NHA CBCS Exam Prep: 125 Questions, 3 Hours, and No Coding Manuals

Last verified: August 17, 2026 · By the Castleport Test Prep Editorial Team

NHA CBCS exam prep starts with one correction that saves you money: the exam has been closed-book since September 24, 2024. You are not allowed to bring CPT, ICD-10-CM, or HCPCS Level II manuals. The exam is 125 questions in 3 hours — 100 of them scored — and you need a scaled score of 390 out of 500 to pass.

If you have been told to buy three coding books for exam day, that advice is out of date. And it is not your fault for believing it. Six current official NHA surfaces do not line up cleanly: three clearly say closed book, the current handbook contradicts itself on the same page, the published test plan still says manuals are required, and the live CBCS page still tells candidates to check “what manuals to bring.”

We will show you all six.

Then we will do something most summaries of this exam do not: we counted every task and knowledge statement in NHA's published test plan and mapped that count against the four official domain weights. That count is useful — but it does not prove which domain is hardest or where you earn the cheapest points. It gives you a second planning lens, not a difficulty ranking.

This page is about the Certified Billing and Coding Specialist (CBCS) exam from the National Healthcareer Association (NHA). If you are studying for AAPC's CPC, AHIMA's CCS, or NHA's CEHRS, this is the wrong page — jump to which credential you actually need.

The current CBCS exam record

Official sources: current NHA Candidate Handbook, current CBCS test plan, CBCS FAQ, and NHA's public store.

Castleport disclosure: this page and the free planner below are ours. Castleport does not currently sell a paid CBCS course, question bank, or diagnostic. NHA sells its own exam-preparation products. We link to official materials where they are the most direct answer.

Build your CBCS study plan first, then read the rest

Put in your test date and how many hours a week you actually have. The planner splits your time across the four domains using the official question counts plus a transparent Castleport planning adjustment based on how many task and knowledge statements NHA publishes in each domain.

That adjustment is not an official NHA formula. It is not a difficulty score. It does not predict whether you will pass. It simply keeps a 33-question domain with 32 published statements from being treated exactly like a 20-question domain with 14 published statements.

The planner also asks one question nobody should skip: does your study material match 125 total questions, 3 hours, four domains, and a closed-book exam? If it still tells you to bring three manuals, it was written for an exam-day rule that ended September 24, 2024. Keep the content that teaches code-set structure and conventions. Drop the timed page-flipping drills.

There is a second tab with six original format-demonstration questions. They are not a practice test — six questions cannot tell you if you are ready. They exist so you can see the kind of reasoning a closed-book item can demand when the necessary excerpt or rule is supplied inside the question.

Best for you if

• You have registered for the CBCS, or you are about to.
• You want to know what you are allowed to bring before you spend money on books.
• You have a score report with Above / Near / Below on it and want to know what to do next.
• You are retaking after a failed attempt and need a plan, not a pep talk.

Not for you if

• You are taking the CPC or the CCS. Different organizations, different rules, and both currently use code books under their own exam policies. Nothing here applies. See credential fit.
• You are taking NHA's CEHRS. Related field, different exam — read our NHA CEHRS exam prep guide instead.
• You want a full question bank. Six format demonstrations is what this page has. NHA sells official CBCS preparation products, and Castleport does not currently sell a paid CBCS product.

The right prep path is not the same for every candidate — it depends on the exam version you will actually sit, your test date, the hours you can protect, and whether you have a prior score report. Build the plan first. Then use the sections below to verify the rules behind it.

Do you need coding manuals for the CBCS exam?

No. Coding manuals have not been allowed on the NHA CBCS exam since September 24, 2024. NHA's CBCS FAQ says they are neither necessary nor allowed, and that the information needed for each application-of-coding item appears alongside the question. Budget $0 for exam-day code books.

This is the single most expensive piece of bad advice in CBCS prep. Current editions of three professional coding manuals can cost hundreds of dollars in total. They may still be useful for training or work. They are not permitted inside the current CBCS exam.

