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FAQs for Educators

Your Questions Answered

The questions in this section address common issues. Many of the questions originally came from the “This Quarter’s Question,” a regular feature in the quarterly Faculty Newsletter. You can subscribe to the newsletter for free.

Have questions about the upcoming changes to the NPTE? Read our frequently asked questions covering new item types and content changes.




Why have a licensure exam?

Why do licensing boards require passing the NPTE for licensure? Why isn’t graduation from a CAPTE-accredited program sufficient?

There are a few points that need to be considered when answering this question.

  • The purpose of the NPTE is different from the purpose of PT or PTA programs. The programs’ primary purpose is to educate PTs and PTAs. The educational component provides a broad range of knowledge, education, and skills, including a clinical component, so that PTs and PTAs understand the role of physical therapists and physical therapist assistants in providing healthcare to patients. Programs teach skills and knowledge that might not be used by entry-level practitioners, but will be used as individual becomes more experienced. The NPTE's specific purpose is to protect the public by testing candidates on the minimum knowledge and education necessary for safe and competent entry-level work; it does not include a clinical component.
  • Programs can be subject to many different pressures—the pressure to graduate a certain number of students or to maintain a certain passing rate on the NPTE are two that come to mind. Development of the NPTE is subject to a different requirement—FSBPT must be able to provide evidence to licensing boards that the NPTE is a valid and reliable tool for measuring entry-level competence of PTs and PTAs.
  • Even though all programs are accredited by CAPTE, there is a variation in programs. This includes coursework and grading standards. The NPTE provides licensing boards with one standard to which everyone is held accountable.
  • Completion of a broad educational program and passing a specific exam that measures entry-level competence provides licensing board members with the assurance that they are licensing or certifying competent entry-level practitioners who will be able to grow and mature in their profession.


How can I best prepare my students for a successful exam-day experience?

Hard deadlines

The most important information you can convey to your students is that there are hard deadlines they must meet.

If they miss the deadlines, they will be required to wait until the next scheduled test. They should not assume that exceptions will be made for them if they ask.

Can they test prior to graduation?

Another way to prepare your students is to communicate with your state licensing board to find out whether it allows students to take the NPTE prior to graduation. Some states allow this option if the school provides the proper paperwork.

Temporary licensure

Some states also allow students to practice during the period between graduation and the state receiving the results of their NPTE; others do not allow unlicensed personnel to practice for any reason. You may want to check with your licensing board to see if this is an option and what the procedures are for obtaining a temporary license.

Licensure reference guide

A quick overview of each state’s rules and regulations on taking the NPTE prior to graduation and temporary licensure can be found in the Licensure Reference Guide.

Always check with your state to ensure you have the latest information.


Who oversees the NPTE Testing Program?

FSBPT's National Physical Therapy Examination (NPTE) program continues to hold Stage One accreditation from the Buros Institute for Assessment Consultation and Outreach (BIACO), a not-for-profit organization that provides independent evaluation of testing programs’ adherence to standards of quality essential for development and administration of fair, valid, and reliable tests.

As part of the Stage One review, FSBPT submitted materials to BIACO describing the NPTE program’s organizational structure, test development and test administration procedures, psychometric methods and analyses, and policies and procedures for test security, scoring, score reporting, and record maintenance. BIACO auditors visited FSBPT to observe processes and interview key personnel.

Stage One accreditation confirms FSBPT's adherence to the BIACO Standards for Proprietary Testing Programs, which are based on testing industry standards and guidelines, including those developed by the American Educational Research Association, American Psychological Association, National Council on Measurement in Education, Association of Test Publishers, and International Test Commission.

In the letter conferring accreditation, BIACO auditors noted that the NPTE testing program meets or exceeds all appropriate testing standards. Highlighted for particular recognition was FSBPT's emphasis on test security in all phases of test development and administration, in support of the FSBPT's mission to protect the public from the practice of physical therapy by unqualified persons.

FSBPT welcomes external review as an essential step in maintaining a high-quality testing program and providing assurance to the public, FSBPT's member licensing boards, and test candidates that the NPTE is a fair, valid, and reliable test.


Why not use “free” NPTE practice questions found on the Internet?

Students need to be very, very cautious when finding "free" sample questions on the internet or in chat rooms.

