NHA CEHRS Exam 2026: The Complete Certification Guide
The NHA Certified Electronic Health Records Specialist (CEHRS) credential, administered by the National Healthcareer Association, certifies that you can accurately manage patient data inside electronic health record systems — a skill every hospital, clinic, and medical office now requires under the HITECH Act and 21st Century Cures Act interoperability rules.
If you want to work in medical records, billing support, patient registration, or as a clinic-side EHR super-user, the CEHRS is the most affordable, entry-level credential that proves you can do the job on day one. This guide walks you through the 2026 exam format, the five domains with exact item counts, fees, the passing score, a study timeline, and a full FREE prep path.
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CEHRS Exam Format & Structure (2026)
| Component | Detail |
|---|---|
| Scored Questions | 100 multiple-choice |
| Pretest Questions | 25 unscored (unmarked) |
| Total Items | 125 |
| Time Limit | 125 minutes (2 hours 5 minutes) |
| Passing Score | 390 on a 200–500 scaled range |
| Exam Fee | ~$125 (verify at nhanow.com) |
| Delivery | PSI test center OR live online proctoring |
| Results | Posted to your NHA account within 2 business days |
| Recertification | Every 2 years, 10 CE credits |
The 25 pretest questions are scattered throughout the exam and you cannot tell which ones they are — treat every item as if it counts. NHA uses a scaled score (not a raw percentage) so that different exam forms are comparable. You do not need to hit any specific percent correct; you need a scaled 390 or higher.
The current test plan took effect June 17, 2020, based on NHA's 2019 nationwide Job Task Analysis — so any study guide older than mid-2020 is on a retired blueprint. As of 2026 the 2019-based plan is still the active blueprint.
Eligibility Requirements
You qualify to sit for the NHA CEHRS exam if you meet one of these pathways:
Pathway 1 — Education
- High school diploma or GED, AND
- Completion of an EHR specialist training program within the last 5 years
Pathway 2 — Work experience
- High school diploma or GED, AND
- 1 year of supervised EHR specialist work in the past 3 years, OR
- 2 years of supervised EHR specialist work in the past 5 years
Most candidates come through pathway 1 because dedicated CEHRS programs run 4 to 12 weeks at community colleges, proprietary schools (MedCerts, Penn Foster, Ashworth, Stepful, ACI Medical & Dental), and career-training bootcamps. You do not need an associate degree — that is what separates CEHRS from RHIT.
The Five CEHRS Domains (2026 Test Plan)
The NHA CEHRS test plan breaks the 100 scored questions into five domains. Memorize this weighting — it tells you exactly where to spend your study hours.
| # | Domain | Scored Items | Weight |
|---|---|---|---|
| 1 | Non-Clinical Operations | 28 | 28% |
| 2 | Clinical Operations | 32 | 32% |
| 3 | Revenue Cycle / Finance | 15 | 15% |
| 4 | Regulatory Compliance | 15 | 15% |
| 5 | Reporting | 10 | 10% |
| Total | 100 | 100% |
Clinical Operations is the largest domain — nearly a third of the exam — so do not treat this as a back-office test. You have to know what a progress note, a SOAP note, an order set, and a medication reconciliation look like from the inside of the chart.