That warning about arriving without books was real for a defined period. NHA's own FAQ says manuals were required through September 23, 2024 and prohibited beginning the next day. NHA's product change log documents the same transition. The official record we could verify supports this timeline:

NHA has not published a clean, fully reconciled archive showing every manual rule before June 1, 2024, so this page does not extend the verified “manuals required” period farther back than the dated change record supports.

Data download: CBCS exam-version map (CSV) — the current four-domain blueprint, the verified 2024 manual window, the September 24 closed-book change, and the June 2026 PSI tool change in one file.

What you should still do: read your own registration confirmation and check NHA's what-to-bring page before test day. If your confirmation contradicts the closed-book rule, contact NHA directly before you travel. Your registration record controls your appointment — not the study guide on your desk and not this page.

That is a few hundred dollars you do not need to spend for exam day. Put the three hours somewhere useful.

Build your CBCS study plan →

Why do official NHA pages still disagree about CBCS coding manuals?

Because the closed-book change was not carried through every official surface. As of August 17, 2026, six current NHA sources a candidate could reasonably check do not give one clean answer. Three say closed book. One says manuals are required. One handbook says both. One live certification page still tells candidates to check what manuals to bring.

We read all six on the same date. This is the current official-source register:

The handbook contradiction is not subtle. The current revision says no reference books are allowed, then preserves a CBCS exception four bullets later. That is a documentation defect candidates should not have to untangle themselves.

The current test plan is still valuable. Its four-domain blueprint, 100 scored-item total, 25 pretest items, and 3-hour limit match NHA's other current exam information. The stale manual paragraph does not make the entire blueprint unusable. It means one operational instruction survived a later policy change.

The fair conclusion is not that anyone is trying to trick candidates. It is that the CBCS exam-day documentation is not synchronized. For the manual question, the dated change log, current what-to-bring article, CBCS FAQ, and your own registration confirmation are the controlling practical sources.

Data download: Six-source CBCS manual-rule register (CSV).

NHA also describes its own CBCS practice tests two different ways

NHA's live CBCS certification page and educator page say there are three different 100-question practice tests with two attempts each. The CBCS FAQ instead describes a Baseline Practice Test with one attempt, Practice Tests with four attempts, and a Final Practice Test with one attempt.

That conflict does not affect the certification exam itself, but it affects what a buyer thinks is included. Check the product description inside your NHA account or cart before purchase. We could not independently verify which package structure every buyer currently receives.

What is on the NHA CBCS exam?

The NHA CBCS exam scores 100 questions across four domains. Billing and Reimbursement gets 33 questions. Coding and Coding Guidelines gets 32. Insurance Eligibility and Other Payer Requirements gets 20. Revenue Cycle and Regulatory Compliance gets 15. You also answer 25 unscored pretest questions, so you see 125 in all, in 3 hours.

A “test plan” is NHA's name for the blueprint — the published outline of what the exam covers and how many scored items each area receives. Pretest questions are unscored items used for exam development. They are mixed into the exam and are not identified, so treat every question as if it counts.

Domains 3 and 4 together are 65% of the scored exam. That is the strongest default priority signal for a first-time candidate who has no diagnostic evidence yet.

NHA's 2020 practice analysis invited roughly 11,800 active CBCS certificants to participate; 696 eligible respondents completed the survey. NHA reports that the resulting evidence supported all 27 task statements and all knowledge statements in the updated outline. The final test plan uses four domains and 100 scored plus 25 pretest items. See the official practice-analysis executive summary.

Data download: CBCS blueprint statement audit (CSV) — official item weights beside Castleport's independently counted task and knowledge statements.

Which CBCS domain should you study first?

For a first attempt with no score report, start with Domain 4, then Domain 3. They make up 33% and 32% of the scored exam. For a retake, start with every domain marked Below or Near on your score report — but do not erase Above domains from the plan.