One reason to avoid using, soliciting or disseminating such materials is theft of copyrighted materials. Just because a website offers test questions as a sample doesn't mean that the questions aren't copyrighted. These questions are most often test questions stolen from a combination of legitimate test preparation courses, FSBPT's Practice Exam and Assessment Tool (PEAT®) and the NPTE itself. Each copyright owner has the right to pursue legal action (including monetary damages) for copyright violation. FSBPT has, more than once, pursued legal action against individuals and companies that used copyrighted questions from PEAT or the NPTE.

In the event that the test questions are not stolen property, important questions should be asked about their quality. Writing effective test questions is extremely time consuming and requires considerable skill. Using poorly written test questions as preparation strategy may be detrimental to students' ultimate success.

A more important reason to avoid such materials is the risk of (1) being denied the opportunity to take the NPTE or (2) having a NPTE passing score invalidated because many of the questions had been compromised. Obviously, this second option is only relevant for NPTE items that were memorized and shared with individuals who had not yet taken the NPTE (recalled questions).

In the past we have found questions advertised as "samples" to be authentic NPTE questions. Before taking the NPTE, examinees sign a contractual agreement acknowledging FSBPT's right to invalidate a test score because of an unfair advantage (such as using recalled NPTE questions to prepare), even if the examinee was unaware the questions used as preparation were recalled from the NPTE. Such an event would be devastating.

In sum, many reasons exist for avoiding the use of sample test questions from chat rooms or the Internet. We highly encourage candidates to review the NPTE content outline.

The content outline provides detailed information about what content will be on the exam, and in what proportion. In addition, candidates might want to attend a legitimate test preparation course, purchase a copy of PEAT or participate in group study opportunities with classmates or others preparing for the NPTE.


Why are examinees limited to taking the NPTE three times in a twelve-month period?

Our current test administration policy was implemented in 2005 in response to recommendations from an external commission convened in 2003 to review FSBPT’s test development and administration procedures. The policy is intended to ensure that we have sufficient items and test forms available during any given year-long time period to account for candidate rescheduling due to technical or administration issues, the impacts of severe weather, or other unforeseeable circumstances. Additionally, the policy helps to ensure the security of the NPTE and may encourage unsuccessful candidates to seek more substantial remediation after a few attempts.


NPTE Development

I have heard that the questions on the NPTE take a long time to develop and validate. Since the profession of physical therapy is rapidly changing and is becoming much more evidence based, how do you assure that the questions on the exam are current?

It is critical that a high stakes licensing examination covers current practice. While it is a challenge to maintain this currency, the item writers and exam committees work very hard to assure the exam reflects current practice. Currency is maintained via the following steps:

  • The exam blueprint or content outline is revised at a minimum of every five years. The exam blueprint determines the content of the exam and assures that the content is relevant to current practice.
  • Currency is stressed at item-writer workshops; item writers are required to reference questions to recognized authoritative texts that are in current use in PT and PTA programs.
  • Items are not used where there may be conflicting references or viewpoints in the literature
  • An item goes through committee review multiple times and each time, it is reviewed for currency.
  • The item goes through a final review for currency (among other things) prior to each and every time it is being released as an operational question.




Do NPTE items have more than one right answer?

I have been told that the exam is structured in such a way that there are two "right" answers, but that one is a better choice. Is the exam scored using a partial credit model to account for an individual who might select the less favorable of the correct choices? Or is it an all-or-none credit system?

There is only one correct answer for each question. The item writers and exam committees go through great lengths assuring that there is one correct answer and three incorrect answers. Each option must be backed up with a rationale and reference as to why it is either correct or incorrect. Beyond this, statistics are collected on the item that also helps support the one correct answer. There is no “partial credit” for an answer. It is either correct or incorrect.


Recalled NPTE Questions

A question from a student: As an exam candidate who just completed my examination, I recall several questions on the exam where I was not sure of the answer. Is it ok for me to discuss the questions with my instructor?

On the surface, it may seem natural for you to go to a faculty member to discuss specific questions on your licensing examination. You may want to be assured that you answered the item correctly. You may also be motivated to “learn from mistakes” and a discussion of the question could be a productive learning experience. This is particularly true if you find you have failed the exam. You certainly want to pass the next time! However, by doing this you are putting yourself and your instructor in jeopardy.

