Do NBEO scores expire for state licensing?

NBEO says its scores do not expire, but boards can set their own windows. Vermont wants scores used within three years, Alaska's exam route within four, Kentucky's standard application within five, and Arizona's regular route within 10.

Does every state require NBEO Part III?

No. Oklahoma lists Parts I, II and TMOD only. New York, New Jersey and Vermont accept NERCOATS in place of Part III, and Montana accepts an equivalent state exam.

Is TMOD a separate exam from Part II?

It is both. About 120 Part II PAM items form an embedded TMOD score with its own pass or fail decision, and NBEO also offers a stand-alone TMOD exam, $630 from August 2026, for those who passed PAM but not TMOD.

NBEO Parts I, II and III: What Each State Asks to See

Q: What happens after six failed NBEO attempts?

You need a sponsor from an ACOE-accredited school, a remediation plan and approval from an NBEO board committee. The request fee is $300 and non-refundable.

The National Board of Examiners in Optometry (NBEO) writes the one exam series that state boards use to license optometrists. Its licensure exam has three parts: Part I Applied Basic Science (ABS), Part II Patient Assessment and Management (PAM) with an embedded Treatment and Management of Ocular Disease (TMOD) score, and Part III Patient Encounters and Performance Skills (PEPS). NBEO also gives the Injections Skill Examination (ISE) and the Laser and Surgical Procedures Examination (LSPE). If you are licensed in one state and applying in another, the question is not whether the new board accepts NBEO. It is which parts it wants, how recent they must be, and whether it adds anything of its own.

What does each part of the exam cover?

Part I ABS is a one-day computer exam at Pearson test centers: 350 scored items and 20 unscored pretest items in two sessions of 185 items, four hours each. Students can first take it at the March administration of their third professional year.
Part II PAM presents cases with three to six items each, 350 items in all, in two sessions of 175 items and 3.5 hours each. About 120 of the items are TMOD items, and candidates receive a separate TMOD score and pass or fail decision alongside the overall PAM result.
Part III PEPS is a simulated live patient encounter and skills exam given only at NBEO's National Center of Clinical Testing in Optometry (NCCTO) in Charlotte, North Carolina.

Parts I and II are reported on a scale from 100 to 900, and anything above 300 passes. Part III reports only pass or fail. For exams given from August 2026, NBEO charges $1,490 for each of the three parts, $630 for stand-alone TMOD, $350 for the ISE and $1,270 for each LSPE section.

Which parts do boards ask an out-of-state applicant to show?

Most boards want the full series. The differences are in TMOD, in whether an older clinical exam still counts, and in a few states that ask for less or for more.

Parts I, II and III plus TMOD

California requires Parts I, II, III and TMOD, and says TMOD is required for every TPA and higher license type. Connecticut asks for Part I, Part II, all three components of Part III and TMOD, verified directly by NBEO. Texas wants Part III passed on or after June 1994 and TMOD passed on or after January 1985. Georgia, Maine, Minnesota, Nebraska, Nevada, Pennsylvania, Virginia, Washington, Wisconsin and the District of Columbia each list the three parts plus TMOD. Missouri requires all written parts and the clinical skills exam, and every applicant must qualify for TPA certification, which needs TMOD.

Three parts, with TMOD tied to a certification

New York licenses on Parts I, II and III and requires TMOD only for certification in therapeutic pharmaceutical agents. Hawaii licenses on the three parts and requires TMOD separately for TPA certification. Rhode Island requires TMOD to use pharmaceutical agents.

An older clinical exam still accepted

New York accepts Parts I and II plus the NERCOATS exam in place of Part III. New Jersey's rules ask for Parts I and II plus Part III or NERCOATS. Vermont accepts Parts I, II and III or NERCOATS scores, plus TMOD.

Less than the full series

Oklahoma lists Parts I, II and TMOD; Part III is not on its list, and a candidate who did not pass TMOD takes an Oklahoma State Board TMOD exam with the July exams. Montana's endorsement route asks for Parts I and II, Part III or an equivalent state exam, and TPA certification in place of TMOD.

