Medical Billing and Coding FAQ (2026)

The job

What is medical billing and coding?

Coding assigns ICD-10-CM, CPT, and HCPCS codes to a documented encounter. Billing uses those codes to build and follow a claim through the payer until it is paid, denied, or adjusted. In a small practice one person often does both. Larger organizations split the roles. See the billing vs coding guide on this site.

What does a medical coder do all day?

A coder reads a provider’s note, assigns diagnosis and procedure codes from the current manuals or encoder, queries the provider when the documentation is unclear, and meets accuracy and productivity targets. Outpatient work is heavy on CPT and E/M. Hospital inpatient work adds ICD-10-PCS and DRG assignment.

What does a medical biller do all day?

A biller verifies coverage, submits claims, posts remittances, works denials and underpayments, and sends patient statements. The job is the money trail after the codes exist. Small practices often combine billing with light coding. Larger groups keep billing as its own desk.

Is medical billing and coding the same as health information management?

Related, not identical. Health information management (the RHIT path) covers records integrity, privacy, and department operations, usually from a CAHIIM-accredited associate degree. Billing and coding certificates target claim codes and payment. Hospital HIM jobs more often name the RHIT or CCS.

Do I need to be a nurse first?

No. BLS lists a postsecondary nondegree award as typical entry education for medical records specialists. Nursing knowledge helps you read charts, but it is not a requirement for the CPC, CCA, CBCS, or CPB. Hospital inpatient coding still wants coding credentials, not an RN license.

Is the work mostly computer work?

Yes. You sit at a computer with an EHR, encoder, and payer portals. You need to read dense notes quickly and follow rules. It is not heavy lifting. It is detail work with production quotas, which is why people who like quiet, rule-based tasks tend to last.

Is medical billing and coding hard?

The hard parts are guidelines, speed with the manuals, and accuracy targets, not algebra. Open-book certification exams still fail people who have not drilled timed cases. If you can follow a multi-step rule without guessing, you can learn this. If you hate sitting and reading, pick a different path.

Will AI replace medical coding?

Computer-assisted coding already exists in hospitals. BLS still projects 7.1 percent growth and about 14,200 openings a year for medical records specialists from 2024 to 2034 (Employment Projections 2024-34, SOC 29-2072). That is not a hiring frenzy and not a disappearance. Employers still want a human who can defend a code.

Is medical coding a good career if I have kids at home?

The desk hours are more predictable than bedside work. Remote jobs exist, but most employers want certification plus production experience first, so the first job is often on site. Starting pay sits near the lower BLS percentiles. Read the salary and remote-work pages before you enroll around a work-from-home promise.

What is a medical records specialist?

It is the BLS occupation (SOC 29-2072) that includes medical billers and coders. BLS does not publish a separate coder occupation. Every wage and outlook figure on this site is that group, and the pages say so. The May 2025 OEWS snapshot counted 194,720 workers.

Pay

How much do medical billers and coders make?

BLS reported a median annual wage of $51,140 for medical records specialists in May 2025 (OEWS, SOC 29-2072). The 10th percentile was $37,000 and the 90th was $81,150. The median describes the middle worker in the occupation, including people with years of experience, not a new graduate.

What is the starting salary for a medical coder?

BLS does not publish a new-graduate wage. The closest published proxies are the 10th percentile ($37,000) and 25th percentile ($43,490) annual wages for medical records specialists in May 2025 (OEWS, SOC 29-2072). Individual first jobs vary by setting and metro. We do not invent a starter figure.

What is the hourly wage?

BLS reported a median hourly wage of $24.59 for medical records specialists in May 2025, with a 10th percentile of $17.79 and a 90th of $39.01 (OEWS, SOC 29-2072). Annual figures assume full-time year-round work. Use hourly if you are comparing a current retail or food-service job.

Which states pay medical coders the most?