We counted every line of NHA's published test plan: 27 task statements and 57 knowledge statements, 84 in total. NHA publishes the official item weights. The statement counts and the planning calculation below are Castleport's independent count of that public blueprint.

\*The planner weight is a Castleport heuristic: 75% official scored-item share plus 25% share of published task/knowledge statements. It is not an NHA weighting, a psychometric difficulty measure, a score converter, or a pass predictor.

The count gives you two useful facts without pretending it gives you more:

Domain 4 carries the most official points and the most published statements. It holds 33% of scored items, 38.1% of the blueprint statements, and 13 of the 27 task statements. That makes it the strongest default first priority for an untested candidate.

Domain 3 is almost the same size in points. At 32% of scored items, it cannot become the “secondary” domain just because the planner gives Domain 4 a small adjustment.

Domain 2 is not “cheap points.” It has 20% of the scored items and 16.7% of the published statements, but statement length and count do not tell us item difficulty, instructional time, or score gained per hour. That is the limit of the evidence.

If you have a score report, use it. NHA tells retakers to spend considerable time on Below and Near domains, while warning that an Above result covers a range and should not be excluded automatically. The planner follows that instruction instead of treating the blueprint as if every candidate starts from the same place.

Turn the blueprint into protected hours, not another table you forget.

Weight my CBCS study time →

Which CBCS domain deserves the most study time?

NHA does not publish a “hardest domain.” Without your own performance data, Domain 4 deserves the largest block because it is 33% of the scored exam, followed almost immediately by Domain 3 at 32%. With a prior score report, Below and Near domains override that default.

Coding sounds technical, so candidates naturally fear Domain 3. That does not make the fear a measurement. Billing and Reimbursement is one point larger and contains claims submission, payment posting, denials, appeals, remittance advice, aging reports, payer edits, collections, and more. Coding and Coding Guidelines contains its own heavy load: abstraction, ICD-10-CM, CPT, HCPCS, modifiers, E/M, sequencing, medical necessity, and documentation.

You do not need a dramatic verdict about which one is “really hardest.” You need a study order that does not abandon either half of the 65% core.

Use this sequence:

1. Retaker: Below domains first, Near domains second, then maintain Above domains.
2. First-time candidate: Domain 4 first, Domain 3 second, then Domains 2 and 1.
3. Candidate with a reliable course diagnostic: let demonstrated weakness override the default, but keep official domain size in the allocation.

There is one practical reason coding may feel different after the manual change: NHA's FAQ says the code information needed for application items is contained alongside the question. You still have to read and apply the supplied rule correctly. You no longer have to prove that you can locate it inside three physical books under exam conditions.

Do you still need to know how the coding manuals are organized?

Yes. Three knowledge statements on the current CBCS test plan cover the use, application, organizing structure, conventions, symbols, and guidelines of ICD-10-CM, CPT, and HCPCS Level II. They survived the September 2024 closed-book change and remain on the blueprint.

This is the detail that decides what to do with the study guide you already bought.

If your material predates September 24, 2024, it may contain both structural instruction and timed lookup drills: tabular list versus alphabetic index, code ranges, conventions, symbols, and repeated exercises in finding a code quickly.

Keep the structure. Drop the exam-day page-flipping drills.

The current test plan still includes:

• k28: ICD-10-CM use, application, organizing structure, conventions, symbols, and guidelines.
• k29: CPT use, application, organizing structure, conventions, and guidelines.
• k30: HCPCS use, application, organizing structure, conventions, and guidelines.

The conventions are still testable. Excludes1 versus Excludes2, modifier logic, code sequencing, and how a supplied descriptor defines a unit can still matter. What changed is the exam-day retrieval method: the CBCS FAQ says the necessary code information is placed with the application item.

That is why “closed book” does not mean “coding books are irrelevant to learning.” It means they are not an exam-day tool.

How long is the CBCS exam, and how should you pace it?

The NHA CBCS exam gives you 3 hours — 180 minutes — for 125 total questions. That works out to 86.4 seconds per question if you divide the clock evenly.