More than the full series

North Carolina adds the ISE to Parts I, II, all Part III PEPS sections and TMOD. West Virginia asks for the ISE or a board-approved injection course and the LSPE or a board-approved laser course. Kentucky's standard application will require the ISE from Jan. 1, 2027. Our post on states that ask for the ISE and LSPE has the details.

Do NBEO scores expire?

NBEO's answer is no: "NBEO exam scores do not expire." It adds that "State boards may have additional requirements for keeping scores active," and several do, mostly for applicants on the exam route:

Vermont: the Office of Professional Regulation says scores must be used within three years of passing.
Alaska: the exam route needs Parts I, II and III, the ISE and TMOD, all passed within the four years before applying.
Kentucky: the standard application requires every part passed within five years of applying.
Arizona: regular applicants need NBEO parts taken within 10 years of the application date.

An older score does not end the conversation in those states. Each has a separate route for experienced optometrists: Arizona's endorsement route for four of the last five years of practice in a state with equal or higher scope, Alaska's license by credentials, and Kentucky's endorsement route for five years of active practice. Vermont's Fast Track Endorsement asks for three years of good-standing licensure and a verification. Which route fits you is the subject of endorsement or NBEO scores.

What if you never passed one of the parts?

That usually means you were licensed before the part existed, you tested on NERCOATS, or you were licensed in Kentucky under a waiver. Texas runs a License without Examination for optometrists licensed elsewhere before 1994 who could not take Part III. Indiana sends applicants who never passed Part III to extra board review. Utah tells applicants missing a part to contact the board about other options. Our guide to routes for optometrists licensed before Part III lists the rest.

Kentucky is a special case. Its Attorney General found board waivers of NBEO requirements "null, void, and unenforceable" (OAG 25-13), and NBEO reports at least 21 licenses issued without every part. A board elsewhere looks at your NBEO record, not at the fact that you hold a Kentucky license, so the missing part matters wherever you apply.

Can you take a missing part years after graduating?

Usually, yes. NBEO's eligibility policy lets any graduate of a program with ACOE status of Accredited or Accredited with Conditions take its exams, and its FAQ says the exams can be taken in any order once you are eligible. A few rules shape the plan:

A passed exam cannot simply be retaken. NBEO allows a retake of a passed exam only if a state board asks in writing, or the candidate files a notarized affidavit that the retake is needed for licensure, and NBEO then grants an exception.
No re-registration before a failing score. Candidates cannot register to retake an exam until they receive the failing score from the previous attempt.
No score reviews or superscoring. NBEO does not accept requests to review a score, and it does not combine best sub-scores across administrations of Parts I, II or III.
Registration does not transfer. A registration cannot be moved to a later administration; you withdraw under the refund policy and register again.

Graduates of programs outside the U.S. and Canada need sponsorship from a state board or an accredited program before they can register at all; see Canadian and foreign-trained optometrists.

How many attempts does NBEO allow?

Candidates must pass each exam within six attempts. An attempt on the embedded TMOD and an attempt on the stand-alone TMOD both count toward the same six, and the Part III CSE and PEPS share one combined limit. The LSPE laser and surgical sections each get six. After the sixth attempt, a candidate needs a sponsor, who must be the chief academic officer or chief executive officer of an ACOE-accredited optometry school, a remediation plan, and approval from an NBEO board committee; the request carries a non-refundable $300 fee.

How do the scores reach the new board?

From NBEO, never from you. New York says "Student copies will not be accepted." Illinois wants a certified copy sent directly to the Division. Texas and California find your record through your OE TRACKER number. NBEO sends free reports to up to five states chosen at registration; after that, and once a year has passed since graduation, reports are purchased. See sending NBEO score reports to a new state board.

One common confusion: the NBEO certificate, which NBEO mails after you pass Parts I, II, III and TMOD and your school confirms graduation, is not board certification, and boards still want the score report itself.

Where does this fit in your plan?

The Optometry Licensing Readiness Review ($149, credited in full toward a first application) lines up the NBEO parts you hold, with dates, against every state you are considering, and flags TMOD, ISE and LSPE gaps and score windows before you pay a board fee. Applications on NBEO scores or by endorsement are $699 per state. See pricing or check a state on the state license index.