- BC-TMH is administered by CCE via the 120-question TeleMental Health Examination (TMHE).
- Implementation of Telemental Health is the heaviest domain at 25% of the exam.
- Application fee is $150; retakes cost $100 with a mandatory 90-day wait.
- Exam authorization windows last 90 days; certification itself lasts five years.
What BC-TMH Actually Is
The Board Certified-TeleMental Health Provider (BC-TMH) credential is issued by the Center for Credentialing & Education, Inc. (CCE). It verifies that a licensed mental or behavioral health professional has the specialized knowledge to deliver services remotely - video, phone, and other distance-based modalities - safely, ethically, and legally. If you're still getting oriented to the basics, start with What Is BC-TMH? and BC-TMH Meaning before diving into this cheat sheet.
This page is a condensed reference - a single stop for the numbers, formats, and deadlines you'll otherwise have to hunt across multiple CCE PDFs. It is not a substitute for full preparation; pair it with the BC-TMH Study Guide 2026: How to Pass on Your First Attempt for a complete prep plan.
Core Numbers to Memorize
| Item | Figure |
|---|---|
| Certifying body | CCE (Center for Credentialing & Education, Inc.) |
| Exam name | TeleMental Health Examination (TMHE) |
| Delivery | Pearson VUE test centers or OnVUE online proctoring |
| Total questions | 120 (12 case studies × 10 questions each) |
| Scored vs. unscored | 100 scored / 20 unscored |
| Time limit | 3 hours |
| Application fee | $150 |
| Retake fee | $100 |
| Required training | At least 9 clock hours, CCE-approved, within 4 years of application |
| Certification validity | 5 years |
| Annual maintenance fee | $45, due in anniversary month |
Exam Format at a Glance
The TMHE is structured around 12 case studies, each paired with 10 multiple-choice questions - 120 items total, with 100 scored and 20 unscored for future form development. You have three hours to work through the full set. The test is closed book, calculators are prohibited, and there is no penalty for guessing, so answering every item is always the right move.
- You can review and change answers before submitting.
- Test-center breaks count against your total exam time.
- OnVUE online testing offers one optional 15-minute halfway break; unscheduled breaks are not permitted online.
- Online candidates must confirm system, ID, webcam/microphone, and private-room requirements in advance.
Passing is determined through subject-matter-expert standard setting combined with statistical equating across exam forms - not a flat percentage cutoff. For a deeper breakdown of how that translates into a target score, see BC-TMH Passing Score 2026: Exactly What You Need to Pass. If you're weighing whether the exam is tough relative to your background, How Hard Is the BC-TMH Exam? Complete Difficulty Guide 2026 and BC-TMH Pass Rate 2026: What the Data Shows go into more depth.
Key Takeaway
Because each case study anchors 10 questions, misreading the scenario early can cost you multiple points at once. Read every case study stem twice before opening the answer choices.
The Six Domains, Weighted
The TMHE content outline was approved in April 2023, and the exam handbook was last revised September 24, 2024 - always confirm you're studying the current version. Here's the weighting breakdown, which should directly shape how much time you spend on each area:
Domain 3: Implementation of Telemental Health - 25%
The single largest domain. Covers the practical mechanics of delivering care remotely.
- Technology setup, platform selection, and connectivity troubleshooting
- Adapting clinical techniques for video/phone modalities
- Session structure and environment considerations for both provider and client
Domain 2: Practitioner Protocols and Informed Consent - 20%
Focuses on the documentation and disclosures that must happen before and during telehealth service delivery.
- Informed consent content specific to remote care
- Verifying client identity and location
- Establishing emergency contacts and local resources
Domain 4: Professional, Legal, and Compliance Standards - 20%
Tests knowledge of the regulatory environment surrounding telemental health practice.
- Licensure jurisdiction and cross-state practice issues
- Privacy, security, and record-keeping obligations
- Reimbursement and documentation compliance
Together, these three domains account for 65% of the exam - meaning your review time should be weighted accordingly rather than split evenly across all six areas. The remaining domains still matter and appear consistently across case studies:
- Domain 1 - Orientation to Telemental Health (10%): foundational definitions, history, and scope of practice.
- Domain 5 - Professional Ethics (13%): boundaries, competence, and ethical decision-making unique to remote settings.
