How to Become a CNA in Texas: Steps, Cost, and Salary

By Justine TacmoSep 13, 2022Updated Jun 25, 2026

A five-step path: eligibility, training, the Prometric exam, the nurse aide registry, and certification, with the text How to Become a CNA in Texas.

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To become a Certified Nursing Assistant (CNA) in Texas, you finish 100 hours of state-approved training (60 classroom hours and 40 clinical hours), pass the two-part Prometric competency exam, and get listed on the state's Texas Nurse Aide Registry. Most people move through that path in 4 to 12 weeks. Texas CNAs earn a median wage of $37,500 a year, or $18.03 an hour, and the state itself charges nothing to issue or renew the certificate. One detail catches almost every new applicant off guard: the certification is run by the Texas Health and Human Services Commission (HHSC), not the Texas Board of Nursing.

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Key Points

A CNA in Texas gives hands-on daily care in nursing homes, hospitals, and home-health settings, always under the supervision of an RN or LVN.
Training is 100 hours at minimum: 60 classroom hours (or HHSC's free computer-based training) plus 40 supervised clinical hours.
The Prometric exam pairs a written or oral test with a hands-on skills test. Current fees run about $120 to $130.
Texas CNAs earn a median of $37,500 a year ($18.03 an hour), roughly $4,760 below the national median for nursing assistants.
Texas sets no high school diploma or GED requirement to train as a CNA; most programs ask that you be 18 (some accept students from 16) and pass a background check.

What a CNA Does in Texas

Texas CNAs handle the hands-on tasks that keep daily patient care moving. Working under an RN or LVN, you help people bathe, dress, eat, move around, and use the bathroom. You also take and record vital signs, track fluid intake and output, assist with transfers and repositioning, and flag any change in a patient's condition for the nursing staff.

The setting varies widely across the state:

Skilled nursing and long-term care facilities
Hospital systems such as Houston Methodist, Memorial Hermann, Baylor Scott & White, HCA Healthcare, and Christus Health
Assisted living and memory care communities
Home health and hospice agencies
Travel CNA assignments

It is physical work. You are on your feet for most of a shift, lifting and moving patients with proper technique, and following infection-control steps at every turn.

How to Become a CNA in Texas

The Texas path has five steps, in order. The training is the bulk of it, and you add a little time for exam scheduling and registry processing. If you want the wider view of how certification works before you start, here is how to get a CNA certification.

Step 1: Meet the Texas Eligibility Requirements

Texas does not require a high school diploma or GED to become a CNA. HHSC has confirmed that no federal regulation or state rule sets a minimum education level for nurse aides. Some programs run their own reading and math placement check, but the state does not gate eligibility on a diploma.

To start training, most applicants need to:

Be at least 18 years old (some programs accept students at 16 or 17 with parental consent and extra clinical-site rules)
Be in good physical health with current immunizations, including a TB test
Pass a Texas Department of Public Safety (DPS) criminal history check
Have a clean record on the Texas Employee Misconduct Registry
Provide a Social Security card and government-issued photo ID
Hold a current CPR or BLS certification (some programs bundle this into tuition)

A criminal record is not an automatic disqualifier. HHSC reviews backgrounds against the list of barring convictions in Texas Health and Safety Code Section 250.006, which covers abuse, neglect, financial exploitation, and certain violent and sexual offenses. If you have a past conviction and want to know where you stand before you pay for training, you can request a Criminal History Evaluation Letter from HHSC for an early read on your eligibility.

Step 2: Complete a State-Approved NATCEP (or HHSC's Free CBT)

You have two ways to meet the 100-hour training requirement. The standard route is a state-approved Nurse Aide Training and Competency Evaluation Program (NATCEP): 60 classroom hours plus 40 clinical hours at an HHSC-approved facility. This is what most Dreambound partner programs offer.

The second route uses HHSC's free computer-based training (CBT) to cover the classroom portion. After you finish the CBT, you still complete the 40 clinical hours through an approved NATCEP. Clinical-only placements are less common than full programs, so most people go the standard NATCEP route, but if you can arrange one, the free CBT lowers your out-of-pocket cost.

