Which certification a medical billing and coding job requires has no single answer in the federal sources.
BLS says certification may be required or preferred for medical records specialists — the BLS occupation that includes medical coders — and that employers may prefer certified applicants or expect certification shortly after hire.
The credentials aimed at the work are AAPC's CPC and CPB, NHA's CBCS, AMBA's CMRS, AMCA's MCBC and AHIMA's CCA.
This guide maps each credential, separates certificates from certifications, and walks through how to get and keep one.
What is medical billing and coding certification?
Certification in medical billing and coding is a credential you earn by passing an examination written and scored by a credentialing body — not by finishing a class.
The bodies behind the credentials in this field are AAPC, AHIMA, NHA, AMBA and AMCA.
Each sets its own rules — eligibility, exam format, passing standard, continuing education and renewal — and the four this page details differ on all of them, which is why every figure below is quoted body by body.
The list of credentials is longer than the name of the field suggests.
AAPC describes itself as the nation's largest education and credentialing organization for medical coders, billers, auditors, practice managers and revenue cycle managers, with a network of more than 300,000 professionals.
It names the CPC, COC, CIC and CRC as its four main core coding certifications, plus the CPB for billers.
AHIMA's credential list, as of 2026-10-13, runs CCA, CCS, CCS-P, RHIT, RHIA, CDIP, CHDA and CHPS.
NHA issues the CBCS, the Certified Billing and Coding Specialist credential whose test plan spans coding and billing and reimbursement domains; AMBA issues the CMRS; AMCA issues the MCBC, a combined coder-and-biller credential.
These are national certifications issued by credentialing bodies.
A certification is not a license and not a job title, and it is separate from the work itself — what the combined role does day to day is the subject of our medical billing and coding specialist career guide.
As for whether you need one, the federal sources hedge.
BLS says certification may be required or preferred for medical records specialists, the BLS occupation that includes medical coders, and that employers may prefer certified applicants or expect certification shortly after hire.
AHIMA states plainly that taking its certification exams is voluntary.
Certificate vs certification: what is the difference?
A certificate and a certification are two different things that share part of one word.
A certificate is a training program: you complete coursework at a college, a career school or a credentialing body's own course, and the school hands you a certificate of completion.
A certification is earned by passing a credentialing examination.
AHIMA draws the line precisely on its CCA page: the certification comes from passing the exam, while training programs count only as recommended preparation.
NAMSS, the credentialing body for medical services professionals, publishes the same kind of guidance distinguishing its certification programs from certificate programs.
The distinction matters because the training and the credential are two separate steps, with two separate costs and two separate issuers.
BLS says medical records specialists typically need a postsecondary certificate to enter the occupation, and that certification may be required or preferred — so the school certificate is the preparation, and the certification is the credential an employer may ask for on top of it.
It also means finishing a course does not, by itself, make anyone a certified coder or biller.
The certification only exists once the credentialing body records that you passed its exam.
Which credentials cover billing, coding or both?
The credentials split three ways: coding-only, billing-only, and credentials written for the combined job.
The formats and fees below are the credentialing bodies' own published figures, as of 2026-10-13.
| Credential | Body | Built for | Exam and fee |
|---|---|---|---|
| CPC | AAPC | Coding across outpatient and physician services — ICD-10-CM, CPT and HCPCS Level II | 100 questions in 4 hours; 70% to pass; $425 for 1 attempt or $499 for 2 |
| CPB | AAPC | Billing — insurance plan types, the claim life cycle, denial resolution and related laws | 135 questions in 4 hours, including 34 cases; $425 for 1 attempt or $499 for 2 |
| CBCS | NHA | The combined billing-and-coding job, tested across four domains from coding to billing and reimbursement | 100 scored items plus 25 pretest in 3 hours; scaled passing score 390; no code books since September 24, 2024 |
| CMRS | AMBA | Medical billing | 16 sections, 694 answers, online and open-book, 45 days to complete; 85% to pass; requires AMBA membership ($99 a year) |
| MCBC | AMCA | Medical Coder and Biller — both halves, renamed from the BCSC on May 11, 2018 | Offered online or on paper |
| CCA | AHIMA | Coding credential at the base of AHIMA's ladder — the only eligibility is a high school diploma | 105 questions in 2 hours; $199 for members or $299 for non-members |
| CCS | AHIMA | Mastery-level coding, generally in the hospital setting | 107 questions in 4 hours; $299 for members or $399 for non-members |
| CCS-P | AHIMA | Mastery-level coding for physician-based settings — offices, group practices, clinics | 121 questions in 4 hours; $299 for members or $399 for non-members |
For the combined job, AAPC says the most popular choices for a first certification are the CPC and the CPC paired with the CPB — the pairing that covers both halves of the seat.
