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Exam Information
Official specifications published by ACSM
Exam Format
210 min
115
550
Clinical/Advanced
Registration
Pearson VUE or online proctoring
Validity
3 years
Earn required Continuing Education Credits (CECs) during the 3-year certification cycle; Maintain current CPR/AED certification; Pay recertification fee
ACSM-RCEP Exam Topics and Domains
ACSM-RCEP is organized into 6 weighted domains. Expect to work with ECG monitoring, Electronic health records, Motivational Interviewing, 6-minute walk test, and more.
1
Patient Assessment
18%
Assess a patient's medical record for information related to their visit
Knowledge StatementsSkill Statements
- Interpret medical records to inform clinical exercise decisions
- Apply HIPAA and HITRUST regulations to patient data management
- Recognize diagnostic findings relevant to exercise programming
Interview patient regarding medical history for their visit and reconcile medications
Knowledge StatementsSkill Statements
- Conduct effective patient interviews using open-ended inquiry and active listening
- Reconcile medications and understand their impact on exercise
- Document patient assessment data accurately
Obtain and assess resting biometric data (e.g., oxygen saturation, blood pressure, body composition, ECG)
Knowledge StatementsSkill Statements
- Obtain and interpret resting biometric data including ECG, blood pressure, and body composition
- Identify normal and abnormal ECG findings
- Recognize the effects of chronic disease and medications on resting vital signs
Determine a sufficient level of monitoring/supervision based on a preparticipation health screening
Knowledge StatementsSkill Statements
- Apply preparticipation screening tools to determine appropriate monitoring levels
- Evaluate patient risk using medical history, diagnostic data, and clinical guidelines
- Identify indications and contraindications for exercise testing and training
Assess patient goals, needs and objectives based on health and exercise history, motivation level and physical activity readiness
Knowledge StatementsSkill Statements
- Assess patient motivation, goals, and readiness for physical activity
- Apply behavior modification theories to support exercise adherence
- Screen for psychological issues that may impact exercise participation
2
Exercise Testing
18%
Select, administer and interpret submaximal aerobic exercise tests (e.g., treadmill, cycle, step test, 6-minute walk)
Knowledge Statements
- Select and administer appropriate submaximal aerobic exercise tests for diverse patient populations
- Interpret submaximal test results in context of chronic disease and medications
- Recognize normal and abnormal test endpoints
Select, administer and interpret tests to assess musculoskeletal fitness, mobility and balance
Knowledge Statements
- Select and administer musculoskeletal fitness, mobility, and balance tests
- Interpret results in context of patient's disease, age, and training status
- Modify testing procedures based on medication use and chronic disease
Select, prepare and administer maximal, symptom-limited exercise tests
Knowledge Statements
- Prepare and administer maximal, symptom-limited exercise tests
- Identify contraindications and appropriate test protocols for various patient populations
- Monitor and interpret ECG during maximal exercise testing
Evaluate and report results from a symptom-limited maximal exercise test to medical providers and in the medical record
Knowledge Statements
- Evaluate and interpret maximal exercise test results including ECG, metabolic, and hemodynamic data
- Apply prognostic tools such as the Duke Treadmill Score
- Communicate exercise test findings to the healthcare team
Identify relative and absolute indications for test termination and report to medical personnel as needed
Knowledge Statements
- Identify and distinguish between relative and absolute indications for exercise test termination
- Apply appropriate termination criteria during exercise testing
- Report findings to medical personnel following proper procedures
3
Exercise Prescription
22%
Develop individualized exercise prescription to support patient needs and goals for various exercise environments
Knowledge Statements
- Develop individualized exercise prescriptions using the FITT principle for patients with chronic diseases
- Apply metabolic calculations to exercise prescription
- Integrate psychological and behavioral considerations into exercise planning
Communicate the exercise prescription, the proper use of exercise equipment, and the importance of promptly reporting adverse reactions or symptoms
Knowledge Statements
- Communicate exercise prescriptions effectively using lay terminology
- Demonstrate proper use of exercise equipment and modalities
- Educate patients on recognizing and reporting adverse symptoms
Explain and confirm patient understanding of exercise intensity and measures to assess exercise intensity
Knowledge Statements
- Explain exercise intensity monitoring methods (HR, RPE, talk test) to patients
- Confirm patient comprehension of intensity guidelines
- Adapt intensity education to patient health literacy
Evaluate and modify the exercise prescription based on the patient's compliance, signs/symptoms and physiologic response to the exercise program
Knowledge Statements
- Evaluate patient response to exercise programming and modify accordingly
- Apply principles of progression and specificity in program modification
- Adjust exercise prescription based on medication changes and physiologic responses
Discuss the importance of addressing barriers to exercise adoption and implement strategies to optimize adherence
Knowledge Statements
- Identify common barriers to exercise adoption in chronic disease populations
- Implement evidence-based strategies to optimize patient adherence
- Apply self-efficacy and goal-setting approaches to support behavior change
4
Exercise Training and Leadership
24%
Discuss and explain exercise training plan, patient and clinician expectations and goals
Knowledge Statements
- Communicate exercise training plans effectively to patients and healthcare teams
- Apply patient-centered approaches to goal setting and expectations management
