How to Become a Medical Biller and Coder: Step by Step

The job has two halves.

The coding side reads clinical documentation and assigns the code sets the entry exams test — the CPC exam, for one, covers ICD-10-CM for diagnosis codes, CPT for procedure codes and HCPCS Level II for procedure and supply codes.

The billing side turns that work into claims, sends them to payers and follows up until the provider is paid.

Credentials and courses exist for each half and for the combined seat — the combined path is the one this page walks.

Our medical billing and coding specialist career guide covers what the work looks like day to day; this page is about getting in.

On education, BLS says medical records specialists — the occupation that includes medical coders (SOC 29-2072) — typically need a postsecondary certificate to enter, although some qualify with a high school diploma and others may need an associate's degree.

BLS lists the typical entry education as a postsecondary nondegree award, with no work experience in a related occupation and no on-the-job training typically needed.

The billing half sits in a different BLS group: billing and posting clerks (SOC 43-3021), a financial-clerks group that BLS says typically needs a high school diploma or equivalent and learns the job through on-the-job training.

The floor is not fixed even on the coding side.

BLS says a high school diploma or equivalent plus experience in a healthcare setting qualifies a person for some medical records specialist positions, while others ask for a postsecondary certificate or an associate's or bachelor's degree.

Certification is the other piece employers talk about.

BLS says employers may prefer to hire medical records specialists who have certification, or may expect applicants to earn it shortly after being hired.

That is the pattern this page builds around: train, certify, then close the experience gap.

On pay and outlook, BLS reported a May 2025 median annual wage of $51,140 for medical records specialists — the closest available BLS group to coding, since the occupation also includes records staff who do not code.

It projects 8% employment growth from 2025 to 2035, which BLS calls much faster than average.

The medical billing and coding specialist salary page breaks the figures down by state.

Start from what BLS describes: community colleges and technical schools offer certificate and associate's degree programs for medical records specialists, typically including courses in medical terminology, health data requirements and standards, and classification and coding systems.

For non-degree certificate programs, AHIMA runs an approval program worth knowing about.

Its Professional Certificate Approval Program (PCAP) is AHIMA's approval pathway for non-degree coding certificate programs, which AHIMA calls the national benchmark for non-degree coding and health information certificate programs.

PCAP-approved programs must give students access to a minimum of 150 real-world coding cases — inpatient and outpatient, including clinic, same-day surgery and emergency department cases.

AHIMA's PCAP manual (revised May 2023) sets the minimum content, and the listed minimums add up to 405 contact hours.

That covers 45 hours each of medical terminology, anatomy and physiology and pathophysiology/pharmacology, 90 hours each of ICD and CPT coding, shorter blocks in health information and delivery systems, reimbursement and legal and compliance, and a 45-hour professional practice experience.

The practice experience must include at least 40 hours of authentic coding from real patient records, and it may be field-based or fully virtual when conditions are met.

AAPC structures its own path by background instead.

People without 2 years of healthcare experience should start with what AAPC calls 'the Essentials' — anatomy, medical terminology and pathophysiology — while those with formal medical education or more than 2 years of field experience can skip them.

Students in AAPC's self-paced or instructor-led CPC courses need its Fundamentals of Medicine course or equivalent real-world experience with those subjects; the Job-Ready program builds the prerequisite content in.

The CPC course itself covers CPT, HCPCS and ICD-10-CM coding for professional (physician) services, with practice on real redacted medical records, E/M level determination and operative-report coding.

Completing a program is not the same as holding a national certification.

BLS notes that certifications usually require candidates to pass an exam and might require previous experience or education, and that certificate or degree programs may help students meet those requirements.

The credential comes from the credentialing body's exam, whatever the school hands you at the end.

When you compare actual programs, two of our guides go deeper: online medical billing and coding programs covers how to pick one, and online medical coding courses covers coding-only course design.

Take the 'required' half of the question first, because the sources line up on it.

AHIMA says taking its certification exams is voluntary.

AAPC says no degree is required for medical coding, though certification and training are typically preferred by employers.

And BLS says employers may prefer to hire people who already hold certification, or may expect new hires to earn it shortly after starting.

So no single credential is named as the door to the field, though both AAPC and BLS describe employers preferring certification.

AAPC names CPC, COC, CIC and CRC as its four main core coding certifications, with the CPB for billers, and says the most popular first-certification choices are the CPC and the CPC+CPB combination.

For a seat that covers both halves of the job, those fit directly: the CPC+CPB pairs the coding credential with the billing one, and NHA's CBCS — Certified Billing & Coding Specialist — is named for the combined role outright.

Eligibility rules differ by body, and each is short.

AHIMA's CCA requires only a high school diploma; six months of coding experience, an AHIMA-approved coding program or other coding training are recommended, not required.