AAPC draws its own scope line between the two: the CPB course emphasizes billing and only lightly touches coding, while the CPC course teaches physician-office coding.
The CPB, CIC, CRC, CPMA, CPCO and CPPM — and AAPC's specialty credentials — are stand-alone: none requires holding the CPC, COC or CPC-P first.
One AAPC wrinkle: passing the CPC exam without two years of coding experience earns the CPC-A, an apprentice designation, and AAPC's exam agreement applies that A to the CPC and COC only.
The CPB is not one of them — the agreement names the CPC and COC only — so a first-time biller who passes the CPB is simply CPB certified.
NHA's CBCS is the credential with the combined job in its name, and NHA states that all of its certification programs, CBCS included, are accredited by the National Commission for Certifying Agencies (NCCA).
Its eligibility is built for newer entrants: a high school diploma or GED plus a billing and coding training program completed within the last five years, or supervised billing and coding work experience in place of the program — one year in the last three years, or two years in the last five.
AHIMA's ladder starts at the CCA, whose only eligibility requirement is a high school diploma, with six months of coding experience or a coding training program recommended.
The CCS and CCS-P above it have no required eligibility — AHIMA recommends coding experience instead — and under AHIMA's 2026 credential hierarchy, passing either one supersedes the CCA, which then no longer needs recertification.
AAPC's other three core coding credentials point at different seats: the COC validates outpatient hospital and facility coding, including APC reimbursement and same-day surgery, ED and hospital outpatient clinic services; the CIC covers inpatient hospital coding built on ICD-10-PCS procedure codes and ICD-10-CM diagnosis codes; and the CRC exam focuses on the ICD-10-CM diagnosis coding used in risk adjustment.
Which one do small practices and billing companies ask for?
Start with what the sources say, because the sources we read do not tie a specific credential to the small-practice job.
BLS says employers may prefer to hire certified medical records specialists or expect them to earn certification shortly after being hired.
AAPC, which sells the training, says no degree is required for medical coding, though certification and training are typically preferred by employers.
Where a posting does name a credential, the names that map to the combined seat are predictable.
AAPC says the CPC, alone or paired with the CPB, is the most popular first certification, and describes CPC-As as qualifying for entry-level roles that include billing and coding specialist, coding trainee, prior authorization specialist and insurance claims specialist.
NHA's CBCS — Certified Billing and Coding Specialist — tests coding alongside billing and reimbursement domains, and AMCA's MCBC carries coder and biller in its name.
What our research does not have is the share.
No verified figure says what percentage of postings require certification or accept a CPC-A, so the practical version of this question is to read the postings themselves — the medical billing and coding specialist jobs on the board show which credentials employers near you name.
Whether a credential also moves pay is a pay question, not a certification question.
The billing and coding salary page carries the federal wage figures for the field, each labeled with its closest BLS occupation group.
How to get certified step by step
The path has the same shape at each body this page details: pick the credential, confirm eligibility, prepare, join, buy the exam, sit, then read the result against the apprentice rules.
The details below come from each body's own pages as of 2026-10-13.