NHA does not publish a required question-by-question pace. These are neutral checkpoints based on equal time:

A useful optional strategy is a 60-second first pass: if you can sustain roughly one minute per item without rushing your reading, you reach question 125 at about minute 125 and preserve roughly 55 minutes for flagged items and review. That is a Castleport pacing strategy, not an explanation of why NHA chose three hours and not a promise that every candidate will finish the first pass that quickly.

Four limits matter:

1. The 86.4-second average covers scored and pretest questions together. You cannot identify the pretest items.
2. Code excerpts, remittance examples, or layered scenarios may take longer than direct recall items.
3. Any permitted in-person break consumes exam time; the clock does not stop.
4. Live remote proctoring does not permit breaks, so a remote candidate should practice at least one uninterrupted three-hour session.

NHA has not published why the current CBCS time limit is three hours. Do not assume the three-hour limit exists because manuals were once required; the dated policy record does not establish that cause.

Do one full-length rehearsal before you discover what three continuous hours feels like.

Build the calendar around my test date →

What score do you need to pass the NHA CBCS exam?

You need a scaled score of 390 or higher. NHA reports scores on a 200–500 scale and uses multiple exam forms. It does not publish a raw “questions correct” conversion for the CBCS, so 390 does not mean 78 correct out of 100.

NHA says the scaled-score process accounts for differences in form difficulty so the passing standard remains 390 across forms. That means two candidates could encounter different forms and still be judged against the same scaled cut.

Do not build your plan around an internet raw-score estimate. Build it around the official domains and your own evidence.

How to read your CBCS score report

NHA score reports use three domain-level performance bands:

The bands are ranges, not exact percentages, and they cannot be added together to reconstruct your total score. NHA also warns that an Above domain on one form does not guarantee the same result on a retake.

All four current CBCS domains contain more than five scored questions, so the handbook's “N/A when a content area has five or fewer questions” rule should not ordinarily block a CBCS domain band under the current blueprint. An invalidated or otherwise exceptional administration can still be handled under NHA's own scoring policies.

How hard is the NHA CBCS exam? The official pass rates

The latest published annual CBCS pass rate is 71.33% for exams administered in 2025. NHA reported 7,878 administrations that year. The annual rate fell in each of the four published years from 2022 through 2025 — but that trend alone cannot prove the exam itself became harder.

\*Approximate counts are Castleport calculations from NHA's rounded annual percentages. They are not separately published NHA counts and may differ by a few administrations because the source percentages are rounded.

The published pass rate declined 5.91 percentage points from 2022 to 2025 while annual testing volume rose by about 51.6%. That is a real trend in the reported outcomes. It is not a diagnosis of why the trend occurred.

Data download: CBCS official pass-rate ledger, 2022–2025 (CSV).

Can the pass-rate trend prove the CBCS exam got harder?

No. Annual pass rates are affected by the population testing, training pathways, retake mix, preparation quality, and exam forms. NHA uses scaled scoring across forms. The four annual PDFs do not isolate those variables, so they cannot tell us whether the exam content became harder.

NHA's standard-setting study adds context but not a target. A panel used a modified Angoff method in 2021 to set a criterion-referenced cut score, which was transformed to 390/500. The initial sample contained 266 candidates and produced a 73.3% pass rate at that cut. That is a reported result from the standard-setting sample — not an annual target, quota, or promise that future cohorts should pass at 73.3%. See the official standard-setting executive summary.

What the active-certification count can — and cannot — tell you

Active CBCS certifications increased from 16,258 at the end of 2022 to 18,006 at the end of 2025, a net gain of 1,748 or about 10.8%.

That stock figure cannot be subtracted from annual passing administrations to estimate how many people lapsed, renewed, or “replaced” expired credentials. Annual pass counts are flows; active certifications are a year-end stock shaped by first-time passes, retakes, renewals, expirations, reinstatements, and timing.

How long should you study for the CBCS exam?

