CNA license requirements in Texas
Everything you need to know to get certified, understand the costs, and start working across Texas.
If you’re thinking about a healthcare career and want to start working with patients quickly, without spending years in school, becoming a Certified Nursing Assistant (CNA) in Texas is one of the most practical moves you can make. Texas has one of the largest and fastest-growing healthcare systems in the country, which means real, consistent demand for CNAs in cities, suburbs, and rural communities alike.
The certification process is well-defined and accessible, even if you’re coming in with no prior medical background. Texas does require more training hours than many other states, 100 hours minimum compared to the federal baseline of 75, but that extra time means you’ll be better prepared when you walk into your first shift. This guide walks you through every step, from enrolling in training to picking up your first shift once you’re on the registry.
Texas CNA requirements at a glance
| Requirement | Detail | Status |
|---|---|---|
| Minimum Age | 18 years old (commonly required by employers) | State Standard |
| Training Program | 100-hour state-approved Nurse Aide Training Program (classroom + clinical) | Required |
| Competency Exam | Written (or oral) knowledge test plus hands-on skills evaluation | Required |
| Background Check | Criminal background screening before employment in healthcare | Required |
| Registry Listing | Texas Nurse Aide Registry, your official certification on file | Required |
| Physical License Card | Not issued in Texas | N/A |
Texas requires 100 training hours, 25 more than the federal minimum of 75. If you’re transferring from a state with lower training hours, you may need to verify your program meets Texas standards before applying for reciprocity.
Who oversees CNA certification in Texas?
CNA certification in Texas is regulated by the Texas Health and Human Services Commission (HHSC). The HHSC approves all state CNA training programs, administers the competency exam process, and maintains the Texas Nurse Aide Registry, the official database employers use to verify your credentials before hiring.
| Agency | Abbreviation | Key Responsibilities |
|---|---|---|
| Texas Health and Human Services Commission | HHSC | Approves all state CNA training programs; sets statewide certification standards; oversees the competency examination process; maintains the Texas Nurse Aide Registry. |
| Texas Nurse Aide Registry | Registry | Official record of all certified CNAs in Texas; serves as your credential in place of a physical license card; updated after passing the competency exam; employers must verify registry status before hiring. |
How to become a CNA in Texas, step by step
Complete a State-Approved CNA Training Program
Texas requires a minimum of 100 hours of training through a state-approved Nurse Aide Training Program. This includes classroom instruction and supervised clinical practice.
Programs are available through community colleges, vocational schools, and select healthcare facilities across Texas. Coursework typically covers patient care fundamentals, infection control, safety procedures, resident rights, and hands-on clinical skills.
Pass the Texas CNA Competency Exam
After completing training, you’ll register for the Texas CNA competency exam. The examination includes both a written knowledge test and a hands-on clinical skills evaluation.
You must successfully pass both portions to become eligible for certification and registry placement.
Clear a Criminal Background Check
Most Texas healthcare employers require a criminal background screening before hiring CNAs. The process is usually coordinated by the employer during onboarding.
Certain findings may require additional review before employment eligibility is determined, so it’s important to address any potential issues early in the process.
Get Listed on the Texas Nurse Aide Registry
Once you’ve passed both exam components, your information is added to the Texas Nurse Aide Registry, which serves as your official certification record.
Texas does not issue a physical CNA license card. Employers verify your certification directly through the registry before allowing you to begin work.
What’s on the Texas CNA competency exam?
The Texas CNA competency exam covers two components, written knowledge and hands-on skills. You need to pass both to earn certification. If you only fail one section, you only need to retake that portion, not the whole exam. Skills are randomly selected on exam day, so make sure you’ve practiced all common tasks during training, not just your strongest ones.
Written Test
- Approximately 70 questions
- Oral (audio) option available
- Basic nursing care
- Infection control & standard precautions
- Patient safety & emergency procedures
- Communication skills
- Resident rights and dignity
- OBRA regulations
Skills Test
- 3–5 skills randomly selected
- Observed by a certified evaluator
- Hand hygiene & infection control
- Measuring vital signs
- Mobility assistance & transfers
- Patient positioning & repositioning
- Personal care tasks
The oral test option is available for candidates with documented reading difficulties. Request it when scheduling your exam, don’t wait until exam day to ask.
