# PA-C certification: PANCE, NP vs PA & jobs

PA-C is the certification a physician assistant earns by passing the PANCE, kept on a 10-year NCCPA cycle. The exam, the upkeep, and NP vs PA.

- **Author:** MedJobList Team
- **Published:** Jul 24, 2026

## What is PA-C certification?

PA-C means Physician Assistant-Certified: the national certification you hold after graduating from an accredited PA program and passing the Physician Assistant National Certifying Exam (PANCE). It's issued by the National Commission on Certification of Physician Assistants (NCCPA), and it's the credential US employers and state boards check before a physician assistant can treat patients. Once you pass, you can put PA-C after your name, and you keep it by logging continuing medical education and passing a recertifying exam every 10 years.

## NP vs PA

The core difference is the training path: a physician assistant trains in the medical model as a generalist, while a nurse practitioner trains in the nursing model and usually enters already licensed as a registered nurse. Both diagnose, order and read tests, and prescribe, and their pay is close, so the choice usually comes down to how you want to get there and how you want to practice.

| Field | Value |
| --- | --- |
| Training model | PAs train in the medical model as generalists across all specialties; NPs train in the nursing model and pick a population focus such as family or acute care from the start. |
| What you need to enter | PA programs take applicants with a bachelor's degree plus hands-on healthcare hours; NP programs expect a registered nurse license and a nursing degree first. |
| Degree earned | Both finish at the graduate level, a master's for most PAs and a master's or doctorate (DNP) for NPs. |
| Certifying body and exam | PAs certify through the NCCPA by passing the PANCE; NPs certify through the AANP or the ANCC on a separate exam, covered in our NP guide. |
| How they practice | PAs practice in collaboration with or under the supervision of a physician, on terms each state sets; in more than half of states NPs can practice without a physician agreement (AANP, 2026). |
| Median pay | Close nationally: $133,260 for PAs and $129,210 for NPs (BLS, May 2024), with specialty and location moving the number more than the title does. |

Neither credential outranks the other on the job. In many clinics a PA and an NP hold the same role, see the same patients, and bill the same way. If you want the NP side in full, including which exam and which body to certify through, see our [NP certification guide](/guides/np-certification).

## Who requires PA-C

PA-C is the credential physician assistant roles are built around, so employers ask for it by name on the posting. In our catalogue those are physician assistant openings across hospitals, specialty and primary care clinics, urgent care, surgical practices, and emergency departments. Listings usually word it as "PA-C" or "current NCCPA certification required," and many also want an active state license and a BLS or ACLS card on top. You can see current [physician assistant jobs](/physician-assistant-jobs) and filter them by state.

## Requirements and eligibility

- Graduate from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). This is the one hard gate for the PANCE.
- PA programs run at the master's level, usually 2 to 3 years, and set their own admission requirements, often a bachelor's degree plus documented healthcare hours.
- No registered nurse license is needed. That's the NP path, and it isn't required for PA certification.
- No physician (MD or DO) degree is involved.
- Sit the PANCE within 6 years of graduating, with up to 6 attempts, no more than 3 in a calendar year and one every 90 days.
- Pass the PANCE to earn the PA-C designation and NCCPA board certification.

## The PANCE: cost and format

The PANCE costs $550 to register (NCCPA, 2026) and is a one-day computer exam at a Pearson VUE test center. It's the exam that turns a PA graduate into a PA-C, and you get one 180-day window after your program signs off to sit it.

| Field | Value |
| --- | --- |
| Exam fee | $550, paid to the NCCPA at registration (NCCPA, 2026) |
| Format | 300 multiple-choice questions in five blocks of 60 |
| Length | 5 hours of testing, about 6 hours at the center with the tutorial and breaks |
| Where | Pearson VUE test centers, offered year round |
| Eligibility window | Up to 6 years and 6 attempts after graduation, capped at 3 per calendar year |
| Pass result | The PA-C designation and NCCPA board certification, valid for a 10-year maintenance cycle |