NHA does not publish one official study-hour requirement for all CBCS candidates. Its CBCS FAQ says course and program length are set by the institution. Your honest answer depends on your training, work experience, prior score report, test date, and available weekly hours.

The planner does not invent a universal number. You tell it the hours you can protect; it allocates them.

For a first attempt with no prior domain data, the default planner weights are:

Those are close to the official 33/32/20/15 item weights because official exam size should dominate. The 25% statement-count adjustment is intentionally small.

For a retake, the tool increases Below and Near domains and keeps a maintenance floor under Above domains. That follows NHA's score-report guidance instead of turning a single Above result into permission to stop studying an entire domain.

A practical study-block structure

Use each block for one job:

1. Learn: rule, workflow, or concept.
2. Apply: original or authorized questions tied to that domain.
3. Explain: say why each wrong option fails.
4. Log: write the rule that would have prevented the miss.
5. Revisit: return after spacing, not five minutes later.

A calendar full of “study CBCS” is not a plan. A calendar that says “Domain 4 — denial reason, appeal route, and ERA posting errors” is.

Who is eligible to take the NHA CBCS exam?

You generally need a high school diploma or recognized equivalent plus either a qualifying training pathway or qualifying supervised work experience in medical billing and coding. The current handbook contains more routes than the short CBCS marketing page shows.

Step 1: education level

You must possess a high school diploma or recognized equivalent. NHA also offers a provisional route for candidates scheduled to graduate from an accredited high school or equivalency program: they may test and receive provisional certification up to 12 months before graduation if the other eligibility requirements are met. A provisional credential must be converted under NHA's rules; it cannot simply be renewed as a full credential.

The current handbook does not state a CBCS minimum age.

Step 2: complete one qualifying pathway

You can qualify through one of these routes:

• Training program: within the past five years, complete a billing-and-coding training program offered by an accredited or state-recognized institution or provider.
• Registered apprenticeship: complete an apprenticeship registered under U.S. Department of Labor guidelines.
• U.S. military training: complete formal medical-services training through a branch of the U.S. military.
• Employer training route: complete the didactic portion of a verified employer-based program; after the exam, the required on-the-job training and employer notification must be completed within 180 days for a passed score to produce the credential.
• Pre-externship route: complete the didactic portion under an institution agreement, then complete the externship and required notification within 90 days after the exam.
• Work-experience route: have at least one year of supervised experience in the field within the last three years, or two years within the last five years.

For the training-program route, the handbook ties the five-year lookback to the registration date. If completion was five years or more before registration, the candidate must use another eligible pathway, such as qualifying work experience.

CBCS does not carry the additional live-skill counts that the handbook imposes on NHA's phlebotomy and EKG credentials.

Certification is not the same as state permission to practice

NHA states that its certification eligibility is separate from any state law, regulation, licensing, or practice requirement. Rules vary by state and job. The CBCS credential does not guarantee that you satisfy every employer or government requirement where you plan to work.

That is why this national exam page does not pretend to answer a state-specific licensing question without a state target. Check the relevant state oversight body and the job posting you are pursuing.

How much does the NHA CBCS exam cost?

NHA's public store listing showed the CBCS exam application at $134 when we verified it on August 17, 2026. The Candidate Handbook says a fee is required for every attempt and directs candidates to NHA's Shop for the applicable amount. Verify the amount in your own account or checkout before you pay.

NHA currently lists the exam application price in its public store, so third-party price ranges are unnecessary.

What can change the amount you see:

• A school or employer may sponsor the exam or have a separate institutional arrangement.
• NHA may change public pricing after this verification date.
• Taxes, bundles, study products, or other account-specific items are separate from the exam application.
• Every retake requires re-registration and the full current exam price under the Candidate Handbook.

Do not plan only for the first attempt if money is tight. Put one possible retake fee in the contingency column, even while you prepare to make it unnecessary.

What happens on CBCS exam day?

