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NPTE Exam information

What it is, what's tested, and how it's scored.
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NPTE exam details

The NPTE (National Physical Therapy Exam) is administered by the FSBPT (The Federation of State Boards of Physical Therapy) and includes a PT (Physical Therapist) version and PTA (Physical Therapist Assistant) version, which slightly differ. Passing the NPTE is a huge step toward becoming a licensed physical therapist or physical therapist assistant. The exam ensures that each candidate has the proper knowledge to practice physical therapy and can adequately provide care to their patients.
The NPTE exam is hosted by FSBPT and costs $485 to register. Participants have 5 hours (PT) / 4 hours (PTA) to answer 225 (PT) or 180 (PTA) multiple-choice multiple-choice questions. The passing score is 600+.

Time

5 hours (PT) / 4 hours (PTA)

Format

225 multiple-choice questions (PT)
180 multiple-choice questions (PTA)

Exam fee

$485

Passing score

600+

Details

The NPTE-PT and NPTE-PTA exams cover the same information, but to different depths. The NPTE-PT exam consists of five sections, each with 45 multiple-choice questions, while the NPTE-PTA exam consists of only four sections, each with 45 multiple-choice questions. The PT exam covers more extensive knowledge than the PTA exam, but the content of the sections is equivalent.
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NPTE's PT/PTA exam summary

Cardiovascular and Pulmonary Systems
14-19%
20 to 27 questions
This section focuses on the anatomy and physiology of the heart, lungs, and blood system. It explores topics such as disease prevention, diagnoses, movement analysis, complications, and adverse effects within these systems. It is crucial to evaluate different breathing and relaxation tactics and fitness endurance plans.
Musculoskeletal System
22-29%
31 to 40 questions
This section focuses on the anatomy and physiology of muscles, joints, bones, and tendons. It explores topics such as joint biomechanics, movement analysis, connective tissue diseases, and diagnoses. Strength exercises, joint mobility strategies, and flexibility methods are examined.
Neuromuscular and Nervous Systems
19-25%
27 to 35 questions
This section focuses on the anatomy and physiology of nerves, motor neurons, and muscle fibers. It covers topics such as motor control and learning, the impact of regenerative medicine, and diagnoses. Awareness of balance and coordination methods is necessary.
Other Systems
11-20%
14 to 29 questions
This section includes the Integumentary, Metabolic and Endocrine, Gastrointestinal, Genitourinary, and Lymphatic systems, as well as System Interactions:
Integumentary System: Covers topics such as skin, hair, nails, and glands, as well as scar mobility, pressure, friction, and surgical interventions. Recognizing techniques for pressure relief, pain management, and healing capabilities is paramount.
Metabolic and Endocrine Systems: Focuses on metabolism, hormones, and the thyroid, covering topics such as diagnoses, health promotion using daily activities and understanding nutrient absorption, and adrenal and pituitary conditions.
Gastrointestinal: Covers the GI tract, including the esophagus, intestines, stomach, and rectum. Explores topics such as diagnoses, muscular tension, bowel movements, and reflux prevention.
Genitourinary System: Covers topics such as urinary organs, bladder, kidneys, and genitals. Explores diagnoses, bladder conditions, pelvic floor retraining, and the reproductive system.
Lymphatic System: Focuses on lymphatic vessels, nodes, organs, and tissues. Explores diagnoses, diseases, compensatory movements, and adverse effects within this system.
System Interactions: Focuses on diseases and conditions involving multiple systems, dimensions of pain, indications and precautions, applications, and adjustments.
Non-system Domains
16-22%
22 to 32 questions
This section includes Therapeutic Modalities and Professional Responsibilities:
Therapeutic Modalities: Focuses on the use of equipment, devices, and modalities such as thermal, electrical, and nerve stimulation, mechanical motion devices, infection control, signs of abuse, injury prevention, and biofeedback.
Professional Responsibilities: Focuses on safety and protection standards, patient/client rights, professional ethics, state and federal laws, socioeconomic factors, risk management, utilization of health records, and billing standards.
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Achievable NPTE content outline

Cardiovascular System
This section covers cardiac anatomy and physiology, blood flow, electrical conduction, and the effects of cardiovascular pathologies such as heart failure, MI, and hypertension. You will study examination techniques like heart rate, blood pressure, auscultation, and EKG interpretation. Interventions include aerobic training, vital sign monitoring, and cardiac rehab phases. Understanding contraindications, MET levels, and emergency responses (e.g., for angina or orthostatic hypotension) is essential.
Pulmonary System
Pulmonary topics focus on normal lung mechanics, oxygenation, and gas exchange, along with obstructive (e.g., COPD, asthma) and restrictive (e.g., fibrosis, scoliosis) lung diseases. You'll review breath sounds, chest wall movement, ABG interpretation, and spirometry values. Interventions include airway clearance techniques, postural drainage, breathing exercises, and the use of oxygen therapy. Recognizing signs of respiratory distress and managing pulmonary devices (e.g., ventilators, O2 masks) is also emphasized.
Neurological System (Including Pediatrics)
This unit addresses central and peripheral nervous system disorders such as CVA, SCI, Parkinson’s, MS, and pediatric conditions like cerebral palsy and developmental delays. Emphasis is placed on motor learning, neuroplasticity, PNF, NDT, gait training, balance assessment, and functional outcome measures. Pediatric milestones, reflex integration, and age-appropriate intervention strategies are also tested. Interventions include facilitation/inhibition techniques, sensory integration, and coordination exercises.
Musculoskeletal System
Topics include joint structure and function, muscle physiology, biomechanics, and common conditions like OA, RA, fractures, tendon/ligament injuries, and post-op protocols (e.g., ACL, THA). Assessment tools include goniometry, MMT, special tests, and palpation. Interventions emphasize therapeutic exercise, manual therapy, modalities, and patient education. Proper progression, contraindications, and assistive device prescription are critical components.
Other Systems
This section involves endocrine, metabolic, integumentary, immune, GI, and GU systems. You’ll study diabetes management, wound healing stages, burns, pressure injuries, and infection control. Interventions include positioning, pressure relief, dressing types, and skin inspection. PTA scope in wound care, post-mastectomy rehab, and oncology-related precautions are also covered.
Non-Systems
Non-systems content includes modalities (e.g., ultrasound, e-stim, cryo/thermotherapy), safety procedures, emergency responses, assistive devices, prosthetics, and equipment. You'll also be tested on research and evidence-based practice, ethics, supervision, documentation, ADA guidelines, and infection control. Knowing parameters and contraindications for therapeutic modalities is key. This section supports clinical reasoning and professional responsibility across all settings.
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