FNP-C vs. FNP-BC: What’s the Difference?

Written By: Lauren Jacobson MS, RN, WHNP-BC

As you finish your family nurse practitioner (FNP) degree you are likely getting ready to study for your certification exam. The nurse practitioner certification process can be confusing. You may be asking yourself and professors questions like, “What credentialing body should I use, and does it even matter?”. “What’s the difference between the FNP-C vs FNP-BC acronyms?” Here we will answer these questions to help you decide which certification exam is right for you. We promise it is not as complicated as it may seem!

Are the Terms Nurse Practitioner Credentialing and Nurse Practitioner Certification One and the Same?

Before we get into the nitty-gritty details of FNP-C vs FNP-BC let’s clear something up. Nurse practitioner credentialing and certification are not the same despite the two terms often being used interchangeably. Nurse practitioner credentialing is the process by which your education, licensure, and certification as well as reference checks are all verified. This is usually done by an employer to ensure that you are fully qualified to provide care and that you can bill for the care you are providing. This is often done after you are hired. Before any of this happens, you need to be a certified nurse practitioner. Have you completed your nurse practitioner education? Congratulations! That’s the main hurdle and now you have just a few more steps before you will be fully recognized as a nurse practitioner.

The next step after graduation is taking a certification exam from a credentialing body to verify that you have the knowledge to provide care within your nurse practitioner population focus (or specialty). Now, remember when I said credentialing and certification are different? That is still true, but the organizations that provide certification services also are often referred to as credentialing bodies or centers, so don’t let that trip you up. Certification is required for licensure. Every nurse practitioner in every specialization must do it to practice. While you may have completed your education, getting certified is beneficial because it shows that you have a credentialing body backing your educational experience. They are essentially saying “hey we have tested this nurse practitioner and agree that he/she has met the educational requirements and is ready to provide entry-level care to this patient population.” After you are certified, you can apply for licensure in your state. The exam you take will depend on your specialty and professional goals.

FNP-C vs FNP-BC: What are the Differences?

While there are some differences between FNP-C and FNP-BC keep in mind that both will give you what you need to provide care to patients. However, you may choose one certification over the other depending on your professional goals. In general, the main difference between the FNP-BC and FNP-C certifications are simply that they are offered by different credentialing bodies. The FNP-BC is granted through the American Nurses Credentialing Center (ANCC) and the FNP-C is granted through the American Academy of Nurse Practitioners (AANP). Both certifications are good for 5 years and require that you graduate from a master’s, postgraduate, or doctoral degree from a family nurse practitioner program. The program must be accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). You must have completed 500 hours of supervised hands-on clinical care to sit for either exam. Additionally, you have to have a valid RN license. The FNP-BC exam is 175 questions, whereas the FNP-C exam is 150 questions. The FNP-BC initial certification is $395 for ANCC non-members and $259 for members. For the FNP-C the certification is $315 for non-members and $240 for members. The only real difference between the two tests are that the ANCC FNP-BC exam has an additional focus on nursing research and theory, whereas the AANP FNP-C exam focuses strictly on clinical content. Again, either certification will enable you to provide clinical care.

Some additional things you may want to know before choosing is information on the credentialing boards administering the tests. The AANP certification board which administers the FNP-C is an independent non-profit certifying organization that was established in the early 1990s. They administer competency-based exams for nurse practitioners in their specific population focus. By passing the AANP certification board exam you will be able to use the credentials FNP-C at the end of your name. According to their website, this certification is recognized by every state nursing board, and by Canada, Puerto Rico, Medicare, Medicaid, the Veterans Administration, and privatized insurance. The ANCC which administers the FNP-BC exam is a subsidiary of the American Nurses Association (ANA) and they administer several certification exams to nurses and nurse practitioners as well as offering accreditation to health care organizations. With the ANCC test, you will use the FNP-BC credentials at the end of your name. Both the AANP and ANCC exams meet the accreditation standards of the Accreditation Board for Specialty Nursing (ABSNC) and the National Commission for Certifying Agencies (NCCA).

FNP-C vs FNP-BC: What Exam Should You Take?

Deciding whether to take the FNP-C or FNP-BC exam can be a little difficult. If you know that you may want to go into academia, then the FNP-BC exam may give you a little bit of a leg up as it does not test on just clinical care. However, the test may have more than just multiple-choice questions including matching, which can be a deterrent for some. There are no restrictions from employers or hospitals on which exam you must take, and you can get licensed as an FNP and provide clinical care with either, so there is little risk if you take one exam and later think you should have taken the other. The FNP-BC exam is slightly more expensive and can take longer to complete as well, so your financial and personal preferences may play a role in this decision. Additionally, the FNP-C exam is open to nurses with a Canadian RN license, whereas the FNP-BC exam through the ANCC is not.

If you are still not sure what exam you should take, look at the specific exam content for each. This may help you clarify which exam is right for you. The FNP-C exam focuses on clinical care and the four primary domains of assessment, diagnosis, planning, and evaluation. Secondary domains will involve prenatal, pediatric, adolescent, adult, elderly, and frail elderly primary care. All questions are multiple-choice. Approximately 36% of questions will be focused on assessment, with 24% and 23% focused on diagnosis and planning respectively. The remaining 17% involves evaluation. Only 3% of questions will focus on prenatal care with 37% focusing on adult care. The remainder is as follows: 14% pediatric, 18% adolescent, 21% geriatric, and 7% elderly. In contrast, the FNP-BC exam content domains are assessment (21% of questions), diagnosis (26% of questions), clinical management (43% of questions), and professional role (10% of questions). Secondary classifications that guide questions are focused on body systems, drug agents, and age groups. Ultimately whether you take the FNP-C or FNP-BC exam is a personal choice that may be aided by talking with professors, colleagues, and fellow FNPs.

The Bottom Line

If you are preparing for your certification exam and are stressed out regarding the difference between FNP-C and FNP-BC remember these two things: The most difficult part is FNP school and that’s over (or almost over), and regardless of which exam you take you will still be able to get licensed in any state and provide clinical care to patients. Deciding between FNP-C vs FNP-BC should not cause you to lose sleep at night. Both will get you where you want to go, and both will require a lot of studying!

Lauren Jacobson MS, RN, WHNP-BC
Lauren Jacobson is a registered nurse and women’s health nurse practitioner who is passionate about global health and gender-based violence prevention. She is Editor and an Advisory Board Member for the Global Nursing Caucus and volunteers with Physicians for Human Rights as a medical evaluator for asylum seekers.