1. Non-Clinical Operations (28%)
Everything that happens before and around the clinical visit:
- Verifying patient identifiers (name, DOB, MRN) before you document
- Collecting and updating demographics and insurance information
- Generating encounter paperwork: admission sheets, face sheets, armbands, labels
- Retrieving patient info from internal provider and financial databases
- Acquiring external data (labs, ancillary facilities, outside EHRs)
- Scheduling, check-in, and check-out workflows
- Providing initial and ongoing end-user EHR training
- Identifying, reporting, and reconciling data discrepancies across systems
- Helping patients register for and navigate the patient portal
- Maintaining an inventory of EHR hardware (scanners, signature pads, cameras, tablets)
2. Clinical Operations (32%)
The documentation and clinical data side of the chart:
- Developing clinical templates for data capture (by diagnosis, procedure, practice)
- Secure transmission and exchange of patient data internally and externally
- Reviewing and monitoring clinical documentation for completeness
- Providing point-of-care and at-the-elbow EHR support to clinicians
- Inputting real-time clinical data and historic data (medications, immunizations, surgeries)
- Supporting computerized provider order entry (CPOE)
- Locating patient education materials within the EHR
- Navigating the chart to retrieve requested patient data
3. Revenue Cycle / Finance (15%)
- Basics of ICD-10-CM, CPT, and HCPCS Level II code sets
- Insurance verification and eligibility checks
- Charge capture and superbill workflow
- Claims submission, clean claims, and common denial codes
- Payment posting and patient statements
- Cost estimates and good-faith estimates (No Surprises Act)
4. Regulatory Compliance (15%)
- HIPAA Privacy, Security, and Breach Notification Rules
- Protected Health Information (PHI) and the 18 HIPAA identifiers
- Minimum necessary standard
- Administrative, physical, and technical safeguards
- HITECH Act, 21st Century Cures Act, and information blocking rules
- ONC certification of EHR software
- Meaningful Use / Promoting Interoperability program basics
5. Reporting (10%)
- Running financial and clinical reports from the EHR
- Quality metrics: MIPS, CQMs, HEDIS basics
- Registries (immunization, cancer, syndromic surveillance)
- Data mining, ad-hoc queries, and exporting data
- Verifying report accuracy before distribution
Free Practice Questions & Study Materials
Each domain includes:
- NHA-style multiple-choice questions with explanations
- Scenario-based chart workflow items
- HIPAA and compliance drills
- AI-powered wrong-answer walk-throughs
Suggested Study Timeline
Most candidates pass with 60–100 focused hours of study on top of their training program. Here is a 6-week plan that mirrors the domain weighting:
| Week | Focus | Hours |
|---|---|---|
| 1 | Non-Clinical Operations — registration, scheduling, patient portal, data reconciliation | 12 |
| 2 | Clinical Operations, part 1 — chart navigation, SOAP notes, problem/med/allergy lists | 14 |
| 3 | Clinical Operations, part 2 — ROI, scanning, audit logs, addenda | 14 |
| 4 | Revenue Cycle — ICD-10/CPT basics, claims, denials, No Surprises Act | 10 |
| 5 | Regulatory Compliance — HIPAA, HITECH, Cures Act, information blocking | 10 |
| 6 | Reporting + full-length practice tests + wrong-answer review | 12 |
Schedule your exam at the end of week 4, not after you feel ready. A fixed test date forces focused review.
7 Common CEHRS Mistakes That Fail Candidates
- Underestimating Clinical Operations. It is 32% of the exam — not an afterthought. If you are non-clinical, this is where your study hours go. Expect scenarios that require reading a partial SOAP note and identifying what is missing.
- Skipping HIPAA edge cases. "Minimum necessary," incidental disclosure, business associate agreements (BAAs), and the 60-day breach notification rule show up on every exam form. Treatment, Payment, and Operations (TPO) exceptions are also heavily tested.
- Confusing CPT and ICD-10. CPT/HCPCS = what was done. ICD-10-CM = why it was done (diagnosis). Know the difference cold, and remember that CPT has Category I, II, and III codes — Category III is emerging technology.
- Memorizing code numbers. You do not need to memorize ICD or CPT codes. You need to know the structure and purpose of each code set — ICD-10-CM is 3 to 7 characters, alphanumeric, with a decimal after the third character; CPT is always 5 digits.
- Ignoring the patient portal and Cures Act. Information blocking questions are now testable — patients have a right to their electronic records without delay. Know the 8 exceptions (preventing harm, privacy, security, infeasibility, content and manner, fees, licensing, health IT performance).
- Guessing on scaled scoring. You do not need 78% or any fixed percentage. You need scaled 390. Answer every question — there is no penalty for guessing. A blank answer is always wrong; an educated guess has at least a 25% chance.
- Running out of time. 125 minutes for 125 items gives you exactly 1 minute per question. Flag and move on; do not camp on hard items. Aim to finish the first pass in 90 minutes, leaving 35 minutes for flagged reviews.
Recommended Study Resources
Beyond OpenExamPrep's free course, candidates commonly pair these materials:
- Official NHA CEHRS Preparation Suite 2.2 — Digital study guide plus two online practice tests (each with A and B versions, re-takeable). NHA's implementation guide recommends about 9.25 hours with the study guide itself, then 2 hours 5 minutes for each practice-test attempt. Exactly aligned to the blueprint.
