Medical billing and coding certification: which one to get

Start with the work you want to do

These are five starting options, not every credential and not a promise that any employer accepts a particular one. The work-to-credential matches are editorial guidance based on each issuer's stated scope: AAPC's billing/coding distinction, CCA, CCS, and CBCS.

The full names are Certified Professional Coder (CPC), Certified Professional Biller (CPB), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), and Certified Billing and Coding Specialist (CBCS). AAPC's exam reference sheet identifies its two credentials; the AHIMA and NHA pages above identify theirs.

Is a course certificate the same as certification?

No. A course completion certificate and professional certification are different things.

Three different things get called "certification":

• A course completion certificate is a document from a school or training company saying you finished their training. They set the rules. It is not one of these professional certifications.
• A professional certification is awarded by a certifying organization after you pass its exam and meet its rules. CPC, CPB, CCA, CCS and CBCS are all in this group.
• An employer's hiring requirement is whatever that employer decides to ask for. It may name one of these credentials, several, or none.

Finishing a training program does not award you any of the five credentials. A program may include an exam voucher — but the voucher is a payment, not a pass.

Billing and coding are also two jobs. A coder turns clinical documentation into standardized codes. A biller turns those codes into a claim, sends it, and chases the ones that don't get paid. The duties can overlap, but a billing credential and a coding credential are not interchangeable. AAPC explains the distinction.

One more option worth knowing about: AHIMA also offers the **CCS-P (Certified Coding Specialist–Physician-based)** for physician-office and specialty settings. If that's your target and an employer names it, compare it directly rather than assuming the CPC is the only route there.

Can you sit for it?

Eligibility, not preference, is what actually removes options from your list. Keep three things separate: what the exam requires, what the organization recommends, and what a job posting asks for.

Sources: AAPC registration prerequisites and apprentice status · AHIMA CCA and Candidate Guide, printed p. 5 · AHIMA CCS · NHA Candidate Handbook, pp. 6–8.

For CBCS training eligibility, NHA specifies recognized training providers and other approved routes, including registered apprenticeship and military training. Its training rule says completion five years or more before registration does not qualify through that route. Qualifying work experience is a separate route. NHA also permits certain institution-arranged pre-externship and employer-training examinations; passing does not remove the remaining completion requirements. High school candidates can qualify for provisional certification up to 12 months before graduation under the handbook's conditions. A provisional credential lasts 12 months and must be converted to full certification; it is not an ordinary two-year credential. NHA Candidate Handbook, pp. 6–8 and 35.

Two things worth pausing on.

The CCS row surprises people. Because none of AHIMA's five pathways is mandatory, a candidate who already has two years of coding experience can go straight to the CCS. And AHIMA's own credential hierarchy says the CCS supersedes the CCA — once the CCS is granted, the CCA is replaced and you no longer have to recertify it. Taking the CCA first therefore adds a separate examination; it is not an obligatory step toward CCS. Compare the CCS preparation recommendations with your actual experience before choosing that route. The replacement rule is in the AHIMA Recertification Guide, p. 5.

And on degrees: none of these five exams requires a college degree. The federal Occupational Outlook Handbook lists a postsecondary nondegree award as the typical entry-level education for medical records specialists and notes that some people qualify with a high school diploma. That doesn't cancel a particular employer's own education requirement. BLS: How to Become a Medical Records Specialist.

What does CPC-A mean?

Pass the CPC with the apprentice requirement still unmet and AAPC issues your credential as CPC-A. The A stands for apprentice. It is not a different or easier exam. AAPC apprentice-status policy.

AAPC's standard is two years of coding experience, but its policies allow specified education and applied-experience credit. Its published documentation options include:

1. Two years of verified coding work. AAPC's documentation page describes signed experience letters, including employer verification.
2. One year of verified experience plus at least 80 contact hours of coding education. The education evidence must establish the contact hours; a CEU total is not a substitute for that evidence.
3. Approved applied-experience credit. AAPC also grants one year toward apprentice removal for successful completion of its qualifying coding practicum. That is experience credit, not an 80-contact-hour course and not proof of paid employment.

