- The Short Answer: Two Cut Scores, Not One
- How the 125-Question Exam Is Scored
- Why Form B Has a Higher Bar
- What Published Pass Counts Actually Tell You
- Where Your Points Come From: Domain Weights
- Before the Score: Eligibility, Fee and Proctoring
- If You Miss the Cut: Retake Rules
- Setting a Realistic Score Target
- Sequencing Your Prep Around the Weights
- After You Pass: Renewal Basics
- Frequently Asked Questions
- The Certified Breast Health Clinical Navigator exam uses a 75% cut score on forms A, C and D, and 79% on form B.
- Of 125 multiple-choice questions, only 100 are scored; 25 are unscored, and you cannot tell which.
- Screening, Diagnosis and Treatment plus Education & Resources each carry 28%, together 56% of the exam.
- The exam fee is $295, and you get three hours to finish.
The Short Answer: Two Cut Scores, Not One
If you are searching for "the" BHCN passing score, the honest answer is that there are two. The Certified Breast Health Clinical Navigator exam, administered by the National Consortium of Breast Centers, Inc. (NCBC), sets a cut score of 75% for forms A, C and D and 79% for form B. Which form you receive determines the number you need to clear.
This matters because many candidates assume a single universal threshold and plan their prep around it. Since you generally will not know your form in advance, the safest planning approach is to aim for the higher bar, and then treat anything above it as a cushion rather than a goal.
This guide covers how the cut scores work, how the exam is built, what the published pass counts do and do not tell you, and how to align your preparation with the exam's content weights. For a broader view of how demanding the test is, see our companion piece, How Hard Is the BHCN Exam? Complete Difficulty Guide 2026.
How the 125-Question Exam Is Scored
The exam contains 125 multiple-choice questions delivered over 3 hours. Of those, 100 questions are scored and 25 are unscored. The unscored items are not labeled, so every question deserves your full effort.
Because the percentage cut applies to the scored portion, the practical math looks like this:
| Form | Cut Score | Scored Questions | Correct Answers Needed (of 100 scored) |
|---|---|---|---|
| A, C, D | 75% | 100 | 75 |
| B | 79% | 100 | 79 |
The table assumes the percentage is applied across the 100 scored items, which is the straightforward reading of the published structure. Check the current candidate handbook on the NCBC site for the precise scoring language before your test date.
Why Form B Has a Higher Bar
Different exam forms contain different sets of questions. A higher cut on one form generally reflects the difficulty of that particular question set, so a harder form may carry a different threshold than an easier one. NCBC publishes the 79% figure for form B alongside 75% for the others, but candidates should not read the gap as a measure of how hard any given form is.
What you can control is the margin you build into your preparation. If your practice scores consistently land in the low 80s or better across all five content areas, the difference between 75% and 79% stops being a concern. If you are hovering right around 75% on practice material, form B is where you are most exposed.
- Do not try to guess which form you will receive.
- Do train to the 79% standard so any form is within reach.
- Do use timed practice sets that mirror the 125-question, 3-hour format.
What Published Pass Counts Actually Tell You
NCBC has posted pass counts that can be converted into percentages. For 2025, the published tally was 129 passes out of 160 candidates, which works out to 80.63%. For the currently posted 2026 tally, the figure is 54 out of 78, or 69.23%.
Treat these numbers with care. The 2026 count is a partial, in-progress tally rather than a final annual result, and neither figure is confirmed as a first-attempt pass rate. A small sample size also means a handful of candidates can swing the percentage noticeably. For a fuller discussion of how to read these numbers, see BHCN Pass Rate 2026: What the Data Shows.
Where Your Points Come From: Domain Weights
Hitting 75% or 79% is easier when you know where the scored questions concentrate. The exam outline (in effect since 2022, with the currently linked description labeled V2 in a July 2023 upload) distributes content across five domains. Our full breakdown lives in BHCN Exam Domains 2026: Complete Guide to All 5 Content Areas; here is the scoring-focused view.
| Domain | Weight | Approx. Scored Items (of 100) |
|---|---|---|
| Breast Health/Breast Cancer | 15% | about 15 |
| Screening, Diagnosis and Treatment | 28% | about 28 |
| Care Coordination | 19% | about 19 |
| Education & Resources | 28% | about 28 |
| Communication | 10% | about 10 |
The item counts above are an illustration of the weights applied to 100 scored questions, not a published item map.
Screening, Diagnosis and Treatment (28%)
This is one of the two heaviest domains. Expect questions that test whether you understand the patient's path from an abnormal finding through workup and into treatment planning.
- Imaging and screening pathways and what each step is meant to resolve
- Diagnostic workup sequencing and how results move a patient forward
- Treatment modalities at a navigator's level of understanding, including how they affect scheduling and support needs
Education & Resources (28%)
Equal in weight to the previous domain, this area rewards candidates who know how to teach patients and connect them with the right supports.
- Patient education principles and matching materials to the patient
- Community and institutional resources a navigator would connect patients with
- Survivorship, supportive services and ongoing patient education needs
Care Coordination (19%)
The third-largest domain focuses on moving patients through the system without delay or loss to follow-up.
- Multidisciplinary coordination, including the role of tumor boards
- Barriers to care and strategies to reduce them
- Tracking, follow-up and handoffs between teams
Breast Health/Breast Cancer (15%) and Communication (10%)
These two smaller domains total 25%, but they underpin everything else. Foundational breast anatomy, risk and disease knowledge supports the clinical questions in the larger domains, while communication questions tend to be scenario-driven.
