The NBCE Physiotherapy Exam: A Complete Guide (Format, Eligibility and How to Study)

You finally have a handle on Parts I through III, and then someone mentions the Physiotherapy exam. Suddenly you have new questions. Do you even need it? When can you take it? And how are you supposed to study for one more board exam while you're already juggling clinic, classes and life?

Here's the good news: the NBCE Physiotherapy exam (PHT) is one of the most manageable exams the NBCE offers. It's shorter than the other Parts, its test plan is published, and its content overlaps with what you already do in clinic every day.

The catch is that many students wing it. They assume "it's just modalities," skim a few parameters the week before and get surprised by how much rehab and functional assessment shows up.

In this guide we'll walk you through the format, eligibility, fees, scoring and a simple study plan, all verified against the NBCE's own pages. If you want the bigger picture of how every NBCE exam fits together first, start with What Each NBCE Exam Part Actually Tests (And How to Study Accordingly).

What Is the NBCE Physiotherapy Exam?

The Physiotherapy exam is an elective NBCE exam that measures your knowledge of physiotherapy and rehabilitation as used in chiropractic practice. It is separate from Parts I, II, III and IV.

"Elective" doesn't mean "optional for everyone." Whether you need it depends on where you plan to practice. Some state licensing boards require or accept it, and requirements change, so check with the licensing board of every state you're considering before you build your board timeline. Our post on how state licensing boards use NBCE scores explains why requirements differ from state to state.

Here are the official basics, from the NBCE Physiotherapy (PHT) Exam page:

Do the math on the timing: 75 minutes for 90 questions is about 50 seconds per question. That pace is the real challenge of this exam. You need to recognize the answer, not work it out from scratch.

Memory hook: "90 in 75." Ninety questions, seventy-five minutes. Practice at that pace.

Physiotherapy Exam Eligibility: When Can You Take It?

According to the NBCE Physiotherapy Eligibility page, you must have completed 120 hours of physiotherapy instruction before the application deadline. Those hours must be taken at, or recognized by, a chiropractic college whose students are currently eligible to take NBCE exams.

A few practical points:

• Registrar approval is required. Your college registrar approves your eligibility online. If you completed hours somewhere else, give your registrar documentation of those hours.
• Many curricula already include the 120 hours. Ask your registrar where you stand rather than guessing.
• You can take PHT alone or alongside Parts I, II or III. It runs in the same computer-based testing windows listed on the NBCE Dates & Deadlines page.
• The process is apply, get approved, pay, then schedule. All four steps need to be done before the published deadlines.

One scheduling note straight from the NBCE: if you book Part III and PHT at a Prometric center on the same day, it's on you to manage the timing between the two. If the second exam isn't registered in time, the NBCE and Prometric won't reschedule or refund it. Also know the rescheduling rules: changes 30 or more days out are free, 18 to 29 days out cost a $50 Prometric fee, and 17 days or fewer means no changes and no refund.

For the full cost picture across all your boards, see our NBCE fee schedule breakdown.

The Physiotherapy Test Plan: What's Actually Tested

This is where most students get the exam wrong. The NBCE publishes a Physiotherapy Test Plan with ten content areas and their weightings:

Now add it up. The four modality areas (thermo, electro, mechano and photo) total 37%. The six assessment, exercise and rehab areas total 63%.

That's the secret most students miss. Nearly two-thirds of the published test plan is about assessment and rehabilitation, not machines. If you only memorize modality parameters, you're preparing for about a third of the exam.

Memory hook: "Machines are a third. Movement is two-thirds."

The single biggest area, Disorder-specific Rehabilitation at 14%, is about applying everything else to a real patient: a low back, a shoulder, a knee. Expect to think clinically. Which modality fits this stage of healing? What exercise progression makes sense next? What would make a treatment inappropriate?

If you've never used a test plan as a study map, read Understanding NBCE Test Plans: How to Use Them as Your Study Blueprint.