| Topic Area | What It Covers | Exam Component |
|---|---|---|
| Infection Control | Hand hygiene, PPE use, and isolation precautions. | Written + Skills |
| Patient Safety | Fall prevention, restraint protocols, and emergency response procedures. | Written + Skills |
| Resident Rights | Privacy, dignity, informed consent, and OBRA regulations. | Written |
| Basic Nursing Care | Vital signs, repositioning, personal hygiene, and feeding assistance. | Written + Skills |
| Mobility & Transfers | Assisted ambulation, wheelchair use, and bed-to-chair transfers. | Skills |
| Communication | Reporting observations, documentation basics, and patient interaction. | Written |
| Exam Detail | Written Test | Skills Test |
|---|---|---|
| Passing Score | 70% or Higher | All Scored Steps Completed Correctly |
| Retakes Allowed? | Yes | Yes |
| Maximum Attempts | 3 Attempts Total | 3 Attempts Total |
| After 3 Failures | Full retraining through a state-approved Texas Nurse Aide Training Program is required before you can retest. | |
How much does it cost to become a CNA in Texas?
Texas training costs run a bit higher than most states, partly because of the 100-hour requirement and partly because program pricing in larger metro areas tends to be higher. That said, employer sponsorship is widely available across the state, especially in skilled nursing facilities that are actively hiring.
| Cost Item | Low Estimate | High Estimate | Notes |
|---|---|---|---|
| Training Program Tuition | $800 | $2,000 | Community colleges tend toward the lower end; private vocational schools and metro-area programs often cost more. |
| Textbooks & Supplies | $50 | $175 | Scrubs, clinical supplies, and textbooks. Sometimes bundled into tuition, so verify before enrolling. |
| Competency Exam | $100 | $125 | Covers both written and skills sections. Retakes are typically charged separately at a reduced rate. |
| Background Check | $35 | $75 | Frequently covered or reimbursed by employers. Ask before paying out of pocket. |
| Registry Application | Free | Free | No separate fee to be listed on the Texas Nurse Aide Registry after passing the exam. |
| Total Estimated Cost | $985 | $2,375 | Lower end assumes community college tuition and employer reimbursement; higher end reflects private programs without financial assistance. |
Employer-sponsored training is especially common in Texas because of the statewide staffing demand. Many skilled nursing facilities will pay for your full training in exchange for a 6- to 12-month work commitment. It’s always worth asking facilities in your area before enrolling anywhere.
CNA salary and job outlook in Texas (2026)
Texas is one of the best states in the country for CNA job availability. The combination of a large population, rapid growth in metro areas, and an aging demographic creates consistent, year-round demand across all care settings. Pay varies by city, setting, and experience, but the opportunities to grow your income are real.
| Role / Setting | Avg. Annual Salary | Notes |
|---|---|---|
| CNA, Skilled Nursing Facility | $32,000–$36,000 | Most common first placement statewide with consistently high hiring demand and frequent openings. |
| CNA, Hospital / Acute Care | $38,000–$44,000 | Higher-acuity environment; often titled Patient Care Tech (PCT). Prior experience may be preferred. |
| CNA, Home Health / Hospice | $34,000–$40,000 | Flexible scheduling and strong demand driven by Texas’s rapidly growing aging population. |
| CNA, Houston / Dallas Metro | $19–$22/hr | Major metro markets typically pay above the statewide average due to stronger demand and higher living costs. |
| CNA, Austin / San Antonio | $17–$20/hr | Fast-growing healthcare markets supported by expanding hospital systems and population growth. |
| CNA, Top 10% Earners (Texas) | $48,000+ | Typically experienced CNAs working in hospitals, specialty units, or overtime-heavy positions. |
Salary Disclaimer: Salary estimates are based on publicly available wage data, employer job postings, and labor market information. Actual earnings vary by employer, geographic location, specialty, shift differentials, overtime opportunities, certifications, and experience level.
Where can you work as a CNA in Texas?
Once you’re on the Texas Nurse Aide Registry, you can work across a wide range of care settings. Texas’s size means there’s no shortage of options, whether you’re in a major city like Houston, Dallas, or San Antonio, or working in a smaller community where CNAs are equally in demand.
