- What You're Actually Paying For
- The Registration Fee Explained
- Additional Program Distribution Costs
- Fee Assistance and Waivers
- Non-Refundable, Non-Transferable: Why It Matters
- Cost Snapshot by Situation
- Hidden Costs Beyond the Registration Fee
- What Happens If Something Goes Wrong on Test Day
- Spending Your Prep Time Where It Counts
- Frequently Asked Questions
- The US Medicine registration fee is $85 USD, covering Casper, the Duet assessment, and results sent to 7 programs.
- Additional program distributions beyond the first 7 cost roughly $18 each.
- All Casper fees are final, non-refundable, and cannot transfer between admissions cycles.
- Applicants approved for AAMC or CASPA fee assistance can have the Casper fee waived entirely.
What You're Actually Paying For
Casper (Computer-Based Assessment for Sampling Personal Characteristics) is administered by Acuity Insights, formerly Altus Assessments, and was originally developed at McMaster University's Michael G. DeGroote School of Medicine. Since launching in 2015, the assessment has passed one million test registrations as of August 2024. That scale matters when you think about pricing: this isn't a boutique credential with unpredictable fees - it's a mature, high-volume assessment used across health professions and other admissions pipelines, with a fee structure that's been stable and well-documented for years.
Because Casper is delivered online with remote proctoring on scheduled sitting dates rather than at physical test centers, your "cost" isn't just a registration fee. It's the fee itself, plus the equipment requirements, plus the opportunity cost of your one allowed attempt per test type per admissions cycle. Before you register, it helps to understand exactly what each dollar buys and where the real financial risk sits.
The Registration Fee Explained
For US Medicine applicants, the Casper registration fee is $85 USD. That single fee covers three things:
- The Casper situational judgment test itself
- The Duet value-alignment assessment, which is bundled in alongside Casper
- Distribution of your results to up to 7 programs
Pricing for other health professions programs is lower at the base level, and fees vary by country and by test type - so a nursing, pharmacy, or dentistry applicant outside the US Medicine track may see a different number when they register. There's no universal flat rate across every discipline; the fee is tied to which program category and country you're testing under.
Additional Program Distribution Costs
If you're applying to more than 7 programs, you'll pay extra to send your Casper results further. Each additional distribution beyond the included 7 runs roughly $18 USD. For applicants casting a wide net across multiple schools, this add-on cost can meaningfully change your total spend - someone applying to 15 programs is paying for 8 extra distributions, not just the base fee.
This is worth planning for early, alongside your understanding of Casper exam dates, testing windows, and scheduling deadlines, since you'll want to know your target program list before you register rather than adding distributions piecemeal.
Fee Assistance and Waivers
Casper does offer a path to reduce or eliminate the cost: applicants who are approved for AAMC Fee Assistance Program or CASPA fee assistance can have their Casper fee waived. If you already qualify for fee assistance through either of those centralized application services, it's worth confirming that the waiver carries over to your Casper registration rather than assuming it applies automatically - check the specifics of how your assistance approval interacts with Acuity Insights' registration system before you pay.
Key Takeaway
If you have AAMC or CASPA fee assistance approval in hand, secure your Casper waiver confirmation before registering rather than paying the fee and hoping for a refund - remember, all fees are final and non-refundable.
Non-Refundable, Non-Transferable: Why It Matters
Every Casper fee is final and non-refundable, and it is not transferable between admissions cycles. That means if you register, pay, and then miss your sitting - or decide not to apply that cycle after all - the money is gone. There's no rolling the fee forward to next year's test date and no partial refund for a missed session.
This policy is exactly why understanding Casper's eligibility rules and how to qualify before you register matters so much. There are no academic prerequisites to sit Casper, which lowers the barrier to registering, but it also means the only real gatekeeper protecting your $85+ investment is your own preparation and scheduling discipline.
| Cost Element | What It Covers | Approximate Amount |
|---|---|---|
| US Medicine base registration | Casper + Duet + 7 program distributions | $85 USD |
| Additional program distribution | Sending results to each program beyond the first 7 | ~$18 USD each |
| Other health professions base fee | Varies by program category, country, and test type | Lower than the US Medicine fee |
| Fee waiver | Full fee waived for approved AAMC or CASPA fee assistance applicants | $0 |
| Retake | Only granted for verified technical failures reported within one week | No standard retest fee published |
Cost Snapshot by Situation
Because Casper pricing shifts based on program type, country, and applicant volume of target schools, it helps to think in scenarios rather than a single fixed number:
- US Medicine applicant, 7 or fewer programs: Pays the flat $85 fee with no additional distribution costs.