These are types of evidence and credit, not three interchangeable promises of automatic removal. Use AAPC's education/work documentation rules and applied-experience credit rule to identify what your completed work satisfies.

If your plan is "pass the CPC, then get hired," plan the apprentice requirement separately from the job search. Clearing the A does not make an employer's work-experience requirement disappear.

What each exam is actually like

Sources: AAPC exam instructions, p. 3, exam length, CPC passing score, and CPB details · AHIMA CCA and CCS · NHA CBCS test plan, p. 1, Candidate Handbook, pp. 31–32, and CBCS FAQ, p. 1.

Pretest questions do not count toward the score. A scaled score is not a percent correct: 390 on NHA's scale does not mean 78% correct, and AHIMA's 300 is not a raw-question target. NHA scoring explanation · AHIMA Candidate Guide, Appendix D: scaled-score explanation.

For AAPC, permitted print books can be from the current or preceding year, one copy of each; approved eBooks are supplied through the examination platform's shared library. Select the permitted format in advance rather than assuming a personal eBook is allowed. AAPC's 2026 HCPCS transition took effect on 2 March 2026. AAPC reference rules · Exam instructions, p. 3.

For CBCS, the no-manual rule took effect on 24 September 2024 and is repeated in NHA's current what-to-bring instructions. Do not apply the open-book rules from CPC, CCA or CCS to this exam.

Where you'll actually take it

An online course and an at-home exam are two different decisions. Check the second one before you commit to the first.

Delivery sources: AAPC exam instructions, pp. 1–2 · CCA and CCS, “Exam testing location” · NHA CBCS: Set a date.

Three test-day rules to plan around

1. Wrong code books, no exam. AHIMA publishes a required code-book list per exam cycle. Exams delivered on or after 1 May 2026 require the 2026 books (CCA list, CCS list). Show up without them and you are not allowed to test and you forfeit the fee. Check the list against your appointment date, not against the year on the calendar.
2. The CCA is one-way. No going back, no flagging. Every answer is final once you move on. Practice deciding and moving forward. The CCS is different: you can return after selecting an answer, and you can flag items for review. CCA exam functionality · CCS exam functionality.
3. Late can mean a lost fee. AHIMA treats a no-show, or an arrival more than thirty minutes late, as a forfeited fee and requires a new application at full price. For NHA appointments at PSI centers or by live remote proctoring, cancel or reschedule at least 24 hours ahead to avoid forfeiture; institution-administered arrangements have different rules. AHIMA cancellation policy · NHA Candidate Handbook, p. 21.

NHA requires one continuous examination session; you cannot stop and resume it later. That session rule is not the same thing as AHIMA's CCA restriction on returning to individual questions. NHA Candidate Handbook, p. 25.

And one scheduling quirk worth knowing: AAPC runs an annual exam blackout starting December 30 while it implements the next year's exam updates. No exams run during it, and they resume on the second Monday of January. If you were planning to squeeze a test in between the holidays, plan around that instead.

What it costs to get, and what it costs to keep

The exam fee is not the cost of being certified. It covers the examination attempt or attempts you purchase, not every expense before and after passing.

Exam fees

Checked 11 September 2026 against AAPC's published exam fees, the AHIMA CCA and CCS pages, and the NHA Candidate Handbook, p. 5. Institutional, promotional and other pricing can differ. Confirm the amount that applies to your own application before you pay.

Two notes on the AAPC rows. If you pass on the first attempt, the second attempt is not transferable to another exam. The standard-price gap between one and two attempts is $74; at the published student prices it is $75. Neither option includes every other cost in your certification plan.

Renewal, and the difference that matters most

Sources: AAPC CEU policy · AHIMA Recertification Guide, pp. 4, 7 and 14 and Recertify · NHA renewal fees and Candidate Handbook, pp. 36–37.

CEU means continuing education unit. NHA uses "CE credits" and its own conversion, so don't treat the numbers across the three organizations as comparable — a smaller number doesn't automatically mean less work.

