Medication Aide Certification: Requirements and Which States Certify

A certified medication aide is an aide who has met a state's training and testing requirements for giving medications and holds that state's credential for it.

The day-to-day work — the medication pass, what an aide may and may not give — is covered in our medication aide career guide.

This page is about the credential itself: how it is earned, who issues it, and where the states differ.

Certification is the umbrella word, but states issue different instruments.

Ohio certifies through its Board of Nursing, and so do Oregon, Arkansas and Kentucky.

New Jersey's Department of Health issues its own CMA, and Massachusetts has its own CMA credential.

Virginia registers medication aides through its Board of Nursing.

Texas issues a permit through HHSC, the Texas Health and Human Services Commission.

Georgia, Nebraska and North Carolina list aides on state registries, Washington lists people who pass the MACE on its Medication Assistant Registry, and Colorado adds names to a CDPHE list.

One abbreviation needs care: CMA.

New Jersey's Department of Health points out that its Certified Medication Aide is not the same credential as a Certified Medical Assistant.

Whatever the instrument, the state's rule — not the title — defines the limits of the job.

The NCSBN-ANA national delegation guidelines state that a licensed nurse cannot delegate nursing judgment, and that what an aide may do depends on state law and employer policy.

Our research documents state medication aide credentials in the states listed in the table below, and it has not compiled a definitive national list of every state that offers one.

Two things make the map readable.

First, the national exam vendors publish where they test.

As of October 2026, Credentia listed MACE testing for Alabama, Colorado, Kentucky, Utah and Washington.

Headmaster/D&S published medication assistant testing for Arizona (CMA), Arkansas (MA-C), Idaho (MA-C), Massachusetts (MAP testing and registry), Michigan (MA-C), Montana (MA I & II), Nevada (MA-C) and Ohio (MA-C).

Second, the issuing agencies are identifiable in state rule.

The states our research covers are:

• Arkansas — the Arkansas State Board of Nursing certifies Medication Assistants-Certified (CMA/MA-C), authorized in nursing homes since Act 1423 of 2005 and extended to Board-approved designated facilities in 2021.
• Colorado — two separate routes: the CDPHE QMAP list and the Board of Nursing's Medication Aide Authority (CNA-Med) for CNAs.
• Georgia — CMAs are placed on the state's Certified Medication Aide Registry, which assisted living communities and nursing homes must check.
• Kentucky — the Kentucky Board of Nursing credentials CMA I, CMA II and the legacy Kentucky Medication Aide under 201 KAR 20:700.
• Maryland — certified medicine aides (CMA) and medication technicians (MT) are credentialed under the Board's COMAR Title 10.39 rules.
• Massachusetts — a Certified Medication Aide (CMA) credential for CNAs employed in long-term care facilities.
• Nebraska — DHHS keeps the Medication Aide Registry under 172 NAC 95-96.
• New Jersey — the Department of Health issues the CMA for assisted living settings.
• North Carolina — a Board of Nursing-approved course and a listing on the NC Medication Aide Registry, with a separate track for adult care homes.
• Ohio — the Ohio Board of Nursing certifies medication aides who may use the title certified medication aide or CMA.
• Oregon — the Oregon State Board of Nursing (OSBN) issues the CMA.
• Texas — HHSC issues the medication aide permit under Health and Safety Code ch. 242 subch. N and ch. 142 subch. B, with standards in 26 TAC ch. 557.
• Virginia — the Board of Nursing registers medication aides for assisted living facilities.

States that do not certify at all are real, too.

Ohio's endorsement rule covers applicants certified or licensed in another state — or with qualifying work experience in a state that does not certify medication aides.

Colorado's QMAP is a place on a state list of people who passed a competency evaluation given by an approved training entity — a list entry, not a certification.

Kentucky shows how the national exam fits inside a state's own scheme: its CMA I candidates take the NCSBN MACE or another Board-approved exam, alongside the state's own training and registry requirements.

Prerequisites are set by each state's issuing agency, and they range from an active nurse aide credential plus documented work experience to a single age minimum.