Either way, you finish training before you can apply to test. Programs run anywhere from a few weeks to a few months depending on the schedule and format, and hybrid options are common in Texas, with online or self-paced classroom hours and in-person clinicals. Packing the right supplies matters too, so look over what to buy for a CNA class before week one.

Tuition on Dreambound generally lands between $500 and $1,500, with some schools folding textbooks and scrubs into the total. If cost or speed is your main concern, compare the cheapest and fastest CNA programs or browse online CNA classes before you commit.

Step 3: Pass the Texas Prometric CNA Exam

Once your program director uploads your completion record to the state's online portal (TULIP) and HHSC approves your application, Prometric emails your login for the Texas Nurse Aide portal, where you schedule and pay for the exam.

The test has two parts:

Written (knowledge) test: 60 multiple-choice questions in 90 minutes, available in English and Spanish. An oral version is offered for candidates with documented reading difficulty.
Skills test: five randomly selected nurse-aide skills performed in front of a Prometric evaluator. Hand hygiene is always one of the five and is scored across every skill in the set.

Current fees, set by Prometric, run about $120 for the written-and-skills combination or $130 for the oral-and-skills version. You can take the written portion at a Prometric site or by remote proctoring, but the skills test is in-person only. You have 24 months from the end of training to pass both parts, with three attempts on each. Miss either part three times and you retake the full NATCEP before testing again. The skills test is the more commonly failed of the two, with most points lost on perineal care, catheter care, and the small steps around hand hygiene and privacy. A little structure helps here, so it is worth reviewing how to prepare for the CNA exam before your date.

Step 4: Get Listed on the Texas Nurse Aide Registry Through TULIP

After you pass both portions, Prometric sends your results to HHSC and your record updates in the Texas Nurse Aide Registry through the TULIP portal. Log in, confirm your status reads active, and print your certificate. Most candidates see active status within a few weeks of testing.

You are not legally employable as a CNA in a Texas-licensed facility until the registry shows you as active. Employers check registry status before they hire, so do not treat a passing score alone as a green light.

If you are training in a NATCEP, Texas lets you work in a nursing facility for up to four months while you finish. After four months, the facility has to let you go if you are not yet on the registry, so plan your timing around that window.

Step 5: Apply for CNA Roles in Texas

With active status, you can apply for the roles covered earlier, from skilled nursing and hospitals to home health and travel assignments. Many partner programs keep ties with the long-term care facilities that host their clinical rotations, which can give you a direct line on local openings.

Texas CNA Programs on Dreambound

Dreambound brings Texas CNA programs together in one place so you can compare your options before picking a school. The four featured below are partner programs with state-approved NATCEPs, all in the Dallas-Fort Worth and Central Texas areas. If you are closer to another major metro, the city links just below these listings point you to training near you.

Nurse Aide - Diamond Career Institute

Format: Hybrid
Length: 5 weeks
Tuition: $274 to start, $920 total
Location: Richardson, TX

Certified Nursing Assistant - TSC Career Institute

Format: Hybrid
Length: 3 weeks
Tuition: $1,050 total
Location: Mesquite, TX

Nurse Aide Training - Integrity Health and Education

Format: Hybrid
Length: 15 days
Tuition: $350 to start, $1,375 total
Location: Denton, TX

Certified Nursing Assistant - Williams Career School of Excellence

Format: Hybrid
Tuition: $725 to start, $1,450 total
Location: San Marcos, TX
No high school diploma or GED required, open to students from age 16

Looking in a specific metro? Compare CNA training in Austin, Dallas-Fort Worth, El Paso, Houston, McAllen, and San Antonio.

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CNA Salary in Texas

Texas CNAs earn a median of $37,500 a year, or about $18.03 an hour, based on May 2025 wage data. That sits roughly $4,760 below the national median of $42,260 for nursing assistants. Pay shifts with setting and metro, and hospital and government employers tend to pay more than home-health roles.

Nationally, nursing assistant jobs are projected to grow 2% from 2024 to 2034, about as fast as the average for all jobs, and Texas runs one of the largest nursing assistant workforces in the country. Steady demand in long-term care, an aging population, and routine turnover keep openings coming across the state.