Use the actual dates in your credential account. AAPC's first CEU submission can be prorated to its membership-based cycle. NHA provisional certification has a 12-month conversion limit, not the full credential's two-year renewal period. AAPC CEU policy · NHA Candidate Handbook, p. 35.

Here is the difference the sticker price hides. AAPC requires you to stay a paying member to maintain the credential. AHIMA membership is optional; NHA publishes a renewal fee rather than the same annual-dues requirement. That isn't a criticism of AAPC — it's a different model. But it means the cheapest exam fee does not establish the cheapest long-term credential. Price the decade, not the day.

One subtraction worth doing: the $249 fee difference

For either AHIMA credential, the standard member rates save $249 across one examination and one renewal at the prices above:

CCA, as a non-member: $299 exam + $249 first renewal = $548.

CCA, at member rates: $199 exam + $100 first renewal = $299, plus the membership dues needed to qualify for both rates.

The CCS works out identically — $648 as a non-member, $399 at member rates before dues, a $249 gap — because the member discount is $100 on the exam and $149 on the renewal either way.

So: compare $249 with the actual extra dues you would pay to qualify for member pricing at both payment dates. Do not automatically multiply an annual rate by two: the date you join, the date you apply, and the first recertification deadline determine which membership payments your plan needs. If the extra dues are below $249, member pricing saves money on these two fees; at $249 it breaks even. Above $249, these two discounts alone do not cover the extra dues.

That arithmetic is ours, built from AHIMA's exam fees and standard recertification fees. It assumes one successful exam attempt and one renewal, holding today's rates constant. It is not a promise of the fee charged when you renew. Training, code books, travel and CEU costs are excluded.

For AAPC there's no equivalent optional-membership calculation, because membership isn't the cheaper option — it's a condition of keeping the credential. Treat it as a fixed recurring line in your budget and check the dues that apply to you before you commit.

Other fees to budget for

AHIMA charges $30 to cancel or reschedule between 14 days and 24 hours before the appointment; you cannot reschedule less than 24 hours ahead. A refund request has a $75 processing fee and must meet AHIMA's deadline, normally at least 14 business days before the scheduled test or eligibility end date. Missing that deadline is not solved by paying the processing fee. AHIMA cancellation and refund rules.

AHIMA also lists a $50 late recertification fee per credential and a $368 reinstatement fee for the applicable reinstatement route. The fee alone does not satisfy the education or other reinstatement requirements. AHIMA Recertification Guide, pp. 14–17.

Before you pay: eight checks

Fill these in before you choose a program or buy an exam voucher. A blank answer is a question to go resolve — not evidence that the cost doesn't exist.

1. The work. What tasks, in what setting? "Healthcare" and "remote" aren't answers. "Outpatient physician coding" and "hospital inpatient coding" are.
2. The postings. Open three real job listings for that work, in the area where you'd actually apply. Write down the exact credential wording each one uses, and whether it says required or preferred. Three postings is not a labor market survey — it's a reality check, and it is more useful for your own decision than a generic national ranking.
3. The credential and who awards it. Full name, issuing organization, and a link to its official requirements. If a school's certificate is also involved, list it separately.
4. Your eligibility route. Which published route do you actually satisfy, what document proves it, and what designation would you receive on day one? Include CPC-A if that applies.
5. Your preparation fit. Compare your training and work with the official exam outline. Record the topics you can already apply and the ones you still need to learn. Eligibility is not a study plan.
6. Your timeline and testing arrangement. Separate learning time, application and appointment availability, examination time, and any status or experience requirement after passing. Record the delivery setting, reference-book edition and any accommodation request you need to make before booking.
7. The full initial cost. Use this: training + exam or voucher + required membership + materials not already included + testing and travel costs − confirmed funding. Mark anything already covered as "included in [named package]" so you don't count it twice. Mark anything unquoted as not quoted — never as zero. Keep a possible retake as its own line. Write down the provider's refund and cancellation terms in their own words.
8. After you pass. Renewal cycle, CEU requirement, renewal fee, and any experience status still to clear.

