CPC vs CCS Certifications: What’s the Difference?

In some ways, the CCS (Certified Coding Specialist) and CPC (Certified Professional Coder) certifications are very similar. Perhaps the most notable similarity is that they are both certifications in medical coding. They can also both be used to help show an employer or prospective employer that you have the skill sets necessary to work in a coding role.

At the same time, these two designations are also very different. Understanding these differences is important for anyone who is interested in beginning a career in medical billing and coding, or someone already working in the field who is looking to boost their career through one of these certifications. Before we explore some of the differences, let’s first explain what each coding certification is.

What is the CPC (Certified Professional Coder) Certification?

CPC stands for Certified Professional Coder. This medical coding certification is offered through the American Academy of Professional Coders (AAPC) and serves to provide a sort of evidence that you have the knowledge and skills needed to work as a professional coder.

Who Could Benefit From a CPC Certification?

This is a good certification for those who are just beginning their career in medical billing and coding, or for someone who is interested in working solely as a medical coder.

About the CPC Certification Exam

To earn this credential, you must pass the CPC exam. This is a 150-question multiple-choice test designed to assess your knowledge in 17 different areas, some of which include anatomy, medical terminology, radiology, and medicine.¹ The certification exam also assesses your ability to properly apply diagnostic, procedural, and treatment codes using the standard medical coding systems, which are:

• International Classification of Diseases (ICD-10-CM or ICD-11)
• Current Procedural Terminology (CPT)
• Healthcare Common Procedure Coding System (HCPCS)

Candidates have 5 hours and 40 minutes to complete the CPC exam and must provide the correct answer to at least 70% of the questions (which means answering at least 105 questions accurately) in order to earn a passing score.

CPC Exam Cost

If you take the CPC exam online, the cost is $299 and you have one attempt at passing it. Take the exam in person at one of the assigned testing locations and the cost goes up to $399, but candidates have two attempts to earn a score of 70% or higher. AAPC membership is required to take the exam, which is another $180.

CPC Exam Eligibility Requirements

You must have a minimum of two years of coding experience to earn the CPC designation. If you don’t have this experience, you may still be able to take the test. However, if you pass, your designation would be CPC-A, which stands for CPC apprentice.

Once you have gained two years of experience, you can request that the “A” be removed from your CPC designation. This is achieved through the submission of two letters of recommendation that verify that you have met this minimum time requirement.

What is the CCS (Certified Coding Specialist) Certification?

CCS stands for Certified Coding Specialist. This coding credential is provided by the American Health Information Management Association (AHIMA). It signifies that you have met the standards as set forth by this organization to provide services as a medical coding specialist. These include having skills needed to maintain data quality and ensure data accuracy, also indicating that you’ve met a certain level of proficiency in medical coding.

Who Could Benefit From a CCS Certification?

This exam may be best suited for those with medical coding experience who are looking to advance their careers and/or earn a higher salary. Generally speaking, the CCS certification exam is more difficult than the CPC certification exam. It also has more stringent eligibility requirements.

About the CCS Exam

The CCS exam consists of two sections. The first section includes answering multiple-choice questions. The second involves answering questions about medical scenarios (inpatient, outpatient, and emergency department). In total, there are between 115 and 140 questions on the CCS certification exam.

Should you decide to take the CCS exam, you have four hours to complete it. It covers four domains: coding knowledge and skills (51.9%), coding documentation (10.1%), provider queries (8.9%), and regulatory compliance (29.1%). You must earn a score of 300 or higher to pass, and this exam has an 83% pass rate for first-time test-takers.³

CCS Exam Cost

The cost of the CCS exam is $299 for AHIMA members or $399 for non-members. AHIMA membership ranges from $49 annually as a student to $199 per year for a Professional – Premier member.