Open the salary page. It ranks every state by the BLS OEWS May 2025 median for medical records specialists. Higher-paying states are often higher-cost states. Click a state for percentiles, employment, and metro tables. We do not pick a ‘best’ state.

Does BLS publish city or metro wages?

Yes, for SOC 29-2072 at the metropolitan-area level. This site publishes those estimates, including metros with no campus in our school list. When BLS suppresses a cell, the page says n/a. We do not interpolate a city from the state.

Do certified coders earn more?

BLS does not publish pay by credential. There is no official CPC salary table. Most employers ask for a certification to hire, so the published occupation wages already describe a workforce that is largely certified. Specialty and inpatient work is described across the industry as sitting higher in the range.

Is there a remote-only salary?

No. BLS does not publish wages by work arrangement. Remote roles sit on the same occupation scale, often tied to the employer’s location or a national band. See the remote coding guide. Certification plus experience is what those postings usually require first.

Why is the mean higher than the median?

BLS reported a mean of $56,790 and a median of $51,140 for medical records specialists in May 2025. A smaller number of high earners pulls the mean up. Prefer the median and the percentiles when you are deciding whether the path beats your current job.

Can I download the wage data?

Yes. A CSV of national, state, and metro OEWS May 2025 estimates for SOC 29-2072 is at /data/medical-records-specialists-wages-oews-2025.csv. The figures are BLS public-domain data, compiled here without rounding. Cite BLS and the May 2025 vintage if you reuse them.

Training and time

How long does it take to become a medical coder?

Certificates commonly take four to twelve months full time. Associate degrees in health information take about two years. Part-time stretches both. After the program you still sit a certification exam, and AAPC’s CPC carries a CPC-A apprentice period until you document experience. See the how-long guide.

Do I need a degree?

No, not for most entry billing and coding jobs. BLS lists a postsecondary nondegree award as typical entry education for medical records specialists. An associate degree from a CAHIIM-accredited program is the route to the RHIT and many hospital HIM roles. Match the credential to the job you want.

Can I complete a program online?

Yes. Many certificates are fully online. Ask whether a practicum must be in person and who finds the site. Online study is common. A remote job after graduation usually still requires certification plus experience. See the online programs guide.

What is a practicum?

Supervised practice hours some programs require before you graduate, sometimes called PPE. Ask who places you, whether it can be done where you live, and whether it is unpaid. A program that cannot answer those questions in writing is a program to skip.

Are accelerated or four-week courses enough?

Some certificates are short. The exam still tests the full blueprint, and employers still want you to code accurately at production speed. A short course that skips timed practice leaves the hard part for you. Read the accelerated-programs page for the range, not a promise.

What will I study?

Medical terminology, anatomy, ICD-10-CM, CPT, HCPCS, reimbursement methods, and compliance. Outpatient programs emphasize CPT and E/M. Inpatient and HIM programs add ICD-10-PCS, DRGs, and records law. Confirm the exam the curriculum maps to before you enroll.

Do I need to buy the code books?

You need current manuals to sit most coding exams and to work. Some programs include them in the published price; some do not. Ask for the total published cost including manuals. We do not quote exam fees. Confirm book editions with the certifying body.

Certificate or associate degree?

A certificate is the usual first credential for physician-office and billing-company jobs. An associate degree from a CAHIIM-accredited HIM program is what makes you eligible for the RHIT and is more common in hospital records departments. See certificate vs associate.

Certification

Which certification should I get first?

Match the job. Physician practice and outpatient coding: CPC, CCA, or CBCS. Billing: CPB or CBCS. Hospital inpatient: CCS, usually after an entry credential or a degree. RHIT requires a CAHIIM-accredited degree. Read ten local postings and count which letters appear.

Is certification required by law?

No state licenses medical billers or coders, and no law requires certification. In practice most employers ask for one because it is standardized proof you can code or bill. This site is not affiliated with AAPC, AHIMA, or NHA.

What is the CPC-A?

