RHIA Exam Guide 2026: 150 Questions, Fees, Domains & Study Plan

The Registered Health Information Administrator (RHIA) credential is AHIMA's administrator-level health information management credential. In 2026, the exam has 150 total items, a 3-hour-30-minute appointment, and a 300 passing scaled score. Those facts matter because many RHIA guides still repeat an older 180-question, four-hour format.

This guide uses the current AHIMA RHIA certification page, the official RHIA Exam Content Outline effective October 1, 2023, and AHIMA's current candidate policies. Verify the official pages again before paying because fees and policies can change.

Start free RHIA practice questionsPractice questions with detailed explanations

RHIA exam facts for 2026

AHIMA does not publish the raw number or percentage of correct answers needed for a 300. Do not translate 300 into “75% correct.” Pretest items are not identified, so treat every item as scored.

AHIMA reports 860 first-time testers and a 67% pass rate in 2025, compared with 71% in 2024 and 64% in 2023. Those are official historical results, not a personal probability of passing. Preparation quality and recent experience can change an individual's outcome.

Who is eligible for RHIA?

AHIMA currently accepts these pathways:

1. Complete the baccalaureate-level academic requirements of a CAHIIM-accredited health information management program.
2. Complete the master's-level academic requirements of a CAHIIM-accredited health information management program.
3. Complete a CAHIIM-approved HIM Certificate of the Degree (Post-Baccalaureate) program.
4. Graduate from a foreign HIM program approved under an AHIMA reciprocity agreement.

A general health informatics degree is not automatically an eligible HIM degree. Work experience also does not replace an eligible academic pathway. Search the CAHIIM program directory and confirm your exact program and pathway before applying.

Students in an eligible program may qualify for early testing when they meet AHIMA's current academic timing rules. Use the form and transcript instructions on the official RHIA page rather than relying on a school's informal summary.

Application checklist

• Create a MyAHIMA account using the same legal name that appears on your identification.
• Confirm that your program and degree pathway meet the current eligibility language.
• Submit the online application and fee.
• Send the required transcript or early-testing form to the AHIMA address listed in the application instructions.
• Wait for the authorization to test, then schedule within the 120-day eligibility window.
• Read the current AHIMA Candidate Guide before test day.

AHIMA's application page says extension requests must meet its timing and fee rules. Do not assume an expired authorization will be restored automatically.

Current RHIA content outline and weights

The current outline uses ranges, not five fixed percentages. A form can vary within each range while remaining consistent with the blueprint. Therefore, converting a range into an exact number of questions creates false precision.

The 100-hour split is a planning baseline, not an AHIMA recommendation. After a diagnostic, move time toward weak tasks while continuing mixed review in every domain.

Domain 1: Data and Information Governance, 17–20%

Study how an RHIA protects trustworthy information across its lifecycle. The official tasks include documentation integrity, data used in quality reporting, data dictionaries, documentation and data standards, retention and destruction policies, information-governance policies, and master patient index management.

Practice choosing the control that addresses the root cause. A duplicate-record trend may require registration standardization, identity matching, and an audited merge process—not simply deleting one record. A disputed metric may require a shared definition and validation before a new dashboard.

Domain 2: Compliance with Access, Use, and Disclosure, 15–18%

Focus on patient access, portals, disclosure requests, internal and external PHI use, breach workflows, privacy, and security. For HIPAA scenarios, first identify the requester, purpose, authority, information requested, and delivery method.

The HIPAA minimum-necessary standard generally applies to payment and health care operations but not to disclosures for treatment. The HHS minimum-necessary guidance also lists other exceptions, so “minimum necessary applies to every disclosure” is a poor rule.

For a breach affecting 500 or more individuals, notice to HHS is due without unreasonable delay and no later than 60 days. Media notice applies only when more than 500 residents of a state or jurisdiction are affected. Review the HHS breach-notification rule summary instead of memorizing “large breach equals media” without the location threshold.

The 2024 42 CFR Part 2 final rule allows a single consent for future treatment, payment, and health care operations uses and disclosures. Covered entities and business associates receiving records under that consent may redisclose them under HIPAA rules, subject to Part 2's remaining protections. Compliance was required by February 16, 2026; use the HHS Part 2 final-rule fact sheet for current language.

Domain 3: Data Analytics and Informatics, 23–26%

This is tied for the largest range. The outline covers EHR end-user support, report design and data visualization, databases and data mining, focused audits, technology-enabled workflow improvement, health information exchange, software and integration evaluation, the systems development life cycle, and health care statistics.

Do not study formulas as isolated flashcards. Define the numerator, denominator, population, time period, exclusions, and data source. Then interpret whether the result supports a decision. For dashboards, match the visual to the question and disclose unstable denominators or missing data.

For system scenarios, distinguish configuration, interface, workflow, training, and governance failures. The strongest answer usually validates the problem, identifies its source, tests the correction, controls access, and monitors the result.

Domain 4: Revenue Cycle Management, 20–23%

Study reimbursement models, coding accuracy, documentation requirements, clinical documentation integrity, claims, the chargemaster, discharged-not-final-billed accounts, accounts receivable, coding and grouping systems, denials, audits, fraud, abuse, and revenue integrity.