- US Medicine applicant, more than 7 programs: Pays $85 plus roughly $18 per program beyond the initial 7.
- Non-medicine health professions applicant: Pays a lower base fee, with the exact amount depending on program category and country.
- Fee-assistance-approved applicant: Pays nothing once the AAMC or CASPA waiver is applied to the registration.
- Australian teacher education applicant: Sits a shorter 8-scenario version of the test, distinct in structure though governed by the same registration mechanics.
Hidden Costs Beyond the Registration Fee
The sticker price isn't the whole financial picture. A few practical realities add cost or risk that don't show up on the registration receipt:
Equipment Requirements
Casper requires a desktop or laptop with a working webcam and microphone. Smartphones and tablets are not supported. If your only reliable device is a phone or tablet, you may need to borrow, rent, or purchase a compatible laptop before test day - a real cost that has nothing to do with the registration fee itself.
- Test the webcam and microphone well before your scheduled sitting
- Confirm a stable internet connection since this is remote-proctored, not in-person
The Cost of a Wasted Attempt
You get one attempt per test type per admissions cycle, and scores are valid for that single cycle only - they never carry forward. If you sit Casper unprepared and perform poorly, there's no discounted retake next month. You either accept the result or wait for the next cycle and pay the full fee again. Reviewing a structured Casper study guide built for passing on the first attempt is functionally a way of protecting your registration fee, not just your application timeline.
What Happens If Something Goes Wrong on Test Day
Retakes are granted only for verified technical failures, and only if reported within one week of the sitting. A connectivity drop, a webcam malfunction, or a platform error that's documented and reported promptly can qualify you for another attempt. But a poor performance, nervousness, or simply feeling you answered a scenario badly does not qualify - there is no "I want to try again" option built into the system.
This is one more reason the exam's difficulty deserves real attention before registration day. If you're unsure how challenging the format actually is, a full breakdown of Casper's difficulty can help you calibrate expectations against the fee you're about to pay.
Spending Your Prep Time Where It Counts
Since your registration fee only buys one shot per cycle, the highest-value thing you can do with your prep time is align it to how scoring actually weights the test. The nine scored domains are Collaboration, Communication, Empathy, Fairness, Ethics, Self-Awareness, Resilience, Problem Solving, and Motivation, but not all of them carry equal practical weight. Because nearly every scenario is built around an interpersonal or professional dilemma, Ethics and Empathy tend to matter most across the 11-scenario, 22-question format.
Ethics and Empathy scenarios
- Practice open-ended responses to interpersonal dilemmas since these dominate scenario construction
- Work through both video-response and typed-response formats, since switching formats mid-test isn't permitted
Collaboration, Communication, Fairness
- Time yourself: 1 minute per video question, 3.5 minutes for a typed pair
- Practice using the optional 30-second reflection period before each scenario
Self-Awareness, Resilience, Problem Solving, Motivation
- Simulate the full 65-85 minute sitting, including the 10-minute break after the video section and the 5-minute break after the first four typed scenarios
- Confirm your webcam and microphone setup on the actual device you'll use
For a domain-by-domain breakdown of what each of the nine areas actually tests, the complete guide to all 9 Casper content areas goes deeper than a single prep schedule can. And if you want a condensed reference to keep nearby during final review, a one-page review of must-know Casper facts is useful for last-minute checks on format and timing rather than content you'd cram.
You can also run full-length timed practice through our Casper practice test platform to get comfortable with the pacing before you spend your one registration attempt.
Frequently Asked Questions
The US Medicine registration fee is $85 USD. It covers Casper, the bundled Duet value-alignment assessment, and distribution of your results to 7 programs.
Each additional program distribution beyond the first 7 costs roughly $18 USD. Applicants applying broadly should plan for this before registering.
No. All Casper fees are final and non-refundable, and they cannot be transferred to a future admissions cycle.
Yes. Applicants approved for AAMC fee assistance or CASPA fee assistance can have their Casper fee waived.
No. Other health professions programs pay a lower base fee, and the exact amount varies by country and by test type.
No. Retakes are granted only for verified technical failures reported within one week of your sitting, and you're limited to one attempt per test type per admissions cycle.
Understanding Casper's fee mechanics is a small but important part of preparing well. For the bigger picture on what the credential involves and whether it's worth the investment for your application strategy, see our guides on whether Casper certification is worth it and exactly what score outcomes mean since there's no traditional passing score. When you're ready to put your prep into practice, start a timed practice session to see how your pacing holds up under real test conditions.
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