- The exam has four domains: Professional Foundation 22%, Care Coordination 30%, Quality Management 26%, Health Promotion 23%.
- Care Coordination is the largest domain, carrying 37 of the 125 scored questions.
- You face 150 questions in three hours; only 125 count and 25 are unscored pretest items.
- Passing requires a scaled score of at least 350 out of 500, not a raw 70%.
How the CMGT-BC Exam Is Built: Four Domains, 125 Scored Questions
- How the CMGT-BC Exam Is Built
- Exam Format and Question Delivery
- Domain Weights and Scored Question Counts
- Domain 1: Professional Foundation (22%)
- Domain 2: Care Coordination (30%)
- Domain 3: Quality Management (26%)
- Domain 4: Health Promotion (23%)
- Sequencing Your Preparation by Domain
- Phaseout Timing and Why It Shapes Your Plan
- Frequently Asked Questions
Key Takeaways
- The exam has four domains: Professional Foundation 22%, Care Coordination 30%, Quality Management 26%, Health Promotion 23%.
- Care Coordination is the largest domain, carrying 37 of the 125 scored questions.
- You face 150 questions in three hours; only 125 count and 25 are unscored pretest items.
- Passing requires a scaled score of at least 350 out of 500, not a raw 70%.
- Exam administration ends December 31, 2027, so plan your testing window around that deadline.
The Nursing Case Management Board Certification Examination, offered by the American Nurses Credentialing Center (ANCC), leads to the designation Case Management Nurse - Board Certified (CMGT-BC). Every question on the exam maps to one of four content domains published in the official Test Content Outline, effective October 23, 2024 and updated September 8, 2025. Understanding how those domains are weighted, and what each one actually asks of you, is the single most useful step you can take before opening a study guide.
This guide walks through each domain in detail, explains how the weights translate into scored questions, and shows how to sequence your preparation around them. If you are still deciding whether to pursue the credential, start with What Is CMGT-BC Certification? and then return here for the content breakdown.
Exam Format and Question Delivery
Before looking at content, it helps to know the container the content arrives in. Prometric administers the exam as a closed-book, computer-based, multiple-choice test at physical test centers. The certification exam is in person only; it is not remotely proctored. A remote readiness test from ANCC does not mean the actual certification exam can be taken remotely.
- Total questions: 150, made up of 125 scored items and 25 pretest items.
- Time allowed: three hours. Breaks consume exam time, so use them sparingly.
- Navigation: you can mark questions and return to them before submitting.
- Guessing: there is no penalty, so never leave an item blank.
- Prohibited: personal calculators and any paper or electronic resources. A dry-erase board is supplied.
- Authorization window: standard authorization lasts 120 days from approval.
The 25 pretest questions are indistinguishable from scored ones, so treat every item as if it counts. Because the domains are distributed across the whole test rather than grouped into blocks, you will move between Care Coordination, Quality Management and the other areas without warning. For more on the testing window itself, see CMGT-BC Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Domain Weights and Scored Question Counts
The issuer publishes rounded percentages for each domain. Those percentages total 101% because of rounding, and they should be read as published rather than adjusted. The scored item allocations out of 125 are what matter for planning.
| Domain | Published Weight | Scored Questions (of 125) |
|---|---|---|
| 1. Professional Foundation | 22% | 27 |
| 2. Care Coordination | 30% | 37 |
| 3. Quality Management | 26% | 32 |
| 4. Health Promotion | 23% | 29 |
Scoring is also not a simple percentage. A passing result requires a scaled score of at least 350 on a 500-point scale, set using the Modified Angoff method. That means you cannot reverse-engineer a fixed number of correct answers. For a deeper treatment, read CMGT-BC Passing Score 2026: Exactly What You Need to Pass.
Domain 1: Professional Foundation (22%)
Professional Foundation covers the role, scope and accountability of the nurse case manager. It is the domain that most directly tests whether you understand case management as a distinct nursing practice rather than a variation of bedside care. With 27 scored questions, it is the smallest domain, but the content is conceptual and tends to reward careful reading of scenario wording.
What to Master in Professional Foundation
Expect questions that ask you to apply professional standards and ethical reasoning to realistic case management situations.
- The scope and standards of practice for nurses working in case management roles
- Ethical and legal principles, including patient autonomy, confidentiality and advocacy
- Professional accountability, boundaries and the limits of the case manager role
- Role definition across settings such as hospitals, payers, community programs and transitions of care
- Communication, collaboration and professional development responsibilities
A common mistake is treating this domain as common-sense material. Because these items often present two defensible-sounding answers, the correct choice is usually the one that best matches formal practice standards and the case manager's specific role, not the most compassionate or expedient option.
Domain 2: Care Coordination (30%)
Care Coordination is the heart of the exam and the largest domain, with 37 scored questions. It reflects what nurse case managers do day to day: assess needs, build and monitor plans of care, manage transitions, and connect patients with the right resources at the right time.
What to Master in Care Coordination
This domain rewards process thinking. You should be able to walk a patient through the full case management cycle and identify the correct next step at any point.
- Comprehensive assessment and identification of patients who need case management
- Developing, implementing and monitoring individualized care plans
- Transitions of care and discharge planning across levels and settings
- Coordination with interdisciplinary teams, payers, families and community resources
- Resource utilization, benefit navigation and removal of barriers to care
- Reassessment, follow-up and evaluating whether goals are being met
Questions here tend to be scenario-driven, asking what the case manager should do first or next. Sequencing matters: assessment generally precedes planning, and planning precedes implementation. Practice reading each stem for the point in the process it describes before looking at the options.
Domain 3: Quality Management (26%)
Quality Management carries 32 scored questions and tends to be the domain nurses with less administrative exposure find most unfamiliar. It addresses how case managers measure, monitor and improve the quality and cost-effectiveness of care, and how data informs decisions.
