1.1 ACI CHTM Exam Structure, Eligibility, Recertification, & Code of Conduct
Key Takeaways
- The ACI CHTM exam has 100 multiple-choice questions and a 2-hour limit, delivered at Kryterion test centers during the May 1–15 and November 1–15 windows.
- ACI sets the CHTM cut score with a criterion-referenced modified Angoff method and does not publish a fixed passing percentage.
- CHTM eligibility has five paths, each requiring recent HTM supervisory or management experience documented within the last five years.
- The 2026 CHTM exam fee is $490 for AAMI members and $565 for non-members; a retake costs $440 or $515.
- CHTM renewal requires 30 CEUs across each three-year cycle plus the renewal fee by December 31 of the expiration year.
ACI CHTM Exam Structure, Eligibility, & Professional Standards
The Certified Healthcare Technology Manager (CHTM) credential is awarded by the AAMI Credentials Institute (ACI). ACI describes the healthcare technology manager as the person responsible for planning and directing the activities of other healthcare technology management (HTM) professionals, monitoring their work, and taking corrective action when necessary. The certification covers two major areas: management of healthcare technology operations and management of personnel. ACI also expects the manager to take part in the leadership of the enterprise, with the skills needed for strategic, business, and change management and for employee relations.
Source check: The logistics in this section were checked on 2026-09-22 against ACI's CHTM web page and the ACI Certification Candidate Handbook 2026 (revision posted September 2026). ACI changes fees and policies; confirm them on aami.org before you apply.
1. AAMI, ACI, and the ACI Credential Family
- AAMI (Association for the Advancement of Medical Instrumentation), founded in 1967, develops consensus standards and education for healthcare technology — for example ANSI/AAMI EQ56 (recommended practice for a medical equipment management program) and AAMI TIR57 (medical device security risk management).
- ACI is AAMI's certification body. The ACI Board and its exam committees set eligibility rules, build the exams, and set passing standards.
| ACI credential | Who it is for | Exam format (per ACI) |
|---|---|---|
| CABT – Certified Associate in Biomedical Technology | Entry-level biomedical technology candidates | 100 questions; live remote proctoring year-round; non-renewable, valid 5 years |
| CBET – Certified Biomedical Equipment Technician | Experienced biomedical equipment technicians | 165 questions; May and November windows |
| CRES – Certified Radiology Equipment Specialist | Imaging equipment specialists | 165 questions; May and November windows |
| CHTM – Certified Healthcare Technology Manager | Supervisors and managers of HTM programs | 100 questions, 2 hours; May and November windows |
| CISS – Certified Industrial Sterilization Specialist | Industrial sterilization professionals (manufacturing of healthcare products) | 75-question core exam plus one 50-question specialty (ethylene oxide, moist heat, or radiation) |
A common exam trap is to confuse CISS with a hospital sterile-processing certification. CISS covers industrial sterilization process development, validation, and control; hospital sterile processing technicians usually hold other credentials.
2. Exam Format, Scoring, and Results
- Length: 100 multiple-choice questions in a 2-hour closed-book session — about 72 seconds per question.
- Delivery: Computer-based testing at Kryterion test centers. The CBET, CRES, CHTM, and CISS exams run in two windows each year: May 1–15 and November 1–15. Applications open at least three months ahead and close about a week before the window. (Only the CABT is offered by online proctoring.)
- Tools: The handbook states that an electronic calculator and notepad are available within the computer interface. Phones and other internet- or camera-capable devices are not allowed in the testing room.
- Scoring: ACI uses a criterion-referenced method. Subject-matter experts rate each item against what an entry-level certificant should know, and the passing standard is set with the modified Angoff method. ACI does not publish a fixed CHTM passing percentage on its CHTM page or in the handbook. Older third-party articles quote "72 out of 100"; treat any fixed number as unofficial, because ACI can reset the standard when forms change.
- Results: Preliminary pass/fail results appear at the end of the exam and by email within 24 hours. Candidates who pass are notified of certification within 45 days after the window closes; certification is official only when ACI issues the certificate. Candidates who fail receive a diagnostic "analysis of performance" by content area.
