Certification for medical billers and coders is an important, though voluntary, step toward gaining professional employment in a medical billing and coding setting.
Most employers prefer to hire medical billers and coders who are certified by one of several certifying agencies, including the American Health Information Management Association (AHIMA), the American Academy of Professional Coders (AAPC), the Board of Medical Specialty Coding (BMSC), the National Cancer Registrars Association (NCRA) and the Professional Association of Healthcare Coding Specialists (PAHCS). Certification is usually maintained through continuing education and regular renewal.
The certifications offered by each organization are listed below:
The American Health Information Management Association offers several credentials, including:
- Registered Health Information Administrator (RHIA)
- Registered Health Information Technician (RHIT)
- Certified Coding Associate (CCA)
- Certified Coding Specialist (CCS)
- Certified Coding Specialist – Physician Based (CCS-P)
- Certified Health Data Analyst (CHDA)
- Certified in Healthcare Privacy and Security (CHPS)
To qualify for certification, billers and coders must pass a written examination, and must meet education and experience requirements. The RHIA and RHIT credentials require graduation from a medical billing and coding program accredited by CAHIIM, or by another accrediting body with which AHIMA has an agreement. Other credentials require various combinations of education and career experience.
The AAPC offers several credentials, including Certified Professional Coder (CPC) in general, outpatient hospital, and payer variations. It also offers credentials in cardiovascular radiology coding, medical auditing and other specialties.
Eligibility requirements for most AAPC credentials are:
- An associate’s degree in medical billing and coding
- Two years of medical coding experience
- AAPC membership
Certification is maintained every 2 years through continuing education and continued AAPC membership.
The Board of Medical Specialty Coding offers the following credentials:
- Specialty Coding Professional (SCP) – 2 years billing and coding experience required
- Advanced Coding Specialist (ACS) – 3-5 years billing and coding experience required
- Certified Compliance Professional – Physician (CCP-P) – 2 years compliance experience required
- Home Care Coding Specialist – Diagnosis (HCS-D) – 2 years home care coding experience required
Medical billers become certified by passing a skill-based exam. Exam fees are $249 for most credentials, and $325 for the ACS.
BMSC-certified medical billers and coders are required to maintain their certification through regular continuing education. Education requirements are listed on the BMSC website, and vary slightly for each credential.
The National Cancer Registrars Association offers the designation Certified Tumor Registrar (CTR) who take one of 4 routes toward eligibility:
- Route A: Graduation from an NCRA-accredited medical billing & coding associate’s degree program and 160 hours of experience, or an NCRA-accredited education program in conjunction with an associate’s degree
- Route B: Graduation from an NCRA-approved healthcare associate degree program, plus 1 year of full-time cancer registry experience
- Route C: Graduation from an associate degree program AND certification in an NCRA-approved healthcare field, plus 1 year of full-time cancer registry experience
- Route D: Graduation from a master’s program in an allied health field, plus 1 year of full-time cancer registry experience
Eligible coders take an NCRA-administrered exam. Exam fees are $240 for NCRA members, $350 for non-members.
NCRA-certified medical billers and coders are required to maintain their certification by engaging in 20 continuing education hours every two years.
The Professional Association of Healthcare Coding Specialists offers certifications in many areas, including:
- Basic Medical (CBMCS)
- Cardiology (CCCS)
- Dermatology (CDCS)
- Emergency Medicine (CEMCS)
- Family Practice (CFPCS)
- Gastroenterology (CGCS)
- General Surgery (CGSCS)
- Internal Medicine (CIMCS)
- Mental Health – Psychiatric / Psychiatry (CMHCS)
- Obstetrics & Gynecology (COBGCS)
- Orthopedics (COCS)
- Otolaryngology/ENT (CENTCS)
- Pain Management (CPMCS)
- Pediatrics (CPEDCS)
- Podiatry (CPODCS)
- Pulmonology/Pulmonary (CPCS)
- Urology (CUCS)
Medical billing and coding specialists become certified by taking a written exam. The exam fee is $250, and a minimum of 2 years of medical coding experience is required for eligibility. Certified medical billers and coders maintain their certification every 2 years through continuing education, and through continued PAHCS membership.
You can find out more about what schools in your area can prepare you for which certifications by exploring medical billing and coding programs near you, and speaking to reps about certification.