AHIMA certification

CCA certification: the entry-level coding credential.

The Certified Coding Associate (CCA) is AHIMA's entry-level medical coding credential. It's the foot-in-the-door cert for new coders, career-changers from healthcare adjacents (medical assistants, billers, nurses moving out of bedside work), and graduates of coding certificate programs who haven't landed their first coding job yet. As of December 2025, 7,753 active CCAs hold the credential, and the most recent first-time pass rate is 62%.

By Taylor Rupe, editor · Updated

Medical coding student practice materials and ICD-10 code book
62%

First-time pass (2025)

$199

Exam fee (AHIMA member)

7,753

Active CCA holders

HS

Diploma only required

Key takeaways

The 8 facts that matter most about the CCA.

  • The CCA is AHIMA's entry-level coding credential. The only one with a high-school-diploma-only floor. Designed to get you past resume filters for your first coding job.
  • $199 for AHIMA members, $299 for non-members. Retake fee is identical. No discounted retakes.
  • 62% first-time pass rate in 2025 across 2,101 first-time test takers (down from 67% in 2024). The CCA is harder than the marketing implies.
  • 2 hours, 105 questions (90 scored), computer-based at Pearson VUE. One-way navigation — you cannot return to a submitted question. Bring current-year code books.
  • The CCS credential supersedes CCA when you earn it. Most AHIMA-track coders use CCA as a 1-3 year stepping stone, then upgrade to CCS once they have inpatient experience.
  • Six exam domains, weighted heavily toward clinical classification systems (30-34%) and reimbursement methodologies (21-25%). Effective 2024 outline.
  • CCA holders earn ~$$48K on average per AAPC's 2025 salary survey. CCS holders earn ~$$58K, CPC holders ~$$60K, and multi-credentialed coders ~$$71K.
  • 20 CEUs every 2 years to maintain. As of January 2025, at least 40% of CEUs must come from AHIMA or its component state associations.

What it is

The entry-level medical coding credential.

The CCA is AHIMA's broad-spectrum, entry-level coding credential. Holders learn to assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes across both inpatient and outpatient settings, but at a generalist level rather than the inpatient-mastery depth of the CCS. The credential is positioned as a starting point: the resume signal that gets a candidate past the screening filter at hospital HIM departments and revenue-cycle vendors.

AHIMA reports 7,753 active CCAs as of December 31, 2025, with 2,101 new candidates sitting the exam that year. That's a fraction of AAPC's CPC holder population (over 200,000), reflecting the CCA's smaller market footprint and the fact that the CCS tends to be the long-term destination for AHIMA-track coders.

The credential's structural advantage is the low eligibility bar — only a high school diploma is required. Its structural disadvantage is that the CCA is widely treated by employers as a stepping stone. A meaningful share of hospital and senior outpatient roles still prefer CCS or CPC. The CCA gets you into the field; you'll likely upgrade within 1-3 years.

Eligibility

High school diploma or equivalent. That's it.

AHIMA's hard eligibility requirement for the CCA is a high school diploma or equivalent. That's the lowest bar of any AHIMA coding credential. Recommended (but not required) prep includes any one of the following:

  • 6 months of direct coding experience

    Real-job coding (medical billing or coding roles where you applied codes to records). This is the most relevant recommended prep.

  • An AHIMA-approved coding program (PCAP)

    Completion of an AHIMA Professional Certificate Approval Program coding curriculum.

  • Other coding training

    Any coding training that covers anatomy and physiology, medical terminology, basic ICD diagnostic and procedural coding, and basic CPT coding.

Honest framing

AHIMA does not transcript-review CCA applicants the way it does for RHIT/RHIA. The recommended pathways are effectively self-attested. But the exam itself is unforgiving — the 62% first-time pass rate makes clear that "recommended" prep is functionally required if you want to pass.

Exam structure

2 hours, 105 questions, one-way navigation.

The CCA is computer-based and 2 hours long. The exam has 105 questions: 90 scored items plus 15 unscored pretest items distributed randomly throughout the test. Delivery is at Pearson VUE testing centers, with limited or no remote-proctor option (verify on the AHIMA candidate guide before scheduling).

The unusual feature: one-way navigation. Once you submit an answer to a question, you cannot return to it. Most AHIMA exams (including the CCS) allow free movement between items; the CCA does not. Practice this constraint during prep — locking in a wrong answer because you didn't realize the navigation was one-way is one of the most common first-time failure modes.

Scoring uses a 100-400 scaled system with a passing score of 300. AHIMA does not publish the raw-to-scaled conversion. Code books are required at the testing center: bring 2026-edition ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II for exams on or after May 1, 2026. Bringing the wrong year forfeits the exam fee.

DetailCCA specification
Time2 hours
Total questions105 (90 scored + 15 pretest)
FormatMultiple choice
DeliveryPearson VUE testing centers
NavigationOne-way (cannot return to submitted items)
Passing score300 (scaled)
Code books requiredICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II (current year)

Source: AHIMA CCA page. 2026 code book list at AHIMA codebook PDF.

Fees

What the CCA exam actually costs.