You can take the CBCS through an authorized institution, at a PSI testing center, or by live remote proctoring. Bring current government-issued photo identification that matches your registration. Do not bring coding manuals, personal notes, a personal calculator, or your own scratch paper.

Tools differ by delivery setting

The calculator wording is another current official conflict. The handbook broadly permits the built-in exam calculator as needed. NHA's June 2026 product update says PSI-delivered exams receive one. The live what-to-bring article still says calculators are only permitted for ExCPT. The safe operational rule is simple: never bring or use a personal calculator; use only the exam-provided tool that appears in your authorized administration.

Accommodation timing

NHA says reasonable testing accommodations may be available for documented disabilities or qualifying medical conditions. Candidates must submit the request form and supporting documentation. NHA recommends allowing 30 days for review.

The handbook describes 150% of standard testing time as its usual additional-time accommodation unless documentation supports more. For a 180-minute CBCS exam, 150% is 270 minutes, or 4.5 hours. The approved accommodation controls; the calculation does not grant it automatically. NHA also warns that some accommodations may not be available through live remote proctoring.

What if you do not pass the CBCS exam?

You wait at least 30 days after the first failed attempt and at least 30 days after the second. NHA allows three attempts under that 30-day cycle. After the third failed attempt, you must wait one year before trying again, and each later failure after the third triggers another one-year wait. Every retake requires the full current exam fee.

A failed attempt is not published on NHA's public verification tool. NHA says that tool does not disclose failed attempts or exam scores. That does not erase the attempt inside your candidate record or change the waiting rule.

Use the 30 days as a repair cycle, not a rerun

The worst retake plan is “do the same book again, faster.” Your score report exists to stop that.

Days 1–3: read the evidence before your emotions rewrite it. Record the total score and every domain band. Do not translate Near into “basically passed.” NHA says Near does not indicate satisfactory performance in that domain.

Days 4–10: rebuild Below domains. Return to the official task statements. For every missed concept, write the rule and one example. Do not copy answers; build the reason.

Days 11–18: repair Near domains. Use fresh, authorized items. Explain every wrong option. If you cannot explain why an attractive distractor fails, you have not repaired the decision.

Days 19–24: maintain Above domains. NHA explicitly warns not to exclude them. Use shorter blocks, not zero blocks.

Days 25–27: run a full 125-question, three-hour rehearsal. Use the same break conditions you will have on test day. If you are remote, that means none.

Days 28–30: review the error log, sleep, and stop adding new resources. The point is to reduce unresolved decisions, not create a new pile of tabs.

The planner calculates the earliest retake date from your attempt count and last exam date. For attempts after the third failure, it adds one calendar year rather than assuming “365 days,” because the handbook uses a one-year rule.

You do not need a pep talk. You need a different 30 days.

Build my retake repair plan →

What CBCS study material should you use — and how do you know yours is current?

Use material that matches the current four-domain test plan, the 125-question / 3-hour format, and the closed-book rule effective September 24, 2024. A resource that still trains you to bring manuals into the exam is operationally stale even if some of its billing and coding lessons remain useful.

Castleport does not currently sell a paid CBCS course, question bank, or diagnostic. The free planner and six format demonstrations on this page are ours. They do not replace comprehensive training or a full exam-preparation product.

NHA currently offers an online study guide, practice tests, and a preparation package. NHA also states that purchase of its preparation material is not required to sit for the exam and does not guarantee a passing score. Because NHA's own pages conflict on the exact practice-test package structure, verify the contents shown in your account before purchase.

Three questions that date any CBCS study material in about 60 seconds

1. Does it describe four domains?

The current test plan has four: Revenue Cycle and Regulatory Compliance; Insurance Eligibility and Other Payer Requirements; Coding and Coding Guidelines; Billing and Reimbursement. A five-domain outline belongs to the older 2013 plan.

2. Does it say 125 total questions in 3 hours?

That is the current published format: 100 scored plus 25 pretest. If a resource gives a different format, verify its edition before trusting the rest.

