How to Pass the National Physical Therapy Exam

NPTE Study Guide, Test Prep Strategies, and Exam Details

African-American physiotherapist in a clinic

Every day, countless patients put their health in the hands of physical therapist assistants (PTAs), trusting their skills and knowledge for successful rehabilitation. No matter the medical condition being treated, there are numerous risks and considerations to account for in a therapy environment, which is why PTAs undergo such extensive classroom and clinical training.

In addition to graduating from an accredited PTA program, physical therapist assistants must pass the National Physical Therapy Exam (NPTE) before they can become licensed and begin treating patients. It’s an important final step in demonstrating a thorough grasp of the concepts and patient-care skills that make for a successful PTA.

If you’re a recent or upcoming graduate of a PTA program, you’ve likely got the NPTE on your mind. And if you’re a little nervous about taking the exam, we’re here to help! This comprehensive test guide will help you learn how to pass the NPTE by teaching you everything you need to know about the testing process, format, length, and requirements. We’ll also include an overview of the exam content, and some helpful tips on studying and test-prep strategies.

Still trying to decide if a career as a PTA is the best choice for you? Learn more about how to become a physical therapist assistant.

NPTE Exam Format, Length, and Details

What is the NPTE?

The NPTE stands for the National Physical Therapy Exam. It’s administered by the Federation of State Boards of Physical Therapy (FSBPT), and there are separate versions of the exam for physical therapists and physical therapist assistants. Passing the NPTE is required to receive a PT or PTA license in all 50 states.

The NPTE exam is designed to ensure that physical therapist assistants have mastered essential PTA skills, and prove they meet the necessary requirements to provide safe and competent care.

How many questions are on the NPTE for PTAs?

The NPTE exam for PTAs currently consists of 200 multiple-choice questions, with four separate 50-question sections. Starting in 2024, the NPTE-PTA exam will move to a total of 180 questions, with up to 35 scenario-based questions.

How long do I have to take the NPTE?

The total testing time for the NPTE-PTA exam is 4 hours, with a short break after each 50-question section. Including the pre-exam tutorial, post-exam survey, and the scheduled break times, you can expect to spend at least 4 hours and 30 minutes at the testing site.

What score do you need to pass the NPTE?

The NPTE exam uses a scaled scoring system with results ranging from 200 to 800. Scoring an 800 doesn’t necessarily mean you answered every question perfectly, but it’s the highest possible score the FSBPT reports.

The NPTE is a pass/fail exam—any score of 600 or higher will pass the NPTE, and any score below 600 counts as failing. Unlike many exams you take in school, it’s not designed to distinguish between varying levels of excellence, it’s meant to ensure anyone who passes will be able to safely practice as a physical therapist assistant.

How many times can you take the NPTE?

If you don’t pass the NPTE on your first attempt, there’s no reason to panic. Plenty of people become successful physical therapist assistants after a difficult first exam. However, it’s important to be well-prepared for your follow-up attempts. Rules can vary by jurisdiction, but the FSBPT only allows a candidate to take the NPTE three times in any 12-month period. There’s also a lifetime limit of six attempts to pass the exam.

How much does it cost to take the NPTE?

As of September 2023, the FSBPT’s current fee for the NPTE exam is $485. You’ll also pay a separate fee to the test provider when scheduling your exam, which is around $80 for PTAs.

Woman wearing glasses using a computer

How do I register for the NPTE exam?

If you’re attending a CAPTE-accredited physical therapist assistant program, your school should create an FSBPT profile for you. The FSBPT site can help you log into or recover your account if you’re having trouble accessing your profile. Once you’re logged in, you can register for the exam in the Services area of your dashboard.

Before you can register for the NPTE, you’ll need to receive and review a licensure application for the state where you intend to practice. Once your school validates your graduation with the FSBPT, you’ll be eligible to register for the NPTE exam. Be sure to review their important dates and deadlines for NPTE exam registration and payment.

How do I schedule my NPTE exam?

Once you’ve successfully registered and paid for your NPTE exam, you’ll receive an Authorization to Test (ATT) letter, accessible via email or your FSBPT account. This ATT is required to schedule your exam time with a test provider, and will include all the important details on how to proceed. Once you’ve received your ATT, it’s a good idea to schedule your exam as soon as possible, as testing dates can fill up quickly.

NPTE Exam Study Guide & Test-Prep Tips

How do I study for the NPTE?

Passing the NPTE exam on your first try not only saves you money on testing fees but also means you’ll be able to start your new career sooner. Like any big test, being well-prepared for what’s on the exam is the key to more confidence and less stress. Getting familiar with the NPTE exam content outline from the FSBPT will give you a great start on the subjects you should review from your textbooks and lecture or clinical notes.

What subjects are on the NPTE?

The majority of the NPTE consists of questions about body systems in nine separate areas:

  • Cardiovascular and pulmonary systems: 20-27 questions
  • Musculoskeletal systems: 31-40 questions
  • Neuromuscular and nervous systems: 27-35 questions
  • Integumentary system: 3-8 questions
  • Metabolic and endocrine systems: 4-6 questions
  • Gastrointestinal system: 0-4 questions
  • Genitourinary system: 0-4 questions
  • Lymphatic system: 2-6 questions
  • Interactions between body systems: 5-7 questions

You should be well-versed in the diseases and conditions for each of these body systems that can impact effective treatment, and the therapeutic interventions used to treat each of them. Where applicable, you should also be confident in your knowledge of any relevant data collection and recording methods for each body system.