ItemMemberNon-member
Exam fee$199$299
Retake fee (full re-app)$199$299
Refund processing fee$75$75
Eligibility window extension$50 / 30 days$50 / 30 days
Recertification (2-year cycle)$100$249

Realistic total for a first-time AHIMA member sitting the CCA with code books and a prep textbook: roughly $500-$700. Non-member first-time totals run $600-$800. Code books alone are $200-$300 depending on whether you buy new from the publisher.

AHIMA membership runs roughly $199/year separately. If you plan to recertify the CCA (and especially if you'll later sit for CCS), membership pays for itself through the exam discount, member-pricing on prep materials, and reduced recert fees.

Pass rate

The CCA is harder than the marketing implies.

AHIMA's published 2025 first-time pass rate is 62% across 2,101 first-time test takers. The 2024 cycle was 67% across 2,490 testers. Some third-party prep sites still quote 70%+ — those figures don't match AHIMA's current published data and should be treated as marketing rather than fact.

The structural reason the CCA is harder than candidates expect: the eligibility bar is low (high school diploma only), which lets unprepared candidates sit the exam. Combine that with the one-way navigation, the unforgiving 300 cut score, and a 6-domain content outline that requires actual coding skill (not just memorization), and the failure rate makes sense. About 38% of first-time CCA candidates need to retake.

62% 38% Passed first attempt Did not pass first attempt Source: AHIMA, 2,101 first-time CCA candidates, 2025 cycle

Exam content

The 6 domains tested on the CCA.

The CCA content outline (effective 2024) covers six domains. Clinical classification systems and reimbursement methodologies together make up over half the exam.

  1. Clinical classification systems — 30-34%

    The biggest domain. Abstracting records, applying ICD-10-CM/PCS, CPT, and HCPCS guidelines, code sequencing by setting, clinical vocabularies and terminologies.

  2. Reimbursement methodologies — 21-25%

    MS-DRG and APC assignment, linking diagnosis and CPT to payer rules, optimal sequencing for reimbursement.

  3. Health records and data content — ~14-18%

    Documentation standards, record content requirements, data quality basics. Inferred from the gap between published domain weights and 100%.

  4. Compliance — 12-16%

    Ethical coding, query and audit support, validating provider-assigned codes against documentation, coding-change updates, provider education.

  5. Information technologies — 6-10%

    Computer-assisted coding (CAC) software, EHR navigation, encoder and grouper use.

  6. Confidentiality and privacy — 6-10%

    HIPAA basics, password and passcode protocols, release-of-information fundamentals.

For the exact percentage weights, download AHIMA's CCA Content Outline PDF.

Study prep

How long to study for the CCA.

Candidates who recently finished a coding certificate program or who have 6+ months of medical billing experience typically prepare 8 to 12 weeks at 8-10 hours per week. Career-changers with no medical background should plan 4 to 6 months at 10-15 hours per week, with anatomy and medical terminology study built in before code-book practice.

AHIMA-published materials: The CCA Exam Preparation textbook (11th edition) and AHIMA's online CCA prep bundle (200 domain-organized practice questions plus 2 full practice exams) are the canonical resources.

Third-party prep: Mometrix's CCA study guide is the most widely-cited paid third-party resource (~$45). Free options include TestPrepReview, Practice Test Geeks, and Quizlet decks. None are AHIMA-endorsed, but they're useful for question stamina.

Required code books: ICD-10-CM, ICD-10-PCS, CPT (current professional edition), and HCPCS Level II. Buy the current year — older or unofficial editions cause forfeit on exam day.

Practice the one-way navigation. AHIMA's official practice exams replicate the one-way constraint. Get comfortable making decisions and moving on without going back.

Credential comparison

CCA vs CCS vs CPC — when to pick which.

The honest decision framework:

  • Start with CCA

    You have no prior coding job, just finished a coding program or are self-studying, and want a credential to put on your resume to land your first coding role. Or you want a low-cost low-eligibility entry point before deciding which direction to specialize.

  • Skip CCA, go straight to CCS

    You already have 2+ years of inpatient or outpatient coding experience, you hold RHIT or RHIA (which waives CCS experience requirements), or your hospital employer has told you they require CCS for promotion. CCS pays meaningfully more — about $$9,179/year more on average per AAPC's survey.

  • Consider CPC instead

    You want to work in physician practice coding rather than hospital coding. CPC (from AAPC) is the industry standard for physician practices, ambulatory surgery centers, and outpatient clinics. CPC and CCS are the two coding credentials senior coders ultimately stack together.

Important AHIMA rule

When you earn the CCS, it supersedes the CCA. You do not maintain both. The CCA credential is replaced by the CCS at certification, and you only recertify the CCS going forward. This matters for budgeting: if you plan to upgrade within 2 years, you can skip CCA recertification entirely.

Salary

What CCA holders actually earn.

Published salary data places CCA-credentialed coders in the $48,000-$52,000 range as a national average, sitting just above the uncredentialed coder baseline and well below the CCS and CPC averages. The CCA premium reflects the credential's entry-level positioning: it gets you above unskilled hourly work, but the big jumps come from experience and from upgrading to CCS or CPC.

