FNP-BC vs. FNP-C: Learn the Difference Between These Nurse Practitioner Certifications

Meg Lambrych, RN-BC
Updated June 11, 2024
Edited by
Family nurse practitioners can pursue credentials from two separate agencies. This article details the differences between FNP-BC and FNP-C certifications.
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Every new family nurse practitioner (FNP) must earn certification to legally practice. However, new FNPs may feel confused about whether to pursue board-certified (FNP-BC) or certified (FNP-C) credentials.

This guide defines, compares, and contrasts FNP-BC and FNP-C certifications. Use our research to choose a pathway that aligns with your personal and professional goals.

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Understanding Certifications in Healthcare

Each licensed clinician practicing medicine must graduate from an accredited program and pass one or more exams to demonstrate competency in specific areas.

Nurse practitioners (NPs) specializing in family medicine are called FNPs. FNPs are required to take one of two certification exams:

Both exams measure entry-level competency after FNP program completion and are offered by highly respected organizations. Their differences are slight but important to understand, as each credential can prepare you for different career paths.

What Is FNP-C Certification?

The FNP-C evaluates test-takers on medical care for children, families, adults, and older adults. The exam covers pathophysiology, pharmacology, physical assessment, and evidence-based practice. It also includes additional content on prenatal and newborn care. FNPs who have graduated from accredited programs can take this exam.

What Is FNP-BC Certification?

The FNP-BC is a certification offered to FNPs that focuses on medical care across the lifespan but includes additional planning content. The exam covers pathophysiology, pharmacology, physical assessment, and evidence-based practice. FNPs who graduate from accredited programs can qualify for this exam.

FNP-C vs. FNP-BC Certification

Generally speaking, the FNP-C credential is best for FNPs who plan on working directly with patients, as it tends to be less expensive and more thorough in its clinical knowledge assessment.

The FNP-BC exam is slightly longer (150 vs. 135 questions) and more costly than its FNP-C counterpart. Experts recommend this credential for FNPs who plan to work in academia or nurse leadership instead of, or in addition to, clinical care.

The following section clarifies exam competencies, eligibility requirements, costs, and more for FNP-BC and FNP-C certifications.

Exam Competencies

The FNP-C exam consists of 135 questions covering the following competencies:

  • Assessment: 43 (32%)
  • Diagnosis: 36 (26.5%)
  • Planning: 36 (26.5%)
  • Evaluation: 20 (15%)

Age groups covered in the exam include: prenatal, newborn, infant, child, early adolescent, later adolescent, young adult, middle adult, and older adults.

The FNP-BC exam consists of 150 questions covering the following competencies:

  • Assessment: 29 (19%)
  • Diagnosis: 26 (17%)
  • Planning: 29 (19%)
  • Implementation: 43 (29%)
  • Evaluation: 23 (15%)

The exam covers all major body systems, with less emphasis on immunological and hematopoietic systems. Patient age groups covered in the exam include infants, school-age children, adolescents, young adults, adults, and older adults.

The following subjects may appear on the exams:

  • Anatomy
  • Physiology
  • Pathophysiology
  • Comorbidities
  • Pharmacologic therapies
  • Non-pharmacologic therapies
  • Integrative therapies
  • Polypharmacy
  • Pain management
  • Cultural competence/sensitivity
  • Diagnostic and therapeutic tests
  • Functional assessment
  • Health history
  • Mental health assessment
  • Physical examination across the lifespan
  • Signs and symptoms
  • Therapeutic communication
  • Clinical decision-making
  • Crisis management
  • Differential diagnosis

Notable differences between the two exams:

  • The FNP-C exam includes prenatal and newborn care, along with other subsets of adolescent and adult patients.
  • The FNP-C exam includes concepts such as cultural competence, mental health, therapeutic communication, crisis management, and integrative therapies, among others.
  • The FNP-BC exam includes 150 scored and 25 unscored pretest questions vs. the FNP-C’s 135 scored and 15 unscored questions. Pretest questions determine if they will be included in the exam in the future. The candidate cannot identify the pretest questions, and responses do not affect the candidate’s test score.

Eligibility Requirements

The FNP-C exam offered by the AANPCB has the following eligibility requirements:

  • Completion of APRN core courses (advanced physical assessment, pharmacology, and pathophysiology)
  • Nationally recognized FNP competencies across the lifespan
  • Current, active RN license
  • Academic transcripts
  • Completion of an accredited FNP or doctorate of nursing practice (DNP) program

Note: Candidates may sit for an exam before their graduation date as long as they have completed all coursework and clinical hours.

The FNP-BC exam offered by the ANCC has the following eligibility requirements:

  • Current, active RN license
  • Completion of an accredited FNP or DNP program; candidates who have completed coursework and clinical hours can sit for the exam
  • Completion of APRN core courses (advanced physical assessment, pharmacology, and pathophysiology)
  • Completion of content related to health promotion and/or health maintenance
  • Completion of content related to differential diagnosis and disease management, including pharmacologic and nonpharmacologic interventions

Cost of Certification

The cost of the FNP-C certification exam through the AANPCB is $240 for AANP members and $315 for non-members.

The FNP-BC certification exam through the AANC costs $295 for members of the American Nurses Association and $395 for non-members. AANP members pay $340, and AANP student members pay $290.

Maintenance and Renewal

Requirements for AANPCB’s FNP-C certification maintenance and renewal:

  • Current AANPCB board certification
  • Current, active licensure
  • Minimum 1,000 practice hours
  • 100 CE hours (including 25 hours of pharmacology)(Student precepting or faculty supervision may be converted to CE hours)
  • NPs may choose to recertify by examination

Requirements for ANCC FNP-BC maintenance and renewal:

  • Current, active license
  • Current ANCC board certification
  • Completion of 75 continuing education (CE) hours (including 25 hours of pharmacology)

Students can fulfill renewal requirements through academic credits, CE activities, professional presentations, and volunteer service, among other possibilities.

In both cases, there is extra work if an FNP chooses to recertify after their credentials expire. The AANP’s FNP-BC offers alternative options for qualifying for recertification. Both offer the option of recertifying by exam.

Choosing Between FNP-C and FNP-BC Certification

Employers find merit in both certifications as long as an FNP is licensed, certified, and in good standing. When choosing between FNP-BC and FNP-C certifications, there are a few differences to consider.

FNPs with either certification can treat patients, but the FNP-C credential includes more clinical information and is often favored by those seeking to practice direct patient care as clinicians.

The FNP-C certification also includes key issues such as diversity and cultural competence, polypharmacy, communication, integrative therapies, and functional assessment.

The FNP-BC certification may appeal to FNPs who are more likely to pursue opportunities in academia or leadership, though they will also be prepared for direct patient care. According to Payscale data from June 2024, the average annual salary for FNPs is $103,900. Nursing instructors took home an annual average salary of $68,820, while nursing professors earned $69,800.

According to the Bureau of Labor Statistics (BLS), all NPs can expect 45% job growth between 2022-2032 — many times faster than the national average.

Frequently Asked Questions About FNP-C and FNC-BC Certification

The FNP-BC designation refers to the board-certified family nurse practitioner credential offered by the ANCC.