HMDC Passing Score 2026: Exactly What You Need to Pass

The Number: 100 on a 0-200 Scale

If you are preparing for the Hospice Medical Director Certified (HMDC) credential, the passing standard is stated plainly by the Hospice Medical Director Certification Board (HMDCB): you must earn a scaled score of 100 on a scale of 0 to 200. That is the threshold for the initial certification examination, and it is the only passing number you should anchor on.

Many candidates, especially physicians accustomed to board exams, instinctively translate "100 out of 200" into "I need 50%." That translation is wrong, and it can lead to poor preparation decisions. This article explains what the scaled score actually means, how it connects to the exam's structure and domain weights, and how to build a study plan around the standard rather than around a myth.

For the broader picture of how the credential works, see our overview of what HMDC certification is, and for eligibility, see HMDC requirements and how to qualify.

Why Scaled Scores Are Not Percentages

A scaled score is a reporting score. The raw number of questions you answer correctly is mathematically converted onto a common 0-200 scale so that results mean the same thing regardless of which version of the exam you took. This matters because no two exam forms are guaranteed to be exactly equal in difficulty.

The equating principle

HMDCB states that the equated raw passing score varies by exam form. In practical terms, if one form happens to contain slightly harder questions, the number of correct answers needed to reach a scaled 100 may be slightly lower on that form; if another form is slightly easier, it may be slightly higher. The scaled score of 100 is the constant; the raw cut is the variable.

What this means for candidates

• You cannot compute your pass/fail status during the exam. Because the raw cut depends on the form, there is no reliable way to count your confident answers and know where you stand.
• Practice-test percentages are only directional. A practice score is useful for finding weak domains, but it is not a prediction of a scaled score unless the practice tool is built around the real standard.
• The goal is broad competence, not a minimum. Because the raw cut shifts, the safest strategy is to aim well above a coin-flip level of mastery across all five domains.

To understand how this standard fits into overall difficulty, read How Hard Is the HMDC Exam?, and for what published outcome data does and does not show, see HMDC pass rate: what the data shows.

Anatomy of the 165-Question Exam

The initial HMDC examination is a computer-based test delivered by appointment through PSI Candidate Services at U.S. assessment centers. Its format shapes how scoring works in practice.

The 15 unscored questions

Of the 165 items, 15 are unscored. These are typically pretest items being evaluated for future exams, and they are not identified for you. The practical lesson: treat every question as if it counts. Do not burn time trying to guess which items are the unscored ones, and do not let one baffling question rattle you, since it may not affect your result at all.

Pacing against the clock

Three hours for 165 questions leaves roughly a little over a minute per item on average. The tutorial at the start of the session is outside the timed exam, but breaks do not stop the clock. Candidates who linger on regulatory scenarios or long clinical vignettes can find the back half of the exam compressed. A reasonable approach is to answer what you know promptly, flag what you do not, and return with the time you saved.

Where the Points Live: Domain Weights

The scaled score is built from performance across five official content domains, each with a published percentage weight in HMDCB's content blueprint. Because the weights are published, you can allocate preparation time in proportion to where the scored items are concentrated.

Why the regulatory domain deserves special attention

Many physicians who take the HMDC come from strong clinical backgrounds. Domain 5 is where the medical director role diverges most from bedside practice. HMDCB's current live blueprint includes updated subobjectives that candidates should specifically review, including:

• Notice of Election and its addendum
• Revocation and discharge
• Advance Beneficiary Notice
• NP and PA billing

On the clinical side, the live outline also lists topics such as prolonged grief disorder and artificial nutrition and hydration. These are the kinds of specific, current items that separate a candidate working from an outdated study source from one working from the live blueprint.

Building a Study Plan Around the Score

Because the standard is a scaled 100 and the raw cut shifts by form, the most defensible plan is one that builds depth in the heavily weighted domains first, then rounds out the smaller ones. Here is a sample sequence tied directly to HMDC's weights. Adjust it to your own gaps and timeline, and see the HMDC study guide for a fuller framework.

Timed practice is not optional filler. Because breaks do not stop the clock, rehearsing under realistic timing is part of preparing to hit the scaled score. Our HMDC practice tests are built around the five official domains so you can see which areas are costing you the most.

Use the official preparation guidance

HMDCB's own "Prepare for the Initial Certification Exam" page lists AAHPM resources, and it cautions that the listed resources do not guarantee comprehensive preparation. Take that seriously: no single resource is a substitute for working through the full blueprint. The initial application fee also includes the Expanded Content Blueprint, which is worth using once you are registered.

Test-Day Rules That Affect Your Score

Your scaled score can only reflect what you know if you are able to demonstrate it. The initial-exam rules in the HMDCB handbook are strict, and knowing them in advance removes avoidable stress.

• No personal notes. You cannot bring written materials into the exam.
• No electronic devices. Phones and similar devices are prohibited.
• No calculators. Any calculations must be done mentally or as the exam interface allows.
• Tutorial is untimed, breaks are not. The introductory practice tutorial sits outside the three-hour limit, but breaks do not pause the clock.

Attempts, Cycles, and What the 2026 Window Teaches

HMDCB permits only one initial attempt per calendar year. This single rule changes how you should think about the passing score: a miss is not something you can correct a few weeks later. That is why we recommend preparing to a comfortable margin rather than to the bare standard.

Historical 2026 cycle details

The 2026 initial certification cycle is now closed as of October 10, 2026, so the following are historical details, not upcoming appointments. They are still useful for understanding how the process is structured and how to plan for a future cycle.

The examination window for that cycle ran March 23 through September 28, 2026, with September 21 as the last scheduling day. The live HMDCB page also listed an August 1-August 7 extension that did not appear in the handbook, a reminder to always verify against the live source. For future planning, check HMDCB directly and see our guides to HMDC exam dates and deadlines and HMDC certification cost.

A note on pass-rate figures

HMDCB published a historical 2020 initial-exam pass rate of 78.9%, but that figure comes from the preceding blueprint and is not a current-cohort rate. Treat it as context, not as a prediction for your own attempt. The standard you are held to is the scaled 100, regardless of how others have performed.

After You Pass: The CCP's Different Standard

It is worth separating the initial exam's scaled-score standard from the standard used to maintain certification. Once certified, you enter the annual Continuing Certification Program (CCP), which begins the year after initial certification. It works very differently from the proctored initial exam:

• 30 longitudinal-assessment questions, open-book and untimed.
• 80% passing threshold, with incorrect answers allowed to be retried until you pass.
• Ongoing requirements: unrestricted licensure, a professional-conduct attestation, and the annual fee.
• 2026 CCP fee: $199, with requirements due October 30, 2026.

Do not confuse the two standards. The 80% threshold applies to the CCP, not to the initial exam, whose passing standard is the scaled 100 described above. Older multi-year recertification rules have been superseded by this annual model.

If you are weighing the long-term picture, our articles on whether the HMDC certification is worth it and HMDC earnings can help you evaluate the investment.

Frequently Asked Questions

For a compact reference of the facts above, our HMDC cheat sheet condenses the essentials, and you can test your readiness against the real domain structure with the HMDC practice exam.