3. Does it tell you to bring CPT, ICD-10-CM, and HCPCS Level II manuals?

That exam-day instruction expired September 23, 2024. Keep useful instruction on code-set purpose, structure, conventions, modifiers, and sequencing. Remove the assumption that you will have physical manuals in the testing room.

What a useful practice question should do now

A current closed-book application question should provide the information needed to solve the item when the task depends on a code excerpt. It should test whether you can interpret and apply the supplied rule, not whether you memorized a proprietary descriptor or reproduced a live exam item.

No prep provider should claim access to current CBCS questions or recalled items. NHA's rules protect exam content, and Castleport's demonstrations are original items written from public source material and the public test plan.

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Is the CBCS the right credential for your goal?

Choose the credential your target job and coding setting actually ask for. CBCS is an entry-level billing-and-coding credential from NHA. CPC is AAPC's professional/outpatient coding credential. CCS is AHIMA's coding credential covering inpatient and outpatient settings. The exams are not interchangeable, and the book rules are not the same.

Official comparison sources: NHA CBCS page, AAPC exam-book policy, and AHIMA CCS page.

We would rather lose you to the correct exam than sell you certainty about the wrong one.

Before you register, search current job postings for the role and setting you want. Record which credential names appear, whether the employer says “required” or “preferred,” and whether experience is also demanded. An exam can certify knowledge. It cannot make an employer's experience requirement disappear.

For a broader map of this field, use the Health Information exam hub.

What we actually verified for this page

Every official exam claim on this page was rechecked on August 17, 2026. Where NHA's own current pages conflict, we show the conflict instead of silently choosing the version that makes the cleanest copy.

Primary sources used

• NHA Candidate Handbook, revised 06/01/2026
• Current NHA CBCS test plan
• NHA CBCS FAQ
• NHA CBCS certification page
• NHA product and certification portal updates
• NHA what-to-bring article
• NHA public store
• NHA CBCS practice-analysis executive summary
• NHA CBCS standard-setting executive summary
• NHA annual pass-rate publications for 2022, 2023, 2024, and 2025
• NHA 2013-to-2020 test-plan crosswalk
• AAPC approved exam-book policy
• AHIMA CCS certification page

What we could not verify cleanly

• NHA has not published a reason for the current three-hour limit.
• NHA does not publish the number of answer choices used on every CBCS item.
• Current NHA pages conflict on the exact number and attempt structure of its CBCS practice tests.
• Current NHA pages conflict on calculator availability for institution-delivered exams.
• The $134 public store price was visible on the official store listing on August 17, 2026, but your own checkout controls the amount you pay.
• NHA can revise the blueprint, handbook, fee, or delivery rules after this verification date.

See Castleport's editorial standards, methodology, independence policy, and corrections policy for how we handle versioned exam facts.

Frequently asked questions about NHA CBCS exam prep

Is the NHA CBCS exam open book?

No. NHA's CBCS FAQ and current what-to-bring page say coding manuals are not necessary or allowed as of September 24, 2024. The information needed for application-of-coding items appears alongside the question.

How many questions are on the CBCS exam?

You see 125 total questions: 100 scored and 25 unscored pretest questions. The pretest items are not identified.

How long is the CBCS exam?

Three hours, or 180 minutes. Equal pacing is 86.4 seconds per question.

What score do I need to pass the CBCS?

A scaled score of 390 or higher on NHA's 200–500 scale. NHA does not publish a CBCS raw-score conversion.

How much is the CBCS exam?

NHA's public store showed a $134 CBCS exam application when verified August 17, 2026. Confirm the current amount in your NHA account or checkout. The full current exam price applies to each retake.

What happens if I fail the CBCS exam?

You wait at least 30 days between attempts through the first three attempts. After a third failed attempt, you wait one year before the next attempt; each later failure after the third triggers another one-year wait. You re-register and pay the full current fee each time.

How long should I study for the CBCS?

