PEPS Salary Guide 2026: Complete Earnings Analysis

Why PEPS Has No Salary of Its Own

Searches for "PEPS salary" usually assume PEPS is a job title or a specialty credential that carries a pay premium. For Patient Encounters and Performance Skills, that assumption does not hold. PEPS is Part III of the National Board of Examiners in Optometry (NBEO) examination sequence, an entry-to-practice licensure examination taken by optometry students and graduates. It is not a standalone, renewable certification, and no employer posts a position called "PEPS" with a pay band attached.

That distinction matters because it changes how you should think about "earnings." Passing PEPS does not raise your salary the way an advanced specialty credential might. It removes a barrier. Without a pass on Part III, you cannot complete the national board requirements that most state licensing boards expect, and without a license you cannot practice or earn an optometrist's income at all. The financial value of PEPS is therefore gating value: it unlocks the career rather than adding a bonus on top of it.

This guide does not quote specific salary figures, because none belong to PEPS itself and publishing numbers from other sources would invite exactly the kind of confusion this topic already suffers from. Instead, it explains what PEPS does and does not influence, what the exam costs you, how delays affect your earning timeline, and how to prepare so the exam stays a one-time expense. If you want a broader view of whether the investment pays off, see our complete ROI analysis of the PEPS exam.

What PEPS Actually Is: Part III of the NBEO Sequence

Before talking about money, it helps to be precise about what you are paying for. PEPS is an in-person performance assessment administered by NBEO at the National Center of Clinical Testing in Optometry (NCCTO) in Charlotte, North Carolina. If the acronym or its history is new to you, our explainers on what PEPS is and what PEPS stands for cover the basics.

The performance format

The exam is built from 12 stations: 10 standardized-patient encounters and two hands-on clinical-skills stations. One of the encounters is unscored data collection, which leaves nine scored encounters plus the two skills stations. These are performance assessments, not multiple-choice questions. Encounters are recorded and assess:

• Focused history-taking
• Clinical interpretation
• Management
• Typed documentation
• Patient education and communication

The session runs 4 hours 30 minutes. Each station has a 3-minute observation period followed by a 15-minute station period, with 4-minute breaks and a 24-minute extended break after cycle 8. Plan on roughly 7 hours on site once check-in, orientation, and check-out are included. NCCTO supplies the equipment.

Reporting and licensure context

PEPS is reported pass/fail, without a scaled score, unlike Parts I and II. Passing requires meeting the overall NBEO cut-off. There is no periodic PEPS certificate renewal; state licensure maintenance is a separate matter handled through your licensing board. For the mechanics of the cut-off, see our guide to the PEPS passing score.

What Really Drives Optometrist Earnings

Once PEPS is in your rearview mirror, income is shaped by factors that have nothing to do with the exam. Understanding these helps you keep PEPS in proportion: it is a hurdle to clear cleanly, not a lever to pull for higher pay.

Notice that PEPS appears only in the first row. Every other driver operates after the exam is behind you. That is the honest framing of a PEPS "salary guide": the exam determines when your earnings start, and the rest of your career determines how large they become.

The Exam-Side Economics: Fees, Attempts, and Time

The real financial exposure of PEPS lives on the cost side of the ledger. For administrations beginning August 2026, the exam fee is USD 1,490. That is the baseline, and it is only part of the story once travel, lodging, and time away from clinic or coursework are counted. For a full line-by-line view, read our PEPS cost and pricing breakdown.

Attempts are limited and cumulative

NBEO allows six attempts that combine former CSE and PEPS attempts. Attempts beyond six require NBEO Board committee approval. For anyone who tested under the former format, prior CSE attempts count against the same total. Know where you stand before you register, because the ceiling is shared across both formats.

The retake penalty is a timeline penalty

Each unsuccessful administration costs you the exam fee again plus another round of logistics. More importantly for earnings, it pushes back the date you can complete licensure and begin practicing. A candidate who passes on the first attempt and one who needs a second attempt can end up months apart in starting an optometrist's income. This is the largest and most controllable "salary" factor tied to PEPS: how quickly you clear it.

Who can sit for the exam

Eligible graduation-year students need institutional confirmation from an ACOE-accredited, accredited-with-conditions, or preliminary-approval program. Eligible accredited-program graduates may also apply, and sponsorship pathways exist for other candidates. Full eligibility details are in our PEPS requirements guide, and scheduling details are in our guide to PEPS exam dates and deadlines.

How the Five Domains Map to Professional Value

The five weighted domain lines are official exam competency objectives, not preparation-curriculum headings. They describe what the exam measures, and they also happen to describe the skills that make a new optometrist valuable to an employer. Using the blueprint's table headings:

One labeling note: the blueprint's prose uses the phrases "Clinical Interpretation and Assessment" and "Communication and Professionalism," but the blueprint table's exact headings, used above, are the ones that control. The nine clinical-presentation categories in the blueprint are a separate axis from these competency domains and are not additional domains. For a deeper walk through each area, see our complete guide to the five PEPS content areas.

The connection to earnings is indirect but real. Clinical interpretation, sound management, accurate documentation, and clear patient communication are the behaviors that make a patient return, refer others, and trust a practice. Those behaviors, more than any exam credential, shape how an employer or practice owner values a new graduate over time.

Who Hires Newly Licensed Optometrists

PEPS does not have its own employer pool. The employers relevant to someone who has just passed Part III are the settings that hire licensed optometrists generally. Common categories include:

• Private practices: independent offices that may offer associate positions with a path toward partnership or ownership.
• Group and multi-location practices: larger organizations with structured onboarding and defined schedules.
• Retail and commercial settings: optical retail environments that employ optometrists alongside dispensing operations.
• Ophthalmology and medical practices: co-management and medical eye care settings.
• Hospital, health system, and government settings: including federal and community health environments.
• Academic and clinical education roles: positions tied to schools and residency programs.

Each setting structures compensation differently, and none of them ask for your PEPS result beyond confirming that you hold a license. If you are exploring what the market looks like after licensure, our overview of PEPS-related jobs frames the landscape, and our page on PEPS certification clarifies how the exam relates to credentials you may see discussed online.

Why a First-Attempt Pass Protects Your Earnings Timeline

Published outcome data gives a sense of the stakes. For the July 1, 2024 to June 30, 2025 administration year, published first-time results report 69.0%. Separately, the NBEO Institutional Yearly Performance Report 2025 reports a 70.09% U.S. first-time Part III CSE/PEPS rate, rounded to 70.1% in some school tables, for 1,628 graduates in the October 1, 2024 to September 30, 2025 graduating cohort who attempted all three parts.

Read those numbers carefully. They use different populations and periods. Neither is a 2026 or current-version PEPS pass rate, and an ultimate all-parts rate is not a PEPS first-time rate. What they do show, in plain terms, is that a meaningful share of first-time candidates do not pass on the first try. Our PEPS pass rate analysis unpacks how to read these figures without over-interpreting them.

Candidates who underestimate the format tend to underestimate the difficulty, and our PEPS difficulty guide explains why a station-based performance exam feels different from the knowledge-based parts that come before it.

A PEPS-Focused Preparation Timeline

Rather than a generic schedule, sequence your preparation around the exam's own weighting and structure. The largest domains deserve the earliest and most repeated attention, while the skills stations benefit from steady hands-on repetition.

For a broader preparation framework, see our PEPS study guide, and keep our one-page PEPS cheat sheet handy for last-week review. To test yourself under realistic conditions, use the PEPS practice tests on the main site, and revisit our practice question bank as you move through each domain.

Frequently Asked Questions