AAPC's 2025 salary survey (based on 2024 data) reports the following averages by credential:

CredentialAverage annual salary
CCA (AHIMA, entry-level)$48,321
CCS (AHIMA, advanced inpatient)$57,500
CPC (AAPC, physician outpatient)$59,605
Two credentials (any combination)$71,130
Three or more credentials$76,035

Source: AAPC 2025 Medical Coding and Billing Salary Survey. Self-reported by AAPC members and other respondents.

For BLS data on the broader Medical Records Specialists occupation that CCA holders join, the May 2024 national median wage is $51,140. See our Medical Coder salary deep dive for the by-state breakdown.

Maintenance

Maintaining the CCA: 20 CEUs every 2 years.

The CCA cycle is 2 years from the date you pass the exam. Requirements:

20 CEUs per 2-year cycle. 0.5 CEU = 30 minutes of qualifying education.

80% of CEUs must fall within the HIIM domains; the remaining 20% can be on tangentially relevant topics.

40% AHIMA-source requirement (effective January 1, 2025): At least 40% of CEUs must come from AHIMA or an AHIMA component state association. The remaining 60% can come from AHIMA-approved providers or other recognized sources. This is a tightening from prior years and matters for candidates who relied on free third-party webinars.

Recertification fee: $100 per 2-year cycle for members, $249 for non-members.

The CCS-supersedes rule: when you earn CCS, the CCA is replaced and you stop maintaining it. If your career plan is to upgrade to CCS within the first 2-year cycle, you may not need to recertify the CCA at all.

Source: AHIMA recertification page and 2025 Recertification Guide.

Career impact

Which jobs the CCA actually unlocks.

The CCA shows up on job postings most often as one of several acceptable credentials ("CCA, CPC, CCS, RHIT, or RHIA required"). Hospital systems and revenue-cycle vendors use it as a screening filter at hire. The credential's career value is concentrated in three settings:

Hospital outpatient departments

The largest CCA-friendly employer category. Outpatient coding roles where the AAS-and-CCA-or-CPC combination is common.

Physician offices and clinics

Smaller practices that want a credential as a baseline but don't require the depth of CPC or CCS.

Revenue cycle service companies

Optum, R1 RCM, Conifer, Ciox/Datavant — large RC vendors that hire CCAs into entry-level coding roles with promotion paths to CCS.

Remote coding entry-level

Some remote-friendly employers hire CCA-credentialed coders, but most require 6-12 months on-site experience before unlocking remote work.

Where the CCA doesn't help much

Inpatient hospital coding (CCS dominates), risk adjustment / HCC coding (CRC from AAPC is preferred), and physician practice coding (CPC dominates). For those lanes, the CCA is at best a stepping stone, not a destination credential.

FAQ

Frequently asked questions about the CCA.

Is the CCA worth it if I plan to get CCS later?+

It depends on how soon you'll qualify for the CCS. If you're a recent graduate with no coding job yet, the CCA is the credential that lands your first role and unlocks the 1 year of experience that opens the CCS via Pathway 3. If you already have 2 years of coding experience, you can skip CCA entirely and sit for the CCS directly via Pathway 2.

How long do I have to wait to retake if I fail?+

AHIMA requires a 91-day wait between attempts, and a full reapplication with the standard exam fee. Use the wait period to identify which domains you struggled with and refocus your prep. Many candidates who fail by 30-50 scaled points pass on the second attempt with targeted study.

Do employers prefer CCA over CPC for entry-level coding?+

Most entry-level coding postings list "CCA, CPC, or equivalent." Hospital HIM departments lean slightly toward CCA because of the AHIMA ecosystem; physician practices and outpatient billing companies lean toward CPC because of the AAPC ecosystem and the CPT/E&M focus that CPC trains on. Pick the credential that matches the setting you want to work in.

Can high schoolers take the CCA?+

You must hold a high school diploma or equivalent to sit for the exam. Current high school students cannot register. Once you graduate or earn a GED, you're eligible immediately — no waiting period.

Will the CCA expire if I don't recertify?+

Yes. The CCA becomes inactive if you don't complete 20 CEUs and pay the recert fee within each 2-year cycle. Inactive credentials cannot be reactivated by simply paying the fee — you'd need to retake the exam. The exception is if you upgrade to CCS, in which case the CCA is officially superseded and the maintenance obligation ends.

Related certifications and roles

Keep exploring.

CCS (advanced inpatient)

The next-step credential after CCA. Hospital inpatient mastery.

RHIT certification

Associate-degree HIM credential. Broader than coding-only.

Medical Coder career

Education paths, credential strategy, and day-in-life details.

Medical Coder salaries

Wages by credential, state, setting, and experience level.

Associate degree in HIM

The 2-year RHIT-eligible degree path.

All accredited programs

The 350 CAHIIM-accredited HIM programs nationally.

Sources

Last refreshed . AHIMA fee schedules, pass rates, and content outlines change between cycles. Always verify current details directly on AHIMA's website.