In the states that build on an aide credential, the requirement is an entry ticket you already hold:

• Maryland — active CNA-1 certification in good standing, plus the required facility experience (COMAR 10.39.03.02).
• Georgia — good standing on the Georgia certified nurse aide registry, which communities running CMA training must verify.
• North Carolina, nursing home track — Nurse Aide I standing and a high school diploma or GED.
• Oregon — a current Oregon CNA certificate.
• Arkansas — good standing on the Arkansas Certified Nurse Aide Registry and current employment at a designated facility.
• New Jersey — existing New Jersey certification as a nurse aide, home health aide or personal care assistant, plus a criminal background investigation.
• Ohio — current STNA standing, or one year of experience as a residential care aide, plus an approved MA-C program completed within the last 60 days, to schedule the exam.
• Kentucky — English literacy, basic math, a high school diploma or equivalent, and six months of continuous SRNA work in a nursing facility or direct-care employment in certain other licensed facilities.
• Texas — age 18 or older, English read/write/speak, a high school diploma or GED, employment as a nurse aide or non-licensed direct care staff member on the first day of training, plus 90 days of that employment in the previous 12 months.

Virginia and Nebraska set lighter-looking prerequisites with their own twists.

Virginia students must first complete the DSS-required direct care staff training for assisted living or an approved nurse aide education program.

Nebraska requires age 18 plus demonstrated command of 10 competencies and the basic medication routes.

Colorado's QMAP route is the outlier: age 18 is the only admission requirement its rule states.

The facility still has to verify the person is on CDPHE's QMAP list and give facility-specific on-the-job training.

Colorado's other track, the Board of Nursing's Medication Aide Authority, does require an active, unencumbered Colorado CNA certificate, age 18, a high school diploma or GED, and at least 1,000 documented CNA work hours in the previous 24 months.

Background checks appear where the state names them: Texas applicants submit fingerprints for an FBI background check, and New Jersey requires a criminal background investigation.

Training hours are set by each state, and the totals differ widely.

Texas' traditional route is a state-approved 140-hour program.

Arkansas requires at least 115 combined classroom, clinical and lab hours.

Oregon programs must run at least 80 hours: 45 didactic, 11 supervised lab and 24 hours of one-to-one supervised clinical experience.

Colorado's CNA-Med program is a Board-approved course of no less than 100 hours — no less than 60 of classroom and laboratory instruction and 40 of clinical experience.

Virginia's program is at least 68 hours: 40 classroom, 20 supervised skills practice and an 8-hour insulin module.

Kentucky's CMA I training includes at least 40 didactic hours, 20 skills lab hours and 40 hours of supervised direct patient contact, plus at least 60 precepted hours; the CMA II insulin add-on takes another 16 didactic and 8 supervised clinical hours.

Maryland's CMA training is at least 60 hours, with at least 30 clock hours of theory and 30 of supervised clinical training.

Nebraska's credential that works in any setting is the 40-hour course.

Ohio's programs run 30 clock hours, including at least 16 of supervised clinical practice.

North Carolina splits its tracks.

The nursing home course is a 24-hour Board of Nursing-approved program offered through community colleges.

Adult care home aides complete a 5-hour state training program and a clinical skills evaluation before unsupervised duties, then a further 10-hour program and the state exam within 60 days of hire — unless they worked as a medication aide in the previous 24 months.

Georgia's CMA training must use the state-approved medication aide program taught by a Georgia-licensed RN, pharmacist or physician, ending in a skills checklist and a written competency exam for registry placement — the rule names no hour minimum in the sources we read.

New Jersey approves programs without publishing a course length in the sources we read, so check both states' current rules with the issuing agency.

Alternate routes exist where the state says so: Texas lets nursing students and recent, unlicensed nursing graduates meet the training requirement through their nursing school coursework, and Oregon accepts qualifying military or nursing routes in place of its program.

Exams come from the state or from a vendor the state contracts.

The Medication Aide Certification Examination (MACE) is the national option: Credentia's handbook for Washington candidates describes a 60-question multiple-choice exam in English, delivered online with proctoring, and Credentia lists MACE testing in Alabama, Colorado, Kentucky, Utah and Washington.

