The NCMHCE at a glance
| What it is | NBCC’s case-based exam for the clinical counseling license |
|---|---|
| Format | 11 cases, 130–150 questions, 100 scored. Format |
| Time | 225 minutes, about 20 per case |
| To pass | A cut of about 59–66 of 100, by form. Passing score |
| Cost | $275; rescheduling $50. Registration |
| Pass rate | 67–77% on first attempts in NBCC university sessions. Pass rate |
| Retake | After 30 days or your state’s wait. Retake plan |
| Changes | 10 cases and a 360 pass mark from July 1, 2027. 2027 changes |
Reading about the exam only goes so far. Work through one case in the real format, with every answer explained: about 20 minutes, no sign-up.
Try a free caseWho takes it: counselors applying for the clinical license
The license is called LPC, LMHC, LCPC, LPCC or LCMHC, depending on the state.
- 20 boards require the NCMHCE. See which states, with five in detail, on NCMHCE requirements by state.
- 23 boards accept it or the NCE, a different exam. Compare the exams in NCE vs NCMHCE.
- Your state: look it up on the state requirements page.
- LMHC states: they are on the LMHC exam page.
How to prepare
- Weight your review: counseling skills (30%) and assessment and diagnosis (25%) are over half the exam.
- Study what shows up: theories by their techniques, diagnoses by their differentials, exact counseling responses.
- Practice full cases from the start, about 20 minutes each. People who passed studied about 9 weeks.
Start with the study guide, make a dated plan with the study plan builder, and try the free practice case.
All guides and tools
New here? Start with the free practice case: about 20 minutes, no sign-up.
Practice
- Free practice caseA full case with every answer explained. No account.
- Sample questions20 questions in the case format, every answer explained.
- Full practice exam11 cases on the 225-minute clock.
Study
- Study guideWhat shows up most, domain by domain. Printable.
- Study plan builderA dated plan from your exam date and hours.
- Study materialsWhat to use for each part of the exam, free and paid.
- How people passedWhat people who took it say helped and what went wrong.
- Prep compared14 products, prices and guarantees.
- Counseling theories15 approaches, and what each one sounds like.
- Mental status examA template, two examples and a cheat sheet.
The exam
- Exam formatCases, sections, questions and time.
- Passing scoreThe cut scores people reported, and the 2027 scale.
- Pass rateFlorida and Virginia board counts, year by year.
- Registration and costFees, scheduling, ID rules and retakes.
- Retaking the examRetake rules and where to focus next.
- 2027 changesThe new format and blueprint from July 1, 2027.
Licensing
- State requirementsWhich exam each state uses, plus fees and hours where published.
- NCMHCE by stateWhich states require it, with five states in detail.
- LMHC examWhich exam each LMHC state uses.
- NCE vs NCMHCEWhich exam your state board uses.
- Counseling CompactMember states and whether you can use it.
NCMHCE FAQ
Is the NCMHCE multiple choice?
Yes. Every question is multiple choice, but the questions sit inside clinical case studies. Each case gives you new information about one client across an intake and two later sessions, and you answer 9 to 15 questions about it.
How long is the NCMHCE?
3 hours 45 minutes (225 minutes) for 11 cases, or about 20 minutes per case. The testing time stays the same when the new version starts on July 1, 2027.
How many questions are on the NCMHCE?
130 to 150, of which 100 are scored. The unscored questions, including one full case, are not marked.
How much does the NCMHCE cost?
The exam fee is $275 in NBCC's current state-licensure supplements. Rescheduling costs $50, a retake is a new registration at the full fee, and some states add their own fees.
Is Licensure Lab affiliated with NBCC?
No. Licensure Lab is an independent educational resource and is not affiliated with, sponsored by, or endorsed by NBCC.
The free practice case is one full NCMHCE-style case: 14 questions, about 20 minutes, no account needed.
Try the free case