100+ Free ACM Practice Questions

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A 72-year-old patient is admitted with community-acquired pneumonia. Which post-acute setting is most appropriate when the patient is medically stable but still requires daily skilled nursing for IV antibiotics and physical therapy at least 5 days per week?

Long-term acute care hospital (LTACH)

Skilled nursing facility (SNF)

Inpatient rehabilitation facility (IRF)

Assisted living facility

to track

2026 Statistics

Key Facts: ACM Exam

175

Total Questions

ACMA Part I + II combined

3 hours

Total Test Time

ACMA

$295/$395

Member/Non-member Fee

ACMA

RN or SW

Track Options

ACMA

4 years

Recertification Cycle

ACMA

The ACM exam is delivered in two parts (a shared core Part I plus a discipline-specific RN or SW Part II) and is administered through ACMA. Content covers transitions, utilization management, reimbursement, psychosocial assessment, ethics, and interdisciplinary practice. Test takers should expect both multiple-choice and clinical simulation formats.

Sample ACM Practice Questions

Try these sample questions to test your ACM exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 72-year-old patient is admitted with community-acquired pneumonia. Which post-acute setting is most appropriate when the patient is medically stable but still requires daily skilled nursing for IV antibiotics and physical therapy at least 5 days per week?

A.Long-term acute care hospital (LTACH)

B.Skilled nursing facility (SNF)

C.Inpatient rehabilitation facility (IRF)

D.Assisted living facility

Explanation: A skilled nursing facility (SNF) is the appropriate setting when a patient needs daily skilled nursing or therapy services (5 days/week therapy or 7 days/week nursing) but does not require the intensity of an LTACH or IRF. Medicare Part A covers SNF stays after a qualifying 3-day inpatient hospital stay.

2Under the CMS 2-midnight rule, when is inpatient admission generally appropriate?

A.When the admitting provider expects the patient to require hospital care spanning at least 2 midnights

B.When the patient has been in the ED for more than 6 hours

C.When the patient is over age 65 and has Medicare

D.When the patient requires any IV medication

Explanation: The CMS 2-midnight rule (effective October 2013) presumes inpatient admission is appropriate when the admitting physician expects medically necessary hospital care to span at least 2 midnights. Stays expected to be shorter should generally be billed as outpatient/observation unless rare exception criteria apply.

3What is the primary purpose of the Important Message from Medicare (IM) letter?

A.To notify the patient their inpatient stay is being changed to observation

B.To inform Medicare inpatients of their hospital discharge appeal rights

C.To request prior authorization for post-acute services

D.To document medical necessity for an inpatient admission

Explanation: The Important Message from Medicare (IM) is a CMS-required notice given to all Medicare inpatients within 2 calendar days of admission and again within 2 calendar days of discharge. It informs patients of their right to appeal a discharge they believe is premature through the Quality Improvement Organization (QIO).

4When is the Medicare Outpatient Observation Notice (MOON) required to be delivered?

A.To any patient placed in observation regardless of payer

B.To Medicare beneficiaries receiving observation services for more than 24 hours, no later than 36 hours after observation starts

C.Only to patients whose observation stays extend beyond 72 hours

D.Only when the hospital plans to bill the stay as inpatient

Explanation: Required under the NOTICE Act, the MOON must be delivered to Medicare beneficiaries (Part A and Medicare Advantage) receiving observation services for more than 24 hours, no later than 36 hours after observation services begin. It explains why the patient is outpatient and the financial implications including non-coverage of SNF benefits.

5Which CMS Hospital Readmissions Reduction Program (HRRP) condition is NOT currently included in the 30-day readmission measure?

A.Heart failure (HF)

B.Chronic obstructive pulmonary disease (COPD)

C.Acute myocardial infarction (AMI)

D.Sepsis

Explanation: The CMS HRRP includes six conditions/procedures: AMI, heart failure, pneumonia, COPD, elective primary total hip and/or knee arthroplasty (THA/TKA), and coronary artery bypass graft (CABG) surgery. Sepsis is tracked under SEP-1 quality measures but is not currently in the HRRP penalty program.

6A homeless patient presents to the ED with chest pain. Under EMTALA, what is the hospital required to do?

A.Provide a medical screening exam and stabilize any emergency medical condition regardless of ability to pay

B.Verify insurance before initiating any treatment

C.Transfer the patient to a public hospital before screening

D.Limit care to triage only

Explanation: The Emergency Medical Treatment and Labor Act (EMTALA) requires Medicare-participating hospitals with EDs to provide a medical screening examination (MSE) to anyone who comes seeking emergency care, and to stabilize or appropriately transfer those with emergency medical conditions, regardless of insurance or ability to pay.

7Which framework is most commonly used for interdisciplinary team handoff communication?

A.PIE (Problem, Intervention, Evaluation)

B.SBAR (Situation, Background, Assessment, Recommendation)

C.SOAP (Subjective, Objective, Assessment, Plan)

D.ABCDE (Airway, Breathing, Circulation, Disability, Exposure)

Explanation: SBAR (Situation, Background, Assessment, Recommendation) is a structured handoff framework developed by the U.S. Navy and adopted in healthcare to standardize critical communication, reduce errors during transitions, and is endorsed by The Joint Commission and the IHI for handoffs and escalation.

8Which Medicare coverage component primarily pays for inpatient hospital stays, SNF stays, hospice, and some home health?

A.Medicare Part A

B.Medicare Part B

C.Medicare Part C

D.Medicare Part D

Explanation: Medicare Part A (Hospital Insurance) covers inpatient hospital care, skilled nursing facility care after a qualifying 3-day inpatient stay, hospice, and limited home health services. Most beneficiaries pay no premium because they or their spouse paid Medicare taxes while working.