Every item on the exam is copyright protected. When a candidate takes the exam, the candidate agrees not to share any question or part of a question with anyone else. Good intentions do not nullify this agreement or the copyright protection of the exam. The bottom line is that it is illegal for a candidate to share a test question with an instructor or anyone else.

You might say: “Ok, so it is technically illegal, but what is the harm if I discuss the item with my instructor? I can trust her. She would not share the information. So, no harm no foul.” However, it is not for you to decide when you can break the law or when you can’t. The law is the law.

A parallel question from an instructor: Can I talk to my students about the NPTE after they have taken it?

Certainly general comments about the exam are not a violation of copyright law. However, if your students discuss specific items or specific characteristics of the exam with you, they are in violation of the confidentiality terms that they agree to when they take the exam. Included in these terms is not disclosing the content of examination items. Legal action could be taken against candidates who violate these terms including criminal prosecution. Ultimately the student may risk being able to ever obtain a license.

Educators may unwittingly cross the line by asking students questions about the exam or by listening to a student share a question from the exam. It is important that educators defend the integrity of the licensure process by making students and colleagues aware of these critical issues and reporting violations when they occur. You can also report any violations to

Educators can find accurate information regarding the exam in the “Educators” section. More detailed information on the NPTE can be obtained by attending an NPTE Educators' Workshop.


Enhancing NPTE test items

Currently, the NPTE contains questions that include graphics. Does FSBPT have plans to add other testing technologies?

Yes, we are in the process of creating two new item types: video and scenario-based items. 

Feedback from the 2016 practice analysis emphasized how much physical therapy is a movement-based profession, yet the NPTE has not assessed that. Video items are similar to the current graphic items. The candidate will need to access and refer to the video to answer the question.

We also needed an effective way to incorporate extended clinical scenarios that are more representative of medically complex cases. Scenarios will contain more patient profile information than found in basic NPTE questions, and they are ideal for detailing patients who have complicated medical conditions and histories. Scenario-based questions will require entry-level physical therapists and physical therapist assistants to integrate several pieces of information in a short period of time and leverage clinical reasoning to make good decisions. 

Scenario-based items use a template that includes the following pieces of information:

  • Gender
  • Age
  • Presenting Problem/Current Condition
  • Past Medical History
  • Other Information
  • Physical Therapy Examination(s)
  • Physical Therapy Intervention(s)

These scenarios are paired with several questions. As the candidate scrolls through the questions, the scenario remains on the left side of the screen for reference. Candidates will need some aspect of the scenario in order to answer each question, so this will test their skills in deciphering what information is relevant. Each item associated with a scenario will be independent of other items for that scenario. In other words, a candidate will not need to know that answer to one question to be able to answer the next.

We have been working on both new item types since 2017. FSBPT introduced video items beginning with the October 2022 NPTE administrations. Scenarios will be on forms effective January 2024.

Why does FSBPT charge for School Reports and Performance Feedback Reports?

 FSBPT currently provides four School Reports with varying amounts of detail at different costs. You may use the School Reports to evaluate the strengths and weaknesses of your program and help improve the pass rates of your students. You can also use the reports to benchmark against the national average.

If individual students do not pass the NPTE on their first attempts, they may wish to purchase a detailed Performance Feedback Report. This is a descriptive diagnostic score report available to all physical therapist and physical therapist assistant candidates.

We are sensitive to candidate costs and all of our fee structures are overseen by the finance committee. However, additional products have fees because they require significant organizational resources to administer and maintain. Not all candidates or schools make use of these services. Rather than incorporate the cost of providing the services into registration fees, we charge those who elect to use the services. Additionally, research has shown that candidates who purchase the Performance Feedback Report use it more and have higher subsequent scores.

We also provide complimentary services. For example, all educators have access to our basic school reports as well as free basic pass rate reports that are accessible from the educator's dashboard. Candidates also receive a free score report.

How are areas with mixed scientific evidence or changing guidelines handled on the NPTE?

In the NPTE development process, subject matter experts (SMEs) are used on an ongoing basis in the development of new test questions and examination forms, as well as review of existing test questions. These individuals are all vetted and licensed physical therapists and physical therapist assistants who are actively engaged in the profession and maintain licenses in good standing. SMEs are essential in providing content validity to the NPTE. They, along with the FSBPT assessment content staff, closely track changes in contemporary practice and evolving evidence-based physical therapy related to safe and effective patient care. 

