The 2026 CCA Exam at a Glance
The Certified Coding Associate (CCA) is AHIMA's foundational coding credential. It tests coding, reimbursement, health-record, compliance, technology, and privacy knowledge. It is not an unrestricted online exam and it is not a general open-book test.
Use this guide as a planning layer, then confirm operational details on the official AHIMA CCA page and Pearson VUE's AHIMA page before your appointment.
| Item | Current 2026 rule |
|---|---|
| Eligibility | High school diploma required; coding work experience is recommended, not mandatory |
| Price | $199 AHIMA member; $299 nonmember |
| Questions | 105 total: 90 scored and 15 unscored pretest |
| Appointment | 2 hours total: 5-minute agreement plus 1 hour 55 minutes for the exam |
| Delivery | Pearson VUE test center only for CCA |
| Navigation | Dated AHIMA instructions enable back-and-forth review for exams scheduled on or after May 1, 2026; follow your ATT and on-screen instructions |
| Passing score | 300 on AHIMA's 100–400 scaled-score system |
| Eligibility window | 120 calendar days after the application is approved |
| Retake | New application, full fee, and at least 30 days between attempts |
The 15 pretest questions are mixed into the exam and are not identified. Treat every question as scored. AHIMA does not deduct points for guessing, so leaving a question unanswered has no advantage.
Two timing facts that change your strategy
The phrase “two-hour exam” includes a five-minute candidate agreement. The question portion is 115 minutes. Dividing 115 minutes by 105 questions gives about 1.095 minutes, or 65.7 seconds, per question.
That average is a planning number, not a rigid limit. A code-lookup question may need more time than a terminology item. Record a best answer on the first pass and use any remaining time to revisit flagged items if the live interface permits review.
AHIMA currently publishes conflicting navigation language
AHIMA's CCA credential page says candidates cannot move backward, flag, or return. Its scheduling instructions, updated February 11, 2026, say candidates scheduled on or after May 1, 2026 can navigate back and forth.
The dated, appointment-specific instruction supports review-enabled navigation for current exams, but your ATT and the instructions displayed at Pearson VUE control your sitting. Practice making a supported first-pass choice so you are prepared even if the live workflow is restrictive.
Eligibility, Application, and Test-Day Delivery
AHIMA requires a high school diploma. It recommends one or more preparation routes—six months of direct coding experience, completion of AHIMA's Professional Certificate Approval Program, or other coding training that includes anatomy and physiology, medical terminology, basic ICD diagnostic and procedural coding, and basic CPT coding—but those recommendations are not additional eligibility requirements.
After approval, you generally have 120 calendar days to test. AHIMA's current certification FAQ permits paid 30-day extensions, up to 90 days total, when requested at least 14 days before the eligibility period ends. Check the current rules before relying on an extension.
CCA is delivered at a Pearson VUE test center. Pearson's AHIMA page lists OnVUE delivery only for CHDA, CHPS, and CDIP; it lists CCA with the in-person credentials. Your Authorization to Test contains the scheduling instructions. Pearson also instructs candidates to bring two forms of valid identification and arrive 30 minutes early.
The Six Official CCA Content Domains
AHIMA's CCA content outline gives percentage ranges, not fixed question counts. Individual forms can vary within these ranges.
| Domain | Official percentage range | What to be ready to do |
|---|---|---|
| Clinical Classification Systems | 30–34% | Apply coding conventions, guidelines, sequencing, modifiers, edits, and documentation principles |
| Reimbursement Methodologies | 21–25% | Connect coding and documentation to payment methods, claims, edits, denials, and reimbursement concepts |
| Health Records and Data Content | 13–17% | Interpret record content, data quality, retention, registries, and documentation requirements |
| Compliance | 12–16% | Recognize compliant coding, auditing, reporting, fraud-and-abuse, and query practices |
| Information Technologies | 6–10% | Use health-information systems, encoders, electronic records, interfaces, and data-security concepts |
| Confidentiality and Privacy | 6–10% | Apply access, disclosure, authorization, privacy, and security requirements |
The midpoints of the six ranges are 32, 23, 15, 14, 8, and 8. Conveniently, they total 100, so they make a useful study-allocation model. They are not an official promise that a form will use those exact percentages.
Clinical Classification Systems and Reimbursement Methodologies together account for roughly 51–59% of the exam. Give them the largest share of practice, but do not ignore the four smaller domains: together they can represent a substantial portion of the scored exam.
Which Codebooks Are Allowed After May 1, 2026?
For exams delivered on or after May 1, 2026, AHIMA's 2026 CCA approved codebook list requires candidates to bring all three of these resources:
- One approved 2026 ICD-10-CM codebook from the official list.
- One approved 2026 ICD-10-PCS codebook from the official list.
- Either the AMA CPT 2026 Professional Edition spiral book (ISBN 978-1-64016-322-5) or the listed CPT Professional 2026 and QuickRef App Bundle (ISBN 978-1-64016-332-4).
Do not buy by title alone. Publisher, edition, format, and ISBN matter. AHIMA warns that candidates who arrive without all required approved books, or with an unapproved book, may be unable to test and may forfeit the exam fee.
Call the exam codebook-assisted rather than broadly open-book. The approved codebooks are permitted; study guides and general references are not. Review the current candidate guide and codebook list for annotation, insert, and inspection rules before test day.
