This is the one-page version of everything you need to know before sitting for the Certified Critical Care Paramedic (CCP-C) exam. No fluff, no filler - just the numbers, domains, and mechanics straight from the IBSC candidate handbook, organized so you can review it in one sitting. If you want the long-form breakdown behind any section, we link out to deeper guides along the way, including the full CCP-C Study Guide 2026: How to Pass on Your First Attempt.
- The CCP-C exam has 135 questions (110 scored, 25 unscored) across two 75-minute sections.
- Passing requires 68 correct scored answers out of 110, per IBSC's published FAQ.
- Airway, Anesthesia, and Analgesics carries the heaviest weight at 13%, followed by Cardiac Patient at 12%.
- CBT/on-site fees are $285 for eligible affiliate members or $385 for non-members.
Exam Snapshot: Format, Fees, and Delivery
The CCP-C credential is issued by the International Board of Specialty Certification (IBSC), with BCCTPC operating as its subsidiary board. You can test at a Prometric testing center, remotely via ProProctor, or through IBSC's mobile/on-site delivery option - useful if your agency or program hosts a group testing event.
| Item | Detail |
|---|---|
| Total questions | 135 (110 scored + 25 unscored pilot items) |
| Total time | 150 minutes |
| Section 1 | 68 questions / 75 minutes |
| Section 2 | 67 questions / 75 minutes |
| Break | Optional 5-minute inter-section break; no return to Section 1 after submission |
| Answer format | Closed book, three answer options per question |
| Fee (affiliate member) | $285 |
| Fee (non-member) | $385 |
Because you cannot go back into Section 1 once you submit it, treat the optional 5-minute break as a hard checkpoint. Flag uncertain items within each section, but finalize your Section 1 answers before you take that break - there's no second chance once you move on.
All 12 Domains and Their Weights
The CCP-C blueprint spans twelve official content domains. Knowing the weight of each one tells you exactly where your study hours should go. Airway, Anesthesia, and Analgesics is the single largest domain, followed closely by the Cardiac Patient domain - together these two account for roughly a quarter of the scored exam.
Domain 2: Airway, Anesthesia, and Analgesics - 13%
The heaviest-weighted domain. Expect content on definitive airway management, sedation and analgesia protocols, and drug-assisted intubation decision-making in the critical care transport setting.
- Rapid sequence induction/intubation pharmacology and dosing
- Ventilator-dependent airway troubleshooting during transport
- Analgesic and sedative selection for hemodynamically unstable patients
Domain 4: Cardiac Patient - 12%
The second-largest domain, covering the full spectrum of cardiac critical care transport scenarios.
- Mechanical circulatory support (balloon pumps, VADs) during transport
- Vasoactive drip titration and hemodynamic monitoring
- Post-arrest and post-STEMI transport management
Here is the complete domain list with published weights:
- Domain 1: Transport and Safety - 6%
- Domain 2: Airway, Anesthesia, and Analgesics - 13%
- Domain 3: General Medical Patient - 10%
- Domain 4: Cardiac Patient - 12%
- Domain 5: Neurologic Patient - 9%
- Domain 6: Respiratory Patient - 10%
- Domain 7: Toxic Exposure and Environmental Patient - 5%
- Domain 8: Trauma/Burn Patient - 10%
- Domain 9: Maternal/Fetal Medicine - 7%
- Domain 10: Pediatric Patient - 8%
- Domain 11: Special Populations - 5%
- Domain 12: Professional Considerations - 5%
For a topic-by-topic breakdown of what falls under each of these twelve areas, bookmark CCP-C Exam Domains 2026: Complete Guide to All 12 Content Areas alongside this cheat sheet.
The Passing Standard, In Plain Numbers
IBSC's exam FAQ publishes a straightforward raw passing score: 68 correct answers out of 110 scored questions. The other 25 questions on your exam are unscored pilot items being tested for future exams - you won't know which ones they are, so treat every question as if it counts. Results are reported as pass/fail only; there is no scaled score or percentile breakdown given to candidates.
Key Takeaway
You need 68 correct scored answers to pass. Since pilot items are unlabeled, answer every question with full effort - guessing strategy doesn't change based on which ones "count."
If you want the full context behind this number, including how it compares to raw-score thresholds candidates sometimes misunderstand, read CCP-C Passing Score 2026: Exactly What You Need to Pass. And if you're trying to gauge your odds going in, CCP-C Pass Rate 2026: What the Data Shows looks at what's publicly known about outcomes.