NHA publishes no universal candidate study-hour requirement. Use your test date, available weekly hours, training, and any prior score-report bands. Without personal data, give the largest blocks to Domains 4 and 3 because they make up 65% of the scored exam.

Which CBCS domain is hardest?

NHA does not publish a hardest-domain ranking. Domain 4 is the largest at 33 scored items, followed by Domain 3 at 32. A retaker should prioritize Below and Near score-report domains.

Do I need work experience to take the CBCS?

Not necessarily. Qualifying recent training, a registered apprenticeship, formal U.S. military medical-services training, eligible employer or pre-externship routes, or qualifying supervised work experience can satisfy the pathway requirement. Read the current Candidate Handbook for the full conditions.

Is there a minimum age for the CBCS exam?

The current Candidate Handbook does not state a CBCS minimum age. It does require a high school diploma or equivalent for full certification, with a provisional route for some candidates up to 12 months before expected graduation.

Can I take the CBCS exam at home?

Yes, through live remote proctoring when available through your registration. Remote testing permits no breaks, so plan for one continuous three-hour session.

When do I get my CBCS results?

Institution-delivered computer exams provide a preliminary score report immediately. PSI test-center and live-remote results are posted within 48 hours. Preliminary results are not the final credential.

Can I use scratch paper or a calculator?

At an institution, the handbook says the proctor provides two scratch sheets. PSI centers provide a physical whiteboard; remote candidates receive a digital whiteboard. Never bring a personal calculator. Official NHA pages conflict on institution calculator availability, while the June 2026 change log says PSI-delivered exams include an embedded calculator.

Does CBCS certification expire?

Yes. A full CBCS certification is valid for two years and requires 10 continuing-education credits for recertification; two hours of qualifying attendance equal one credit. A provisional certification expires 12 months after the exam and must be converted before it lapses or the candidate must retest. NHA allows a one-month grace period for standard recertification. Reinstatement within one year requires 15 credits plus applicable fees; after one year, reinstatement is not permitted and the person must retest.

Is the CBCS the same as the CPC?

No. CBCS is NHA's combined billing-and-coding credential. CPC is AAPC's professional-coding credential. They have different blueprints, owners, and exam-book rules.

Does CBCS certification give me a state license?

No. NHA says its certification rules are separate from state practice or licensing requirements. Check the state oversight body and employer requirements for the role you want.

Are the six questions in the planner real CBCS questions?

No. They are original Castleport format demonstrations written from public rules and the public blueprint. They are not recalled, leaked, or live exam items, and six questions cannot predict your result.

Your next step

If you have read this far, you already know the decisions that cost candidates the most. You know what you do not have to buy for exam day. You know the four-domain weight. You know what 390 means — and what it does not. You know the retake cliff after the third failure. You know how to tell whether the book on your desk belongs to the current exam.

The only thing left is putting the work on a calendar.

Build your CBCS study plan from the exam you are actually sitting

Your test date, your available hours, your prior score bands, your delivery setting, and the vintage of the material on your desk. Free, no sign-up, nothing stored by the component itself. Build my CBCS study plan →

Castleport Test Prep is an independent publisher and is not affiliated with, endorsed by, or approved by the National Healthcareer Association, AAPC, AHIMA, or any exam owner, certifying body, testing vendor, or government board. Exam and credential names are used descriptively to identify the examinations discussed. Castleport claims no ownership in those names or marks.

This page is study guidance, not legal, licensing, medical, employment, or career advice. The exam owner sets and changes its own eligibility, fees, policies, scoring, permitted materials, and delivery rules. Confirm current requirements in your own registration record before payment or travel.

The planner's weighting formula and all format-demonstration questions are original Castleport editorial tools built from public blueprints and public rules. They do not reproduce live or recalled exam content, do not predict an outcome, and do not guarantee a passing score. Castleport does not offer a pass guarantee.

Written and verified by the Castleport Test Prep Editorial Team. Last verified August 17, 2026. Found something out of date? Use the process described in our corrections policy.