- Retakes: A retake cannot be scheduled until official results arrive, and candidates must wait at least 60 days. No more than three attempts in two years are allowed; after a third unsuccessful attempt, the candidate waits one year before reapplying.
3. Content Outline and Weights
ACI publishes approximate weights. On a 100-question form, the percentages translate roughly into item counts.
| Domain | Weight | ≈ Items | What the official outline lists |
|---|---|---|---|
| Operations Management | ~40% | ~40 | HTM service activities (work orders, project management, customer satisfaction); CMMS documentation regardless of ownership; coordinating service providers; reviewing performance data and KPIs; departmental policies (MEMP, SOPs, EOC manual), goals, staffing and scheduling, and committee reporting (EOC, patient safety, risk, performance improvement, radiation safety, infection control, COSR, benchmarking); regulatory, accreditation, and deemed-status compliance (CMS, FDA, FCC, HIPAA, NRC); departmental resources; capital planning inputs (feasibility, sustainability, MAUDE, standardization, cybersecurity); project management; meetings and communication; stakeholder collaboration (needs assessment, utility interruptions, interoperability); electronic data management |
| Financial Management | ~20% | ~20 | Financial planning and analysis; business justification and ROI; annual budgets and the general ledger; financial statements and forecasts; life expectancy and capital planning; GAAP and accounts payable/receivable compliance; service contracts (cost, compliance, terms); sourcing options; fair market value of purchase, lease, or asset recovery |
| Risk Management | ~16% | ~16 | Identifying and evaluating technology risks; mitigation policies; RCA, incident investigation, and FMEA; reports (Safe Medical Devices Act, Sentinel Event alerts); data integrity (PACS, EMR, networked devices); networked-device risk (cybersecurity, physical security, patching, hardening, WMTS, segmentation); recalls, hazards, and safety advisories |
| Human Resources | ~13% | ~13 | Job descriptions, selection, retention, and termination; performance evaluations; personnel management (goals, coaching, recognition, conflict, change, hearings and investigations, competency); labor laws (ADA, EEOC, FMLA, NLRA); a safe workplace (OSHA, PPE) |
| Education & Training | ~11% | ~11 | Training needs analysis; evaluating training effectiveness; staff training and professional development (safety, soft skills, technical, regulatory, internal policies, orientation); operator training for failure trends and use error; collaboration with user and non-clinical departments; availability of manuals and training materials |
The September 2026 handbook version of the outline includes Operations items I–M (project management, meetings, stakeholder communication and collaboration, electronic data management) that the shorter version on the CHTM web page omits. Study from the handbook version.
4. Eligibility Pathways
Every path requires management experience. Candidates without a supervisor or manager title must confirm that they perform management duties through self-attestation or third-party attestation.
| Path | Education or credential | Required experience |
|---|---|---|
| 1 | Current CCE, CBET, CRES, or CLES certification | At least 3 years as an HTM supervisor or manager in the last 5 years |
| 2 | Completion of the Department of Defense BMET training program | At least 3 years (military or civilian) as an HTM supervisor or manager in the last 5 years |
| 3 | Associate degree in biomedical technology, a related healthcare discipline, information technology, or business | At least 3 years as an HTM supervisor or manager in the last 5 years |
| 4 | Bachelor's degree or higher in biomedical technology, engineering, a related healthcare discipline, information technology, or business | At least 2 years as an HTM manager in the last 5 years |
| 5 | A degree in an unrelated field, or no degree | 7 years of HTM work experience, including 3 years of management in the last 5 years |
The handbook lists accepted healthcare disciplines (for example accounting, business administration, clinical engineering, healthcare administration, information technology, and nursing) and asks applicants whose degree is not listed to contact ACI. ACI reviews complete applications within 3 to 5 business days; an incomplete application must be corrected within 5 business days, and a denial can be appealed within 30 days.
