Certified Nursing Assistant (CNA) License Requirements in Missouri
- Training hours
- 175 hrs
- Upfront cost
- $135
- Exam
- Knowledge Test, Skill Test
- Renewal cycle
- Every 2 years
- Issuing board
- Missouri Department of Health and Senior Services (DHSS) — CNA, CMT and Insulin Registry
How to get licensed
- 1
Meet the prerequisites
Be at least 18 years old, pass a criminal background check. DHSS's official FAQ states: 'To take a CNA Program you must be 18 years of age unless you are taking the course through a High School Vo-Tech Program.' Background check: applicants must not be listed on Missouri's Employee Disqualification List (EDL) and must not have certain disqualifying felony/misdemeanor convictions. DHSS moved the CNA registry pages off /safety/cnaregistry/ to the /providers/ section; the citation above is the current page. The 175-hour split (75 classroom + 100 on-the-job) was re-confirmed there on 2026-07-27; the fee and exam figures were carried over from the retired FAQ page and are not restated on the new page. [1]
- 2
Complete approved training
Complete 175 hours of training (including 100 clinical hours) at a state-approved program. Missouri requires a state-approved course totaling 175 hours: 75 hours of classroom training plus 100 hours of on-the-job (clinical) training. This is well above the federal 75-hour floor (42 CFR 483.152). DHSS moved the CNA registry pages off /safety/cnaregistry/ to the /providers/ section; the citation above is the current page. The 175-hour split (75 classroom + 100 on-the-job) was re-confirmed there on 2026-07-27; the fee and exam figures were carried over from the retired FAQ page and are not restated on the new page. [1]
- 3
Knowledge Test
Pass the Knowledge Test (fee: $32). Multiple-choice (75 questions); an audio format is available. MSDH's own FAQ states the combined exam cost is $135 total ($32 knowledge + $103 skills); an earlier version of the D&SDT-Headmaster candidate handbook listed $30 knowledge / $95 skills — DHSS's official FAQ page is treated as the more current figure. You have 3 attempts to pass the knowledge and skill portions within one year of your training start date. DHSS moved the CNA registry pages off /safety/cnaregistry/ to the /providers/ section; the citation above is the current page. The 175-hour split (75 classroom + 100 on-the-job) was re-confirmed there on 2026-07-27; the fee and exam figures were carried over from the retired FAQ page and are not restated on the new page. [1]
- 4
Skill Test
Pass the Skill Test (fee: $103). Hands-on demonstration of nurse aide skills. Combined Knowledge + Skill total is $135. Same 3-attempt / one-year window as the Knowledge Test. DHSS moved the CNA registry pages off /safety/cnaregistry/ to the /providers/ section; the citation above is the current page. The 175-hour split (75 classroom + 100 on-the-job) was re-confirmed there on 2026-07-27; the fee and exam figures were carried over from the retired FAQ page and are not restated on the new page. [1]
- 5
Submit your application
Submit your application to Missouri Department of Health and Senior Services (DHSS) — CNA, CMT and Insulin Registry. [1]
- 6
Receive your license
Once your application is approved, Missouri Department of Health and Senior Services (DHSS) — CNA, CMT and Insulin Registry issues your Certified Nurse Assistant (CNA) for Missouri.
Fees
| Fee | Amount |
|---|---|
| Application fee [1] | None specified |
| License fee [1] | None specified |
| Renewal fee [1] | $20 |
| Knowledge Test [1] | $32 |
| Skill Test [1] | $103 |
No separate DHSS application/certification fee beyond the D&SDT-Headmaster exam fees (listed under exams). The $20 renewal fee is paid electronically through the TMU portal when renewing with documented work hours. DHSS moved the CNA registry pages off /safety/cnaregistry/ to the /providers/ section; the citation above is the current page. The 175-hour split (75 classroom + 100 on-the-job) was re-confirmed there on 2026-07-27; the fee and exam figures were carried over from the retired FAQ page and are not restated on the new page.
Renewal & continuing education
Renew every 2 years.
You must renew eligibility every 24 months by documenting at least 8 consecutive hours of paid nurse aide work during the previous 24 months (a paystub, W2, or employer letter) plus a $20 fee submitted through TMU. No continuing-education-hour requirement was found. DHSS moved the CNA registry pages off /safety/cnaregistry/ to the /providers/ section; the citation above is the current page. The 175-hour split (75 classroom + 100 on-the-job) was re-confirmed there on 2026-07-27; the fee and exam figures were carried over from the retired FAQ page and are not restated on the new page.
Reciprocity
Endorsement/reciprocity from another state is available.
No interstate compact covers CNAs/nurse aides (unlike the RN/LPN Nurse Licensure Compact). Missouri offers free reciprocity: as long as a CNA's certification is active and in good standing in another state, they can apply through TMU (uploading their out-of-state certificate and identity documents, plus verification of at least 8 hours of paid nursing-related work in the prior 24 months) to be added to the Missouri Nurse Aide Registry. Missouri does not, however, complete reciprocity verification forms for other states when a Missouri CNA transfers out. DHSS moved the CNA registry pages off /safety/cnaregistry/ to the /providers/ section; the citation above is the current page. The 175-hour split (75 classroom + 100 on-the-job) was re-confirmed there on 2026-07-27; the fee and exam figures were carried over from the retired FAQ page and are not restated on the new page.
2 state-approved training providers in Missouri — browse programs and compare schools on tradecolleges.org.
Cost calculator
- $32
- $103
Frequently asked questions
How many hours of CNA training does Missouri require?
175 total hours: 75 hours of classroom training plus 100 hours of on-the-job (clinical) training.
Who administers the Missouri nurse aide exam?
D&S Diversified Technologies LLP / Headmaster LLP, via the Missouri TMU testing platform. The exam has a 75-question Knowledge Test and a hands-on Skill Test.
How much does the Missouri nurse aide exam cost?
$135 total ($32 knowledge + $103 skills), per DHSS's official FAQ. You have 3 attempts to pass within one year of your training start date.
How old do I need to be to become a CNA in Missouri?
18, unless you're taking the course through a High School Vo-Tech Program.
Can I transfer my nurse aide certification from another state to Missouri?
Yes, Missouri offers free reciprocity for CNAs who are active and in good standing in another state — apply through TMU with your out-of-state certificate and proof of at least 8 hours of paid work in the prior 24 months.
Sources
- [1] health.mo.gov/providers/cna-cmt-lima-and-insulin-registry/certified-nurse-assistant-cna — accessed 2026-07-27