When areas with mixed scientific evidence arise or when guidelines change, FSBPT reviews test questions dealing with the topic at large and, when necessary, FSBPT makes updates. One such example was when the American Heart Association and the American College of Cardiology revised their blood pressure clinical practice guidelines in 2017. At that time, FSBPT identified all NPTE test questions in the item bank related to this topic and reviewed each item to determine what, if any, updates were required for each individual test question. We also reviewed all NPTE test questions to be administered in the near future to determine if any key changes would be necessary based on the new guidelines. In addition to all the work that took place internally, FSBPT also released an article in the Q4 2017 Faculty Newsletter that detailed this update and the measures FSBPT took to keep the NPTE current and educators informed.



Public Pass Rate Reports

Please explain the timing and rationale for posting pass rates

When are pass rate data updated on FSBPT’s websites?

Pass rate data are updated quarterly on the following schedule:

  1. February 1
  2. May 1
  3. August 1
  4. November 1

Why do you post ultimate pass rates for individual programs and not first time pass rates on the public site?

The FSBPT Board of Directors believe that first time pass rates can be misleading because there could be many factors that influence that short term indices whereas the ultimate pass rate would be more indicative of the school’s overall program.


State Practice Acts


We’d like to be able to see what our state’s practice act allows, such as whether it allows temporary licensure or direct access to physical therapy services. Does FSBPT maintain that kind of regulatory information?

Yes, you can find all kinds of regulatory information in the Jurisdiction Licensure Reference Guide. This guide compares some of the major similarities and differences among the jurisdictions’ practice acts. It may be used as a reference for educational programs, students, licensing boards, professional associations, and others. Information is listed in aggregate and by individual jurisdiction. 


Continuing Competence


What is the FSBPT doing about continuing competence?

FSBPT has committed to building a continuing competence initiative, which will develop resources, tools and a system for its physical therapy licensing boards and the licensees themselves.

Why a continuing competence initiative?

Patients have every right to assume that a health care provider’s license to practice is the government’s assurance of his or her current professional competence, and clinicians themselves would like assurance that those with whom they practice are current and fully competent.

Physical therapy licensing boards have acknowledged their responsibility in this area. They are eager to take on this aspect of public protection for the people living in their state. They want to ensure that the PTs and PTAs licensed to practice in their state continue to be competent throughout their career.


Initial Licensure Requirements


Where can we find information about initial licensure requirements?

FSBPT’s website offers two ways to find that information.

  • Go to the Licensure Reference Guide which offers a quick overview of requirements. There are a number of other topics in the Licensure Reference Guide that may be of interest as well.
  • Go to the Licensing Authorities page which links to each state’s physical therapy board website. You’ll find information about licensure requirements, the fees and the license application.

What do we need to do to comply with the Federal regulations per 34 CFR 668.43(a)(5)(v) and (c)?

The U.S. Department of Education implemented new regulations effective July 1, 2020, that entry-level PT and PTA programs that lead to professional licensure or certification must adhere to if they participate in Title IV HEA funding and if they are “designed to meet educational requirements for a specific professional license or certification that is required for employment in an occupation, or is advertised as meeting such requirements, information regarding whether completion of that program would be sufficient to meet licensure requirements in a State for that occupation.”

This new regulation requires programs to provide the following:

    • A list of all States for which the institution has determined that its curriculum meets the State educational requirements for licensure or certification;
    • A list of all States for which the institution has determined that its curriculum does not meet the State educational requirements for licensure or certification; and
    • A list of all States for which the institution has not made a determination that its curriculum meets the State educational requirements for licensure or certification.

FSBPT has licensure requirements for each jurisdiction in the FSBPT Licensure Reference Guide, including initial licensure requirements for graduates of CAPTE accredited programs.

FSBPT also maintains a list of licensing boards' contact information. However, this list does not include American Samoa, Northern Mariana Islands, or Guam. This information is included below:




How are FSBPT and APTA different?

The Federation of State Boards of Physical Therapy and the American Physical Therapy Association each have unique missions, purposes, and roles to play in the physical therapy profession. FSBPT is a membership organization of 53 jurisdiction physical therapy licensing authorities striving for excellence in its mission of public protection.