What to Master in Quality Management
Think in terms of outcomes, measurement and improvement cycles rather than individual patient interactions alone.
- Outcome measurement, performance indicators and use of data to evaluate care
- Quality improvement methods and the logic of identifying and closing gaps
- Patient safety, risk management and adverse-event response
- Utilization management, cost-effectiveness and appropriate use of resources
- Regulatory, accreditation and compliance considerations that shape practice
- Evidence-based practice and applying research findings to case management
If your background is primarily clinical, give this domain disproportionate attention relative to your comfort level. The questions are less about what you do at the bedside and more about how you demonstrate that your interventions are working. Pairing this domain with practice questions is especially effective, because applying a concept to a scenario exposes gaps that reading alone does not.
Domain 4: Health Promotion (23%)
Health Promotion accounts for 29 scored questions and focuses on empowering patients and populations to manage their own health. It connects case management to prevention, education, self-management and the social factors that influence outcomes.
What to Master in Health Promotion
This domain asks you to apply behavior-change and education principles within a case management framework.
- Patient and caregiver education, including adapting teaching to literacy and readiness
- Self-management support for chronic conditions
- Prevention, screening and wellness strategies at the individual and population level
- Social determinants of health and how they affect access and adherence
- Cultural humility, communication and engaging patients in shared decision-making
- Behavior-change approaches such as motivational techniques
These questions often pair a patient situation with a barrier, such as limited health literacy, a cultural consideration or a lack of social support, and ask for the most appropriate intervention. The right answer typically empowers the patient rather than doing the task for them.
Sequencing Your Preparation by Domain
Generic study schedules help little here. A better approach is to order your preparation by how much each domain demands and how likely it is to be unfamiliar. The timeline below is one reasonable arrangement for a four-week push once you have reviewed the outline.
Care Coordination
- Walk the full case management cycle from assessment to reassessment
- Drill transitions of care and resource navigation scenarios
Quality Management
- Learn outcome measures, improvement cycles and utilization concepts
- Review safety, risk and compliance fundamentals
Professional Foundation and Health Promotion
- Review scope, standards and ethical reasoning
- Cover patient education, self-management and social determinants
Mixed Practice and Timing
- Take full-length, timed sets that mimic the 150-question format
- Revisit your weakest domain based on results
Starting with Care Coordination front-loads the heaviest and most interconnected content. Practicing under timed conditions in the final week matters because three hours for 150 questions leaves roughly 72 seconds per item, and breaks draw from the same clock. Our full CMGT-BC Study Guide 2026: How to Pass on Your First Attempt expands this into a complete plan, and the CMGT-BC Cheat Sheet 2026: One-Page Review of Must-Know Facts is a useful last-day refresher.
Key Takeaway
Use your first practice set as a diagnostic. If one domain scores noticeably lower, shift study hours toward it, but keep every domain in rotation. All four contribute to a single scaled score, and a weak area can sink an otherwise strong attempt.
Phaseout Timing and Why It Shapes Your Plan
This certification is on a defined wind-down schedule, and that affects how you should approach the exam. Initial applications are accepted through December 31, 2026. The examination and retesting end December 31, 2027, after which the program becomes renewal-only. Nurses who are actively certified on January 1, 2028 may continue renewing.
Practically, that means your attempts are bounded by the final testing deadline. Retesting requires at least 60 calendar days after a previous attempt, renewed eligibility, and no more than three attempts in 12 months, all subject to that final deadline. If you fail late in the window, you may not have time for another try. Aim to test with a buffer rather than at the last moment, and confirm current details through CMGT-BC Requirements 2026: Eligibility, Prerequisites & How to Qualify.
| Item | Detail |
|---|---|
| Initial fee | $395 nonmember, $295 ANA member (includes a $140 nonrefundable administrative fee) |
| Eligibility highlights | Active RN license, two FTE years as an RN, 2,000 case management practice hours within three years, 30 specialty CE hours within three years |
| Certification length | Five years |
| Initial applications close | December 31, 2026 |
| Exam and retesting end | December 31, 2027 |
Fee and pricing context is covered in CMGT-BC Certification Cost 2026: Complete Pricing Breakdown. If you are weighing the investment against the shrinking window, Is the CMGT-BC Certification Worth It? Complete ROI Analysis 2026 lays out the considerations.
To gauge how these domains translate into difficulty and outcomes, see How Hard Is the CMGT-BC Exam? Complete Difficulty Guide 2026 and CMGT-BC Pass Rate 2026: What the Data Shows. The most recent published figures show a 66% first-time pass rate for 2025, with 188 passes among 286 first-time candidates, which suggests the exam is passable with focused preparation but not trivial.
When you are ready to test your knowledge against realistic items organized by domain, try the CMGT-BC practice test and review your results by content area to see exactly where to spend your remaining study time.
Frequently Asked Questions
There are four: Professional Foundation (22%), Care Coordination (30%), Quality Management (26%) and Health Promotion (23%). The issuer's rounded percentages total 101%, which is a rounding artifact rather than an error in the outline.
Care Coordination, at 30% of the content, with 37 of the 125 scored questions. Quality Management follows with 32, then Health Promotion with 29 and Professional Foundation with 27.
No. Of the 150 questions, 125 are scored and 25 are unscored pretest items. You cannot tell which are which, so answer every question carefully. There is no penalty for guessing.
No. The certification exam is delivered in person at Prometric test centers. Remote delivery of an ANCC readiness test does not mean the certification exam is available remotely.
You need a scaled score of at least 350 on a 500-point scale. The standard is set with the Modified Angoff method, so it is not a raw 70% cutoff and does not correspond to a fixed number of correct answers.