CPC-A is the apprentice designation AAPC attaches to a new CPC who has not yet documented coding experience. Many practices hire CPC-As. Some postings want the A removed. AAPC publishes the current routes to remove it. Check AAPC, because those routes have changed.

Does the CCA have an apprentice period?

No. Unlike AAPC’s CPC-A, AHIMA’s CCA has no apprentice label. That is one reason some new coders choose the CCA, especially if they are aiming at hospital settings where AHIMA credentials are well known.

Can I take the CPC without a course?

AAPC does not require a course. It recommends education in anatomy and terminology and roughly 80 contact hours of coding instruction, and it requires membership to sit and hold the credential. Most candidates still take a program built around the blueprint.

Is the CPC exam open-book?

As published by AAPC, the exam allows the current CPT, ICD-10-CM, and HCPCS manuals. Open-book is a speed test with rules, not an easy pass. Untabbed manuals are how people run out of time. Confirm current format and time limit on AAPC’s site.

Is the CPC enough for hospital inpatient coding?

Usually not by itself. Inpatient work uses ICD-10-PCS and DRG assignment, which the CPC does not emphasize. That work more often asks for the CCS or an RHIT. Use the CPC for physician-office and outpatient postings.

Can I take the RHIT without a degree?

No. AHIMA requires graduation from a CAHIIM-accredited health information program. A coding certificate does not make you eligible. Verify CAHIIM accreditation before you enroll in any two-year program for this credential.

Should I get certified before I have a job?

Most entry-level postings ask for certification or eligibility, so candidates usually test first. Some employers hire graduates who are scheduled to sit. The CPC-A rule means even certified new coders often start as apprentices.

How do I keep a credential current?

AAPC, AHIMA, and NHA each renew on their own cycle, usually two years, with continuing education units and membership. Confirm current unit counts and fees with the body that issued the credential. We do not quote fees.

Can I hold more than one certification?

Yes. Experienced coders often add a second credential, for example a CPC plus a CCS. Each renews separately. Do not pay for a second exam until a job or a posting asks for it.

Remote work and first jobs

Can I work from home right after training?

Usually not. Remote coding jobs exist. Most employers want certification plus production experience first. Plan on an on-site or hybrid first job unless a specific posting says otherwise. See the remote coding guide.

Where do new coders actually get hired?

Physician practices, outpatient centers, and billing companies are the common first desks. Hospitals tend to pay more and ask for more credentials or experience. BLS reports medical records specialists across hospitals, offices, and administrative support, which includes billing companies.

Do I need experience to sit for the exam?

Not for the CPC, CCA, CBCS, or CPB as those bodies currently publish eligibility. Experience is what employers and the CPC-A rule care about after you pass. The CCS has published pathways that can include experience. Confirm current eligibility with the body.

How long until the first offer?

BLS does not publish time-to-hire. Public threads from working coders report everything from a few weeks to many months. Treat those as individual stories, not a statistic. This site is collecting a first-party survey so we can report a sample with a methodology attached.

Schools, cost, and how we rank

How should I compare medical billing and coding schools?

Ask which exam the curriculum maps to, verify institutional accreditation in the Department of Education database, get the total published program cost including manuals, and find out who places the practicum. Editorial lists on this site are ordered by an independent BOC Score from federal data, not by advertising.

What is the BOC Score?

A 0 to 100 composite from College Scorecard and IPEDS: graduation rate 30 percent, median earnings 25 percent, net price 20 percent (lower is better), retention 15 percent, and online availability 10 percent, as percentiles within peer groups. Full formula: /about/methodology. Advertising cannot move a school on those lists.

Why is a school I know missing?

Editorial lists include institutions that reported CIP 51.07 completions to IPEDS. Non-Title-IV providers do not appear in that federal file, so they are absent from the school database. Partner widgets are a separate, labeled system and are not mixed into those lists.

Do you rank a school number one?