- Domain 6 - Crisis Management (12%): safety planning and emergency response when the clinician isn't physically present.
For a full walkthrough of every domain with sample topic lists, see BC-TMH Exam Domains 2026: Complete Guide to All 6 Content Areas.
Eligibility Snapshot
Before you can sit for the TMHE, CCE requires:
- A master's degree or higher in a mental or behavioral health field
- A qualifying professional license, or an active National Certified Counselor (NCC) credential
- Supervised associates/interns may apply within the limits of their current practice
- At least nine clock hours of CCE-approved telemental health training completed within the four years before applying
- Submission of credential documentation, training records, and an ethics disclosure
Candidates who are initially credentialed while under supervision must document full licensure or another eligible active credential before their first five-year cycle ends. For the full checklist and documentation tips, read BC-TMH Requirements 2026: Eligibility, Prerequisites & How to Qualify, and for guidance on selecting an approved training provider, see BC-TMH Training.
Fees, Timeline, and Retakes
Once approved, your application window is valid for three years, and each individual exam authorization is valid for 90 days from issuance - so don't apply for authorization until you're genuinely ready to schedule a seat. If you fail, you must wait a minimum of 90 days before retaking, and you're allowed three total attempts per application. A third failure requires submitting an entirely new application.
- Application fee: $150
- Retake fee: $100 per attempt
- Minimum wait between attempts: 90 days
- Maximum attempts per application: 3
- Exam authorization validity: 90 days
- Application period: 3 years
A complete cost breakdown, including training expenses, lives at BC-TMH Certification Cost 2026: Complete Pricing Breakdown. For scheduling specifics tied to Pearson VUE and OnVUE availability, check BC-TMH Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Maintenance Cheat Sheet
Certification is valid for five years, and renewal has clear, fixed requirements:
- Minimum 4 telemental-health CE hours per year
- At least 20 CE hours across the full five-year cycle
- $45 annual maintenance fee, due in your credential's anniversary month
- Compliance and renewal documentation submitted on schedule
- CE records are subject to audit - keep certificates and logs organized
Key Takeaway
Don't wait until year five to collect CE hours. Spreading four hours annually is the built-in minimum pace - treat it as a floor, not a target to catch up on later.
Full renewal mechanics and audit specifics are covered in the maintenance policy referenced on CCE's site; for context on how the credential fits your broader career, see Is the BC-TMH Certification Worth It? Complete ROI Analysis 2026 and BC-TMH Salary Guide 2026: Complete Earnings Analysis.
One-Week Review Schedule
If you already have clinical experience and just need a final, focused pass before test day, allocate your last week around domain weight rather than equal time per topic.
Implementation of Telemental Health (25%)
- Review platform/technology scenarios and session adaptation questions
- Practice case studies focused on troubleshooting mid-session
Practitioner Protocols & Legal/Compliance (20% + 20%)
- Drill informed consent content and identity/location verification
- Review jurisdictional licensure rules and documentation standards
Ethics, Crisis Management, Orientation (13% + 12% + 10%)
- Work through crisis and safety-planning case studies
- Review ethical decision-making frameworks for remote practice
Full Timed Practice
- Simulate a 3-hour, 120-question session under closed-book conditions
- Review missed items by domain, not just by question number
Run full-length timed simulations on our practice test platform so the three-hour pacing and case-study format feel familiar before exam day.
Frequently Asked Questions
The Center for Credentialing & Education, Inc. (CCE) administers BC-TMH and its qualifying exam, the TeleMental Health Examination (TMHE), delivered through Pearson VUE test centers or OnVUE online proctoring.
The TMHE has 120 questions total across 12 case studies (10 questions each), with 100 scored and 20 unscored items, and a three-hour time limit.
You must wait a minimum of 90 days before retaking, pay a $100 retake fee, and you get up to three total attempts per application. A third failure requires a new application.
Implementation of Telemental Health at 25% is the single largest domain, followed by Practitioner Protocols and Informed Consent and Professional, Legal, and Compliance Standards, each at 20%.
Certification lasts five years, with renewal requiring 4 CE hours annually (20 minimum per cycle) and a $45 annual maintenance fee due in your anniversary month.
Keep this page bookmarked as your quick-reference sheet, and rely on BC-TMH Certification and BC-TMH Jobs for the bigger-picture career context as you finalize your application and study plan.