Medical Billing and Coding Certification

Medical Billing and Coding Certification – Overview

Medical billing and coding certification are in high demand in the US. These professionals are also in demand in the global healthcare industry too.

Those aspiring to be medical billing professionals can fully expect a fruitful and satisfying career ahead of them.

Employers in the healthcare industry seek highly certified professionals. Those with a solid education and relevant experience are most sought-after by employers.

Medical Billing and Coding Certification

According to data from the US Bureau of Labor Statistics, the demand for certified medical billing professionals is set to grow by 13% by 2026.

Medical coding and billing professionals are required in almost every healthcare practice, clinic and hospital.

Once you gain significant and relevant experience in this field, you can also choose to work from home. Medical certification in billing and coding requires thorough knowledge of at least 1 of 3 commonly used codes.

  • CPT (Current Procedural Terminology)
  • HCPCS (Healthcare Common Procedure Coding System) Level II
  • ICD-10-CM

Getting an additional medical certification in medical billing will give you an extra edge over your peers.

Several organizations offer three of the most common medical coding and billing certifications in the US. Aspiring medical billing coding professionals can choose from:

  • Certified Professional Coder (CPC)
  • Certified Coding Specialist (CCS)
  • Certified Medical Coder (CMC)

In this article, we have detailed everything you should know about medical billing and medical certification.

This includes details of becoming a certified professional coder, a certified coding specialist and a certified medical coder.

How to get Certified Professional Coder (CPC) Certification?

The Certified Professional Coder certification is ideal for working in outpatient departments. CPC professionals are usually employed by outpatient clinics or physician’s offices.

This is the most popular certification exam in the medical billing coding field.

How to get Certified Professional Coder (CPC) Certification

How to get Certified Professional Coder (CPC) Certification

The CPC certification is provided by the AAPC (American Academy of Professional Coders). This is the largest such organization, with over 170,000 members.

The AAPC suggests those with a minimum associate’s degree from an accredited institution should appear for the CPC exam.

Usually, candidates with significant experience in the medical coding field choose to take the CPC exam.

It is important to remember that completing the CPC exam does not guarantee you a Certified Professional Coder certificate.

Newbies to the field are initially awarded the CPC-A (Certified Professional Coder – Apprentice) certificate.

These candidates will also need to complete a minimum of 2 years of gaining professional experience. They will also need to submit 2 letters of recommendation to the AAPC.

You can pay an exam fee to appear for this exam. The fee is usually around US$ 80 for active students, while non-students are charged around US$ 150.

To remain certified, you will need to continue your education.

You will need to complete at least 36 hours of approved Continuing Education Units (CEUs) every 2 years. You can earn CEUs by attending online courses, conferences and similarly approved events.

To learn additional details on eligibility criteria and the application process, you can visit the official AAPC website at

How to get a Certified Coding Specialist (CCS) Certification?

Certified Coding Specialist (CCS) professionals are usually employed at inpatient medical facilities. The AHIMA (American Health Information Management Association) organizes and holds the CCS exam.

The eligibility criteria to appear for this exam require the candidate to have at least the following:

  • A degree or diploma from a medical coding training program
  • Two years of relevant experience in medical coding
  • A current medical coding certification with 1 year of experience in medical coding

Similar to CPC, candidates for the CCS exam need to be members of the AHIMA. Uncertified individuals can get a membership by paying a US$ 175 fee. Existing members can renew their membership with a US$ 10 fee.

The CCS exam covers 8 relevant topics:

1. Diagnosis and procedure coding

2. Health information documentation

3. Guidelines and reporting requirements for outpatient services

4. Guidelines and reporting requirements for inpatient services

5. Information Technologies

6. Data and quality management

7. Compliance

8. Privacy, confidentiality, legal and ethical issues

To remain certified as a CCS professional, you will need to continue your education.

You will need to complete a minimum of 20 hours of approved Continuing Education Units (CEUs) each year. Apart from this, you will also need to complete an annual coding self-assessment test.

For additional details on CCS eligibility criteria, application process and exam details, you can visit the official AHIMA website at

How to get Certified Medical Coder (CMC) Certification?

The Certified Medical Coder (CMC) certification is not as popular as CCS and CPC. However, it is recognized as a significant certification to become a professional medical billing and coding expert.

In effect, the CMC exam format is considered more difficult than CCS and CPC.

The Practice Management Institute (PMI) organizes the certified medical coder examination every year.

Aspiring candidates should have at least 1-year of experience in medical coding.

Newbies can also choose to take the Principles of Coding course. However, these preparatory courses are not mandatory to appear for the CMC exam.

The CMC exam differs from CPC and CCS because it does not follow the multiple-choice-question format. Thus, candidates need to assess coding scenarios and fill in the blanks accordingly.

The CMC exam is also held in a live, proctored setting and includes around 133 questions. Candidates with more than 70% marks are considered for CMC certification.

If you want to remain certified as a CMC professional, you will need to earn a minimum of 12 Continuing Education Units (CEUs) every year.

In addition, you will also need to submit proof of completing it to the PMI.

To learn further details of eligibility criteria, application process and other queries, you can simply visit the official PMI website at


Certified medical billing and coding certification give a boost to your career. These are also incredibly useful to stay ahead of the competition and increase your employment value too.

Feel free to visit the official website of the above-given organizations to learn additional information on the CPC, CMC and CCS exams.

See Also

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How to Apply Medical Billing and Coding Schools

Medical Billing and Coding Grants

What Doctor Makes the Most Money

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How to Dispute Medical Bills

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