- ABTC awards CCTC; PSI delivers the exam; ROC-P manages applications.
- Domestic cost is $645 total ($495 exam + $150 application); international adds $225.
- 175 questions (150 scored, 25 unscored), 3 hours, closed-book, no calculators.
- Post-operative Monitoring, Evaluation, and Reporting leads all domains at 39% of the exam.
Credential Basics: Who Runs the CCTC
The Certified Clinical Transplant Coordinator (CCTC) credential is awarded by the American Board for Transplant Certification (ABTC). PSI Services is the testing vendor that delivers the computer-based exam, and applications flow through ROC-P. If you only remember one sentence from this cheat sheet, remember that pairing: ABTC certifies, PSI tests, ROC-P processes the paperwork. For a fuller narrative on what the credential represents and why transplant programs require it, see What Is CCTC Certification? and the broader overview at CCTC Certification.
Fees, Registration & Logistics
Budget accurately before you apply. The domestic initial cost is $645, split into a $495 examination fee and a $150 application fee. Candidates testing internationally pay an additional $225 administration charge. There is no way around either the exam fee or the application fee - both are required components of the initial cost, not optional add-ons.
- Exam fee: $495
- Application fee: $150
- Domestic total: $645
- International add-on: $225
Once your application is approved, you receive a 90-day authorization period in which to schedule and sit the exam through PSI. Miss that window and you'll need to work through ROC-P again to re-establish eligibility. A detailed cost breakdown, including how the fee structure compares across renewal cycles, is available in CCTC Certification Cost 2026: Complete Pricing Breakdown, and scheduling mechanics are covered thoroughly in CCTC Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Exam Format at a Glance
The CCTC exam is a computer-based, closed-book test administered at PSI centers. Here's what shows up on test day:
| Element | Detail |
|---|---|
| Total questions | 175 multiple-choice |
| Scored questions | 150 |
| Unscored pretest questions | 25 |
| Time allowed | 3 hours |
| Book/notes allowed | None (closed-book) |
| Calculators | Prohibited |
| Content split | 50% general, 50% organ-specific |
Because 25 of the 175 questions are unscored pretest items mixed in with no indication of which is which, you should treat every question as if it counts. There's no strategic value in trying to guess which items are experimental - pacing consistently across all 175 is the safer approach. For a deeper dive into how difficult this format actually feels in practice, read How Hard Is the CCTC Exam? Complete Difficulty Guide 2026.
Key Takeaway
Plan pacing around 175 questions in 180 minutes - roughly one minute per question - since you won't know which 25 are unscored.
Domain Breakdown & Weightings
The current CCTC outline is a three-domain structure that took effect July 1, 2026, and it's the backbone of every serious study plan. The three domains are weighted unevenly, so time allocation should not be split evenly across them.
Domain 3: Post-operative Monitoring, Evaluation, and Reporting - 39%
This is the largest domain and covers the coordinator's role after transplant surgery: tracking graft function, recognizing rejection or complications, managing follow-up labs and imaging, and reporting outcomes accurately to the transplant team and registries.
- Recognizing early signs of organ rejection or dysfunction across solid organs
- Coordinating post-op labs, biopsies, and follow-up visits
- Accurate documentation and outcome reporting
Domain 1: Transplant Education - 31%
Covers patient, family, and staff education across the transplant continuum - informed consent concepts, medication adherence teaching, and communicating risk in ways patients from varied backgrounds can understand.
- Immunosuppression education and adherence strategies
- Informed consent communication
- Adapting education for adult and pediatric populations
Domain 2: Pre-Transplant Evaluation and Management - 30%
Focuses on candidate workup: medical and psychosocial evaluation, listing criteria, and managing patients while they wait for an organ.
- Evaluation criteria for transplant candidacy
- Waitlist management and status changes
- Psychosocial and support-system assessment
Note the secondary content specification layered on top of these three domains: the exam is 50% general transplant concepts and 50% organ-specific content, and it spans multiple solid organs across both adult and pediatric practice. That means you can't prepare with a single-organ mindset - kidney, liver, heart, lung, and pancreas concepts can all appear, filtered through whichever domain is being tested. For a domain-by-domain study breakdown, see CCTC Exam Domains 2026: Complete Guide to All 3 Content Areas.
