The CARES Exam is administered multiple times throughout the year, typically within several weeks of each Academy, and at the beginning of each CARES Academy Connect (held twice each year). 
Because many people who attend the Academy have not taken a test of any kind in 10 or 20 years, it is not unusual for them to have fear around the exam. However, it is possible to remain a CARES in good standing, and maintain certification, without passing the exam (but without the ability to bill Medicaid for Certified Peer Specialist–Addictive Disease services). 
CARES who prepare for the exam by reviewing the CARES Academy Manual carefully report little difficulty in passing the exam. However, it is a thorough test of the material covered in the Academy, and CARES who do not prepare for it have frequently had to retake the test in order to pass it.