Around 15% of the NPTE exam consists of non-body-system questions in the following areas:

  • Equipment, devices, and technologies: 8-10 questions
  • Therapeutic modalities: 5-7 questions
  • Safety and protection: 6-8 questions
  • Professional responsibilities: 2-4 questions
  • Research and evidence-based practice: 1-3 questions

There may also be a few additional questions on essential PTA proficiencies like communication skills, teaching and learning techniques, or telehealth best practices. Anything that stuck out as important during your PTA program will likely appear in some form on the NPTE exam!

NPTE Exam Preparation Tools

The sheer volume of content on the NPTE exam can be intimidating. Fortunately, there are some excellent resources available directly from the FSBPT to help you study for the NPTE. Beyond this guide, exploring the NPTE Candidate Handbook is a great follow-up for learning all about the exam, and what to expect before and after you take the test.

Physiotherapist helping their patient use exercise bands

By far one of the most useful NPTE study resources is the Practice Exam and Assessment Tool, or PEAT. It includes the same types of questions you’ll find on the real NPTE exam, with immediate scoring and a detailed performance report by subject area. PEAT also includes rationale and explanations behind correct answers to help address any misunderstandings.

PEAT is a web-based tool that includes two full-length practice exams for $99, which you can access anytime during a 90-day window of logging onto the first practice test. You can pause the exams if you’re unable to complete them in one sitting, or take them in a more realistic timed mode to re-create a real testing environment. Compared to the cost of taking the NPTE exam a second time and delaying your career, many people find paying for PEAT is well worth it.

If you want to get a feel for the user interface and take a tutorial ahead of time, the official NPTE Demonstration Exam is another free resource to familiarize you with the look and feel of the testing platform. It also includes a handful of practice questions, complete with an answer key. While not nearly as comprehensive as PEAT in measuring how well you know the material, it gives you an idea of what to expect at the testing center.

Third-party exam guides are also available online and in many bookstores. It’s tough to go wrong with many of these, as long as they generally follow the subjects in the content outline from the FSBPT. The most important thing is that you’re reviewing the material and taking your NPTE test preparation seriously, which will give you the best chance to pass!

Sample NPTE Exam Questions for PTAs

Taken from the NPTE Candidate Handbook, the following sample exam questions will help you learn what to expect while taking your exam. Keep in mind that there is always one correct answer per question. (We’ll include an answer key at the end of the article.)

1. During a physical therapy evaluation, a patient with a sprain of the deltoid ligament of the ankle reports pain with palpation of the affected area and with ankle motion that stresses the ligament. To determine any change in the patient’s pain level during subsequent treatment, a physical therapist assistant should palpate which of the following areas?

a. Anterior to the lateral malleolus while the patient’s ankle is passively everted
b. Inferior to the medial malleolus while the patient’s ankle is passively everted
c. Over the sinus tarsi while the patient’s ankle is passively inverted
d. Deep to the Achilles tendon while the patient’s ankle is passively dorsiflexed

2. Which of the following instructions would be MOST appropriate to give a patient who is learning pursed-lip breathing?

a. Exhale through pursed lips while contracting abdominal muscles
b. Exhale by blowing air out forcefully between pursed lips
c. Exhale by relaxing air out through pursed lips
d. Exhale in quick short puffs through pursed lips

3. A patient with impaired kinesthesia who is performing active range-of-motion exercises of the upper extremities will MOST likely require which of the following supplemental interventions?

a. Visual cues while performing the exercises
b. Pain-relieving modalities prior to performing the exercises
c. Trunk stabilization while performing the exercises
d. Stretching prior to performing the exercises

Test Day Tips for the NPTE

When the day comes to take your exam, keep the following tips in mind to give yourself the best chance at success:

Arrive early: Even minor tardiness can delay the start of your new career by forcing you to reschedule your exam for a later date. Make sure you know how to get to the testing center, where you’re parking, and what traffic is usually like in the area. Allow yourself more time than you think you’ll need.

Bring ID: Licensure exams have serious legal implications, and you’ll need to bring two separate forms of ID (showing the same name as your Authorization to Test letter) to verify your identity.

Be well rested: A good night’s sleep the night before your NPTE exam should be your top priority. Your brain and memory function much better after adequate rest, and you’ll want to be on top of your game.

Hydration and nutrition: Four hours is a long time to take an exam on a growling, empty stomach. While you may not want a sleep-inducingly hearty meal beforehand, it’s wise to have something to eat. Be sure you’ve had enough water, too—you’ll have the opportunity for bathroom breaks.

Smiling African-American allied health professional

Prepare to Pass the NPTE at Provo College

Passing the NPTE exam is a critical final step to achieving your new career as a physical therapist assistant, and any respectable PTA program will do its best to make sure you’re prepared. The physical therapist assistant program at Provo College features a curriculum built around helping you achieve licensure, with experienced instructors who can help you master the material and conquer any test-taking anxiety.

With a blended online and in-person program, you’ll have the flexibility to learn at your pace, while getting the hands-on training it takes to learn proper therapeutic techniques. By the time you graduate, you’ll have the knowledge and confidence you need to pass the NPTE, earn your PTA license, and begin your exciting new career helping people become healthier.

Still making your decision about where to attend PTA school? Click here to learn how to choose the best physical therapist assistant program for your needs.

Sample Question Answer Key: 1 – b; 2 – c; 3 – a