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National Clinical Mental Health Counseling Examination (NCMHCE)
The NCMHCE is the case-study licensure and certification examination developed and owned by the National Board for Certified Counselors (NBCC), administered through its affiliate CCE and delivered by Pearson VUE: 11 clinical case studies (one unscored) carrying 130-150 four-option multiple-choice questions (100 scored) answered in 225 minutes, covering six domains (Professional Practice and Ethics; Intake, Assessment, and Diagnosis; Treatment Planning; Counseling Skills and Interventions; Core Counseling Attributes; plus Areas of Clinical Focus embedded in the cases). It is required for counselor licensure in many states and is one of two exam options for the NCC certification and the exam for the CCMHC specialty certification. It is distinct from NBCC's National Counselor Examination (NCE).
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Questions130–150 multiple-choice questions per test form, of which 100 are scored; delivered as 11 case studies (one case study and some items unscored), each case study comprising one narrative and 9–15 four-option multiple-choice questions with one correct answer
Testing time225 minutes (3 hours 45 minutes) of examination time; total test session 255 minutes (4 hours 15 minutes) including a 5-minute confidentiality agreement, 10-minute tutorial, and one scheduled 15-minute break after the fifth case study; the exam clock does not stop for voluntary breaks
ScoringPass/fail against a form-specific cut score: each of the 100 scored items counts one point (maximum score 100); the cut score is set by a subject-matter-expert standard-setting process and statistically equated across test forms, so the passing score varies slightly by form. (From July 1, 2027: scores scaled 100–500 with a fixed passing point of 360.)
Exam feeUSD 350 examination registration fee paid to CCE for the initial exam and USD 275 for a re-exam (state licensure route), per the Florida licensing board; NBCC/CCE do not publish the fee on their public pages — it is shown during Credentialing Gateway registration — and fees are nonrefundable (USD 50 Pearson rescheduling fee; USD 150 national-certification cycle reregistration fee)
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What to know before choosing your prep
- Who runs it
- NBCC
- Category
- Counseling & Addiction
- Current version
- Current: NCMHCE Content Outline revised October 8, 2025 (test blueprint finalized 2021 from the June 2019 job analysis). Announced revision: 'NCMHCE Examination Specifications Effective July 1, 2027' — new six-domain blueprint from the 2024–2025 national work analysis (finalized October 2025), 10 case studies, and scaled scoring 100–500 with passing point 360.
- Where it applies
- United States — national
- Exam languages
- English
- Score scale
- Current: raw points on the 100 scored items (0–100), reported pass/fail; from July 1, 2027: scaled scores 100–500, passing 360
- Testing provider
- Pearson VUE (administration and scoring), coordinated through NBCC's affiliate CCE
- Format
- Computer-based; two delivery options — in-person at a Pearson VUE test center or online from home via Pearson VUE's OnVUE remote-proctored platform
- Availability
- Continuous monthly administration by appointment within a month-long approved test authorization window (state licensure route): in-person Monday–Saturday by appointment; OnVUE online offered 24 hours a day. National-certification candidates receive a 6-month testing window.
- Results
- Unofficial score report immediately after the exam (at the test center or via the OnVUE dashboard); official score reports sent to the state board approximately 30 business days after the monthly exam administration window closes
- Remote testing
- Available
Exam structure
11 clinical case studies (one unscored), each presented in three sections — initial intake summary plus two counseling sessions — where each section starts with narrative followed by 9–15 four-option multiple-choice questions; 130–150 items per form, 100 scored, distributed across six domains: Professional Practice and Ethics 15%, Intake/Assessment and Diagnosis 25%, Treatment Planning 15%, Counseling Skills and Interventions 30%, Core Counseling Attributes 15% (Areas of Clinical Focus is embedded in the case scenarios, not weighted at item level)
Where rules vary
One uniform national exam. Whether a state requires the NCMHCE, the NCE, both, or either varies by state board, but the exam itself does not vary; state licensing agencies set eligibility and may direct longer retest periods (e.g., Texas sets no attempt limit for its licensure).
Eligibility
Minimally qualified candidate has graduated from (or is well-advanced in) a counseling program accredited by CACREP or housed in an institutionally accredited college or university, with coursework across the required content areas; state-licensure candidates must also meet their state board's licensure eligibility requirements, which the state determines
Retake policy
30-day minimum wait after a failed attempt (longer if directed by the state licensing agency); a separate registration and fee is required for each retake; national-certification (NCC/CCMHC) candidates are limited in cycle timing and may not test more than once per examination cycle