Are you wondering whether you need to be certified to work as a medical biller or coder? California does not require certification to work as a medical coder or biller, but most employers are looking for certified candidates.
Medical coding is a complex process, requiring a great degree of accuracy. If you are seeking a job as a medical biller and coder, certifications will help you gain a competitive edge in your job search.
Medical billing and coding is a fulfilling career with numerous upsides and few downsides. Most medical coding and billing training programs are less than a year in length. This means you can start earning a living relatively quickly, and most billing and coding jobs can be done remotely.
State Licensing Requirements for Medical Billers and Coders
Which states require medical billing and coding certification? None of the fifty states officially require a specific medical billing or medical coding certification to work in that capacity. Each state has their own guidelines, but state medical boards do not have licensing mandates for medical coders or billers. This is unlikely to change soon.
However, it may benefit candidates from a hiring and career advancement perspective to get certified in medical coding and billing. Healthcare employers depend on a high level of accuracy in medical coding and billing, as well as the patients, and insurance providers.
Is a Medical Billing or Medical Coding Certificate Worth It?
Medical coders and billers play a crucial role in medical offices, private practices, clinics, and hospitals. They must accurately interpret each patient visit into a set of standardized codes. If they are less than highly accurate, the medical office may not be properly compensated by the insurance company. In some cases, the medical office may be audited.
For these reasons, most health facilities look for certified medical billing and coding candidates. Medical coding certification means the candidate is adequately trained in the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT). These are the standards used by the healthcare system for medical coding and billing.
Not only does medical coding and billing certification give you a practical advantage in getting a job, but it may also help you get a better salary.
A 2021 report by the Bureau of Labor Statistics showed the median salary for all medical records specialists (coders and billers) was $46,660.[1] A 2022 salary survey by the American Association of Professional Coders found that medical coders with a CPC certification earned a median salary of $58,895. This data suggests a correlation between medical coding and billing certification and higher median salary.
The AAPC survey also shows a correlation between more coding certifications and higher median salary.
What Are the Different Medical Billing and Coding Certifications?
There are many medical billing and coding certifications, these are some of the most prominent.
Medical Billing Certifications
Certified Medical Reimbursement Specialist (CMRS)
Exam offered by the AMBA (American Medical Billing Association). Awarded by the Certifying Board of the American Medical Billing Association (CBAMBA).
Prerequisite. Deep knowledge of the CPT, ICD-10, HCPCS standards.
Created in 2000, it remains one of the most thorough and respected medical billing certifications.
Certified Professional Biller (CPB)
Exam offered by the American Association of Professional Coders (AAPC). All AAPC certifications require applicants to have a AAPC membership and any other prerequisites.
Prerequisite. Deep knowledge of the medical billing claims process, and CPT, ICD-10, HCPCS standards.
Medical Coding Certifications
Certified Coding Associate (CCA)
Exam offered by the AHIMA (American Health Information Management Association).
Prerequisite. One of the following: Six months experience coding at a healthcare organization, complete an AHIMA-approved coding certificate program, or complete another formal coding training program.
Certified Coding Specialist (CCS)
Exam offered by the AHIMA.
Prerequisite. Minimum three years of experience in a hospital or other physician-based setting applying coding to various cases. Also, complete coursework in anatomy and physiology, pathophysiology, and pharmacology, or demonstrate equivalent proficiency in those areas.
Certified Outpatient Coder (COC)
Exam offered by the American Association of Professional Coders (AAPC). All AAPC certifications require applicants to have a AAPC membership and any other prerequisites.
Prerequisite. Two years medical coding experience or equivalent.
This coding certification is for ambulatory services, dialysis centers, outpatient radiology centers, outpatient clinics and therapy, outpatient cancer centers, hospital emergency rooms.
Certified Inpatient Coder (CIC)
Exam offered by the AAPC.
Prerequisite. Deep understanding of inpatient coding and reimbursement fundamentals, anatomy, and medical terminology. This is an advanced certification.
This certification is for hospital and facility inpatient coding, acute care hospitals, long term health care facilities, inpatient rehab facilities, general care hospitals. Focuses on patient services provided by the medical facility instead of the physician.
What States Pay the Most for Medical Billing and Coding?
According to the Bureau of Labor Statistics [2], the American Association of Professional Coders[3], and Allied Health Schools [4], the states where medical billers and coders are paid the highest are New Jersey, District of Columbia, Massachusetts, and Connecticut.
Reported Avg Salary and Hourly Wage for Medical Billers and Coders, as of May 2022
| State | Avg Salary, BLS data, May 2022 | Avg Salary, AAPC data | Avg Salary, Allied Health | Avg Hourly Wage, BLS data, May 2022 | Avg Hourly Wage, AAPC data |
|---|---|---|---|---|---|
| New Jersey | $67,130 | $65,568 | $61,680 | $32.28 | $31.52 |
| District of Columbia | $63,270 | $65,000 | n/a | $30.42 | $31.25 |
| Massachusetts | $58,950 | $66,222 | $59,120 | $28.34 | $31.84 |
| California | $57,950 | $67,660 | $51,170 | $27.86 | $32.53 |
| Connecticut | $57,480 | $62,659 | $55,100 | $27.64 | $30.12 |
| New York | $55,350 | $62,369 | $48,350 | $26.61 | $29.99 |
| Washington | n/a | $61,920 | $48,500 | n/a | $29.77 |
| Maryland | n/a | $63,068 | $48,350 | n/a | $30.32 |
| New Hampshire | n/a | $60,959 | $38,180 | n/a | $29.31 |
| Colorado | n/a | $60,615 | $47,510 | n/a | $29.14 |
| Oregon | n/a | $60,830 | $47,940 | n/a | $29.25 |
| Rhode Island | n/a | $65,110 | $47,340 | n/a | $31.30 |
| Minnesota | n/a | $60,462 | $50,470 | n/a | $29.07 |
Note: Data shown is from the respective sources, as of May 2022.
There is a range of data, because the organizations survey different medical records specialists, and they have a different range of education, experience, and professional certifications.
Start Your Medical Billing and Coding Career in 36 to 42 Weeks
Campus offers a Medical Billing and Coding certification program that can be completed in 36 to 42 weeks. This program is fully online; all of the coursework can be done remotely from your computer with a broadband internet connection.
If you see working as a medical billing and coding professional in your future, contact our Admissions department today, and they can answer any questions you have about the course.
We’re here to help you start a rewarding career in medical billing and coding.
[1] Note: The data provided above are from a source unaffiliated with Campus, formerly known as MTI College, are for informational purposes only and represent the employment field as a whole. They are not solely specific to Campus graduates and, by providing the above information, Campus makes no representation, direct or implied, or opinion regarding employability.
[2] https://www.bls.gov/oes/current/oes292072.htm
[3] https://www.aapc.com/tools/medical-coding-salary-survey/
[4] https://www.allalliedhealthschools.com/blog/best-states-for-medical-biller-coders/