Medication Aide Certification 2026 June — MACE State Requirements Guide

Medication Aide Requirements by State

Not all states have a medication aide program. The states that do recognize the medication aide or medication technician role typically require candidates to:

• Hold a current, active CNA (Certified Nursing Aide) license in that state
• Have a minimum of 1 year of full-time experience as a CNA in a long-term care or assisted living setting
• Complete a state-approved medication aide training program (typically 40–80 hours)
• Pass the MACE or a state-specific medication aide exam
• Maintain a clean disciplinary record on the state nurse aide registry

States that use the MACE exam (Pearson VUE): Alabama, Arkansas, Georgia, Indiana, Iowa, Kansas, Maine, Mississippi, Missouri, Nebraska, New Hampshire, North Carolina, Oklahoma, Rhode Island, South Carolina, Tennessee, Utah, Virginia, and others.

States that do NOT recognize medication aides: California, New York, New Jersey, and several other states do not permit CNAs to administer medications regardless of training — this practice is limited to licensed nurses (LPN/RN) in these jurisdictions.

MACE Exam Format and Content

The MACE (Medication Aide Certification Exam) is a computer-based, multiple-choice examination administered through Pearson VUE testing centers. Exam specifications:

• Total questions: 75–100 multiple-choice questions (varies by state version)
• Time allowed: 2 hours
• Content areas: Basic pharmacology, medication classifications, administration routes, documentation, infection control, client rights, and error reporting
• Passing score: Varies by state — most require 70–75% (scaled)
• Retake policy: Most states allow up to 3 attempts; additional attempts require re-application and re-training in some states

Steps to Become a Certified Medication Aide

Here is the typical pathway from CNA to Certified Medication Aide:

1. Hold an active CNA license: You must first be a certified nursing aide in your state. If you are not yet a CNA, complete a state-approved CNA training program (4–12 weeks) and pass the NNAAP exam administered through your state's Pearson VUE testing program.
2. Gain CNA work experience: Most states require 1 year (approximately 1,600–2,000 hours) of full-time CNA work in a licensed care facility before applying for medication aide training.
3. Complete medication aide training: Enroll in a state-approved medication aide program. Many employers offer this training on-site or cover the cost as a professional development benefit. Programs typically run 40–80 hours over 1–3 weeks.
4. Apply to your state board: Submit your training completion certificate, CNA license verification, and required fees to your state board of nursing or nurse aide registry.
5. Pass the MACE exam: Register through Pearson VUE and schedule your exam within the validity window on your authorization letter (typically 60–90 days).
6. Receive certification and begin practice: Once your certificate is issued, you may administer medications within your state's defined scope of practice.

Medication Aide Salary and Job Outlook

Medication aides earn a meaningful pay premium over standard CNA wages. According to BLS and state wage surveys:

• The national average medication aide wage is approximately $18–$24 per hour
• Medication aides earn $1.50–$4.00 more per hour than CNAs without the certification
• Facilities offering full-time positions often include benefits (health insurance, 401k, tuition assistance)
• Demand is strong: BLS projects home health and personal care aide employment to grow 22% through 2032