9What does HIPAA's minimum necessary standard require?

A.Healthcare workers may share PHI freely within the same hospital system

B.PHI use and disclosure must be limited to the minimum necessary to accomplish the intended purpose

C.Only the attending physician may release PHI

D.Patients must authorize every release of PHI for treatment purposes

Explanation: The HIPAA Privacy Rule's minimum necessary standard requires covered entities to limit the use, disclosure, and request of protected health information (PHI) to the minimum necessary to accomplish the intended purpose. Exceptions include disclosures to/by the patient, for treatment, and as required by law.

10A patient with end-stage heart failure and recurrent hospitalizations expresses goals focused on comfort and avoiding further ICU stays. Which referral is most appropriate?

A.Cardiac rehabilitation

B.Palliative care consult

C.Skilled home health for cardiac monitoring

D.Long-term acute care hospital

Explanation: A palliative care consult is appropriate at any stage of serious illness to address symptom management, goals of care, and quality of life. For a patient with end-stage HF expressing comfort-focused goals, palliative care helps clarify goals, manage symptoms, and explore hospice eligibility if appropriate.

About the ACM Exam

The Accredited Case Manager (ACM) credential from the American Case Management Association is built specifically for hospital and health-system case managers, with separate tracks for RNs and Social Workers. The exam has a shared Part I covering core case management practice and a Part II tailored to clinical (RN) or psychosocial (SW) discipline. Topics span care coordination, utilization management, reimbursement, transitions, ethics, and interdisciplinary collaboration.

Questions

175 scored questions

Time Limit

3 hours total

Passing Score

Pass/No Pass

Exam Fee

$295 member / $395 non-member (American Case Management Association (ACMA))

ACM Exam Content Outline

25%

Care Coordination and Transitions

Utilization review, discharge planning, transitions of care, post-acute placement (SNF, IRF, LTACH, home health), readmission prevention (CMS HRRP), and patient/family education.

15%

Utilization Management

InterQual and MCG criteria, observation vs. inpatient (2-midnight rule, Condition Code 44, MOON, IM letter), Medicare prior authorization, denials, and appeals.

10%

Resource Management

Length of stay targets, throughput, capacity management, ED holds and boarders, and avoidable day analysis.

15%

Psychosocial Assessment and Intervention

SDOH screening, mental health and substance use, abuse/neglect, IPV, end-of-life and advance directives, palliative and hospice referral, and caregiver assessment.

15%

Reimbursement and Regulatory

Medicare A/B/C/D, Medicaid LTSS, value-based programs (HVBP, HRRP, BPCI, MIPS, ACO REACH), 30-day readmission penalties, and coordinated care organizations.

10%

Ethics, Advocacy, and Legal

ACMA Code of Ethics, patient self-determination, informed consent, EMTALA, HIPAA, advance care planning, and mandatory reporting.

10%

Communication, Collaboration, and Leadership

Interdisciplinary rounds, SBAR handoff, team-based care, conflict resolution, mentoring, and process improvement (PDSA).

How to Pass the ACM Exam

What You Need to Know

Passing score: Pass/No Pass
Exam length: 175 questions
Time limit: 3 hours total
Exam fee: $295 member / $395 non-member

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ACM Study Tips from Top Performers

1Master the CMS 2-midnight rule and the difference between inpatient, observation, and outpatient status

2Learn the IM letter, MOON, ABN, and NOMNC notice requirements and timing

3Know the six HRRP conditions: AMI, HF, pneumonia, COPD, elective THA/TKA, and CABG

4Differentiate post-acute settings: SNF (3-day rule, daily skilled care), IRF (3-hour therapy rule), LTACH (medically complex, 25+ day average LOS), and home health (intermittent skilled, homebound)

5Memorize Medicare Part A/B/C/D coverage and the SNF 3-day qualifying stay rule

6Understand value-based programs: HRRP penalty up to 3%, HAC Reduction 1%, HVBP four domains, BPCI Advanced bundles

7Practice SDOH screening (PRAPARE, Z codes Z55-Z65) and trauma-informed care principles

8Know EMTALA, HIPAA TPO, mandatory reporting, and ACMA Code of Ethics standards

Frequently Asked Questions

What is the ACM credential?

The Accredited Case Manager (ACM) is a national certification from the American Case Management Association (ACMA) for hospital and health-system case managers. Separate tracks are available for Registered Nurses (RNs) and Social Workers (SWs).

How does the ACM differ from CCM and CMGT-BC?

ACM is hospital/health-system focused with discipline-specific tracks (RN or SW). CCM (CCMC) is a multi-disciplinary credential applicable across settings including payer and community case management. CMGT-BC is the ANCC nursing-specific case management credential for RNs only.

What does the ACM exam cover?

The ACM exam includes a shared Part I on core case management practice (care coordination, transitions, utilization management, reimbursement, ethics) and a Part II specific to the RN or SW track. Both multiple-choice questions and clinical simulations are used.

How much does the ACM exam cost?

Application fees are approximately $295 for ACMA members and $395 for non-members. Verify current pricing with ACMA at acmaweb.org/acm.

How should I prepare for the ACM exam?

Plan 80-120 hours of study. Master CMS rules (2-midnight rule, IM letter, MOON, NOMNC, 3-day SNF rule, HRRP), post-acute settings (SNF, IRF, LTACH, HHA), payer mechanics (Medicare A/B/C/D, Medicaid MCO, HVBP, BPCI), psychosocial assessment, and the ACMA Code of Ethics. Complete 100+ practice questions covering all domains.