When the credential matches the work, you understand your eligibility route, and the real costs are written down, you have enough to make the next decision. That's the point of the exercise. It isn't an eligibility determination, and nothing here can tell you whether you'll pass.

What the checks look like in practice

Hypothetical example — not an actual job posting or a hiring prediction: a physician-practice vacancy names CPC and separately requires two years of paid coding work. The applicant has coding education but no coding job experience.

The credential fits the work. That does not settle the application: the applicant must check both the designation they would hold after passing and the employer's separate experience requirement. Even accepted apprentice-removal credit does not, by itself, establish two years of paid work. The useful next action is to ask whether the employer accepts apprentice applicants or training-based credit — before treating the exam fee as the whole path to that vacancy.

For the preparation check, use the free CCA outline, CCS outline, or CBCS test plan when one of those is on your shortlist. For CPC or CPB, start with AAPC's exam specifications and permitted-reference instructions. These documents define scope and administration; they do not establish how many hours you personally need to study.

What the published pass rates actually say

AHIMA publishes first-time-tester pass rates for its exams. These are AHIMA's figures, first attempts only:

Sources: AHIMA CCA: Certified Professionals and Pass Rates · AHIMA CCS: Certified Professionals and Pass Rates.

Read the denominator before you read the number. These count first-time testers only, not every attempt, and AHIMA publishes the percentages rounded — don't convert them back into a headcount. AHIMA also reports 7,753 CCA holders and 36,925 CCS holders as of 31 December 2025.

The part worth sitting with. In 2025 the entry-level credential had the lower first-time pass rate and the advanced one had the higher. Those figures do not report the candidates' preparation or experience, so they cannot tell us why. A pass rate describes a population as much as a test. It does not, by itself, measure difficulty, and it can't forecast your result.

You can't line these up against AAPC's number. AAPC publishes that 80% of AAPC students pass on the first attempt. That describes AAPC students, not everyone who sits the exam. Different population, different meaning. The AAPC page making that statement does not supply an exam-specific cohort size or reporting year for it.

NHA does publish a CBCS rate, but its denominator is different again. Its 2025 annual report lists 7,878 CBCS examinations administered and a 71.33% pass rate. That is an examination-administration cohort, not a table labeled first-time testers. Keep it separate from AHIMA's first-attempt figures; do not use these numbers to rank which credential is easiest.

What the work pays, and the caveat BLS includes

The federal government uses separate occupational categories for medical records specialists and billing and posting clerks. Neither is a salary survey of people holding one particular certification.

Medical Records Specialists (SOC 29-2072) — the occupation that includes medical coding. Median annual wage $51,140 in May 2025, against $50,980 for all occupations. The lowest 10% earned under $37,000; the highest 10% earned over $81,150. Employment was 200,700 in 2025 and is projected to reach 216,300 by 2035 — 8% growth, against 3% for all occupations — with about 14,000 openings a year. Where you work matters: hospitals paid a median of $59,120, offices of physicians $47,120. (BLS Occupational Outlook Handbook)

Those annual openings include replacements for people leaving the occupation, not just newly created jobs. The median is not an entry-level salary or a promised result of certification. BLS: Pay and Job Outlook.

Billing and Posting Clerks (SOC 43-3021) is broader than medical billing: it covers multiple industries and explicitly excludes medical records specialists. Its May 2023 historical median was $45,590. (BLS archived May 2023 occupation profile) That is neither a current medical-biller salary estimate nor a same-year comparison with the May 2025 figure above.

And the caveat that belongs beside the growth figure. BLS also says increasing adoption of AI-powered solutions that make medical coding more efficient may affect demand for these workers. Both things sit in the federal projection at once: growth above the national average, and a named headwind. Both belong in a description of the outlook. BLS: Employment.

Is any of this a license?

No. These are professional certifications from private organizations, not licenses to practice issued by a state.

An employer can still require a credential for a particular job. NHA states directly that its eligibility requirements are separate and distinct from any state requirements to practice, that those rules vary, and that you're responsible for checking with the oversight body in the state where you plan to work. That distinction matters for all five credentials; this comparison is not a 50-state licensing determination. If you have any reason to think your state or your specific setting regulates this work, ask that state body — not a school's admissions page, and not us. NHA Candidate Handbook, p. 12 · BLS: Licenses, Certifications, and Registrations.

