Guide to Dialysis Technician Certifications From BONENT & NNCC - CHT, CCHT, CHBT

Dialysis is a process that helps those suffering from kidney disease or failure. It functions as a kind of artificial kidney, using dialysis machinery to remove fluids and excess blood from the body. The duties of dialysis technicians and technologists include operating these machines, assisting physicians and specialists in whatever way is necessary, and monitoring patient status as they undergo a series of treatments.

Certification as a dialysis technician from the proper credentialing agencies outfits medical professionals with an in-demand skill set. Credentials as a CHT (certified hemodialysis technician/technologist), CCHT (certified clinical hemodialysis technician/technologist), or CHBT (certified hemodialysis bio-medical technician/technologist) show medical facilities that candidates possess the requisite technical knowledge. It also shows commitment to the field and indicates a dialysis technicians’ desire to engage with leading research and techniques.

Once candidates have successfully completed an accredited and recognized nephrology or dialysis program, they are eligible to take a certification exam to demonstrate their learning.

To become a certified dialysis technician at the national level, prospective dialysis technicians must go through the Board of Nephrology Examiners Nursing and Technology (BONENT), the Nephrology Nursing Certification Commission (NNCC), or the National Nephrology Certification Organization (NNCO).

In addition to national certifications, a dialysis technician’s state of residence will likely have its own standards for certification. This generally includes professional registration and licensing requirements. States may recognize certain individualized components of the national exam for some of these purposes. Check your state health authority’s website or call their office with questions. It should be noted, however, that positions in the field as a certified CHT, CCHT, and CHBT professional may require that additional requirements be met.

Read on for a complete guide to dialysis technician certification and registration.

National Certification – CHT, CCHT, CHBT

In order to apply for the required credentials, proper and thorough certification as a dialysis technician requires a few steps.

The Board of Nephrology Examiners Nursing and Technology (BONENT), the Nephrology Nursing Certification Commission (NNCC), or the National Nephrology Certification Organization (NNCO) are the main authorities on dialysis technician certification in the United States. While there are other organizations and agencies working to certify professionals in this area, NNCC and BONENT represent the best of the best in terms of comprehensive training and education in the field. For a wealth of industry information, practice exams, and study resources, the National Association of Nephrology Technicians/Technologists (NANT) should be consulted. It’s the country’s leading authority on dialysis technician credentialing and certification. Additional options and certifying agencies are covered below.

For the average dialysis technician program, there tend to be few prerequisites. In fact, it’s not uncommon to find a dialysis technician program that requires only a high school diploma or its equivalent (GED) in order to enroll. What’s more, like many technical or vocational medical assisting certifications, an approved program may take as little as one semester to complete.

BONENT’s list of approved national and international training programs offers a great place to examine all of the technical training and expertise options available to dialysis technicians. The organization also offers an online practice CHT test for $50, and there are also a number of study guides available to help students further familiarize themselves with dialysis technician knowledge and practice.

Applicants generally may take tests in one or two ways, or a hybrid of the two: PPE (paper and pencil exam) and CBT (computer based testing). See specific testing sites for more information on dialysis tech exam format.

It should be noted that applicants to any hemodialysis certification program must be in compliance with both state and federal legislative regulations regarding hemodialysis practice.

CHT – Certified Hemodialysis Technician

The Board of Nephrology Examiners Nursing and Technology (BONENT) offers an exam for the credential of certified hemodialysis technician (CHT). This is the most general of the three dialysis technician certifications covered in this article.

Like all other dialysis technician certification sources, an educational minimum of a high school diploma or GED is required. Beyond that, in terms of occupational experience and expertise, the CHT credential requires 12 months of clinical experience or satisfactory completion of an approved educational program before registering for and taking the exam.

Upon completion of an approved training program, prospective dialysis technicians must submit the BONENT exam application, along with copies of their high school diploma and proof of completion of an approved educational program. A dialysis technologist instructor (or a qualifying supervisor) needs to sign the application and a signed reference letter must also be provided from that instructor. A signed reference letter must also be submitted from another instructor or a professional in the field of nephrology.

The cost is $220 for PPE (paper and pencil exam) and $250 for CBT (computer based testing). The exam takes approximately two to three hours to complete (with a time limit of three) and is made up of 150 multiple-choice questions. The exam covers a total of five knowledge domains:

  • Patient Care (45 percent)
  • Water Treatment (15 percent)
  • Infection Control (18 percent)
  • Machine Technology (12 percent)
  • Education & Professional Development (10 percent)

CCHT – Certified Clinical Hemodialysis Technician

The Nephrology Nursing Certification Commission (NNCC) provides certification for the clinical hemodialysis technician (CCHT) credential.

Applicants for the CCHT certification exam must possess a high school diploma or GED and are expected to have completed a training program for clinical hemodialysis technicians that contained both supervised clinical experience and classroom instruction. Applicants must also meet all training and experience requirements of the “CMS Conditions for Coverage for End Stage Renal Disease Facilities” in the state in which they aim to work. Signatures from program educators must be obtained and presented before certification is awarded.

