The NHA CBCS exam is a nationally recognized certification that validates your expertise in the revenue cycle. Earning this credential opens doors to CBCS jobs in hospitals, physician offices, and insurance companies nationwide. Practice with the free Certified Billing and Coding Specialist practice test on PracticeTestGeeks (8 questions with answer explanations).

CBCS Exam at a Glance

What changed for CBCS in 2026

• Oct 16, 2026: Time limit changed to 3 hours (previously time limit: 3 hours).^[1]
• Oct 16, 2026: Renewal changed to Every 2 years with 10 CE credits (previously recertification: Renew every 2 years; complete 10 continuing education (CE) credits before expiration and pay the recertification fee (NHA cites ~$8/month as-you-go option). If certification expires, there is a 1-year window to reinstate.).^[3]
• Oct 16, 2026: Eligibility changed to HS diploma/GED plus training program (within 5 years) or work experience (previously eligibility: High school diploma or GED (or scheduled to earn one within 12 months) PLUS either: completed a medical billing & coding training/education program within the last 5 years, OR 1 year of supervised work experience in medical billing & coding within the last 3 years (or 2 years within the last 5 years).).^[2]

Free Certified Billing and Coding Specialist Study Tools

Interactive Certified Billing and Coding Specialist resources on PracticeTestGeeks, free to start:

• Certified Billing and Coding Specialist flashcards — review key terms and concepts card by card
• Certified Billing and Coding Specialist study guide — topic-by-topic overview of what the exam covers
• Certified Billing and Coding Specialist cheat sheet — one-page printable summary for last-minute review

According to National Healthcareer Association, “PATHWAY 2: WORK EXPERIENCE – Have either at least one (1) year of supervised work experience in the last three (3) years OR 2 years of supervised work experience in the last five (5) years.*”^[2]

CBCS content outline and where to practise each area

The content areas below are copied from the official CBCS content outline published by National Healthcareer Association. The right-hand column shows which of our practice sets covers it.

Worked examples: how to reason through CBCS questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: What is a Business Associate Agreement (BAA) under HIPAA?

1. A contract between an insurance company and a healthcare provider specifying reimbursement rates
2. A written contract between a covered entity and a business associate that specifies permitted uses of PHI and requires the business associate to protect PHI
3. An agreement between two competing healthcare providers not to share patient information
4. A consent form signed by patients authorizing their information to be shared with third parties

Answer: B. A written contract between a covered entity and a business associate that specifies permitted uses of PHI and requires the business associate to protect PHI

Explanation:

B is correct. A Business Associate Agreement is a written contract between a covered entity and a business associate, and it sets out what the associate may do with protected health information and requires safeguards for it. A is wrong because reimbursement rates belong in payer contracts, not in a privacy agreement. C is wrong because a BAA is not an arrangement between competing providers. D is wrong because a patient authorization is a separate document and not a contract between two organizations. The rule to remember: whenever an outside vendor will access, use or disclose PHI to perform a service for a covered entity, a BAA must be in place first.

Example 2

Question: What is 'balance billing' and when is it prohibited?

1. Billing the patient the balance of a claim after insurance pays its portion — always permitted
2. Billing the patient the difference between the provider's charge and the insurer's payment, which is prohibited for in-network providers (covered by contract) and in states with surprise billing protections
3. Billing for the patient's deductible and copay — always required
4. Billing a secondary insurer for the balance after the primary pays — always prohibited

Answer: B. Billing the patient the difference between the provider's charge and the insurer's payment, which is prohibited for in-network providers (covered by contract) and in states with surprise billing protections

Explanation:

B is correct. Balance billing means billing the patient for the gap between the provider's charge and what the insurer paid. It is barred for in-network providers by their contract, and in states with surprise billing protections. A is wrong because it says the practice is always permitted, which ignores those limits. C is wrong because it describes deductibles and copays, which are normal patient responsibility and not balance billing. D is wrong because billing a secondary insurer after the primary pays is routine coordination of benefits. The rule to remember: check the provider's network status and the applicable protections before billing a patient for any remaining amount.

Example 3

Question: A patient is seen for type 2 diabetes with diabetic chronic kidney disease, stage 3. What combination code would be used?

1. E11.65
2. E11.22
3. E11.9
4. N18.3

Answer: B. E11.22

Explanation:

B is correct. E11.22 is the combination code for type 2 diabetes with diabetic chronic kidney disease, so the link between the two conditions is captured in one code. A, E11.65, describes diabetes with hyperglycemia, which is a different complication. C, E11.9, is type 2 diabetes without complications, which is wrong because the patient has kidney disease. D, N18.3, describes only the kidney disease stage and leaves out the diabetes. The rule to remember: when the classification offers a combination code for diabetes and a complication, use it, then add the stage code as the guidelines direct so the stage 3 detail is still reported.

How to use these practice tests

Start with the NHA test plan and candidate handbook so you know the content areas and the rules for registration, retakes and renewal. Then take the Full Exam Simulation once as a baseline, without looking anything up, and note which areas cost you the most questions.

