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State of California—Health and Human Services Agency
California Department of Public Health

AFL 08-30
November 3, 2008

Certified Hemodialysis Technician (CHTs)
End Stage Renal Disease Clinics (ESRDs)
Hemodialysis Training Programs

CHT or Patient Care Technician (PCT) Certification

​New Regulation:​Code of Federal Regulations (CFR) Title 42 § 494.140(e)

On April 15, 2008 the Centers for Medicare and Medicaid Services (CMS) established new conditions for coverage for dialysis facilities to be certified under the Medicare program. The conditions established specific standards which include the certification of "Patient Care Technicians" (PCTs), known in California as "Certified Hemodialysis Technicians" (CHTs). 

According to 42 CFR Section 494.140(e) (4), Patient care dialysis technicians must … 

Be certified under a State certification program or a national commercially available certification program, as follows: 

  1. For newly employed patient care technicians, within 18 months of being hired as a dialysis patient care technician; or 
  2. For patient care technicians employed on October 14, 2008, within 18 months after such date. 

States with formal certification and competency programs (including standardized tests, which reflect the content listed in the regulation, administered in a proctored environment by an independent examiner) that are specific to PCTs can satisfy this requirement. A "standardized test" is one developed and tested to validly and reliably measure the knowledge required to demonstrate competency in the area. 

At this time, California’s certification program does not offer a "standardized test" as a condition for certification.

Effective October 14, 2008, PCTs are required to obtain certification via the three (3) national commercially-available certification programs:

  • Certified Clinical Hemodialysis Technician (CCHT) offered by the Nephrology Nursing Certification Commission (NNCC)
    East Holly Avenue, Box 56
    Pitman, NJ 08071-0056
  • Board of Nephrology Examiners for Nursing and Technology (BONENT)
    1901 Pennsylvania Avenue, NW Suite 607
    Washington D.C. 20006
  • National Nephrology Certification Organization (NNCO) examination
    1350 Broadway 17th floor
    New York, NY 10018

(Additional national programs that are interested in offering a certification program may apply to CMS for approval.)

PCTs working on October 14, 2008, who are not yet certified under an approved program, must be certified before April 15, 2010. PCTs hired after October 14, 2008 must be certified within 18 months of their hire date. If a PCT who is not certified changes jobs from one dialysis facility to another, the time he/she was employed in the first facility will count towards the 18-month deadline for certification, unless he/she had a gap in employment as a dialysis technician of more than 18 months.

If a reuse technician or water treatment technician changes positions to become a PCT, he/she must be certified within 18 months of the date he/she started in the new PCT position.

Upon receipt of evidence of PCT certification, facilities may submit documentation of Federal regulation compliance to the following address:

CHT Program
California Department of Public Health (CDPH)
Licensing and Certification Program
ATCS – MS 3301
P.O. Box 997416
Sacramento, CA 95899-7416

Or via fax at (916) 552-8785

Compliance with Business and Professions Code Sections 1247 through 1247.9 is required for continued certification as a hemodialysis technician in California.

If you have any questions, please contact Ley Arquisola, R.N., Chief, Aide and Technician Certification Section, at (916) 327-2445.



Original Signed by Kathleen Billingsley

Kathleen Billingsley
Deputy Director

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