Back to Blog
Certifications 6 min readMay 22, 2026

CRCST vs CIS vs CER vs CHL — Which Sterile Processing Certification Should You Get?

Not sure which sterile processing certification to pursue? This guide breaks down the differences between CRCST, CIS, CER, and CHL to help you choose the right path.

Houcine Boutam

Houcine Boutam

15+ Years in Sterile Processing · BS Healthcare Science

The 4 HSPA Sterile Processing Certifications

HSPA (Health Sterile Processing Association) offers four main certifications for sterile processing professionals. Each targets a different role and level of expertise.

CRCST — Certified Registered Central Service Technician

Who it's for: Entry-level and experienced sterile processing technicians.

The CRCST is the foundational certification in sterile processing. It covers the full scope of central service work — decontamination, preparation, packaging, sterilization, and storage.

  • Exam questions: 150 (125 scored)
  • Pass score: 72%
  • Experience required: 400 hours of central service work
  • Best for: Anyone starting or working in sterile processing

CIS — Certified Instrument Specialist

Who it's for: Technicians who specialize in surgical instrument care and handling.

The CIS certification focuses specifically on surgical instruments — identification, care, handling, inspection, and testing. This is a specialty certification on top of the CRCST.

  • Exam questions: 150
  • Pass score: 70%
  • Prerequisite: Active CRCST certification
  • Best for: Technicians working closely with OR instruments

CER — Certified Endoscope Reprocessor

Who it's for: Technicians who specialize in flexible and rigid endoscope reprocessing.

The CER covers all aspects of endoscope reprocessing — leak testing, high-level disinfection, automated reprocessors, storage, and infection prevention specific to scopes.

  • Exam questions: 150
  • Pass score: 70%
  • Prerequisite: Active CRCST certification
  • Best for: Technicians in endoscopy or GI departments

CHL — Certified Healthcare Leader

Who it's for: Supervisors and managers in sterile processing departments.

The CHL is a leadership certification covering management, regulations, quality assurance, budgeting, and staff development in the sterile processing setting.

  • Exam questions: 150
  • Pass score: 70%
  • Prerequisite: Active CRCST + 1 year supervisory experience
  • Best for: SPD supervisors, managers, and directors

Which Certification Should You Get First?

Always start with the CRCST. It is the prerequisite for all other certifications and the most widely required by employers.

After your CRCST:

  • If you work with surgical instruments → pursue CIS
  • If you work with endoscopes → pursue CER
  • If you are or want to be a supervisor → pursue CHL

Many experienced technicians hold CRCST + CIS + CER — making them highly valuable in any sterile processing department.

Salary Impact of Certifications

Certified sterile processing technicians consistently earn more than non-certified technicians. Each additional specialty certification (CIS, CER, CHL) typically adds to your earning potential and opens doors to senior roles.

Start with our free practice questions for all four certifications and build your confidence before exam day.

Official Resources

Topics covered:

CRCST vs CISsterile processing certificationsCIS certificationCER certificationCHL certificationHSPA certificationsfree sterile processing practice testfree CIS practice questions

Ready to test your knowledge?

1,381+ free practice questions for CRCST, CIS, CER & CHL.

Start Practicing Free