- Foundational disease and risk concepts that recur inside other domains
- Therapeutic communication, handling emotional distress and culturally responsive interaction
Key Takeaway
Two domains, Screening, Diagnosis and Treatment and Education & Resources, carry 56% of the exam between them. A weak showing in either can make 75% nearly unreachable, so confirm competence there before polishing the smaller domains.
Before the Score: Eligibility, Fee and Proctoring
You cannot earn a passing score until you are approved to sit for the exam. The published requirements include a valid RN license or licensure as a medical imager/radiologic technologist, 1,500 navigation hours in the past two years, and eight relevant education hours, with up to four allowed from tumor boards. Our complete walkthrough is at BHCN Requirements 2026: Eligibility, Prerequisites & How to Qualify.
The exam fee is $295. For a full cost view that includes renewal, see BHCN Certification Cost 2026: Complete Pricing Breakdown.
On test day, the exam is available in two delivery modes: paper/pencil or live remote proctored. A publicly linked 2023 policy named Examity for remote proctoring, though current vendor branding is unconfirmed, so verify the provider when you register. The exam is US-only. Unauthorized aids are prohibited, and no calculator entitlement has been verified, so do not assume you may bring one. Scheduling windows are covered in BHCN Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
If You Miss the Cut: Retake Rules
A score below the cut is not the end of the road. NCBC's retake policy gives you one no-additional-fee retake within 12 months, and requires a minimum of six months between attempts.
That six-month gap is the planning constraint to take seriously. It means a failed attempt costs you at least half a year before you can try again, so a rushed first sitting carries a real time penalty, even though the fee for the retake itself is covered under the stated policy.
- Request and review any score feedback available to you, noting which domains were weakest.
- Rebuild your plan around those domains, weighting by exam percentage rather than by comfort level.
- Schedule the retake inside the 12-month window so the no-additional-fee provision still applies.
Setting a Realistic Score Target
A passing score is a floor, not a target. Because you will not know in advance which form you get, and because 25 unscored items add noise to how the exam feels from the inside, building in a buffer is sensible.
| Practice Performance | What It Suggests |
|---|---|
| Consistently below 75% | Not yet ready on any form; return to content review before scheduling |
| Between 75% and 79% | May clear forms A, C and D, but form B remains a risk |
| Consistently above 79% on timed sets | Reasonable margin on all forms, assuming the practice material is representative |
The quality of your practice material matters as much as your score on it. A practice bank that is easier than the real exam will inflate your confidence. Use the BHCN practice tests under timed conditions, and review every miss for the reasoning behind the correct answer, not just the answer itself.
Sequencing Your Prep Around the Weights
Because the passing score is a function of how well you perform across weighted domains, the logical way to prepare is to spend time in proportion to weight and weakness. Here is one example of how that sequencing might look over a multi-week plan. For a fuller approach, see BHCN Study Guide 2026: How to Pass on Your First Attempt.
Screening, Diagnosis and Treatment
- Cover the heaviest-weighted domain first while energy is highest
- Map screening-to-treatment pathways end to end
Education & Resources
- Second 28% domain; focus on patient teaching and resource matching
- Take a first timed practice set and log scores by domain
Care Coordination and Breast Health/Breast Cancer
- Review multidisciplinary coordination and tumor board concepts
- Shore up foundational disease knowledge used across domains
Communication and full-length simulation
- Practice scenario-based communication questions
- Complete a full 125-question timed set and compare against the 79% bar
Adjust the order if your own background makes certain areas stronger. A navigator from imaging may need less time on diagnostics and more on resources, while an RN from oncology may flip that. The one-page BHCN Cheat Sheet 2026: One-Page Review of Must-Know Facts is a useful companion for the final week.
After You Pass: Renewal Basics
Earning the credential is the start of an annual maintenance cycle. Renewal is annual and requires valid licensure and eight CE credits: four general or tumor board credits plus four navigation-specific credits. The live renewal page advertises $150 including membership, though older wording citing $159.34 still appears in places, so confirm the amount at checkout.
If you are weighing the long-term return on all of this, see Is the BHCN Certification Worth It? Complete ROI Analysis 2026 and BHCN Salary Guide 2026: Complete Earnings Analysis for the career side of the decision.
Frequently Asked Questions
The cut score is 75% for forms A, C and D, and 79% for form B. The percentage applies to the scored portion of the exam, which is 100 of the 125 questions.
There are 125 multiple-choice questions, but only 100 are scored. The other 25 are unscored, and they are not identified, so answer every question carefully.
You have 3 hours. That works out to a little under 1.5 minutes per question if you use the full time across all 125 items.
You may retake the exam once at no additional fee within 12 months, with a minimum of six months between attempts. Plan your remediation around the domains where you scored lowest.
Not really. The posted figures are 80.63% for 2025 (129 of 160) and 69.23% for the current 2026 tally (54 of 78), but the 2026 number is partial and neither is confirmed as a first-attempt rate. Use them as context, not as a forecast.
For a broader introduction to the credential itself, you can also read What Is BHCN Certification?, and when you are ready to test your readiness against the real cut scores, start a timed session on the BHCN Exam Prep practice test platform.