Work through the practice sets for those weak areas next. For every question you miss, read the explanation and write down the rule behind it in your own words, not just the right letter. For coding sets, keep your code book or reference open while you practise so you learn where to look things up, then repeat the questions without it.

Mix in the compliance and HIPAA sets alongside the coding work, because billing questions often depend on a privacy or payer rule. Revisit the sets you struggled with after a few days and check whether the same mistakes repeat.

Close to test day, do the Full Exam Simulation again under timed conditions, sitting it in one go to match the timed format NHA describes. Use the official practice material for a final check, and treat our questions as practice written by us, not as real exam items.

• Topics: Diagnosis coding, procedure coding, bundling.
• Questions: ~20 questions

Expect to spend between $200 and $500 total for the exam and self-study materials. Formal training programs will increase the total CBCS certification cost significantly but may offer more comprehensive preparation.

Ready to Pass Your CBCS Exam?

Join thousands of successful candidates who used our free practice tests to earn their certified billing and coding specialist (cbcs) credential.

NHA allows you to earn Continuing Education (CE) credits through various activities, including webinars, conferences, and articles. Keep your CBCS credential active to avoid having to retake the exam.

Pros and Cons at a Glance

Sample Certified Billing and Coding Specialist Practice Questions

Try these questions from our free Certified Billing and Coding Specialist practice tests. The correct answer and an explanation follow each question.

1. When verifying a patient's eligibility, the CBCS confirms the patient has both a primary and a secondary insurance plan. What critical step must be taken to ensure proper claim submission?

   • A. Bill only the primary insurance to simplify the process.
   • B. Ask the patient which insurance they would prefer to use.
   • C. Verify the Coordination of Benefits (COB) to determine the correct billing order.
   • D. Submit the claim to both insurance companies simultaneously.

   Answer: C. Verify the Coordination of Benefits (COB) to determine the correct billing order.

   When a patient has multiple insurance plans, it is essential to determine the Coordination of Benefits (COB) to establish the correct order for billing. Billing the wrong payer first will lead to claim denials and payment delays.

2. During a review of the practice's finances, a CBCS is tasked with analyzing the Accounts Receivable Aging Report. The report shows a significant balance in the '120+ days' category. What does this indicate for the revenue cycle?

   • A. The practice is collecting payments from patients too quickly.
   • B. The charge capture process is highly efficient.
   • C. There is a problem with collecting payments in a timely manner.
   • D. Front-end registration errors have been eliminated.

   Answer: C. There is a problem with collecting payments in a timely manner.

   The A/R aging report categorizes outstanding balances by the length of time they have been unpaid. A large balance in the '120+ days' bucket indicates that many claims are significantly overdue, highlighting inefficiencies and problems in the A/R follow-up and collections process which negatively impact cash flow.

3. A patient presents for a scheduled procedure. The eligibility check performed the previous week showed active coverage. What is the best practice for the CBCS on the day of service?

   • A. Proceed with the service, as eligibility was already confirmed.
   • B. Ask the patient if there have been any changes to their insurance.
   • C. Perform a real-time eligibility check to confirm the policy is still active.
   • D. Collect the co-payment based on the previous week's verification.

   Answer: C. Perform a real-time eligibility check to confirm the policy is still active.

   Best practices dictate that eligibility should be checked before every single appointment, even for established patients, as coverage can change unexpectedly. A real-time check on the date of service ensures the most accurate and current information is used, preventing potential claim denials due to a lapsed policy.

4. A CBCS is verifying benefits for a specific surgical procedure. Beyond confirming the policy is active, which piece of information is crucial to obtain?

   • A. The patient's preferred pharmacy.
   • B. The name of the insurance agent who sold the policy.
   • C. Whether pre-authorization is required for the procedure.
   • D. The patient's complete medical history.

   Answer: C. Whether pre-authorization is required for the procedure.

   A complete eligibility check includes verifying whether a prior authorization or referral is required for the specific service. Failing to secure a necessary pre-authorization is a common reason for claim denials, making this a critical step in the verification process.

Take the full Certified Billing and Coding Specialist practice test

Official Resources

• NHA — Certified Billing and Coding Specialist (CBCS): the National Healthcareer Association is the certifying body that develops, administers, and renews the CBCS exam.
• American Medical Association (AMA): the AMA owns and maintains the CPT procedure code set that the CBCS exam tests you on.
• CMS — ICD-10 Codes: the Centers for Medicare & Medicaid Services publishes the official ICD-10 diagnosis codes used throughout medical billing and coding.

Sources & last verified

1. National Healthcareer Association — time limit (official source). “The Final Practice Test is timed (3 hours), without rationales, to provide the “experience” of sitting” Verified Oct 27, 2026 · source checked Oct 27, 2026.
2. National Healthcareer Association — retake fee, retake policy, eligibility (official source). “For each retake attempt, you must re-register and pay the full examination price.” Verified Oct 19, 2026 · source checked Oct 19, 2026.
3. National Healthcareer Association — validity, renewal, delivery, score release (official source). “Certifications must be renewed every two years” Verified Oct 19, 2026 · source checked Oct 19, 2026.
4. National Healthcareer Association — other (official source). “billing and reimbursement” Verified Oct 30, 2026 · source checked Oct 30, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.