Additional eligibility qualifications for CCHT include proof of number of hours spent as a hemodialysis technician (a minimum of six months or 1,000 hours).

The CCHT certification exam costs $225, comprises 150 questions, can needs to be completed in 180 minutes or less. A response rate of 74 percent is required to gain CCHT certification.

CHBT – Certified Hemodialysis Bio-Medical Technician

BONENT also hosts the certified hemodialysis bio-medical technician (CHBT) certification exam. This credential prepares dialysis technicians for more specialized types of work in the field.

The CHBT exam is meant to track and measure technical proficiency in medical skills and dialysis best practice, with a focus on bio-medical environments. This exam is only offered from BONENT in the paper and pencil (PPE) format. The cost of the exam is $220. The CHBT exam consists of 150 multiple-choice questions and has a three-hour time limit. The test covers the following eight “domains of practice and tasks performed in the scope of hemodialysis technology”:

  • Medical Machine Maintenance (24 percent)
  • Quality Assurance Performance Improvement (7 percent)
  • Water Treatment System Management (30 percent)
  • Concentrate System Management (11 percent)
  • Reprocessing of Dialyzer (4 percent)
  • Life-Safety and Physical Plant Maintenance (9 percent)
  • Documentation Practices (7 percent)
  • Professional Responsibilities (8 percent)

Dialysis Technician Certification Renewals

For nationally recognized certifications through BONENT, NNCC, or the NNCO, renewal is typically required every two to four years. However, this varies from organization to organization.

Certification through an organization such as BONENT means that applicants might not need to retake the exam but simply ensure that they meet recertification criteria and pay a renewal fee. While there is no fee to recertify, all dues and fees must be up-to-date in order for BONENT recertification to properly go through. To be eligible, certification-holding professionals must get at least 40 contact hours or retake the application examination, or use a once-in-a-lifetime waiver to automatically recertify.

For the NNCC’s CCHT credential, there are two options: retake the application exam for the standard fee of $220/$250 (PPE/CBT) or provide proof of ongoing clinical experience. This means demonstrating a total of 30 contact hours of continuing education verified by an organization like the American Nephrology Nurses Association (ANNA).

On the state level, the process may vary. For example, in Oregon, if you have been fully certified, you can apply for renewal of your certification. Any applications for the 2021 through 2023 certification period must be submitted or postmarked on or before May 30, 2021.

There are only a few states that observe a grace period if your dialysis certification lapses. In most states, hemodialysis technicians cannot legally work after their certification expires. Recertification on the state level will usually cost the same amount that initial certification did.

State Certification for Dialysis Technicians

Registration, licensing, and certification requirements for CHT, CCHT, or CHBT professionals vary from state to state. Check with the dialysis technician or dialysis nursing board in your state for more detailed information on how to become a registered dialysis technician.

In combination with national certification from NNCC, BONENT, or NNCO, state certification grants dialysis technicians the right to legally perform their duties under specific state laws. Furthermore, registering through these agencies adds an additional layer of official approval.

In the state of Oregon, for example, to work as a registered dialysis technician, candidates must apply for a license from the Oregon Health Authority via the Oregon Department of Health. To be eligible for certification in Oregon, students are expected to pass a nationally-available certification examination, such as the NNCC, NNCO, or BONENT. The process for certification in Oregon also includes passing a nationally-recognized exam, forwarding those numerical test scores, and completing a hemodialysis technician certification application form. The fee for Oregon certification is $150.

Upon qualifying for certification in Oregon, applicants must take a three-part exam that includes:

  • Hands-on practical exam performed on a typodont
  • Computerized written general knowledge exam
  • Computerized law and ethics written exam

To receive and maintain dialysis technician certification in Oregon, applicants must:

  1. Complete continuing education units (CEUs) during the two-year certification period. The number of CEUs needed can be prorated if a candidate has been fully certified for less than two years.
  2. Complete hemodialysis technician work hours. The number of work hours needed is prorated if a candidate has been fully certified for less than two years.
  3. Complete the Oregon CHT application. Depending on how far into a certification cycle a technician might be, or how far past expiration they’ve gone, certification cost and CEU requirements will be prorated.
  4. Submit the certification application, CEU documentation, hours worked, and the $150 application fee as a check or money order.
Kenneth Parker
Kenneth Parker Writer

Kenneth Parker is a feature writer, poet, and musician living in the Pacific Northwest. His writing on remote work, education, and technology has been published by,, and other websites. His poetry, short fiction, and album reviews have appeared in Scifaikuest, Nanoism, and No Clean Singing. His background includes time spent as an associate editor, proofreader, private grammar instructor, freelance content editor, medical claims agent, and SEO consultant. He is a graduate of the University of Oregon, where he studied literature and worked as a composition tutor.