The CBCS certification from NHA validates medical billing and coding skills in a single credential. At roughly $117, it's the most affordable major certification in the field. The closed-book exam has 100 scored questions plus 20 pretest items, and you'll need a scaled score of 390 out of 500 to pass. Certified billing and coding specialists earn a median of $50,250 per year, with certified professionals averaging 20.7% more than their uncertified peers.
- 1.The CBCS is issued by the National Healthcareer Association (NHA) and tests both billing and coding in one credential.
- 2.At ~$117, it's the most affordable major medical billing and coding certification available.
- 3.You'll take 100 scored questions plus 20 unscored pretest questions in a closed-book, computer-based format.
- 4.A scaled score of 390 out of 500 is required to pass (NHA).
- 5.Many training programs bundle the CBCS exam fee into tuition, so you may already have it covered.
- 6.Renewal requires just 10 continuing education credits every 2 years, with free CE courses from NHA.
~$117
Exam Fee
Lowest major cert cost
120
Total Questions
100 scored + 20 pretest
390/500
Passing Score
Scaled scoring
$50,250
Median Salary
BLS May 2024 (SOC 29-2072)
7%
Job Growth
2023-2033 (BLS)
10 CEs
Renewal
Every 2 years, free from NHA
What Is the CBCS Certification?
The CBCS (Certified Billing and Coding Specialist) is a professional credential issued by the National Healthcareer Association (NHA). It validates proficiency in both medical billing and coding, combining two skill sets that other certifying bodies typically test separately.
NHA is one of the largest allied health certification organizations in the country, with over one million certified professionals. The CBCS is accredited by the National Commission for Certifying Agencies (NCCA), the accreditation arm of the Institute for Credentialing Excellence.
You'll find the CBCS especially popular among graduates of medical billing and coding training programs. Many vocational schools, community colleges, and online programs include the CBCS exam fee in their tuition. That bundling model makes it one of the most commonly held entry-level credentials in medical billing and coding.
Source: NHA, 2025
CBCS Exam Format and Structure
The CBCS exam has 100 scored questions plus 20 unscored pretest questions (120 total), delivered in a computer-based format. Scaled scores range from 200 to 500, and you'll need a minimum passing score of 390 to earn the credential (NHA).
You can take the exam three ways: at your training school (if it's an NHA-approved testing site), at a PSI testing center, or through live remote proctoring from any location with a reliable internet connection and webcam (NHA).
NHA posts exam results to your online account within two business days. Printed certificates typically arrive about two weeks after passing (NHA).
One important distinction: the CBCS is a closed-book exam. You won't have code books or reference materials during the test. That's different from the CPC and CCA, which both allow open codebooks. Strong concept retention is essential.
CBCS Certification Cost Breakdown
| Fee Type | Amount | Notes |
|---|---|---|
| Exam Fee | ~$117 | Often bundled into training program tuition |
| Retake Fee | ~$115 | Per attempt if you don't pass |
| Renewal Fee | Free | Complete 10 CEs every 2 years |
| Reinstatement (Expired) | $376.50 | $277.50 renewal + $99 reinstatement fee |
| NHA Membership | Not required | Unlike AAPC, NHA doesn't require paid membership |
Source: NHA, 2025
Eligibility Requirements
To qualify for the CBCS exam, you'll need to meet one of these eligibility pathways (NHA):
Pathway 1, Training Program: Hold a high school diploma or GED and complete a medical billing and coding training program within the last 5 years.
Pathway 2, One Year of Work Experience: Hold a high school diploma or GED and have 1 year of supervised work experience in medical billing and coding within the last 3 years.
Pathway 3, Two Years of Work Experience: Hold a high school diploma or GED and have 2 years of supervised work experience in medical billing and coding within the last 5 years.
Unlike the CCA, which only requires a high school diploma, the CBCS requires either formal training or documented work experience. That requirement helps make sure candidates have a solid baseline before testing.
Assigning standardized codes to patient diagnoses. You'll need to understand coding guidelines, medical terminology, and anatomy as they apply to code selection.
Coding procedures and services using CPT codes for physician services and HCPCS Level II for supplies, equipment, and non-physician services.
Understanding health insurance plans (commercial, Medicare, Medicaid, Tricare), claims submission, coordination of benefits, and authorization procedures.
