The NPTE-PT has 225 questions, but only 180 of them count. FSBPT decides how those 180 are split across body systems and non-system topics with a published blueprint: the NPTE-PT Test Content Outline, in effect since January 2024 and still current for 2026. Here is every number in it, and what it means for how you study.
What's on the NPTE-PT?
The NPTE-PT has 225 multiple-choice questions, of which 180 are scored. Musculoskeletal (44–54 scored items) and neuromuscular/nervous systems (39–48) together make up about half the exam, followed by cardiovascular and pulmonary (22–27). The rest comes from six smaller systems, system interactions, and five non-system areas such as safety and research.
Those ranges come straight from FSBPT's NPTE-PT Test Content Outline, effective January 2024. FSBPT built the outline from a practice analysis it completed in June 2022, and its NPTE Content page confirms the January 2024 outline is the one in effect. The other 45 questions are unscored pretest items: new questions FSBPT is trialing, mixed in with the scored ones so you can't tell which is which.
NPTE content areas ranked by weight
Each bar spans the minimum to maximum number of scored items FSBPT allows from that area on any exam form, on a scale of 0 to 60. Percentages are of the 180 scored items.
The full NPTE-PT blueprint
Inside every body system, FSBPT splits questions into three kinds of knowledge. The table shows how many scored items each system can contribute to each kind.
| Body system | Examination | Foundations* | Interventions | Total | % of 180 |
|---|---|---|---|---|---|
| Cardiovascular & Pulmonary Systems | 7–8 | 7–9 | 8–10 | 22–27 | 12.2–15.0% |
| Musculoskeletal System | 14–18 | 15–18 | 15–18 | 44–54 | 24.4–30.0% |
| Neuromuscular & Nervous Systems | 13–16 | 13–16 | 13–16 | 39–48 | 21.7–26.7% |
| Integumentary System | 2–3 | 3–4 | 3–4 | 8–11 | 4.4–6.1% |
| Metabolic & Endocrine Systems | – | 2–3 | 2–3 | 4–6 | 2.2–3.3% |
| Gastrointestinal System | 1–2 | 1–2 | 1–2 | 3–6 | 1.7–3.3% |
| Genitourinary System | 0–1 | 1–2 | 1–2 | 2–5 | 1.1–2.8% |
| Lymphatic System | 1–2 | 1–2 | 2–3 | 4–7 | 2.2–3.9% |
| System Interactions | – | 8–10 | – | 8–10 | 4.4–5.6% |
| Total across systems | 38–50 | 51–66 | 45–58 | – | – |
*Foundations for Evaluation, Differential Diagnosis & Prognosis. A dash means FSBPT allots no items to that cell.
| Non-system area | Items | % of 180 |
|---|---|---|
| Equipment, Devices, & Technologies | 5–6 | 2.8–3.3% |
| Therapeutic Modalities | 4–6 | 2.2–3.3% |
| Safety & Protection | 5–7 | 2.8–3.9% |
| Professional Responsibilities | 4–5 | 2.2–2.8% |
| Research & Evidence-Based Practice | 3–5 | 1.7–2.8% |
| Total non-system | 21–29 | 11.7–16.1% |
The ranges overlap on purpose. Every exam form totals exactly 180 scored items, but FSBPT has room to move a few items between areas from one form to the next. So a form heavy on neuro will be lighter somewhere else.
What "Examination," "Foundations" and "Interventions" mean
These three categories matter as much as the systems do, because they tell you what kind of thinking a question wants.
- Physical Therapy Examination (38–50 items): choosing and interpreting tests and measures, including outcome measures, and the anatomy, physiology and movement analysis behind them. For musculoskeletal, FSBPT adds joint biomechanics.
- Foundations for Evaluation, Differential Diagnosis & Prognosis (51–66 items, the largest category): the diseases and conditions themselves, their pathophysiology, medical management (imaging, lab values, surgery), how medications affect PT, and telling similar conditions apart.
- Interventions (45–58 items): which treatment to use and how, plus the adverse effects of PT interventions, including the effects on one system of treating another.
Foundations is the biggest block across the exam. A lot of NPTE questions are really "what is going on with this patient?" questions dressed up as treatment questions.
Musculoskeletal system: 44–54 items (24.4–30.0%)
Musculoskeletal is the largest area on the NPTE-PT, at 44–54 of 180 scored items. It is split almost evenly between examination (14–18), foundations (15–18) and interventions (15–18). Besides orthopedic conditions, FSBPT's outline puts connective tissue disease and the effect of regenerative medicine, such as platelet-rich plasma and stem cells, in this area.
High-yield topics our reviewers see come up again and again:
- Special tests by region, including what a positive finding means and how useful the test is
- Joint mobilization: grades, the convex–concave rule, indications and contraindications
- Fracture healing timelines and weight-bearing progressions
- Post-operative protocols: ACL reconstruction, total hip and knee arthroplasty, rotator cuff repair
- Spinal conditions: disc herniation, stenosis, spondylolisthesis, and red flags that need referral
Neuromuscular and nervous systems: 39–48 items (21.7–26.7%)
Neuromuscular and nervous systems contribute 39–48 scored items, split evenly across examination, foundations and interventions (13–16 each). The outline covers central, peripheral and autonomic nervous system conditions, and it's the only system where motor control and motor learning are named explicitly under interventions.
- Stroke: syndromes by artery, recovery stages, and task-specific training
- Spinal cord injury: ASIA Impairment Scale and expected function by level
- Traumatic brain injury: Rancho Los Amigos levels
- Progressive conditions: Parkinson disease, multiple sclerosis, ALS, Guillain-Barré syndrome
- Vestibular rehabilitation, including BPPV canal identification and repositioning maneuvers
Cardiovascular and pulmonary systems: 22–27 items (12.2–15.0%)
Cardiovascular and pulmonary systems make up 22–27 scored items, with interventions (8–10) slightly ahead of examination (7–8) and foundations (7–9). FSBPT's examples include rib cage excursion and breathing pattern. Expect vital-sign responses to exercise, when to stop a session, and how cardiac and pulmonary medications change what you see.
