow enough time to fully review all the material. Some strategies to help you be fully prepared can include:

  • Create a study schedule — A schedule can help keep you on track, stay organized and potentially keep you from becoming overwhelmed by the amount of information. You may want to spend two weeks on the “big three” topics (cardiovascular and pulmonary; musculoskeletal; neuromuscular and nervous) and one week on the other topics. Take an additional week closer to the exam to hit the “big three” again for a refresher. The week before the exam, work on building your testing endurance to be ready for the five-hour exam. You could do 50 questions on Monday, 100 on Tuesday, 150 on Wednesday, 200 on Thursday and the full amount on Friday. Take it as a marathon, not a sprint. Also, be sure to give yourself time for brain breaks to recharge so you can stay better focused.
  • Go beyond memorization — The NPTE now incorporates scenario-based questions, so you’ll want to know how to apply the knowledge in a practical setting for the exam. This helps ensure that you understand concepts, outcome measures, rehabilitation treatment strategies and the current best practices to help patients.
  • Invest in the right study material — Not all study guides are created equally. It will be worth the price to invest in quality study materials that will work best for you. Before purchasing, think about which methods of studying work best for you and find a study guide set that matches your needs. Using what you feel comfortable with will also help you avoid study fatigue and keep you engaged by keeping study sessions interesting.
  • Take more than one practice exam — Taking multiple practice tests can really allow you to get a feel for the exam and how to push through when you encounter harder questions. It also gives you a chance to see a large number of practice questions. Some tests may be harder than others as well and may leave you thinking, “That wasn’t so hard!” after completing the NPTE. Don’t stress about practice test scores.
  • Turn to online content — Look for a test outline that breaks down the content. This can help you create your study schedule to best fit your needs. It’s also the best way to stay up to date with any changes. The FSBPT did make changes effective January 2024, so it is good to keep an eye out for additional changes. 
  • Don’t study stressed — If you are feeling overwhelmed and stressed to the max, take a step back and take a break from studying. Don’t wait until the last minute and try to cram. Take a day or two off to let your mind rest before the big exam day. Taking time to make sure you do things you enjoy can help ward off stress and make your chances of success higher. Study in a comfortable place so you can focus on studying. 
  • Find a tutor — If you’re feeling overwhelmed and not confident you’re studying how you should or remembering what you need to know, get connected with a physical therapy tutor who has taken the exam. This can help you work with someone who has been there and knows what to expect. You don’t have to do it alone!

Stay positive and don’t give up! Look for and use strategies that work for you. Keep your eyes on the prize and once you pass, it will have all been worth it. And in the event you don’t pass the first time, you can take the exam again. Adjust your study methods and conquer the NPTE. 

Is preparing for the NPTE posing a challenge for you? Alliance PTP is here to help 

Need a partner to help you address challenges like tackling the NPTE? Alliance Physical Therapy Partners’ nationwide partnership in care is here for you.

We’ll help you get the support you need as a newly graduated physical therapist or physical therapy assistant. Even better, you’ll get full access to our employee support services while still maintaining full control over how you’re working to improve your skills. 

Find out if our Alliance PTP partnership has a career opening for you today.