All test materials are developed by subject matter experts (SMEs) who are California-licensed acupuncturists and who receive training from the examination contractors in developing test content. Items are then reviewed and approved by several panels of SMEs to ensure questions are entry level before they are included on the examination.

The final examination is reviewed for accuracy by a team consisting of three to four SMEs (one representing each language group), the examination liaisons, the examination contractor, the executive officer, and the manager of the Department of Consumer Affairs' Office of Examination Resources prior to being administered.

The Acupuncture Board examination is validated by updating the occupational analysis on which the examination is based. The examination content through the year 2020 will be based on the most recent occupational analysis conducted in 2015, which was approved by the Board and released to the public in January of 2015.