Per their website, the APTA is an individual membership professional organization representing more than 80,000 member physical therapists, physical therapist assistants, and students.

Unlike APTA, individual PTs and PTAs are not the primary members of the FSBPT. FSBPT members are the 53 jurisdiction licensing boards. Each jurisdiction sends a voting and alternate delegate to the annual Delegate Assembly which is held during the FSBPT’s annual meeting.

Whereas most physical therapist and physical therapist assistant licensing board members are also American Physical Therapy Association members, the typical APTA member has had little or no opportunity for interaction with FSBPT outside of the National Physical Therapy Examination (NPTE). It is important that PTs and PTAs understand the unique roles of the APTA and FSBPT: where they may overlap and where they may diverge.

Historically, the NPTE has been the primary focus of FSBPT. Prior to 1986, however, the NPTE was developed by the APTA. Visionaries within the then APTA Section on Health Policy saw the potential for problems with the professional organization developing the entrance exam to the profession. What were some of these concerns? These visionaries identified that there was a potential for a lack of credibility of the examination process if developed by the professional organization. Additionally, the potential for conflict of interest was very real. In 1986, FSBPT was formed in response to these concerns.

In 1993, the transfer agreement between APTA and FSBPT brought the responsibility and ownership of the exam under FSBPT. Under the agreement there are certain terms and obligations that must be met by FSBPT until 2014. Since FSBPT took over the examination, it has worked hard to assure the defensibility of the NPTE and assure that it meets current standards for the development of a licensure exam. Today the NPTE has high credibility as a high stakes, secure examination which meets rigorous professional standards and earned external accreditation.

The NPTE, however, is not the only thing happening at the FSBPT. It is a dynamic organization developed to support the jurisdiction members and promote best practices in regulation. The FSBPT actively communicates and collaborates with the member jurisdictions and other stakeholders in the areas of discipline and ethics, legislation and professional standards, continuing competence, and standards for foreign educated physical therapists and physical therapist assistants.

APTA membership is completely voluntary for physical therapy professionals. Some PTs and PTAs go their entire career without APTA involvement. However, every licensed /certified PT or PTA has had to interact with a licensing board, usually during initial licensure and then upon each renewal. Licensing is mandated for physical therapists in all jurisdictions, and in most jurisdictions for physical therapist assistants.

Licensing boards must comply with the individual statutes and regulations in their jurisdictions. FSBPT has no authority to mandate anything to its member licensing boards; all products and services developed are completely voluntary. They always have the option of opting in or opting out. APTA National also has its components which include the State Chapters and the Sections. These components are required to follow the same policies as set forth by the national organization, but the components remain independent organizations.

Just as individuals and APTA chapters look to APTA for resources, jurisdictions often come to FSBPT for resources and support when going through the process of updating the practice act or regulations or making scope of practice decisions. FSBPT tracks state and national legislation of interest to the physical therapy community and communicates that information to the jurisdictions.

Typically the legislative changes, introduction of bills, and lobbying are performed by APTA. The APTA has utilized the FSBPT’s Model Practice Act as the best practice for legislative language regarding physical therapy. Unlike the FSBPT, APTA also maintains a Political Action Committee, the PT-PAC which accepts monetary contributions to further the professional association’s goals.

Both APTA and FSBPT support that it is the responsibility of the individual PT and PTA to maintain competence throughout a lifetime of practice. Jurisdictions can only mandate a minimal competence level to protect the public from incompetent providers. FSBPT has developed a continuing competence program to meet the goal of ensuring minimal competence and safety. Professional development is beyond the purview of the licensing authorities but well within the scope of the professional association. Professional development is an ongoing process of assessment and planned actions that provide the opportunity for the acquisition and application of knowledge, skills, and abilities that meet or exceed contemporary performance standards.

It is completely appropriate and encouraged that state boards and state chapters interact and collaborate towards a common goal. State APTA chapters and state licensing boards have often found ways to work together. In some instances, state boards are legally prohibited from lobbying or initiating changes to the practice act. The boards find it necessary to engage the chapter for help in these matters and work together to promote the changes.

APTA and FSBPT both play vital, but different roles in the world of physical therapy. The organizations have different missions and therefore, different goals. Understanding that each organization represents a different point of view with a different primary focus, while fostering relationships and communication between them allows for a stronger PT profession.