No. We do not name a best school. Editorial cards are ordered by BOC Score where enough federal data exists. Schools without enough data are listed, not scored. Partner listings may reflect compensation and carry Esy’s sponsored label.

How much do programs cost?

Published prices vary by credential length and institution type. Compare the total program price including manuals. Tuition on our school cards is the institution’s IPEDS sticker price, not the program price. We do not give financial aid advice and we do not quote exam fees. See the cost guide.

Is the tuition on the school card the program price?

No. It is the institution-wide published sticker price from IPEDS. Program prices, books, and exam attempts are separate. Ask the school for a total published cost in writing before you enroll.

Are you affiliated with AAPC or AHIMA?

No. MedicalBillingPath.com is independent of AAPC, AHIMA, NHA, CAHIIM, every school, and every government agency. Certification names are used descriptively. Confirm current exam rules with the body that issues the credential.

How do you make money?

Some schools pay us when a visitor requests information through partner listings. That compensation never changes editorial content, federal data, or BOC Score order. Disclosure is on every widget page, in the footer, and in the advertiser disclosure.

Outlook and whether it is worth it

Is the field growing?

BLS projects 7.1 percent employment growth for medical records specialists from 2024 to 2034, about as fast as average, with about 14,200 openings a year, most from replacement (Employment Projections 2024-34, SOC 29-2072). That is demand, not a guarantee you will be hired.

Is medical billing and coding worth it?

It is worth it if the 10th and 25th percentile wages beat your current job after you subtract months of unpaid study and the first-job constraints (CPC-A, on-site start). It is not worth it if you enrolled because an ad promised work-from-home at the 75th percentile. Work the numbers on the salary and worth-it pages.

What if I fail the exam?

Ask the program, in writing, what a retake costs you in time and money and whether unused vouchers expire. A voucher is a prepaid attempt, not a pass. We do not quote exam fees. Confirm retake rules with the certifying body.

Can I do this with a criminal record?

There is no state license that automatically bars you. Employers and some clinical practicum sites run background checks. Ask the program how they handle practicum placement, and ask employers directly. We cannot predict a specific hospital’s policy.

Am I too old to start?

BLS does not publish an age cutoff, and no state licenses this work. Career changers from clinical, admin, and retail jobs are common in public discussions of the field. The constraints are the same at any age: time to study, exam, CPC-A or equivalent first-job rules, and pay near the lower percentiles at the start.

What is ICD-10-CM versus CPT versus HCPCS?

ICD-10-CM is the diagnosis code set. CPT is the AMA procedure code set used on professional and outpatient claims. HCPCS Level II covers supplies, drugs, and some services CPT does not. Hospital inpatient procedures use ICD-10-PCS, not CPT. The code-sets guide walks through one encounter.

What is an E/M code?

Evaluation and management codes in CPT pay for office and hospital visits, leveled by complexity. They show up on the CPC exam and on most clinic jobs. A program that treats E/M as a footnote is a weak CPC-prep program.

What is a denial?

A payer’s refusal to pay a claim or a line, with a reason code. Billers work denials by correcting the claim, sending records, or appealing. Coders see denials when a code and a diagnosis do not support each other. Days in A/R go up when denials sit.

Do I need a state license?

No state, including yours, licenses medical billers or coders. Employers look for a completed program and an industry certification. Confirm any employer-specific rules in the posting. This is not legal advice.

Where does the wage data come from?

U.S. Bureau of Labor Statistics Occupational Employment and Wage Statistics, May 2025, SOC 29-2072, plus BLS Employment Projections 2024-34. School lists come from IPEDS and College Scorecard. Every statistic on this site traces to hugo/data files built from those agencies. See data sources.

How do I report a wrong number?

Use the contact form with the page URL and the source you believe is correct. We check the federal file, update the page, and record material corrections on the public corrections log. Generated school and salary pages are fixed in the generator, not by hand-editing one URL.