Eligibility and Registration Mechanics
Before you can sit for the exam, IBSC requires:
- A current, unrestricted paramedic license or certificate
- A completed application submitted to IBSC
- Credential verification confirming your license status
Critical-care transport experience and additional critical care education are recommended preparation, though the core legal requirement centers on your paramedic credential and the application/verification process. If you're unsure whether your current experience level lines up well with the exam, the detailed breakdown at CCP-C Requirements 2026: Eligibility, Prerequisites & How to Qualify walks through it step by step.
Once you're eligible, testing windows and scheduling deadlines matter just as much as the fee. Check CCP-C Exam Dates 2026: Testing Windows, Deadlines & Scheduling before you lock in a Prometric or ProProctor slot so you don't miss a registration cutoff.
High-Yield Clinical Topics by Domain
Beyond the top two domains already covered, several mid-weighted domains deserve deliberate review time because they combine broad scope with real point value.
Domain 6: Respiratory Patient - 10%
Ventilator management across transport platforms, ARDS strategies, and non-invasive ventilation decision points are core content here.
- Lung-protective ventilation strategy adjustments in transport
- Management of refractory hypoxemia scenarios
Domain 8: Trauma/Burn Patient - 10%
Covers multi-system trauma resuscitation and burn physiology as they apply to critical care transport decision-making.
- Damage control resuscitation principles
- Burn fluid resuscitation calculations and airway concerns
Domain 3: General Medical Patient - 10%
A broad category spanning sepsis, endocrine emergencies, and general critical illness management during interfacility transport.
- Sepsis bundle compliance during transport
- Metabolic and endocrine crisis management
Domains weighted at 5-9% (Neurologic, Maternal/Fetal, Pediatric, Toxic Exposure/Environmental, Special Populations, Transport and Safety, and Professional Considerations) still make up nearly half the scored exam combined, so they cannot be skipped even though no single one dominates. A domain-by-domain study allocation is laid out in detail in the domains guide linked above.
Recertification: The Four-Year Clock
CCP-C certification is valid for four years. When it's time to renew, you have two paths:
- Renew by examination - retake the CCP-C exam
- Renew by continuing education - complete 100 approved CE contact hours, including at least 75 clinical hours and 16 hours from an approved review course
Either path also requires current unrestricted licensure and payment of applicable renewal fees. Start tracking your CE hours well before your four-year window closes - the 75-hour clinical minimum and 16-hour review course requirement take planning to hit comfortably.
Final-Week Review Plan
Generic study techniques like spaced repetition work best when mapped directly onto the CCP-C blueprint rather than applied generically. In the final stretch before test day, sequence your review by domain weight, not alphabetically.
Heaviest domains first
- Airway, Anesthesia, and Analgesics (13%)
- Cardiac Patient (12%)
Mid-weight domains
- General Medical Patient, Respiratory Patient, Trauma/Burn Patient (10% each)
Remaining domains
- Neurologic, Pediatric, Maternal/Fetal, Transport and Safety, Toxic Exposure, Special Populations, Professional Considerations
Timed section practice
- Simulate the 68-question/75-minute and 67-question/75-minute split with a full break in between
Running full-length practice sessions under this exact two-section structure on our practice test platform is the closest you can get to simulating the real testing-day rhythm before you sit at Prometric or log into ProProctor.
Who Actually Hires CCP-Cs
CCP-C-credentialed paramedics typically work in settings where interfacility and critical care transport skills are the job itself: air medical programs, ground critical care transport (CCT) units, and specialty transport teams moving ventilated, drip-dependent, or post-surgical patients between facilities. Employers in these settings often look for the certification specifically because it validates competency across all twelve domains above - not just field paramedic scope.
If you're weighing whether pursuing this credential fits your career path, Is the CCP-C Certification Worth It? Complete ROI Analysis 2026 and CCP-C Salary Guide 2026: Complete Earnings Analysis go deeper into the employment and compensation picture. For active postings and role types, CCP-C Jobs is worth a look, and if you're still building your foundation before testing, CCP-C Training covers preparatory coursework options.
Frequently Asked Questions
The exam has 135 total multiple-choice questions: 110 are scored and 25 are unscored pilot items used for future exam development. You won't know which is which during testing.
IBSC's published exam FAQ lists a raw passing score of 68 correct scored answers. Results are reported as pass/fail, with no scaled score shown to candidates.
The published CBT/on-site fee is $285 for eligible affiliate members or $385 for non-members.
Start with Airway, Anesthesia, and Analgesics (13%, the largest domain) and Cardiac Patient (12%, the second largest), since together they represent the biggest share of scored questions.
Certification is valid for four years. You can renew by retaking the exam or by completing 100 approved CE contact hours, including at least 75 clinical hours and 16 hours from an approved review course, plus maintaining unrestricted licensure and paying renewal fees.