A Weight-Aware Eight-Week Study Plan
Week 1: Baseline and book navigation
Take a mixed diagnostic without notes. Record each miss by official domain, skill, and error type. Set up the exact approved books you will take to the test and practice locating tables, conventions, instructional notes, appendices, and indexes.
Weeks 2–3: Clinical Classification Systems
Build reliable code-selection routines rather than memorizing isolated codes. Practice identifying the principal condition or service, applying conventions and sequencing, confirming in the tabular list, and checking documentation support. Include ICD-10-CM, ICD-10-PCS, and CPT work that matches the outline.
Week 4: Reimbursement Methodologies
Connect codes to the claim and payment process. Review prospective payment concepts, medical necessity, edits, denials, coverage, charge capture, and how incomplete documentation affects reimbursement. When you miss a question, identify whether the error was coding, documentation, payer logic, or terminology.
Week 5: Records, data, and compliance
Study record components, data quality, retention, completion, registries, auditing, queries, and compliant reporting. Separate an internal policy question from a legal or regulatory requirement; the exam may test both, but they are not interchangeable.
Week 6: Privacy, confidentiality, and technology
Review access, authorization, minimum-necessary concepts, release-of-information workflows, safeguards, electronic records, encoders, interfaces, and basic data integrity. Practice short scenarios that ask for the best next action.
Week 7: Mixed timed sets
Use mixed sets that require a supported answer on the first pass. If your simulator permits review, flag only the items worth revisiting and track how much second-pass time remains. For every miss, explain why the key is supported and why each distractor fails.
Week 8: Full simulation and repair
Complete at least two 105-question simulations in 115 minutes, using only approved codebooks. Follow the current review-enabled workflow when available, but finish every first-pass answer before relying on a return. Spend the final days repairing repeat errors instead of rereading entire chapters.
A Better Question Routine
- Identify what the stem is asking before opening a codebook.
- Eliminate choices that violate an explicit convention, documentation fact, or workflow rule.
- Look up only the fact needed to separate the remaining choices.
- Record the best supported answer before advancing.
- If uncertain, make an educated guess and flag the item if the live interface permits review.
A good error log has four fields: domain, missed concept, reason for the miss, and a scheduled retest date. “Careless” is not a useful reason. Record whether you misread the stem, searched the wrong index term, skipped a tabular instruction, confused two reimbursement concepts, or applied a privacy rule too broadly.
Passing Score and Recent Results
AHIMA reports scaled scores from 100 to 400, with 300 required to pass. A scaled score is not a raw percentage, so “300” does not mean 75% correct.
AHIMA's CCA page reports 2,101 first-time test takers and a 62% first-time pass rate for 2025. It reports 67% for 2024 and 70% for 2023. These are historical results, not a forecast of an individual candidate's chance. As of December 31, 2025, AHIMA reported 7,753 active CCA certificants.
Retakes and Maintaining the Credential
After an unsuccessful attempt, AHIMA requires a new application, the full exam fee, and a wait of at least 30 days before retesting. Use the score report to target the next study cycle rather than immediately repeating the same plan.
The March 2026 AHIMA Recertification Guide assigns the CCA a two-year recertification cycle with 20 continuing-education units. At least 80% of those CEUs must fall within AHIMA's health informatics and information management domains. The guide lists a $100 member or $249 nonmember recertification fee for a first credential; additional-credential fees differ.
Do not rely on older summaries that claim every CCA must earn five annual self-review CEUs or that 40% of CEUs must come directly from AHIMA. The current AHIMA removal notice says CCHIIM dissolved the proposed 40% source rule effective immediately; no annual self-review requirement applies.
Career and Salary Context Without the Hype
CCA is designed to demonstrate entry-level coding competence. It can support applications for coding and health-information roles, but a credential does not guarantee a job, remote work, or a particular salary. Employer requirements vary by setting, specialty, location, and experience.
The U.S. Bureau of Labor Statistics reports that medical records specialists had a median annual wage of $51,140 in May 2025. BLS projects 8% employment growth from 2025 through 2035 and about 14,000 openings per year. Those figures cover the occupation as a whole; they are not CCA-holder salary statistics.
Treat CCA, CCS, and other coding credentials as different evidence of competence, not an automatic salary ladder. AHIMA describes CCS preparation as more advanced and recommends experience through several possible paths, but it does not make two years of experience a universal prerequisite.
Official 2026 Source Checklist
Before paying or testing, verify these primary sources:
- AHIMA CCA credential page for eligibility, fees, format, results, and retakes.
- AHIMA CCA content outline for the six percentage ranges and task statements.
- AHIMA 2026 CCA codebook list for allowed editions and ISBNs.
- AHIMA exam-time FAQ for the five-minute agreement and 115-minute exam allocation.
- AHIMA scheduling instructions for the May 1 navigation change and ATT process.
- Pearson VUE AHIMA page for test-center scheduling and identification rules.
- AHIMA recertification page for current maintenance requirements.
- BLS Medical Records Specialists profile for occupation-wide wage and outlook data.
Policies, prices, approved books, and delivery rules can change. Use the linked official pages—not a screenshot or an old forum post—for the final check before applying.
Buy on Amazon
Flashcards on Mometrix
Practice exams on ExamEdge