NCSBN states it no longer develops or owns the MACE's content and refers content and scheduling questions to Credentia.

Washington's fee is $80 per attempt; candidates get three attempts, and a no-show forfeits the fee without counting as one of them.

Candidates who pass are listed on the Washington Medication Assistant Registry.

Vendor-run state exams are the other lane.

Arkansas' MA-C exam is given by D&S Diversified Technologies and must be taken within 90 days of finishing the program.

Ohio's Headmaster exam charges $30 for the knowledge test — 50 multiple-choice questions with up to 60 minutes — and $80 for the skills test; candidates get two attempts before a new program is required.

North Carolina's nursing home exam is Credentia's, at $60, and its adult care home exam is Credentia's at $25; the adult care home written exam requires a score of at least 90 percent.

Georgia's competency test is online, 50 questions with a 2-hour limit, administered by an approved CMA instructor.

State-run and state-shaped rules fill the rest: Virginia requires a clinical skills evaluation and a written exam through PSI, and an applicant who does not test within 2 years of training, or who fails 3 times, must complete a new program.

New Jersey candidates must register for the exam within 3 months of finishing training and pass within 6 months, with no oral substitute.

Nebraska requires its state exam for the 40-hour credential, and Texas may allow one retest without another fee.

Colorado's QMAP competency evaluation has written and practical portions, given by a qualified instructor of a CDPHE-approved training entity.

A medication aide credential is scoped to the settings its state's rule names — the same job title can even mean two different credentials in one state.

North Carolina runs two separate medication aide credentials: a nursing home Medication Aide Registry listing does not qualify someone to give medications in an adult care home, and the reverse is equally true.

North Carolina also requires medication testing for anyone not otherwise licensed who administers drugs in any adult care home, assisted living facility or family care home.

The settings each credential names are the employer map.

Ohio limits its certified medication aides to residents of nursing homes and residential care facilities, under nurse supervision.

Virginia registers medication aides for assisted living facilities.

New Jersey's CMAs work in assisted living residences, comprehensive personal care homes, dementia care homes and assisted living programs.

Georgia's assisted living communities must confirm each aide's standing on the state CMA Registry before the aide gives medications, and Georgia nursing homes may employ CMAs listed on the DCH medication aide registry.

Nebraska draws the line by training level: the 40-hour medication aide may work in any setting, while a competencies-only aide may not work in nursing homes, assisted living facilities or ICF/DD facilities.

Texas writes its permit statute around facilities and home and community support services agencies.

Colorado's QMAP rules reach assisted living residences, adult foster care, alternate care facilities, adult day care and correctional and juvenile facilities, among others.

Arkansas authorized MA-Cs in nursing homes in 2005 and extended use to Board-approved designated facilities, such as local correctional facilities, in 2021.

For a job seeker that means the credential and the posting have to match.

When you browse medication aide jobs, check that the setting — nursing home, assisted living, home and community services — is one your state's credential covers, and confirm the match with the issuer if you are moving between settings or states.

The table pulls together the requirements our research documents for the states covered above, as of October 2026.

Where a cell says an item was not named, the state's pages we read do not state it — that is not an absence of a rule.

Moving between states runs through the new state's application, because our research found no automatic transfer.

Maryland requires medication technician applicants from any other state to meet all of Maryland's requirements.

North Carolina does not list medication aides by reciprocity, endorsement or transfer.

New Jersey reciprocates with no other state's medication aide program, and Kentucky directs out-of-state aides to contact its Board for reciprocity instructions.

Endorsement routes exist where a state provides them.

Virginia lets medication aides registered or certified in another state apply by endorsement; endorsed applicants are then deemed eligible to sit the Virginia exam.

Ohio issues certificates by endorsement to applicants certified or licensed elsewhere, or with qualifying experience in a state that does not certify.

Arkansas' endorsement requires a substantially similar program of at least 115 hours, a similar exam, and a Board scope-of-work course with a post-test score of at least 80 percent.

Career information, not licensing, legal, medical, benefits or tax advice — medication aide rules are set by each state's board, agency or registry, so confirm the current requirements with the issuer before you enroll, test or apply.