CRCST Exam PrepThe short answer: Of the 150 questions, 125 are scored and 25 are unscored pilot questions, results are pass/fail, and HSPA does not publish a numeric cut score. Pass rates vary from year to year, but a meaningful share of candidates do not pass on the first attempt, which makes structured preparation across the weighted domains more important than ever.
The big picture
HSPA delivers thousands of CRCST exams every year, and published pass rates show the exam is genuinely challenging: a meaningful share of candidates do not pass on their attempt. That is not a reason to panic. It is a reason to prepare with structure instead of hoping for the best.
The sheer exam volume also tells you something important about the field itself: sterile processing is growing, and thousands of new technicians are entering the pipeline every year. You are not preparing for a niche test that a few hundred people take. This is a major allied-health certification with a large, active candidate pool.
What the pass rate means for you
The published pass rate sits in an interesting middle ground. It is not a near-guaranteed pass, and it is not a brutal weed-out exam either. Compare it mentally to a coin flip: the odds favor you, but not by enough to wing it.
Here is the most useful way to read that number: the pass rate reflects the whole candidate pool, including people who walked in underprepared. Candidates who complete a structured study plan and work through realistic practice questions consistently outperform the average. The pass rate is not a verdict on the exam's difficulty so much as a report card on how the average candidate prepared.
How HSPA scores the exam
The scoring mechanics matter because they shape your test-day strategy:
- 125 questions count toward your score. These are the scored items that determine pass or fail.
- 25 questions are unscored pilot items. HSPA uses these to field-test questions for future exams. They do not affect your result, but they are not identified, so answer every question as if it counts.
- Scoring is pass/fail. You receive a pass or fail result, not a ranked grade you can compare with other candidates.
- HSPA does not publish a numeric cut score. Unlike some exams that tell you exactly how many questions you must answer correctly, HSPA does not disclose the passing threshold.
The unpublished cut score frustrates some candidates, but it should not change your approach. Since you cannot aim for a precise number of correct answers, the only rational strategy is to maximize correct answers across every domain. There is no benefit to gaming the test, and guessing is always better than leaving a question blank.
Why pass rates move over time
Published pass rates have moved over the years, and it is natural to ask why.
The honest answer: HSPA has not published an official explanation for these shifts. Any specific cause you read online is speculation, not an HSPA statement. That said, a few plausible contributors are commonly discussed by sterile processing educators:
- A much larger and less experienced candidate pool. With exam volume growing substantially, more first-time candidates with less hands-on background are testing, which can pull the average down even if the exam itself is unchanged.
- Test content evolves. Certification exams are periodically updated to reflect current guidelines and practice. Candidates studying from outdated materials may be caught off guard.
- Self-study without structure. As the field attracts more career changers, more candidates prepare without a formal program, and unstructured preparation shows up in the numbers.
None of these change what you control. Whatever drove the decline, the response is the same: study the current content outline, practice under realistic conditions, and do not rely on outdated materials. Our guide to common CRCST exam mistakes covers the traps that catch underprepared candidates.
How CRCST scoring compares to other healthcare certifications
Most allied-health certification exams share the same basic design as the CRCST: multiple-choice questions, a pass/fail result, and unscored pilot items mixed in for test development. The CRCST's structure is squarely in the mainstream here.
Where exams differ is transparency. Some certifying bodies publish their cut scores or scaled-score bands; HSPA does not, which puts the CRCST on the less transparent end of the spectrum. Practically speaking, this changes nothing about how you prepare. It does mean you should ignore anyone online claiming to know the exact number of questions you need right. That number is not public.
One genuine advantage the CRCST has over some competing credentials: year-round, on-demand scheduling through Prometric. Some certifications only offer limited testing windows, which can delay a retake by months. If you need a second attempt at the CRCST, you can get back in far sooner. (The alternate body, CBSPD, uses limited testing windows instead. See our CRCST vs CBSPD comparison.)
What happens if you fail
Failing is disappointing, but it is not the end of the road. HSPA allows candidates to retake the exam, and with year-round scheduling you do not have to wait for a distant testing window. Because retake fees, waiting periods, and reapplication steps can change, check the current retake policy at myhspa.org before planning your next attempt rather than relying on secondhand information.
If you do need a retake, treat it as a diagnostic exercise. Your score report shows how you performed by domain, which tells you exactly where to focus. Most retake candidates fail by a narrow margin concentrated in one or two weak domains, not across the board. A targeted study plan built around your weakest domains, which you can map using our exam content outline, is far more effective than restudying everything equally.
How to use the pass rate to plan your study
Turn the statistics into a study strategy:
- Weight your time by domain weight. Cleaning/Decontamination/Disinfection, Preparation/Packaging, and the Sterilization Process are each 21% of the exam. Together that is 63%. Master these three and you have covered nearly two-thirds of the test.
- Do not ignore the small domains. The remaining four domains total 37%. Candidates often skip Professional Development and Patient Care Equipment because the weights look small, but those are easy points if you review them.
- Practice under exam conditions. 150 questions in 3 hours is a comfortable pace, but only if you have practiced it. Take full-length timed practice tests so the real thing feels familiar.
- Study current materials. Because exam content evolves, outdated study guides are a real risk. Make sure your materials reflect the current HSPA content outline.
- Give yourself enough runway. If you are unsure how much time you need, read how long to study for the CRCST for a realistic planning framework.