CCS Exam Eligibility Requirements

If you meet the minimum qualifications, you can apply to take the CCS exam. To apply for the CCS exam, you must either:²

• have two years of coding experience; or
• have completed medical billing and coding courses plus have at least one year of coding experience; or
• hold a Certified Coding Associate (CCA) credential plus have at least one year of coding experience; or
• hold some other coding credential plus have at least one year of coding experience; or
• hold a credential as a Certified Coding Specialist – Physician-Based (CCS-P), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA).

What Are the Key Differences Between the CPC and CCS Certifications?

There are several key differences between AAPC’s CPC certification and AHIMA’s CCS certification. They are:

• Who may be best suited for the certification? If you are new to medical billing and coding, CPC certification can show potential employers that you have the knowledge needed to utilize and apply the standard coding systems. If you have experience in medical coding and want to advance your career or increase your income, CCS certification may be better suited to help you achieve these goals.
• Eligibility requirements. You must be an AAPC member to take the CPC certification exam. While you cannot earn the CPC designation until you have two years of medical coding experience, you can take the exam prior to meeting this requirement. Upon passing the exam, your designation would be CPC-A, which is a CPC apprentice. To take the CCS certification exam, you must either have two years of experience or one year of experience combined with completed medical billing and coding courses or another coding credential. You can also take the CCS exam if you already have your certification as a CCS-P, RHIT, or RHIA.
• Cost. Although both AAPC and AHIMA offer the exam for either $299 or $399, the cost of the exam varies based on different factors. Namely, to qualify for the $299 CPC exam, you must take it online. To qualify for the $299 CCS exam cost, you must be an AHIMA member.
• Level of difficulty. Many consider the CCS certification exam to be more difficult than the CPC certification exam. This could be, in part, because the CPC certification exam includes a medical scenario section in addition to the multiple-choice questions. This also might be why it requires that test-takers have at least some experience before applying to take the test.

How to Choose Between CPC and CCS Certification

Both of the CPC and CCS medical coding certifications can show potential employers that you have the knowledge and skills needed to work in a medical coder role. The one that is best for you can vary based on your specific situation and medical billing and coding career goals.

One strategy that some in this field pursue is obtaining their CPC certification first, then pursuing their CCS certification later — after gaining some experience. Whether this is also a good strategy for you depends on a number of factors.

To help you make the best decision for you when choosing between a CPC or CCS designation, here are a few questions to ask yourself:

• What are my medical billing and coding career goals?
• Would one certification be more likely to help me achieve those goals than the other?
• Based on the roles I want to pursue (either now or later), is one certification better than the other?
• What certifications does my employer or potential employer either prefer or require?
• Do I meet the minimum eligibility requirements for the medical coding certification exam that I’d like to take?
• If I don’t meet the eligibility requirements, what do I still need to do before I am able to apply to take the certification exam?

Answering questions such as these can help you determine which certification may be best for you based on your circumstances and goals.

Medical Coding Education and Certification Exam Success

Although neither the APPC nor AHIMA requires a formal education in medical billing and coding, both indicate that having knowledge and training in this field can be beneficial. At a minimum, having the proper education can help give you the best chance at passing both the CPC and CCS certification exams, which is especially important since you have limited attempts with each before having to pay for a whole new test.

If you’d like to learn the skills necessary to work as a medical coder or medical biller and coder, Ultimate Medical Academy (UMA) offers two options: an online Medical Billing and Coding diploma and an online Medical Billing and Coding associate degree. The online Medical Billing and Coding diploma program can be completed in 11 months³ and includes courses that teach about diagnostic coding, procedural coding, anatomy, medical terminology, claims processing, and more.

UMA’s online Medical Billing and Coding associate degree program can be completed in 18 months³ and provides instruction in these same topic areas. It also offers additional courses designed to improve the student’s knowledge in working with computers, communicating with other healthcare professionals, and working with people. It includes a few general education courses as well (English, math, etc.), giving students a more well-rounded education.

Both programs provide the foundation needed to work in medical coding. They also help better prepare you to sit for the CPC coding certification exam offered through the AAPC, as long as you meet the agency’s certification testing eligibility requirements.

Contact UMA today to learn more about how we can help you reach your medical billing and coding career goals!