- Address health literacy considerations in patient education
Instruct and modify in cardiorespiratory fitness, muscular strength and endurance, flexibility, coordination and agility exercise modes
Knowledge Statements
- Instruct patients in multiple exercise modes adapted to their disease and ability
- Modify exercises based on patient response, symptoms, and disease-specific considerations
- Lead individual and group exercise sessions safely
Provide patient monitoring (e.g., pulse oximetry, biometric data) and supervision during exercise
Knowledge Statements
- Monitor patients using telemetry, oximetry, and glucometry during exercise
- Interpret ECG rhythms and identify abnormalities during exercise training
- Recognize and respond to adverse exercise responses
Evaluate the patient's contraindications to exercise training and associated risk/benefit and modify the exercise/activity recommendations accordingly
Knowledge Statements
- Evaluate contraindications to exercise training and modify recommendations
- Perform risk-benefit analysis for exercise in patients with chronic diseases
- Identify indications to stop exercise and escalate care
Evaluate, document and report patient's clinical status and response to exercise training in medical records
Knowledge Statements
- Document patient exercise sessions, outcomes, and clinical status in medical records
- Apply HIPAA and privacy regulations to medical documentation
- Recognize and report signs of disease progression
Discuss clinical status and response to exercise training with patients and modify the exercise program, as indicated
Knowledge Statements
- Discuss exercise training outcomes with patients and adjust programs accordingly
- Assess expected versus actual training adaptations
- Modify exercise programs based on patient tolerance and feedback
Promptly report new or worsening symptoms and adverse events in the patient's medical record and consult with the responsible health care provider
Knowledge Statements
- Recognize and promptly report new or worsening symptoms during exercise training
- Document adverse events according to facility policies and professional standards
- Collaborate with interdisciplinary healthcare team members for patient care coordination
5
Education and Behavior Change
13%
Continually evaluate patients using observation, interaction and industry-accepted tools to identify those who may benefit from counseling or other behavioral health services
Knowledge Statements
- Screen patients for behavioral health concerns using validated tools
- Apply health behavior change theories to clinical exercise settings
- Identify patients who need referral to behavioral health specialists
Assess patient understanding of their disease and/or disability and conduct education to teach the role of lifestyle in the prevention, management and treatment of the disease/disability
Knowledge Statements
- Assess patient understanding of their disease and role of lifestyle interventions
- Conduct patient education using evidence-based counseling techniques
- Apply risk factor reduction strategies tailored to individual patient needs
Use motivational interviewing techniques to engage patients in collaborative conversations, exploring and strengthening their motivation for behavior change
Knowledge Statements
- Apply motivational interviewing techniques in clinical exercise settings
- Develop patient self-efficacy for exercise behaviors
- Set SMART goals collaboratively with patients
Promote adherence to healthy behaviors through a patient-centered approach
Knowledge Statements
- Promote long-term adherence to healthy behaviors using patient-centered approaches
- Apply relapse prevention techniques to support exercise maintenance
- Connect patients with community resources for continued health improvement
6
Legal and Professional Responsibilities
5%
Evaluate the exercise environment and perform regular inspections of any emergency equipment and practice emergency procedures per industry and regulatory standards and facility guidelines
Knowledge Statements
- Maintain emergency equipment according to industry standards
- Practice emergency procedures per regulatory and facility guidelines
- Ensure compliance with OSHA, JCAHO, and HIPAA requirements in exercise settings
Follow industry-accepted scopes of practice, ethical, legal (e.g., data privacy, informed consent) and business standards
Knowledge Statements
- Apply industry-accepted scopes of practice and ethical standards
- Understand professional liability and negligence in clinical exercise settings
- Adhere to HIPAA and informed consent requirements
How do I earn this certification?
Passing ACSM-RCEP earns the ACSM Certified Clinical Exercise Physiologist (ACSM-CEP) certification. It sits in the Clinical Exercise Physiology track.
Current Level Exams
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How to study for this exam?
The most effective way to prepare for ACSM-RCEP is by using the PlanetCert Simulator to practice questions and review detailed explanations.
What's changed on this exam?
Current Status
- ACTIVE
- Last content update: 2025-07-10
Updates
- Wearable Fitness Devices and Apps Integration The 2021 JTA explicitly includes knowledge of fitness technology (wearable devices, apps) and their application to exercise prescription communication. Candidates should be familiar with how to integrate technology into clinical exercise programming.
- Virtual Exercise Programming The 2021 JTA includes virtual environments as a recognized exercise setting. ACSM-CEPs should know how to prescribe and supervise exercise in virtual/telehealth settings. Up to 50% of clinical experience hours can be virtual counseling hours.
Who should take this exam?
Basic Life Support Provider (BLS) or CPR for the Professional Rescuer certification (with hands-on practical skills component)
First Aid certification (beginning 2027)
- Experience in cardiac and pulmonary rehabilitation settings
- Familiarity with 12-lead ECG interpretation
- Understanding of chronic disease pathophysiology
- Coursework in clinical exercise testing and prescription, advanced exercise physiology, and clinical exercise physiology/pathophysiology