- Normal and abnormal responses to exercise, and termination criteria
- Cardiac rehabilitation phases and exercise prescription
- ECG rhythms a PT must recognize and act on
- Obstructive vs restrictive lung disease, and airway clearance techniques
- Oxygen delivery devices and lines you'll meet in acute care
Integumentary system: 8–11 items (4.4–6.1%)
A smaller area, but a predictable one. FSBPT names friction, shear, pressure and scar mobility in its examples. Know pressure injury staging, burn depth and the rule of nines, wound bed descriptions, debridement methods, and how to choose a dressing from the wound's drainage and tissue type.
Metabolic, GI, genitourinary and lymphatic systems: 13–24 items combined
Individually these areas are small: metabolic and endocrine 4–6, gastrointestinal 3–6, genitourinary 2–5, lymphatic 4–7. Together, though, they're worth 13–24 scored items, which is always more than the entire integumentary section (8–11). FSBPT's outline gives concrete examples here:
- Gastrointestinal: Murphy test, Rovsing test and McBurney point; positioning for bowel movements and reflux prevention; bowel programs.
- Genitourinary: bladder programs, biofeedback and pelvic floor retraining.
- Metabolic and endocrine: no examination items at all. Everything here is about the conditions and their management, so diabetes and exercise, hypoglycemia, and thyroid disorders.
- Lymphatic: lymphedema assessment and management, including compression.
System interactions: 8–10 items (4.4–5.6%)
These questions sit entirely in the foundations category. FSBPT's examples are specific: conditions that hit more than one system (cancer, multitrauma, sarcoidosis, autoimmune disorders, pregnancy), polypharmacy, comorbidity pairs such as "diabetes and hypertension; obesity and arthritis; dementia and hip fracture," psychological conditions such as grief and depression, and the dimensions of pain.
Non-system areas: 21–29 items (11.7–16.1%)
Five non-system areas add up to 21–29 scored items: equipment, devices and technologies (5–6), therapeutic modalities (4–6), safety and protection (5–7), professional responsibilities (4–5), and research and evidence-based practice (3–5). They're rules-based topics that reward memorization more than the system questions do.
- Equipment, devices & technologies: walkers, wheelchairs and seating, mechanical lifts, upper- and lower-extremity prostheses including microprocessor-controlled devices, braces, taping, compression garments and serial casts.
- Therapeutic modalities: thermal agents, iontophoresis, NMES, TENS, FES, interferential and high-voltage pulsed current, ultrasound, traction, biofeedback and intermittent compression.
- Safety & protection: safe patient handling, fall prevention, lines, tubes and ventilators, CPR and emergency response, infection control, and signs of abuse and neglect.
- Professional responsibilities: documentation, patient rights (ADA, IDEA, HIPAA), PT and PTA roles, ethics, billing and coding, mandatory reporting, regulation (state boards, Joint Commission, CARF, CMS), cultural and socioeconomic factors, and telehealth.
- Research & evidence-based practice: study designs and levels of evidence, reliability and validity, and statistics including t-tests, chi-square, ANOVA, likelihood ratios, effect size and confidence intervals.
What the outline doesn't show
FSBPT adds a caveat that's easy to miss. Some skills, such as communication and teaching and learning, aren't listed as their own area, but they're "encompassed by multiple knowledge areas" and appear in test content "to a greater extent than is apparent from this outline." In practice, a question about a stroke patient can also be testing whether you know how to teach a caregiver.
How to turn the blueprint into a study plan
Spend study time roughly in proportion to the weights, then adjust for your weak areas. On a 12-week plan, that works out to about three weeks of musculoskeletal, two and a half of neuro, a week and a half of cardiopulmonary, a week and a half of non-system topics, and the rest spread across the smaller systems, with practice exams on top. Our NPTE study plan lays out 6-, 8- and 12-week versions week by week.
Then test yourself against the same blueprint. The free NPTE practice test draws its 50 questions from these areas in roughly these proportions, and our practice questions by content area let you drill one system at a time. For recall, our free NPTE flashcards and NPTE mnemonics are sorted by the same content areas.
NPTE content outline: frequently asked questions
Did the NPTE content outline change for 2026?
No. The NPTE-PT content outline that took effect in January 2024 is still the current outline for 2026. It came out of a practice analysis FSBPT completed in June 2022.
How many questions on the NPTE are musculoskeletal?
Between 44 and 54 of the 180 scored questions, or 24.4–30.0% of the scored exam. That makes musculoskeletal the single largest content area.
Do the 45 pretest questions follow the same outline?
Pretest questions are new items FSBPT is evaluating before using them as scored questions. They don't count toward your score, and you won't know which questions they are, so treat every question as if it counts.
Is the NPTE-PTA content outline the same?
No. The PTA exam has 180 questions, 140 of them scored, with its own outline. Its categories are data collection, diseases and conditions that affect treatment, and interventions, rather than examination and differential diagnosis.
Where can I download the official NPTE content outline?
FSBPT publishes the full outline as a free PDF on its NPTE Content page. The link is in the sources at the end of this page.
Study the blueprint, not a guess at it
Every flashcard, mnemonic and practice question in TherapyExams is tagged to the FSBPT content areas, so you can see exactly which systems are costing you points.
Start Your Free 7-Day Trial →Sources
Every figure on this page comes from the primary sources below, checked on September 27, 2026. If an official source changes, it overrides this page.