If those numbers fit your goals, line up Texas CNA programs on Dreambound by cost and length to see what works for your timeline.

How HHSC Regulates CNAs in Texas

The Texas Health and Human Services Commission (HHSC) is the agency that issues, renews, and revokes nurse aide certifications. The Texas Board of Nursing handles RN and LVN licenses but has no role with CNAs. That split matters in two practical ways: HHSC is who you contact for any registry, renewal, or background-check question, and HHSC is whose rules govern your day-to-day status as a working CNA.

Two sets of rules shape Texas CNA practice:

Texas Administrative Code, Chapter 556 sets the framework for NATCEPs, the registry, and renewal.
Texas Health and Safety Code, Chapter 250 (Section 250.006) lists the convictions that bar employment in HHSC-regulated facilities.

HHSC charges no fee to issue or renew a CNA certificate. The real cost of becoming a CNA in Texas is training plus the Prometric exam fee; beyond that, the state itself does not charge.

Renewing Your Texas CNA Certification

Texas CNA certification is good for two years. To renew and keep active status, you meet three conditions during the 24-month cycle:

Work at least eight paid hours of nursing or nursing-related services in a Texas-licensed facility within the period.
Complete at least 24 hours of in-service education, including required training in geriatrics and the care of residents with dementia or Alzheimer's disease.
Keep a clean record on the Employee Misconduct Registry and avoid disqualifying convictions under Health and Safety Code 250.006.

Renewal runs through the TULIP portal. If your facility submits the employment verification for you, the process is mostly hands-off; if not, you submit it yourself with your employer's details. Miss the paid-hours requirement and your status moves to expired, which means you cannot legally work as a CNA in a licensed Texas facility until you reactivate, often by retesting through Prometric.

Out-of-state CNAs can apply for Texas reciprocity through TULIP, as long as their home-state certification is active and their home-state registry meets federal nurse-aide standards.

Frequently Asked Questions

How long does it take to become a CNA in Texas?

Most Texas programs run four to 12 weeks. Accelerated formats can wrap up classroom and clinical work in about three weeks, while part-time and evening schedules often stretch to eight or 12 weeks. After you pass the Prometric exam, your registry status usually turns active within a few weeks. Browse Texas CNA programs on Dreambound to find a schedule that fits your timeline.

Can you work as a CNA in Texas before you're on the registry?

Yes, but only for a limited stretch. Texas lets students in a NATCEP work in a nursing facility for up to four months while they finish training and testing. The four-month clock starts on your first day of work, not your first day of class, and the facility has to let you go after that if you are not yet listed as active.

Can I take the CNA exam in Texas without attending a training program?

Usually no, but there are exceptions. Texas can let you challenge the exam without a full NATCEP if you finished an approved program in another state, completed equivalent military training, or attended an accredited RN or LVN program. Most first-time candidates still complete a NATCEP, since it is the most direct route to testing.

What disqualifies you from becoming a CNA in Texas?

Disqualifiers fall under Texas Health and Safety Code 250.006 and the Employee Misconduct Registry. Convictions involving abuse, neglect, financial exploitation, or certain violent and sexual offenses, along with any current Employee Misconduct Registry finding, can bar employment in HHSC-regulated facilities. HHSC reviews cases one by one rather than applying a flat felony cutoff, so request a Criminal History Evaluation Letter if you are unsure.

Does Texas accept CNA certification from other states?

Yes, when your home-state certification is active and unencumbered and your home-state registry meets federal nurse-aide standards. You apply through TULIP, complete a fresh Texas DPS criminal-history check, and clear the Employee Misconduct Registry. Most transfers process within a few weeks once HHSC has everything it needs.

Starting Your CNA Career in Texas

The Texas CNA path is one of the shortest and most affordable ways into healthcare in the country, and the details that trip people up are the ones worth knowing first. HHSC sets the terms, not the Board of Nursing. The state requires no diploma and charges nothing for the certificate itself, and the free computer-based training option is there if you want to keep your upfront cost down.

When you are ready, compare Texas CNA programs on Dreambound to find one that matches your schedule and budget.