Pick the credential that matches the seat you want
Coding-first seats point at the CPC or AHIMA's CCA; billing seats at the CPB or CMRS; the combined small-practice job at the CPC+CPB pair or the CBCS. AAPC says the CPC and the CPC+CPB options are the most popular first certifications.Confirm you are eligible to sit
AAPC's requirements are procedural: current membership, a valid email and address on file, an unused exam voucher and a government photo ID. No degree or work experience is required to sit for the CPC, though AAPC recommends two years of experience in the field. AHIMA's CCA requires only a high school diploma. NHA's CBCS requires a diploma or GED plus a training program completed within five years, or supervised work experience instead. AMBA's CMRS requires AMBA membership and a high school diploma, with no prerequisite courses.Prepare against the current code sets
AAPC builds its exams on the current calendar year's code sets and rebuilds them every January. AAPC says most people complete its CPC coursework and pass the exam in 4 to 8 months. The CPC itself runs 100 multiple-choice questions in four hours, and a passing score is 70% — at least 70 of the 100 questions.Join the body and buy the exam
AAPC requires active membership to sit for its exams and to keep the credential afterward — $229 a year as of 2026-10-13. Core exams cost $425 for one attempt or $499 for two, and student pricing is $400 for one attempt or $475 for two. Fees are non-refundable, a voucher must be used within one year, and the two-attempt voucher is how AAPC sells a retake. AHIMA's CCA costs $199 for members or $299 for non-members as of 2026-10-13.Schedule and sit
AAPC asks candidates to register three weeks before the exam date, and its exams run at home with a live remote proctor or on a computer at a testing center — all AAPC exams have been electronic since 2024. No AAPC exams run between December 30 and the second Monday of January. AHIMA's coding exams are testing-center exams at Pearson VUE, scored on a scale where 300 is passing — a scaled score, not a percentage — with results shown immediately outside beta periods. Exams on or after May 1, 2026 require the 2026 code books on AHIMA's list. NHA's CBCS can be taken at a school, a PSI testing center or by live remote proctoring.Read the result against the apprentice rule
AAPC posts results online within 7 to 10 business days and says candidates may not represent themselves as certified until official written notice arrives. Passing the CPC without two years of qualifying coding experience attaches the CPC-A. AAPC removes it four ways: two years of coding employment, one year plus education, Practicode plus an approved 80-hour course, or its Job-Ready program — and experience gained before the exam counts toward it.
Exam rules change — confirm with the body
Keeping the credential: CEUs and renewal
Getting certified is the smaller half of the commitment.
The renewal rules below cover AAPC, AHIMA, NHA and AMBA, and each expects continuing education on its own terms — with cycles that are not uniform: AAPC, AHIMA and NHA run on two years, AMBA's CMRS on one.
AAPC ties renewal to membership and CEUs together: keep the annual membership and earn 36 CEUs every two years for one credential — 40 for two, 44 for three, 48 for four and 52 for five or more.
CEUs must come from AAPC-approved sources and carry an AAPC index number, at least two-thirds must be core educational content, nothing carries over between cycles, and AAPC randomly audits 25% of submissions.
AHIMA also runs a two-year cycle: 20 CEUs for the CCA, CCS, CCS-P and RHIT, and 30 for the RHIA, CHDA, CHPS and CDIP, with 10 more per additional credential up to a 50-CEU cap.
The first cycle starts the day you pass the exam, and recertification costs $100 per cycle for members or $249 for non-members as of 2026-10-13.
NHA certifications are valid two years and require 10 continuing education credits per cycle.
AMBA runs the shortest cycle here: CMRS certificates are valid one year, and holders must earn 15 CEUs a year while keeping membership current.
Lapses are handled differently too.
AAPC can reinstate credentials cancelled within the last three years without retesting, for the missed membership fees and CEUs plus a $200 reinstatement fee as of 2026-10-13.
Career information, not coding, billing-compliance, legal or tax advice. Exam, fee, CEU and renewal rules belong to the credentialing bodies named here — AAPC, AHIMA, NHA, AMBA and AMCA — and change over time; confirm current details with the body before you register or recertify.