How to Study for the Physiotherapy Exam (A Simple 4-Week Plan)

You don't need months for this exam. You need a focused plan built around the test plan weightings. Here's a simple structure that fits around clinic and other boards. Adjust it based on your own strengths.

Three study habits make the biggest difference:

1. Study contraindications as a group. Many modalities share the same "don't do it" situations, such as impaired sensation, active malignancy in the area, or applying deep heat over acute inflammation. Learn the shared list once, then learn the exceptions.
2. Think in stages of healing. Acute, subacute and remodeling phases drive almost every modality and exercise decision. If you know the stage, you can usually eliminate two answer choices.
3. Use active recall, not rereading. Close your notes and explain why you'd choose one modality over another. That's the skill the exam rewards.

The NBCE also publishes a Physiotherapy Reference Text List on its PHT exam page. Use it to check that your study sources line up with what the exam draws from.

Test Yourself: Physiotherapy Warm-Up

These are original practice questions we wrote to show the kind of thinking this content requires. They are not recalled exam items.

1. A patient needs therapeutic ultrasound for a tendon lying close to the skin surface. Which frequency is most appropriate?
A. 0.5 MHz
B. 1 MHz
C. 3 MHz
D. 10 MHz

2. Conventional (high-rate) TENS is primarily thought to reduce pain through which mechanism?
A. Endorphin release only
B. Gate control at the spinal cord
C. Increased muscle hypertrophy
D. Deep tissue heating

3. Which condition is a contraindication to cryotherapy?
A. Acute ankle sprain
B. Raynaud's phenomenon
C. Post-exercise soreness
D. Acute muscle strain

4. In the acute phase of a soft tissue injury, which goal takes priority?
A. Maximal strengthening
B. Controlling pain and inflammation while protecting the tissue
C. Plyometric training
D. Sport-specific power drills

Answers

1. C. Higher frequency (3 MHz) is absorbed more superficially; 1 MHz reaches deeper tissue.
2. B. Conventional TENS stimulates large-diameter sensory fibers, which is explained by the gate control theory.
3. B. Cold can trigger vasospasm in Raynaud's phenomenon, so cryotherapy is contraindicated.
4. B. Early rehab protects healing tissue and manages pain and inflammation before progressing to loading.

Physiotherapy Exam FAQ

How many questions are on the NBCE Physiotherapy exam?

The PHT exam has 90 multiple-choice questions with 75 minutes of testing time, according to the NBCE.

What is the passing score for the NBCE Physiotherapy exam?

The NBCE recommends a passing score of 375, but individual states may require a higher score. Check with each state licensing board where you plan to practice.

How much does the Physiotherapy exam cost?

The NBCE lists the Physiotherapy exam fee as $450. An optional 50-question official sample test costs $15.

Who is eligible to take the Physiotherapy exam?

You need 120 hours of physiotherapy instruction completed before the application deadline, taken at or recognized by an NBCE-eligible chiropractic college, with approval from your college registrar.

Do I need the Physiotherapy exam to get licensed?

It depends on your state. PHT is an elective NBCE exam, and state requirements vary, so confirm directly with the licensing board in each state you're considering.

Can I take the Physiotherapy exam with Part III?

Yes. You can take PHT alone or alongside Parts I, II or III. If you book Part III and PHT on the same day at a Prometric center, you are responsible for managing the timing between them.

Pass Your Boards Faster, With Less Guesswork

The Physiotherapy exam rewards students who study the way the NBCE tests: by weighting, by clinical reasoning and at exam pace. That's exactly how we build every Chiro AlignEd Learning course.

Our review courses are self-paced and organized around how the NBCE actually tests. You get searchable videos, digital study materials, built-in quizzes and full-length practice exams, with 90 days of access that starts immediately on any device.

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Taylor R., Part I & II Review student

Preparing for Parts I, II or III too? Our Part I, Part II and Part III Review Courses include our Access Until You PassTM Guarantee: meet the Exam Readiness Standards before your exam and, if you don't pass, we renew your 90 days of access once at no cost.

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