Medical Billing and Coding Certification

Medical Billing and Coding Certification – Overview

Medical billing and coding certifications are in high demand in the US and in the global healthcare industry.

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 the US Bureau of Labor Statistics, the employment of medical records and health information technicians, including medical billing and coding professionals, is projected to grow 8% from 2019 to 2029.

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 work from home. Medical billing and coding certification requires knowledge of several coding systems, including but not limited to CPT, HCPCS Level II, and ICD-10-CM.

  • 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 gain a minimum of 2 years of professional experience and submit 2 letters of recommendation to the AAPC.

As stated by the AAPC, CPC-certified professionals are required to complete 36 Continuing Education Units (CEUs) within a two-year renewal cycle. 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.

AHIMA cost for exam is:

Non-member price: $399

Member price: $299.

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

CCS-certified professionals must complete 20 Continuing Education Units (CEUs) per year to maintain their certification, as per AHIMA’s standards. This is part of their commitment to ongoing professional development. 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?

Although the Certified Medical Coder (CMC) certification is not as popular as the CCS and CPC, it is recognized as a significant certification for becoming 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 for appearing 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 completion 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 certifications boost your career. They are also incredibly useful for staying ahead of the competition and increasing your employment value.

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

See Also

Medical Billing and Coding Salary

How to Apply Medical Billing and Coding Schools

Medical Billing and Coding Grants

What Doctor Makes the Most Money

Nurse Practitioner Salary

How to Dispute Medical Bills

Current Version
December 15, 2021
Written By
Shubham Grover
March 30, 2024
Updated By
Asher Ashfaq, OMPT, PT, CPC, CMP

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