CBCS Certification: NHA Exam Guide, Requirements & Passing Score
Complete CBCS certification guide: NHA exam format, eligibility pathways, passing score of 390/500, content domains, salary data, and free practice tests.
What Is the CBCS Certification?
The CBCS (Certified Billing and Coding Specialist) is a professional certification awarded by the NHA to individuals who demonstrate competency in medical billing and coding. Unlike some credentials that focus exclusively on diagnosis or procedure coding, the CBCS covers the full revenue cycle — from patient registration and documentation through claim submission, reimbursement, and compliance. This makes it a well-rounded credential for front-end and back-end billing roles in physician offices, hospitals, clinics, and health systems.
The CBCS is widely accepted by employers across the United States and is often listed as a preferred or required qualification for medical billing specialist, coding analyst, and revenue cycle coordinator positions. It pairs well with other healthcare certifications and serves as a strong entry point for professionals entering the medical billing and coding field.
CBCS Exam Format
The CBCS exam consists of 100 multiple-choice questions, of which 85 are scored and 15 are unscored pretest items used for future exam development. Candidates have 2 hours and 30 minutes to complete the exam. Questions are presented in a proctored computer-based format, available at PSI testing centers nationwide or via remote online proctoring.
The CBCS passing score is a scaled score of 390 out of 500. NHA uses scaled scoring to ensure consistency across different exam versions; a raw score is converted to the 500-point scale before results are reported. Candidates receive a pass/fail result immediately upon completion, with a detailed score report available through their NHA candidate portal.
- Total Questions: 100 (85 scored + 15 pretest)
- Time Limit: 2 hours 30 minutes
- Format: Multiple choice, computer-based
- Delivery: PSI test center or remote proctoring
- Passing Score: 390 out of 500 (scaled)
- Score Type: Scaled score (not percentage)
- Results: Immediate pass/fail on screen
- Score Report: Available in NHA candidate portal
- NHA Member Fee: $117
- Non-Member Fee: $137
- Retake Policy: Full fee applies per attempt
- Registration: nhanow.com candidate portal
- Renewal Cycle: Every 2 years
- CEUs Required: 10 continuing education units
- Renewal Fee: Varies by NHA membership status
- Renewal Method: CEU submission via NHA portal
CBCS Content Areas
The CBCS exam tests five content domains. Understanding the weight of each domain is essential for an effective CBCS study guide strategy:
- Billing and Reimbursement — 30%: Claim submission, payer types (Medicare, Medicaid, commercial), EOB interpretation, denial management, and revenue cycle processes.
- Coding — 30%: ICD-10-CM diagnosis coding, CPT procedure coding, HCPCS Level II codes, and coding guidelines for various care settings.
- Compliance and Regulatory — 20%: HIPAA privacy and security rules, fraud and abuse laws (False Claims Act, Anti-Kickback Statute), and payer-specific compliance requirements.
- Documentation — 10%: Medical record documentation standards, physician query processes, and documentation requirements for accurate coding.
- Patient Data Management — 10%: Patient registration, insurance verification, prior authorization, and demographic data accuracy.
Allocate study time proportionally — billing/reimbursement and coding together account for 60% of the exam.
CBCS Eligibility
The NHA offers two eligibility pathways for the CBCS certification, allowing both recent graduates and working professionals to qualify:
Pathway 1 — Education: Completion of an accredited medical billing and coding program. The program must be from an institution accredited by a nationally recognized accrediting body. This pathway is ideal for students finishing a certificate, diploma, or associate degree program in health information technology, medical billing and coding, or a related field. There is no minimum work experience requirement under this pathway.
Pathway 2 — Work Experience: A minimum of 1 year of work experience in medical billing and/or coding within the past 3 years. This pathway is designed for professionals who entered the field without a formal credential and now wish to become certified. Employers may require documentation of job duties to verify that experience aligns with CBCS content domains.
All candidates must agree to NHA's code of ethics and meet identity verification requirements at the time of exam registration. There is no prerequisite exam or training course required by NHA — candidates choose their own preparation method, which may include self-study, instructor-led courses, or practice test platforms.
Medical Billing and Coding Salary
Earning the CBCS certification can meaningfully impact your earning potential in the medical billing and coding field. According to national labor data and industry surveys, credentialed billing and coding specialists typically earn more than their non-certified counterparts, and certification is increasingly required for career advancement.
Nationally, medical billing and coding specialists earn between $39,000 and $48,000 per year, with the median falling around $43,000–$44,000. In urban markets and high-demand regions — such as California, New York, Texas, and the Pacific Northwest — salaries commonly range from $44,000 to $55,000, with senior billing specialists or coding leads earning above $60,000.
CBCS vs. CPC: Which Certification Is Right for You? The CBCS (NHA) and the CPC — Certified Professional Coder (AAPC) — are two of the most recognized entry-to-mid-level coding credentials. The key difference lies in emphasis: the CBCS covers billing more heavily, including reimbursement, claim management, and patient data workflows, making it ideal for billing-heavy roles. The CPC covers medical coding more deeply, with a stronger focus on CPT, ICD-10-CM, and HCPCS guidelines across specialties, making it preferred for coding analyst and compliance roles. Many professionals hold both credentials to maximize job market flexibility.
- +Lower exam fee than CPC — $117-$137 vs $399-$499 makes CBCS more accessible for new professionals
- +Work experience pathway — 1 year experience accepted without formal program completion
- +Strong billing focus — ideal for roles emphasizing claims processing and revenue cycle
- +NHA membership provides job board, CEU resources, and professional network
- −Less specialized in coding than CPC — employers wanting deep coding expertise may prefer CPC
- −Smaller professional community than AAPC — fewer CBCS-specific study groups and forums
- −10 CEUs required every 2 years — ongoing cost and time commitment for renewal
- −Not as widely requested in job postings as CPC for hospital-based coding roles