5. Fees and Scheduling Rules
| Fee | AAMI member | Non-member |
|---|---|---|
| CHTM exam (2026) | $490 | $565 |
| CHTM retake (2026) | $440 | $515 |
| CHTM exam (2027) | $510 | $590 |
| CHTM retake (2027) | $460 | $540 |
- Fees apply only to the window selected and cannot be transferred to another window.
- Cancellations requested by April 25 (May window) or October 25 (November window) are refunded minus a $100 processing fee.
- A candidate may reschedule once within the same window, for a fee, at least five business days before the appointment. A no-show forfeits all fees.
6. Recertification
- A new certification covers the rest of the year in which it is earned plus a full three-year cycle, and it always expires on December 31. Example from the handbook: certified May 1, 2026 → journal and payment due December 31, 2029.
- Renewal requires 30 CEUs per cycle (no matter how many ACI certifications you hold) plus the renewal fee by December 31. One CEU equals one hour of educational activity.
- CEU categories: I – additional certifications (maximum 15; an ACI certification earns 5 CEUs); II – leadership roles such as committee work (maximum 15); III – developing educational content, such as writing ACI items (maximum 15); IV – professional development such as classes, webinars, and conferences (minimum 15, no maximum); V – college courses (maximum 15; 1 CEU per 10 class hours, grade C or better); VI – work experience in HTM (maximum 6; 1.5 CEUs per full-time year).
- 2026 renewal fees: $100 (member) or $150 (non-member), plus $50/$75 for each additional certification. A $100 reactivation fee applies during the three-month grace period after December 31.
- ACI audits up to 10% of certificants each cycle. A certificant who cannot correct audit deficiencies within 15 business days loses the certification and must retake and pass the exam to regain it.
- There is no "retest instead of CEUs" renewal option for CHTM. Retesting is the route back after a lapse or revocation. (The CABT is the only non-renewable ACI credential.)
7. The ACI Code of Conduct
All ACI applicants, candidates, and certificants agree to a ten-point Code of Conduct. They commit to:
- Conduct professional activities with honesty and integrity.
- Uphold the highest ethical standards.
- Represent certifications and qualifications honestly and provide only services they are qualified to perform.
- Maintain and improve knowledge and competence through self-assessment, continuing practice, and continuing education.
- Act free of bias and discrimination toward clients, colleagues, and customers.
- Protect privacy and confidentiality unless disclosure is required by legal authority.
- Obey all applicable laws, regulations, and codes.
- Follow ACI certification policies and requirements.
- Not use the certificate in a misleading manner.
- Stop using the certificate and marks after suspension, revocation, or withdrawal.
Worked Ethical Scenario: The Overdue Ventilators
Scenario: During a respiratory surge, the chief nursing officer asks the HTM director to release 15 ventilators that are 45 days past a manufacturer-required overhaul. The COO says: "Sign them off as inspected; we need them now."
Analysis:
- Signing off work that was not done creates a false record. That breaks the Code's honesty commitment (items 1–2) and its commitment to obey laws and regulations (item 7). CMS requires that equipment be maintained to ensure an acceptable level of safety and quality (42 CFR §482.41(d)(2)).
- Compliant response: Refuse to falsify, then solve the capacity problem: run around-the-clock overhauls with qualified staff, rent validated units, borrow from affiliated facilities, and document the risk discussion in writing with clinical and executive leaders.
Hospital conflict-of-interest policies — and, in some cases, federal anti-kickback rules — govern gifts from vendors. The ACI Code's integrity commitments point the same way: decline personal benefits that could influence a purchasing recommendation, and disclose the offer.
A clinical engineering supervisor holds a Bachelor of Science in Healthcare Administration and no ACI certification. For the past 28 months she has managed 8 biomedical technicians, approved department purchase orders, and written their annual evaluations. Which ACI CHTM eligibility path fits her background?
An HTM supervisor is building a 12-week CHTM study plan and wants to describe the exam accurately to a colleague. Which statement is accurate according to ACI?
While a physiological monitoring upgrade is being selected, a vendor offers an HTM manager a paid trip to an international conference, with luxury lodging and golf, if the manager recommends the vendor's platform. The manager's CHTM also expires on December 31 this year. What should the manager do?