Questions people ask

Can I hold more than one certification?

Yes, but two credentials do not always mean two of every fee or CEU requirement. AAPC requires 40 CEUs for two certifications, not 72. AHIMA adds 10 CEUs per additional credential, capped at 50 total, and ordinarily adds $20 per additional credential for members or $50 for non-members; Premier members have a different additional-credential fee. The CCS/CCA replacement rule still applies. NHA's 10-credit requirement can cover multiple non-pharmacy credentials, but stacked certifications have additional fees. Credentials from different organizations must each satisfy their own issuer's rules. AAPC CEU policy · AHIMA Recertification Guide, pp. 5 and 14 · NHA renewal rules.

How many times can I retake it?

AHIMA requires at least a thirty-day wait before a new application can be approved after an unsuccessful CCA or CCS attempt, and a new application at the full fee. NHA allows the first three attempts with at least thirty days between attempts; after a third failure, and after each later failure, you wait one year. You re-register and pay the full fee each time. AAPC's two-attempt option describes what that voucher covers, not a lifetime limit on attempts. AHIMA CCA and CCS retake policies · NHA Candidate Handbook, p. 34 · AAPC attempt pricing.

What happens if I let it lapse?

With AHIMA, the credential goes Inactive for six months, then Temporarily Revoked for six more, then Permanently Revoked if the requirements remain unmet — and you may not use the letters while the credential is not Active. There's a $50 late fee per credential and a $368 fee for the applicable reinstatement route. AHIMA Recertification Guide, pp. 14–17.

NHA has a grace period during which ordinary renewal remains available without an additional fee. After that grace period, reinstatement within the first year requires 15 CE credits and reinstatement payments, rather than the usual 10-credit renewal. Once the reinstatement window closes, you must retake the exam at full price. Check the exact deadline in your NHA account; the provisional-credential rules are different. NHA renewal and reinstatement · Candidate Handbook, pp. 36–37.

For AAPC, don't treat the two-year CEU cycle as permission to miss annual dues: its maintenance policy requires membership payment every year.

How long does it take?

There's no single honest answer, because four separate clocks are involved: learning time, application and scheduling time, the exam itself, and any experience status you still have to clear afterward. Plan them separately. For a rough planning frame, dividing your total planned study hours by realistic weekly hours gives you a number of study weeks — but both of those inputs are yours, not an official minimum, and scheduling and eligibility sit on top.

Your next step

Complete the eight checks above for the credential on your shortlist. Resolve the missing eligibility evidence or unquoted cost before paying; completing a comparison is useful even when the answer is to wait, choose a different credential, or apply for a role that accepts your current experience.

For the wider set of health information credentials, start at the health information hub. For the five credentials here, the issuing organizations' requirements linked throughout this article are the right next stop.

Sources and how we checked

The links beside each table and explanation go to the issuing organizations or the U.S. Bureau of Labor Statistics. The comparison uses official-source research, not firsthand exam or program evaluation. The work-to-credential matches, the eight pre-payment checks and the hypothetical vacancy example are editorial guidance. The fee calculations show their inputs and exclusions.

This article was developed and checked with AI assistance. That is not credentialed professional review. See Castleport's editorial standards.

Last verified: 11 September 2026, covering the cited exam formats, published fees, eligibility rules, renewal requirements, pass-rate datasets and labor-market figures. Candidate-specific application prices and membership dues must be checked in the applicable account. Fees and rules change. Confirm yours with the issuing organization before you register or pay.

Independence. Castleport Test Prep is an independent exam prep publisher. We are not affiliated with, endorsed by, or approved by AAPC, the American Health Information Management Association (AHIMA), or the National Healthcareer Association (NHA). Exam and credential names are used to identify their subjects, and trademarks belong to their respective owners. Nothing here guarantees certification, employment, pay, or licensure.

Castleport Test Prep Editorial Team