Eligibility Snapshot
Before you can even submit an application through ROC-P, you need at least 12 months of clinical vascular-organ transplant-coordinator experience, verified by a supervisor. This isn't a general nursing or transplant-adjacent requirement - it's specific coordinator-role experience that must be documented and confirmed. The current candidate handbook governing these requirements is dated August 13, 2026, so always check that you're referencing the latest version before applying. Full eligibility mechanics, including what counts as qualifying experience and how supervisor verification works, are laid out in CCTC Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Employers hiring for coordinator roles - transplant centers, organ procurement organizations, and post-transplant clinics - often list CCTC as preferred or required once a candidate has logged that first year on the job. If you're mapping out career trajectory alongside certification, CCTC Jobs and CCTC Salary Guide 2026: Complete Earnings Analysis cover how the credential factors into hiring and compensation conversations.
Passing Standard & Retake Rules
CCTC uses a single overall passing standard rather than separate cut scores per domain. The standard is set through an expert-driven, psychometrically equated minimum-competence process - meaning the passing bar reflects what a minimally competent coordinator should know across the whole test, not a fixed percentage you can predict in advance. For the exact mechanics of how that standard is derived, read CCTC Passing Score 2026: Exactly What You Need to Pass.
ABTC's published 2024 results show a 62% pass rate among 244 candidates - figures that predate the July 2026 blueprint change, so treat them as historical context rather than a guaranteed outcome under the current outline. A full statistical discussion lives in CCTC Pass Rate 2026: What the Data Shows.
If you don't pass, you must wait 90 days before retesting. After a third failed attempt, ABTC requires 20 Category 1 CEPTCs before you're allowed to reapply - a rule worth knowing up front so a repeat attempt doesn't catch you unprepared.
Key Takeaway
There is no domain-by-domain pass/fail line - overall performance determines the result, so don't panic over one weak domain if your overall command is strong.
Certification Cycle & Recertification
Once earned, CCTC certification is valid for three years. To renew, you need 60 Continuing Education Points for Transplant Certification (CEPTCs), broken into at least 20 ABTC-approved Category 1 credits and at least 10 Category 2 credits, plus a $395 recertification fee. Alternatively, successful re-examination is a valid path to renewal if you'd rather retest than accumulate CE credits.
- Certification period: 3 years
- CE requirement: 60 CEPTCs total
- Category 1 minimum: 20 credits
- Category 2 minimum: 10 credits
- Recertification fee: $395
- Alternative path: Pass the exam again
Whether the ongoing CE commitment and fee structure pay off in career terms is a fair question to ask before you commit - that ROI question is explored in Is the CCTC Certification Worth It? Complete ROI Analysis 2026.
One-Week Cheat Sheet Study Plan
For candidates in the final stretch before their PSI appointment, allocate the week by domain weight rather than evenly. This is the only place in this cheat sheet where general study technique applies - and it's tied directly to the CCTC blueprint.
Post-operative Monitoring, Evaluation, and Reporting (39%)
- Drill rejection signs and complication recognition across solid organs
- Review outcome-reporting and documentation standards
Transplant Education (31%)
- Practice adherence-education scenarios for adult and pediatric patients
- Review informed-consent communication points
Pre-Transplant Evaluation and Management (30%)
- Review listing criteria and waitlist status changes
- Run full-length timed practice sets covering all three domains
For a longer runway with a full multi-week plan, see CCTC Study Guide 2026: How to Pass on Your First Attempt. And to rehearse the exact pacing - 175 questions, 180 minutes, no calculator - work through timed sets on our practice test platform before your PSI appointment so the format feels routine rather than novel on exam day.
FAQ
PSI Services delivers the computer-based exam. ABTC awards the credential, and ROC-P manages the application process.
175 multiple-choice questions total - 150 scored and 25 unscored pretest items - with 3 hours allotted, closed-book, no calculators permitted.
Post-operative Monitoring, Evaluation, and Reporting at 39% is the largest domain, followed by Transplant Education at 31% and Pre-Transplant Evaluation and Management at 30%.
Domestic candidates pay $645 total: a $495 exam fee plus a $150 application fee. International candidates pay an additional $225.
Certification lasts three years. Renewal requires 60 CEPTCs (at least 20 Category 1 and 10 Category 2) plus a $395 fee, or successful re-examination as an alternative.