Course price: $499.99; selected gift cards are paid add-ons that increase the total.
Access: 30 months.
Practice: 2,500+ board-style questions across 15 body-system modules, plus five 240-question mock exams.
CME: The PANRE Clinical Review Module awards up to 100 AAPA Category 1 CME credits after you complete the activity requirements.
Gift card note: Amazon and Apple gift cards are optional paid add-ons, not free gifts.
PANRE-LA gives you more than one way to get through the assessment
PANRE-LA is structured differently from a single-day recertification exam. Your final score is based on your best eight quarters, and you may complete the assessment as early as eight quarters. You may skip up to four quarters, provided you participate in at least one quarter in year seven and one in year eight.
Each quarter includes 25 questions, with five minutes per question. You can use printed or online references, but you may not consult with other people. You receive immediate feedback on each question, including the correct response, an explanation, and references. Starting with the second quarter, five topics repeat each quarter; for each repeated topic, the better response counts and the other is removed from your score.
These features offer several opportunities to build and demonstrate your knowledge over time. Still, it is reasonable to ask what happens if the PANRE-LA does not go your way.
If you do not pass PANRE-LA, what comes next?
If you do not pass by the end of the 12 quarters, NCCPA provides three attempts to take and pass the traditional PANRE in year 10 before your certification expires. That is the fallback path, but it is a different testing experience.
| PANRE-LA | Traditional PANRE | |
|---|---|---|
| Format | 12 quarters in years 7–9; may finish as early as eight quarters | One sitting at a Pearson VUE test center |
| Questions | 25 per quarter; five minutes per question | Four blocks of 60 questions; 60 minutes per block |
| References | Printed or online references allowed; no consulting others | No references during the exam |
| Retake path | If you do not pass by the end of 12 quarters, three PANRE attempts in year 10 | Generally, up to two attempts in year nine and three in year 10, with a maximum of four total attempts |
| Content | Same NCCPA content blueprint | Same NCCPA content blueprint |
The PANRE-LA failure path is specific: after not passing by the end of the assessment quarters, you have three year-10 attempts to pass PANRE. For the full rules, and your own dates, check the NCCPA maintain-certification page and NCCPA key dates. NCCPA is the source of truth for your eligibility and deadlines.
Build knowledge that transfers between formats
PANRE and PANRE-LA use the same NCCPA content blueprint, even though the exam experiences differ. A broad, well-supported review can help you prepare for either path: continuing through PANRE-LA or taking a traditional PANRE sitting in year 10.
The PANRE Review Course is built around that shared content. It includes 2,500+ board-style questions across 15 body-system modules, five full-length 240-question mock exams, per-question rationales with cited sources, and a readiness dashboard with topic tracking, question flagging, unlimited retakes, and an “on track to pass” indicator at 75% or higher. Each mock exam contains 240 questions, the same total number of questions as a traditional PANRE sitting, so it offers a practical rehearsal for that format if you need it.
The course is now a web app, so you can access its lectures, study materials, post-test, evaluation, and certificate on a phone, tablet, or computer without downloading software. Answer explanations have been rewritten to current 2023–2025 guidelines and are individually cited.
Keep CME requirements on your maintenance checklist
Participating in PANRE-LA does not replace your CME requirements. NCCPA maintenance includes 100 CME credits in each two-year cycle, with at least 50 Category 1 credits. You must continue meeting those requirements while participating in PANRE-LA.
The PANRE Review Course’s PANRE Clinical Review Module awards up to 100 AAPA Category 1 CME credits. These credits apply to the PANRE Review Course module, not the Pharmacology course. The activity is part of Comprehensive Clinical Review for Practicing PAs: 2026–27 Enduring CME Activity, AAPA reference number CME-2016187, with approval valid from August 26, 2026, to August 26, 2027.
To earn credit, review all module content, complete the post-test with a score of 70% or higher, and complete the activity evaluation. You may retake missed questions. A certificate stating your precise credit is issued after both requirements are complete; claim only credit commensurate with your participation. Complete the activity before it expires.
For each PANRE-LA quarter in which you answer all 25 questions, NCCPA awards two Category 1 Self-Assessment CME credits, or three credits with NCCPA’s 50% Self-Assessment bonus. These credits can help, but they supplement rather than replace your cycle requirements.
For NPs and physicians: AAPA Category 1 acceptance for NP renewal varies by state; verify with your state board of nursing before purchase. The activity meets AAPA Category 1 requirements, but physicians report it as Category 2 CME for their own reporting.
Optional Amazon and Apple gift cards are paid add-ons
At checkout, you can add an Amazon or Apple gift card in $100 tiers from $100 to $1,500. These are paid add-ons, not free gifts. The selected card price is added to the course price, and the total purchase runs through CME funds in one transaction. You do not have to finish the course first: gift cards are emailed within 2–3 business days of purchase.
Gift card packages are nonrefundable, and CME Review Courses is not affiliated with Amazon or Apple. Check your employer’s CME policy before choosing an add-on. If you buy two or more CME courses, 20% comes off each course automatically; the discount does not apply to gift card add-ons, which stay at face value. You can add a gift card to each course you buy. These cme gift cards are an optional way to use your CME budget, subject to your employer’s rules.
Practice question: Infective endocarditis
You are seeing a 55-year-old patient with two weeks of low-grade fevers, chills, fatigue, and malaise. The exam reveals a new regurgitant murmur not documented at the last visit. The patient had a recent dental cleaning, and urinalysis shows microscopic hematuria. Vital signs are not specified in this vignette. What is the next best step?
Correct answer: Obtain blood cultures before starting empiric antibiotics.
A. Obtain blood cultures before starting empiric antibiotics.
B. Start empiric IV antibiotics immediately and culture later.
C. Send the patient home with oral antibiotics and reassess in a week.
D. Order a CT abdomen to find the infection source first.
Why A is correct: Fever with a new regurgitant murmur and microscopic hematuria raises concern for infective endocarditis. Obtain blood cultures before the first dose of empiric antibiotics.
Why the other options are incorrect: B is the classic trap: cultures drawn after antibiotics start are much harder to interpret. C delays assessment despite the new murmur and hematuria constellation. D does not establish endocarditis and delays obtaining cultures.
Real-world exam note: When endocarditis is suspected, fever plus a new regurgitant murmur, both exam reasoning and clinical practice favor drawing blood cultures before the first antibiotic dose. This topic appears in the course’s Infectious Disease module, which includes 67 questions.
Review your options
The PANRE Review Course is $499.99 for 30 months of access. Explore the PANRE Review Course or try the free test drive. For official recertification rules and date guidance, consult the NCCPA maintain-certification page.
If you are earlier in your career and preparing for initial certification, that is a different exam stage: pance prep courses serve PANCE preparation, while this post focuses on recertification.
About the faculty
Jeremy Boroff, MPAS, PA-C, is an Emergency Medicine PA with 24 years of clinical experience, a PA educator, author, and CME developer. He is the sole faculty for this activity and has no relevant financial relationships to disclose.