The full billing workflow from patient registration and charge capture through claims processing, payment posting, AR follow-up, and denial management.
HIPAA privacy and security rules, fraud and abuse laws, medical necessity requirements, and documentation standards that govern billing and coding.
What the CBCS Exam Covers
The CBCS exam tests knowledge across both billing and coding domains. According to NHA, the exam covers medical coding (ICD-10-CM, CPT, HCPCS Level II), insurance types and billing processes, revenue cycle management, and compliance regulations.
That dual focus on billing and coding makes the CBCS distinct from certifications that only test one discipline. It's a real advantage if you're working in a small practice or billing company where one person handles both functions.
Study Tips and Preparation
Focus on concept retention, not code memorization
You won't have code books during the exam. Learn the structure and logic of ICD-10-CM, CPT, and HCPCS systems so you can reason through questions instead of looking up codes.
Study the billing cycle thoroughly
A large portion of the exam covers claims processing, insurance types, and revenue cycle steps. Understand the full workflow from patient registration through payment posting and denial management.
Use NHA's official study materials
NHA offers a study guide and practice exams designed specifically for the CBCS. These materials match the actual exam content and question format.
Practice with timed mock exams
Timed practice builds confidence and keeps you from overthinking individual questions. Most candidates prepare for 1 to 3 months after completing a training program.
Review HIPAA and compliance rules
Questions on privacy regulations, fraud and abuse laws, and documentation requirements appear throughout the exam. Know the key provisions of HIPAA, the False Claims Act, and the Anti-Kickback Statute.
Source: NHA, 2025
Maintaining Your CBCS Certification
Your CBCS must be renewed every two years. You'll need 10 continuing education (CE) credits within each two-year cycle (NHA). NHA calculates CE credits at 1 credit per 2 hours of continuing education.
If you hold multiple NHA certifications, you still only need 10 total CE credits, and they apply across all your NHA credentials. That's a meaningful perk if you eventually add credentials like the CMAA (Certified Medical Administrative Assistant).
If your CBCS expires, reinstatement requires 15 CE credits plus a $277.50 renewal fee and a $99 reinstatement fee ($376.50 total). Certifications expired for more than one year without reinstatement aren't valid, and you'd need to retake the exam (NHA).
Source: BLS OEWS, May 2024
Career Impact and Salary Data
The CBCS is widely accepted by healthcare employers, particularly in physician offices, outpatient clinics, and billing companies. Its dual billing-and-coding scope makes you a versatile candidate for roles that combine both functions.
According to the Bureau of Labor Statistics, medical records specialists (SOC 29-2072) earn a median annual salary of $50,250 as of May 2024, with projected job growth of 7% from 2023 to 2033 and roughly 14,200 annual openings (BLS). The AAPC 2025 Salary Survey found that certified professionals average $66,979, compared to $55,721 for non-certified workers, a premium of 20.7%.
The CBCS is often the first credential new graduates earn. While the CPC and CCA may carry more weight with some employers, the CBCS provides a strong foundation. Many CBCS holders later pursue the CPC or CCS to move into specialized coding roles or higher-paying positions.
CBCS vs. CPC vs. CCA: Quick Comparison
| Factor | CBCS (NHA) | CPC (AAPC) | CCA (AHIMA) |
|---|---|---|---|
| Exam Fee | ~$117 | $425-$499 | $199-$299 |
| Membership Required? | No | Yes ($222/yr) | No (but discounted fee for members) |
| Exam Format | Closed-book | Open-codebook | Open-codebook |
| Questions | 120 (100 scored) | 100 | 100 (90 scored) |
| Scope | Billing + Coding | Outpatient coding | Inpatient + Outpatient coding |
| Best For | Entry-level, training program grads | Physician office coding | Hospital HIM departments |
| Passing Score | 390/500 scaled | 70% (70/100) | 300 scaled |
Source: NHA, AAPC, AHIMA (2025)
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Angela R.
Medical Billing & Coding Specialist | Consultant
Angela worked as a medical billing and coding specialist for multiple chiropractors and orthopedic surgeons. After years in the field, she started her own medical billing and coding consulting company, working with numerous clients throughout Southern California. She brings firsthand industry experience to every article on this site.