- The 2026 exam fee is $2,100, including a $200 nonrefundable administrative fee.
- Testing runs September 8-28, 2026 at Pearson VUE centers, one day, 280 questions.
- Clinical Practice (14%) and HPC Transplantation (11%) are the two heaviest domains - study them first.
- Passing is a scaled score of 500, not a fixed raw percentage correct.
Quick Facts at a Glance
This page is a one-stop reference for the American Board of Pathology's initial subspecialty certification in Blood Banking/Transfusion Medicine - officially abbreviated BB/TM. It is not a laboratory specialist credential and it is not any other program that happens to share the same three-letter acronym. If you want the full narrative version of these numbers, pair this cheat sheet with the BB/TM Study Guide 2026: How to Pass on Your First Attempt and the deeper dive in BB/TM Exam Domains 2026: Complete Guide to All 15 Content Areas.
| Item | 2026 Detail |
|---|---|
| Certifying body | American Board of Pathology (ABPath) |
| Credential | Initial subspecialty certification, BB/TM |
| Exam fee | $2,100 total, includes $200 nonrefundable administrative fee |
| Testing window | September 8-28, 2026 |
| Testing location | Pearson VUE Professional Testing Centers |
| Format | One-day, computer-based, 280 single-best-answer MCQs |
| Content sections | Six sections combining written and practical material |
| Scheduled testing time | 6 hours 22 minutes |
| Total scheduled day | 8 hours 52 minutes, including tutorial, survey, lunch, breaks |
| Passing standard | Criterion-referenced scaled score of 500 |
The 15 Domains Ranked by Weight
The 2026 blueprint spreads content across 15 domains with published Written/Practical percentages that total 100%. Knowing the order matters more than memorizing every decimal - it tells you where to spend limited review hours. For the complete breakdown of what each domain actually tests, see BB/TM Exam Domains 2026: Complete Guide to All 15 Content Areas.
Domain 1: Clinical Practice - 14%
The single largest domain. Expect case-based reasoning about transfusion decisions, patient management, and clinical correlation across the whole discipline.
- Highest point value on the exam; prioritize this first
Domain 14: Hematopoietic Progenitor Cell (HPC) Transplantation - 11%
The second-largest domain. Covers HPC collection, processing, and transplant-related transfusion support.
- Pairs naturally with Domain 2 (Histocompatibility) content
Domains 3 and 5: RBCs/RBC Components and Hazards of Transfusion - 10% each
These tie for third place. RBC component selection, compatibility issues, and specific adverse transfusion events are both dense, detail-heavy topics.
- Together they account for a fifth of the exam
| Domain | Weight |
|---|---|
| 1. Clinical Practice | 14% |
| 14. Hematopoietic Progenitor Cell (HPC) Transplantation | 11% |
| 3. RBCs and RBC Components | 10% |
| 5. Hazards of Transfusion: Specific Adverse Events | 10% |
| 8. Blood Donors and Blood Collection | 7% |
| 10. Surgery Patients | 7% |
| 13. Obstetric and Pediatric Patients | 7% |
| 4. Apheresis | 8% |
| 6. Plasma Components and Derivatives | 6% |
| 9. Management, Quality, Legal, & Regulatory Issues | 6% |
| 12. Platelet and Platelet Components | 6% |
| 7. Infectious Hazards of Transfusion | 4% |
| 15. Management and Informatics-General | 2% |
| 2. Histocompatibility and Tissue Banking | 1% |
| 11. Biovigilance | 1% |
Key Takeaway
Six domains - Clinical Practice, HPC Transplantation, RBCs/RBC Components, Hazards of Transfusion, Apheresis, and Blood Donors and Collection - together account for well over half the blueprint. Master these before touching the 1-2% domains.
Registration, Fees & Testing Window
Budget $2,100 for the 2026 cycle, which folds in a $200 nonrefundable administrative fee. Testing takes place only during the September 8-28, 2026 window at Pearson VUE Professional Testing Centers - there's no rolling or year-round scheduling for this subspecialty exam. For the full mechanics of fee timing, refunds, and what the administrative fee actually covers, read BB/TM Certification Cost 2026: Complete Pricing Breakdown. If you're mapping deadlines against a fellowship schedule, cross-reference BB/TM Exam Dates 2026: Testing Windows, Deadlines & Scheduling before you commit to a testing month.
Eligibility Snapshot
You need one of two certification pathways plus fellowship training:
- AP/CP or CP primary certification, or primary certification from another ABMS member board
- 12 months of ACGME-accredited Blood Banking/Transfusion Medicine fellowship training
- A qualifying medical degree
- Program verification from your fellowship director
- A full, unrestricted medical license
None of these substitute for each other - all are required. See BB/TM Requirements 2026: Eligibility, Prerequisites & How to Qualify for documentation timelines and common eligibility snags.
