AAPC Exams

The Business of Healthcare

The American Academy of Professional Coders (AAPC) was founded in 1988 to establish standards for medical coders in physician-based settings. The organization reports over 300,000 members worldwide as of 2025. While clinical staff handle patient care, AAPC credential holders manage the revenue cycle that keeps healthcare facilities operational.

In the United States, healthcare providers rely on accurate documentation to receive payment from insurance companies, Medicare, and Medicaid. A single administrative error can result in a denied claim or a compliance audit. AAPC credentials prove that an individual understands the complex web of medical terminology, human anatomy, and federal regulations required to submit clean claims.

AAPC Certification Structure

Unlike enterprise IT certifications that follow a strict progression from associate to professional to expert, AAPC structures its credentials laterally. Each certification targets a specific function within the medical office.

You do not need to pass a foundational exam before attempting a specialized one. Candidates choose their exam based on their daily responsibilities or target job role. For most professionals entering the revenue cycle management field, the path starts with either medical coding or medical billing.

The CPC: Certified Professional Coder

The CPC (Certified Professional Coder) is the organization's flagship credential. It validates your ability to read a patient chart, interpret the provider's notes, and translate that clinical information into standardized alphanumeric codes.

Employers in physician offices, outpatient clinics, and specialty practices treat the CPC as a baseline hiring requirement. The credential proves you understand how to apply guidelines from three major code sets: CPT (Current Procedural Terminology), ICD-10-CM (International Classification of Diseases), and HCPCS Level II (Healthcare Common Procedure Coding System).

The CPC exam consists of 100 multiple-choice questions. Candidates have exactly four hours to complete the test.

The content spans medical terminology, anatomy, and specific coding guidelines. It tests your knowledge across the entire CPT manual, including the 10000 through 60000 series for surgical procedures, evaluation and management (E/M) principles, anesthesia, radiology, and pathology. The exam also features ten practical cases where you must read a simulated medical record and select the correct codes. Questions assess your understanding of modifiers, which append to a code to indicate a service was altered by a specific circumstance without changing the definition of the code itself.

You must score at least 70 percent to pass, which requires answering 70 questions correctly.

The CPB: Certified Professional Biller

While coders translate medical records into codes, billers use those codes to generate and track financial claims. The CPB (Certified Professional Biller) targets this second half of the revenue cycle.

A biller's job involves navigating conflicting payer rules. Medicare requires different modifiers and claim forms than a private commercial insurer like Blue Cross. The CPB exam tests your knowledge of these specific payer policies, along with federal regulations like HIPAA, the False Claims Act, and the Fair Debt Collection Practices Act.

The CPB exam format differs slightly from the CPC. It contains 135 multiple-choice questions, but you still have exactly four hours to finish.

The test assesses your grasp of the entire life cycle of a medical claim. Questions cover managed care, Medigap, workers' compensation, and third-party liability payers. You will need to understand the function of Advance Beneficiary Notices (ABNs) and how to handle claims that a payer rejects or denies. The exam includes 34 case analysis questions where you review provided source documents to identify billing errors or apply policies.

Passing requires a 70 percent score, equating to 95 correct answers.

The Reality of Open-Book Exams

AAPC administers its exams either in person at a testing center or online with a live remote proctor. Both the CPC and CPB are open-book exams. You are permitted to bring physical copies of the current year's CPT, ICD-10-CM, and HCPCS Level II manuals.

Do not mistake open-book for easy. The manuals contain thousands of pages of codes, guidelines, and instructional notes.

With 100 questions on the CPC exam, you have roughly 2.4 minutes per question. On the CPB exam, that window drops to 1.7 minutes per question. If you have to look up basic anatomy or search the index for every diagnosis, you will run out of time. The open-book format tests your navigation speed and your ability to apply specific coding guidelines, rather than your raw memorization skills.

Testing rules permit candidates to write notes and highlight sections within their printed code manuals before the exam. However, you cannot bring loose paper, sticky notes with extensive text, or digital devices.

Career Weight

AAPC credentials carry direct weight in hiring algorithms for healthcare administration. Healthcare providers face strict federal oversight regarding how they bill for services. Hiring certified staff reduces a practice's risk of submitting fraudulent claims or facing financial penalties from government audit failures.

If you fail an AAPC exam, the organization provides a breakdown of your performance by category. You receive sub-scores for areas where you scored 65 percent or lower. This specific feedback dictates exactly which sections of the CPT manual or billing regulations you need to review before scheduling your second attempt.