| Work Setting | What to Expect | Typical Schedule | Best For |
|---|---|---|---|
| Skilled Nursing Facilities (SNFs) | Daily hands-on resident care including bathing, dressing, vital signs, mobility assistance, and routine support. The most common first placement for new CNAs across Texas. |
12-Hr Shifts
Rotating days and nights |
New CNAs Building Experience |
| Hospitals & Acute Care | Faster-paced environment with higher-acuity patients. You’ll support RNs on post-surgical and medical floors. Often titled Patient Care Technician (PCT). |
8- or 12-Hr Shifts
All days available |
Career-Focused CNAs |
| Assisted Living Communities | Supportive daily care for residents with lower medical acuity. More relationship-focused with a predictable and consistent routine. |
Day / Evening
Consistent hours |
Slower-Paced Preference |
| Home Health Agencies | One-on-one care in a patient’s home. Greater independence and scheduling flexibility. Tasks range from personal care to light household support. |
Flexible Schedule
Hourly or shift-based |
Independent, Self-Directed CNAs |
| Rehabilitation Centers | Support patients recovering from surgery, stroke, or injury. Active patients working toward discharge goals with faster turnover than SNFs. |
Day-Heavy Schedule
Some weekends |
Therapy-Adjacent Interest |
| Hospice & Palliative Care | End-of-life comfort care focused on dignity and quality of life. Emotionally demanding but deeply meaningful, often with lower physical demands than SNF work. |
Varies
Some on-call availability |
Empathetic & Resilient CNAs |
Demand is strong across Texas’s major metro areas, Houston, Dallas-Fort Worth, San Antonio, Austin, and El Paso, as well as mid-size cities and rural communities where staffing shortages often mean faster hiring and sign-on incentives for qualified CNAs.
CNA license renewal in Texas
Texas CNA certification must be renewed every 24 months. The renewal requirement is simple, you need to have actively worked as a CNA at some point during that period. No continuing education credits are required, which keeps the process straightforward as long as you stay active in your role.
| Renewal Requirement | Details |
|---|---|
| Renewal Cycle | Every 24 months from the date of your initial certification listing. |
| Work Requirement | At least 8 hours of paid CNA work must be completed during the 24-month renewal period. Volunteer hours do not count toward this requirement. |
| Continuing Education | No state-mandated CEU hours are required for standard renewal. Texas uses a work-activity model rather than a continuing education credit model. |
| Registry Update | Active employment is reported to the Texas Nurse Aide Registry by your employer. It’s worth checking that your registry listing is current before your renewal date rather than assuming it has been updated automatically. |
| If You Haven’t Worked 8 Hours | Your certification becomes inactive. You may need to complete retraining through a state-approved Texas Nurse Aide Training Program or re-take the competency examination before returning to active status. |
| Tip to Stay Active | Even occasional PRN or per-diem shifts satisfy the 8-hour requirement. If you’re taking a career break, keeping a small number of shifts on your schedule is usually the easiest way to prevent certification lapse. |
Transferring a CNA license to Texas
Texas does allow reciprocity for CNAs certified in other states, but it’s worth paying attention to the training hours requirement. Because Texas mandates 100 hours of training, applicants from states with lower minimums may need to verify their program met the standard. Here’s everything you need to know before applying:
| Requirement | What You Need to Know |
|---|---|
| Active Certification | Your home-state CNA certification must be currently active and in good standing. Expired, inactive, or lapsed certifications generally do not qualify for Texas reciprocity. |
| Good Standing | There must be no substantiated findings of abuse, neglect, or misappropriation of resident property on your home-state registry record. Any disciplinary history will be reviewed during the Texas application process. |
| Training Hours | Texas requires 100 training hours, which exceeds the federal minimum of 75 hours. If your original program only met the federal minimum, Texas may require additional training or testing before approving registry placement. |
| Application Process | Submit a reciprocity application through the Texas Nurse Aide Registry and provide proof of active out-of-state certification. Verify current processing timelines with HHSC before accepting employment offers or scheduling a move. |
| Background Check | A criminal background check is still required in Texas, even if you completed one in another state. This requirement applies to all reciprocity applicants. |
| Re-Testing Required? | Usually not required when certification status, training hours, and registry standing can be verified. However, additional testing, coursework, or documentation may be required if there are training-hour deficiencies or compliance concerns. |
Ready to start working as a CNA in Texas?
Once you’re listed on the Texas Nurse Aide Registry, you can start picking up shifts right away. Texas’s healthcare market is one of the most active in the country, which means faster placement, more scheduling options, and consistent work availability wherever you’re located in the state.
With MyShyft, you can find shifts at facilities near you, work the hours that fit your life, and get paid quickly, without sitting through weeks of traditional hiring paperwork.
Frequently Asked Questions
Licensing Information Disclaimer: Licensing requirements, fees, examination details, renewal standards, and Nurse Licensure Compact participation may change over time. While we strive to keep this information current and accurate, MyShyft does not guarantee the completeness or accuracy of the information provided. Always verify licensing requirements directly with the Texas Board of Nursing before making educational, licensing, employment, or relocation decisions. Reliance on information contained on this page is at the reader’s own risk.