Map the cycle rather than memorizing acronyms: documentation supports code assignment; codes and charges support the claim; payer edits and medical-necessity rules affect adjudication; denials and payment variance feed corrective action. A compliant answer never recommends changing documentation or codes merely to increase reimbursement.

Know which payment families fit the setting. For example, Medicare acute inpatient hospital payment uses MS-DRGs under IPPS, while hospital outpatient payment uses APCs under OPPS. When a scenario supplies current-year coding or payment details, use the rule given in the item rather than an older remembered value.

Domain 5: Management and Leadership, 23–26%

This domain is also tied for the largest range. The official tasks cover organizational goals, change management, contracts, human resources, work design and process improvement, training, budgets, accreditation, legal and regulatory compliance, and project management.

Prepare to select a management action in context. A staffing problem may require workload data before hiring. A vendor problem may require contract metrics, an audit, corrective action, and escalation. A project problem may require scope control, stakeholder communication, risk tracking, and change governance.

Separate improvement tools by purpose. A fishbone diagram organizes possible causes; a Pareto chart prioritizes categories; a control chart distinguishes common- and special-cause variation; PDSA tests a change; and a project charter defines authority, scope, objectives, and stakeholders.

A 10-week RHIA study plan

AHIMA does not prescribe a universal number of study hours. Use this 100-hour plan as a flexible starting point, then adjust it to your diagnostic results and graduation date.

A useful error log has five columns: objective, why your answer failed, controlling rule or concept, why the keyed answer is better, and the date you retested it. Labels such as “careless” are not diagnoses. Rewrite the decision rule you missed.

Use retrieval practice: answer before reading notes, explain the rule in one sentence, then solve a new scenario. Mix domains regularly because the real exam does not announce which domain a question tests.

Timing practice

The launched exam allows 205 minutes for 150 items, or about 82 seconds per item on average. That is an average, not a cap. Move efficiently through direct items so you can spend more time on calculations and management scenarios.

AHIMA allows candidates to move backward and forward after selecting an answer and to flag answered items for review. Use three passes:

1. Answer direct questions and select the best provisional answer on harder items.
2. Revisit flagged calculations and close decisions.
3. Use remaining time to check unanswered items and accidental answer changes.

Do not spend extra time trying to identify the 20 pretest items. They are mixed in and not labeled.

RHIA test-day rules

AHIMA currently requires RHIA testing at a Pearson VUE test center; remote proctoring is not listed for this credential. The Candidate Guide instructs candidates to arrive at least 30 minutes early and warns that arriving more than 15 minutes late can result in denial of admission.

Bring two acceptable original IDs. The primary ID must include a photograph and signature; the secondary ID must include a signature. Your name must match the authorization to test. Read the Candidate Guide for the full approved-ID list and rescheduling rules.

There are no planned breaks. A test-center candidate may request an unscheduled break, but the exam clock does not stop. Personal items and reference books are prohibited; AHIMA lists no required books or resources for RHIA exam day.

Scoring, failing, and retaking

The passing scaled score is 300. AHIMA provides the result immediately and includes performance information by domain. Because the score is scaled, a domain percentage on the report should guide remediation but should not be converted into an assumed raw-score requirement.

If you fail:

1. Save the domain report and identify the specific outline tasks behind weak areas.
2. Submit a new application and pay the full $229 member or $299 nonmember fee.
3. Wait 30 days for RHIA retest approval; AHIMA says it does not waive the security waiting period.
4. Retest concepts with new scenarios rather than memorizing earlier item wording.

Transcripts remain on file for a retake, according to the current RHIA page.

RHIA recertification in 2026

RHIA is maintained on a two-year cycle with 30 continuing education units (CEUs). Under AHIMA's current 2026 recertification guide, at least 80% of CEUs must fall within the health informatics and information management domains; up to 20% may be relevant to the holder's professional position.

The current AHIMA removal notice says CCHIIM dissolved the proposed 40% AHIMA-source rule effective immediately. The enforceable content rule remains at least 80% of CEUs within approved HIIM domains. Review the AHIMA recertification page and the 2026 Recertification Guide for fees, audit documentation, and multi-credential requirements.

RHIA versus RHIT

A credential does not guarantee a job title or salary. AHIMA describes RHIAs as working across clinical, financial, administrative, and information-systems functions in providers, insurers, vendors, consulting, government, education, and other settings.

For broader labor-market context, the U.S. Bureau of Labor Statistics reports a $123,860 median annual wage in May 2025 and 24% projected growth from 2025 to 2035 for medical and health services managers. That occupation is broader than RHIA holders, so those figures are not an RHIA-specific salary estimate. See the BLS Occupational Outlook Handbook.

Official RHIA resources

• AHIMA RHIA certification, eligibility, format, fees, pass rates, and retakes
• Official RHIA Exam Content Outline effective October 1, 2023
• AHIMA certification application and scheduling
• AHIMA certification FAQs
• AHIMA Candidate Guide
• CAHIIM accredited-program directory
• Pearson VUE AHIMA testing page
• AHIMA recertification hub

practice current RHIA questionsPractice questions with detailed explanations