NHA's CBCS asks for a high school diploma or GED, or one expected within 18 months.

It also asks for either a billing and coding training program completed within the last 5 years or supervised billing and coding work experience — 1 year within the last 3, or 2 years within the last 5.

AAPC describes its prerequisite Essentials courses as optional, noting students perform better academically in its certification courses with that preparation.

One AAPC-specific rule shapes first jobs.

Pass the CPC exam without the required experience and the credential comes with an apprentice 'A' attached — CPC-A — which AAPC calls a temporary step until you show 2 years of coding experience or approved substitutes.

If you are weighing the CCA as your entry exam, AHIMA publishes its own outcome data: a 62% first-time pass rate in 2025, with 2,101 first-time testers, and 7,753 people holding the credential as of December 31, 2025.

The credential-by-credential comparison — AAPC, AHIMA and NHA side by side, with exam formats and renewal — lives in medical billing and coding certification.

Certification exams test knowledge; the experience requirement is about coded work.

AAPC's answer to that gap is the apprentice 'A', and it lists four ways to remove it: 2 years of coding employment, 1 year of employment plus education, Practicode plus an 80-hour coding course, or its Job-Ready Program.

The course-plus-Practicode route is the one that finishes before a first job.

AAPC says an approved 80-hour medical coding course removes one year of the apprentice experience requirement and its Practicode program removes the second, so doing both satisfies the whole requirement before a first coding job.

The course credit can be documented with an instructor letter on school letterhead, a certificate or diploma, or an unofficial transcript showing at least 80 contact hours — not CEUs — and AAPC accepts an equivalent course from an instructor or school, not only its own.

Practicode itself requires a minimum of 600 cases with an overall score of 70% or higher.

Externships are another way in.

AAPC's Xtern Program matches newly certified coders with participating employers for a 160-hour supervised externship; candidates must hold an AAPC certification and have completed formal coding training or have prior healthcare experience.

Xtern onboarding includes a background check, documents (membership card, ID and waiver) and HIPAA Privacy training, and after the 160 hours the employer may — but is not obligated to — offer a job.

Placement through AAPC's Job-Ready program is for qualified graduates only (as of October 2026).

Requirements AAPC lists include completing the CPC or CPC+CPB course through AAPC with course scores of 87% (B+) or better, no more than two absences, and 70% or higher on the certification exam(s).

Placements then give a minimum of 160 hours of hands-on work with partner employers.

AAPC calls that placement guaranteed — for the graduates who clear those thresholds.

There is also the federal registered-apprenticeship route, which is a different thing from the CPC-A.

The Department of Labor's Office of Apprenticeship recognizes 'Medical Coder/Biller' as an apprenticeable occupation (RAPIDS 1114CB), revised in 2018 from time-based to competency-based training at the AHIMA Foundation's request.

Registered Apprenticeships are employer-sponsored programs registered with the DOL or a State Apprenticeship Agency; the apprentice 'A' is credential status attached to AAPC's CPC.

Three clocks stack: training, the exam and the experience period after it.

The training clock has published numbers; the other two depend on the route you pick.

On the training side, AAPC's self-paced CPC course has an average completion time of 4 to 8 months with 6 months of access, and its instructor-led course runs 16 weeks via weekly live online sessions of 1.5 hours (figures as of October 2026).

The CPC+CPB combined course runs 32 weeks instructor-led — 16 weeks for each half — and the Job-Ready version is a 30-week program followed by a 16-week live virtual internship.

A certificate program built to AHIMA's PCAP minimums carries 405 contact hours of minimum content.

No single month count covers every route: training length, exam scheduling and the experience path stack differently for each person.

What the sources do not support is a shortcut — the credential requires passing an exam, and the apprentice period runs on the rules above.

For new coders, the first-job question is the CPC-A question: can you get hired with an apprentice credential?

AAPC — which publishes the CPC-A and sells the training — says most employers are familiar with apprentice credentials and regularly hire certified entry-level coders for trainee, support, billing, revenue cycle and physician office roles.

Treat that as the credential publisher's read, but it names the job families worth targeting.

Read postings by duties, not titles.

AAPC says job titles alone do not determine apprentice-removal eligibility — what matters is whether the duties involve qualifying coding work using CPT, ICD-10-CM or HCPCS Level II.

When you scan ads, look for what the duties involve rather than the word in the job title.

If you came through an externship, work it.

The employer that supervised your 160 hours has seen your output, and AAPC says it may offer a job — though nothing obligates it to.

Ask the supervisor who reviewed your work to be a reference, and keep the case types you handled specific on your resume.

When you are ready to look, our medical billing and coding specialist jobs page collects live openings in one place, filterable by salary and benefits.

Career information, not coding, billing-compliance, legal or tax advice. Confirm certification, exam and program details with AAPC, AHIMA, NHA or the school you are considering.