Scoring: What Passing Actually Means
BB/TM uses a criterion-referenced scaled score, not a fixed raw percentage correct. The threshold is a scaled score of 500. That means the specific number of correct answers needed can shift slightly between administrations depending on item difficulty, while the underlying competency standard stays constant. Full explanation of how scaled scoring differs from a percentage cutoff is in BB/TM Passing Score 2026: Exactly What You Need to Pass.
The 2025 Pass Rate Data Point
According to ABPath's 2025 Annual Report (released 2026), the overall BB/TM pass rate was 90% (44 of 49 candidates). First-time takers passed at 91% (39 of 43), while repeat takers passed at 83% (5 of 6). These are the only pass-rate figures tied to this exact certification - don't let outside benchmarks skew your expectations. A deeper breakdown, including what the first-time versus repeat gap suggests about preparation, lives at BB/TM Pass Rate 2026: What the Data Shows. If you're still weighing how demanding this exam is relative to your training background, How Hard Is the BB/TM Exam? Complete Difficulty Guide 2026 puts these numbers in context.
Exam Day Format, One-Page Version
The exam is a single computer-based day at a Pearson VUE center: 280 single-best-answer multiple-choice questions across six sections, blending written and practical material. Practical items include antibody-identification panels, images, charts, graphs, tables, diagrams, formulas, and calculations - so this is not a pure recall test. You'll need fluency reading panels and doing calculations under time pressure, not just recognizing terminology.
- Scheduled testing time: 6 hours 22 minutes
- Total scheduled day: 8 hours 52 minutes (includes tutorial, survey, lunch, and other breaks)
- Question format: single-best-answer MCQ throughout, no separate essay or oral component
Because roughly two and a half hours of the scheduled day are non-testing time, pace yourself against the 6 hour 22 minute testing block specifically, not the full 8 hour 52 minute day.
Last-Mile Domain Priority Plan
If you have limited weeks left before your September testing window, sequence review by domain weight rather than alphabetically or by fellowship rotation order. Here's a compressed four-week sprint built around the blueprint's heaviest domains; stretch each week if you have more runway.
Clinical Practice (14%) + Hazards of Transfusion (10%)
- Drill case vignettes tying clinical decision-making to specific adverse event recognition
- Review antibody-identification panel workups until they're fast, not just accurate
HPC Transplantation (11%) + RBCs and RBC Components (10%)
- Map HPC processing steps against RBC compatibility and component selection rules
- Practice calculation-style items: dosing, volumes, and component conversion formulas
Apheresis (8%), Blood Donors and Collection (7%), Surgery Patients (7%), Obstetric and Pediatric Patients (7%)
- Group these four mid-weight domains together since they overlap on donor eligibility and special-patient logistics
Remaining domains + full practice day
- Cover Plasma Components, Management/Quality/Legal, Platelets, Infectious Hazards, Informatics, Histocompatibility, and Biovigilance
- Run one full-length timed session against the 6 hour 22 minute testing block
For a longer-horizon version of this plan with weekly targets stretched over several months, see BB/TM Study Guide 2026: How to Pass on Your First Attempt. You can also run timed, domain-weighted practice sets on our practice test platform to simulate the six-section structure before test day.
After You Pass: Maintenance Basics
BB/TM certificates carry no fixed expiration date, but they remain contingent on ongoing ABPath Continuing Certification. The standard route requires:
- 70 CME credits per two-year reporting cycle, with at least 80% related to your scope of practice
- At least two improvement-in-practice or quality-assurance activities per two-year cycle
- Ongoing licensure and professionalism requirements
Separately, CertLink assigns 10-15 questions quarterly. You must complete assigned questions and maintain at least 60% correct cumulatively over the four-year assessment period. These maintenance thresholds are entirely separate from the initial exam's 500 scaled-score passing standard - passing the exam and staying certified are two different systems.
Key Takeaway
Don't confuse CertLink's 60% cumulative threshold with the exam's scaled-score passing standard - they measure different things at different career stages.
If you're deciding whether the credential is worth pursuing given fellowship time and fees, weigh it against BB/TM Salary Guide 2026: Complete Earnings Analysis and Is the BB/TM Certification Worth It? Complete ROI Analysis 2026. For a plain-language overview of the credential itself, What Is BB/TM Certification? and BB/TM Certification cover the basics, while BB/TM Jobs outlines the hiring landscape for holders. You can also practice against realistic questions at our practice test site anytime while you work through this plan.
FAQ
There are 280 single-best-answer multiple-choice questions across six sections, with 6 hours 22 minutes of scheduled testing time within an 8 hour 52 minute total exam day.
The total fee is $2,100, which includes a $200 nonrefundable administrative fee.
Clinical Practice is largest at 14%, followed by Hematopoietic Progenitor Cell (HPC) Transplantation at 11%, then RBCs and RBC Components and Hazards of Transfusion, each at 10%.
No. Passing is a criterion-referenced scaled score of 500, not a fixed raw percentage of questions answered correctly.
Certificates have no fixed expiration date, but staying certified requires ongoing ABPath Continuing Certification, including CME credits, quality-improvement activities, and CertLink quarterly questions.