## NCCPA certification maintenance: PANRE and CME

You keep PA-C on a 10-year maintenance cycle made of five 2-year CME cycles, plus one recertifying exam by the end of year 10. The continuing education is due every 2 years; the exam comes once, by the end of year 10.

| Field | Value |
| --- | --- |
| Certification cycle | 10 years, split into five 2-year CME cycles (NCCPA, 2026) |
| CME per 2-year cycle | 100 credits logged with the NCCPA, at least 50 of them Category 1 |
| Maintenance fee | $180 each 2-year cycle, due by December 31 of your cycle-end year (NCCPA, 2026) |
| Recertifying exam | PANRE or PANRE-LA, passed by the end of year 10 |
| Recert exam fee | $350 for either PANRE or PANRE-LA (NCCPA, 2026) |
| When you take it | PANRE in year 9 or 10; PANRE-LA is a longitudinal option you apply for in year 6, then answer questions across quarterly windows in years 7 to 9 |
| CME logging window | May 1 of your certification-issue year through December 31 of your expiration year |

## Certification is not the same as a state license

NCCPA certification and a state license are two separate things, and you need both to work. The PA-C from the NCCPA is national and proves you passed the PANCE; the license comes from your state's medical or PA board and is what actually lets you see patients there. Nearly every state requires current NCCPA certification to grant and renew that license, so in practice the two move together. A few states run differently: California, for example, licenses PAs on a passing PANCE score without requiring you to keep the NCCPA certification active afterward. Check your own state board before you assume one covers the other.

## How to get certified

1. Finish an ARC-PA accredited PA program. Your program reports your completion to the NCCPA.
2. Create or update your NCCPA record and register for the PANCE. Registration opens about 90 days before your expected graduation.
3. Book a seat at a [Pearson VUE center through the NCCPA](https://www.nccpa.net/become-certified/) inside your 180-day window.
4. Pass the PANCE. You'll earn the PA-C designation and NCCPA board certification.
5. Apply to your state medical or PA board for a license before you start seeing patients. Most boards want proof of your NCCPA certification.
6. Start logging CME right away and put your recertification year on the calendar, since the exam and fees fall due on that 10-year cycle.

## Demand for PA-C on MedJobList

PA-C is named in 653 of the active US openings we track right now. They cluster in physician assistant roles across hospitals, specialty clinics, and urgent care, and postings almost always list the certification as required rather than preferred, because a state license depends on it. You can browse those openings in the section below or filter the full job list by PA-C yourself.

## On the job

Your PA-C goes on your badge, your charts, and your prescriptions, so employers verify it at hiring and again when your license renews. The collaboration or supervision agreement with a physician is usually set up by the practice, not by you. Ask at onboarding who covers your CME and your recertification and PANRE fees: many hospitals and larger groups budget for both, and it's worth confirming before the next 2-year cycle comes due.

## FAQ

### What's the difference between a PA and a PA-C?

PA is the job, physician assistant; PA-C is the credential. The C stands for certified and means you passed the PANCE and hold current NCCPA board certification. Employers and most state boards want the PA-C, not just the degree.

### Is it better to become an NP or a PA?

Neither is better across the board. PAs train in the medical model as generalists and practice with a physician agreement; NPs train in the nursing model, need a registered nurse license first, and can practice independently in more than half of states (AANP, 2026). Pay is close: $133,260 for PAs and $129,210 for NPs (BLS, May 2024). See our [NP certification guide](/guides/np-certification) for the nursing route.

### How much does the PANCE cost?

$550, paid to the NCCPA when you register (NCCPA, 2026). That covers one attempt at a Pearson VUE test center within your 180-day eligibility window.

### How often do physician assistants have to recertify?

The certification runs on a 10-year cycle. You log 100 CME credits every 2 years, pay a $180 maintenance fee each cycle, and pass a recertifying exam (PANRE or PANRE-LA, $350) by the end of year 10 (NCCPA, 2026).

### Do you need NCCPA certification to work as a PA?

In nearly every state, yes. State boards require current NCCPA certification to grant and renew a PA license. A few states, such as California, license on a passing PANCE score without requiring you to keep the certification active. Check your state board.

Source: https://medjoblist.com/guides/pa-c-certification