HMDC Pass Rate 2026: What the Data Shows

What the Published Pass-Rate Data Actually Shows

Candidates searching for the pass rate of the Hospice Medical Director Certified (HMDC) examination usually want one number to calibrate their anxiety. The honest answer is that the Hospice Medical Director Certification Board (HMDCB), the independent body that certifies and administers the credential, has a limited public record of outcomes. The one figure we can cite with confidence is the board's 2020 initial-exam pass rate of 78.9%, published in its November 2020 results release.

That is the full extent of the verified data. We will not manufacture a "2026 pass rate," extrapolate trends, or quote figures from forums, because any number not published by HMDCB would be invented. What this article does instead is explain what the 78.9% figure can and cannot tell you, why pass rates behave differently on a scaled-score exam, and how to use the structure of the exam itself to estimate your own readiness. For a broader look at difficulty, see our guide on how hard the HMDC exam is.

The 78.9% Figure: Context and Limits

A 78.9% pass rate suggests that roughly four in five initial candidates passed in 2020. That reads as encouraging, but several limits apply before you lean on it.

It reflects an older blueprint

The 2020 results predate the current Content Blueprint, which is based on the 2020 Practice (Job) Analysis Study. The live blueprint has since added updated subobjectives, including prolonged grief disorder, artificial nutrition and hydration, NP and PA billing, Notice of Election and its addendum, revocation and discharge, and the Advance Beneficiary Notice. An exam that tests different content can produce a different pass rate, even if the passing standard is conceptually the same.

It is one cohort in one year

A single year's result cannot reveal trends. Pass rates can shift with cohort composition, form difficulty, and changes in the candidate pool. One data point cannot separate those effects.

It describes a population, not an individual

Even if a pass rate is high, your personal probability depends on your preparation, your practice background, and how well your experience maps to the tested domains. A physician with years of hospice medical director work but no exposure to the regulatory domain faces different risks than a recent fellowship graduate who has strong clinical knowledge but limited compliance experience.

Why a Single Pass Rate Can Mislead on a Scaled-Score Exam

The HMDC does not use a simple percent-correct cutoff. Passing requires a scaled score of 100 on a 0-200 scale. The equated raw passing score varies by exam form, which means the number of questions you must answer correctly is not fixed and is explicitly not a 50% correct requirement.

This matters for interpreting any pass rate. Equating adjusts for the fact that one exam form may be slightly harder than another, so a candidate on a harder form is not penalized relative to a candidate on an easier one. The consequence is that pass rates are driven by candidate ability relative to a fixed standard, rather than by how generous or strict any individual form happens to be. For a detailed breakdown of how the scoring works, read our article on the HMDC passing score.

Who Sits the HMDC Exam: A Self-Selected Candidate Pool

One reason pass-rate comparisons with other medical exams are unreliable is that HMDC candidates are a filtered group. Eligibility requires a current unrestricted medical license in the United States, its territories, or Canada, a professional-conduct attestation, and 400 hours of broad hospice-related activities in the preceding five years. On top of that, candidates must satisfy one of three pathways:

• Two years of hospice work in the preceding five years, verified by a senior administrator
• Current ABMS or AOA board certification in hospice and palliative medicine
• Completion of a 12-month ACGME or AOA-accredited clinical hospice and palliative medicine training program

Fellows may apply during training but must test after successful completion. In practical terms, almost everyone who reaches the exam room has already worked in or trained for hospice medicine. That self-selection tends to raise performance relative to an open-enrollment exam, but it also means the exam is calibrated to practicing hospice physicians, so the questions assume operational familiarity. If you are still confirming your eligibility, our HMDC requirements guide covers each pathway in detail.

Where the Points Live: Domain Weights and Pass-Rate Risk

Since an aggregate pass rate tells you little about your own risk, the domain weights are more useful. The five official domains and their published percentages are:

Medical Knowledge and Regulatory together account for 56% of the exam. A candidate who is strong clinically but weak on regulation can lose a large share of the available points in Domain 5 alone. Our complete guide to the five HMDC domains walks through each content area in more depth.

Format Rules That Affect Outcomes

Several features of the exam format influence performance independent of knowledge.

• Length and timing: 165 multiple-choice questions, of which 150 are scored and 15 are unscored, in a three-hour limit. That works out to a little over a minute per question.
• Breaks: Breaks do not stop the clock, so time spent away from your seat comes out of your three hours.
• Tutorial: The introductory practice tutorial is outside the timed exam, so it does not cost you time.
• Allowed materials: Personal notes, electronic devices, and calculators are prohibited on the initial exam.
• Delivery: Computer-based testing by appointment at U.S. assessment centers, administered through PSI Candidate Services.

The no-notes, no-calculator rule is important for Domain 5. You cannot look up billing rules or election-period details during the test, so recall of regulatory specifics has to be internalized beforehand. A condensed reference such as our HMDC cheat sheet is useful for review in the days before the exam, though it is not something you can bring in.

The 2026 Cycle: Fees, Windows, and One-Attempt Stakes

The 2026 initial certification cycle is now closed as of October 10, 2026. The dates and fees below are historical and are not upcoming appointments.

The live deadlines page also lists an August 1 to August 7 extension that does not appear in the handbook. September 21 was the last scheduling day, and the examination window ran March 23 to September 28, 2026. The initial application fee includes the Expanded Content Blueprint. For the full cost picture, see our HMDC certification cost breakdown, and for scheduling logistics see HMDC exam dates and deadlines.

Turning the Data Into a Preparation Plan

Because the available pass-rate data is thin, the best use of your time is to prepare against the structure of the exam rather than against a statistic. One simple way to sequence your preparation, tied to the domain weights:

For a fuller plan, see our HMDC study guide, and when you are ready to test yourself on realistic questions, try our HMDC practice tests. HMDCB's own preparation page lists AAHPM resources but cautions that listed resources do not guarantee comprehensive preparation, so treat any single resource as a supplement rather than a complete solution.

After You Pass: The Continuing Certification Program

Passing the initial exam is not the end of the process. Annual participation in the Continuing Certification Program (CCP) begins the year after initial certification; older multi-year recertification rules are superseded. The CCP requires ongoing unrestricted licensure, a professional-conduct attestation, 30 open-book untimed longitudinal-assessment questions with an 80% passing threshold, and the annual fee. Incorrect answers may be retried until passing. The 2026 CCP fee is $199, with requirements due October 30, 2026.

This design means the high-stakes moment is the initial exam, while ongoing maintenance is lower pressure. If you are weighing the long-term value, see our analysis of whether the HMDC certification is worth it and our HMDC salary guide.

Frequently Asked Questions

For a foundation on the credential itself, see what HMDC certification is, and for another view of the same statistics question, revisit our companion piece on the HMDC pass rate.