- Quizlet CEHRS flashcard decks — Free, user-generated, variable quality. Best for vocabulary drill (HIPAA terms, code-set abbreviations) in 10-minute bursts.
- MedCerts, Penn Foster, Ashworth, Stepful, ACI Medical & Dental — Full training programs if you need the education pathway. $1,500–$4,000. Check for employer or WIOA funding; some report NHA pass rates above 90%.
- AAPC + AHIMA free resources — Not CEHRS-specific, but their HIPAA primers and coding basics pages are free and authoritative.
- YouTube: "CEHRS exam review" — Several full-length review videos; useful for passive learning during commutes.
Do not rely on dumps, "leaked" questions, or pay-to-view actual exam items. NHA rotates forms and prosecutes item theft — it violates the candidate agreement and can void your attempt.
Fees, Retakes & Recertification
| Item | 2026 Cost |
|---|---|
| Initial exam fee | ~$125 (verify at nhanow.com) |
| Study package (optional) | $39–$69 add-on |
| Retake fee | Same as initial exam fee |
| Recertification | ~$169–$185 every 2 years |
Retake policy: If you do not pass, you may reapply after 30 days. After three unsuccessful attempts, you must wait 12 months before trying again. Fail-first-time rates run roughly 25–30%, so a retake is not unusual — it is also not free, so study properly the first time.
Recertification: Every 2 years you must complete 10 continuing education (CE) credits and pay the renewal fee. NHA offers CE through its own CE2Go library (month-to-month for about $8/month); many employers cover CE as part of annual training. Let your certification lapse and you have to re-test — do not let that happen.
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CEHRS Career Outlook & Salary (2026)
The Bureau of Labor Statistics classifies CEHRS-style roles under Medical Records Specialists (SOC 29-2072). Current 2024–2034 BLS projections show 7% employment growth — roughly twice the average for all occupations — driven by healthcare expansion, aging population, and interoperability mandates.
| Source | Salary Range |
|---|---|
| ZipRecruiter (Feb 2026, US average) | ~$70,180 / year |
| Glassdoor (2026, US average) | ~$61,228 / year ($29/hr) |
| PayScale (CEHRS-credentialed) | $50,000–$60,000 / year |
| BLS (Medical Records Specialists, median) | ~$48,780 / year |
| New York state (ZipRecruiter 2026) | ~$76,779 / year |
| New Jersey (ACI / ZipRecruiter) | ~$66,000 / year |
Typical job titles include EHR Specialist, Medical Records Coordinator, Health Information Clerk, Patient Access Representative, EHR Super User, Scanning Technician, and Release of Information Specialist. Industries: hospitals (inpatient and outpatient), physician practices, ambulatory surgery centers, skilled nursing facilities, behavioral health, and increasingly health-tech vendors and revenue-cycle companies.
Career Ladder After CEHRS
CEHRS is a doorway, not a ceiling. Most credential-holders move up within 2–4 years by stacking experience with additional certifications:
- Year 0–1: EHR Specialist, Patient Access Rep, ROI Specialist ($40k–$55k)
- Year 1–3: Senior EHR Specialist, EHR Trainer, Credentialing Coordinator ($55k–$70k). Many candidates add CBCS (Certified Billing and Coding Specialist) or CPC during this phase.
- Year 3–5: EHR Analyst, HIM Supervisor, Epic/Cerner/Meditech Build Analyst ($70k–$95k). This is typically where you add CCA → CCS or pursue the RHIT via an associate degree.
- Year 5+: EHR Application Analyst, HIM Manager, Revenue Integrity Analyst ($90k–$130k). Epic certification (offered by Epic directly, employer-sponsored) dramatically opens this tier.
The CEHRS-to-Epic-Analyst path is one of the cleanest "no-degree-to-six-figures" tracks in healthcare because hospital IT teams hire CEHRS-credentialed internal staff for Epic build training.
CEHRS vs. RHIT vs. CCA: Which Credential Should You Choose?
These three entry- and mid-level health information credentials look similar but target different careers.
| Feature | CEHRS (NHA) | CCA (AHIMA) | RHIT (AHIMA) |
|---|---|---|---|
| Focus | EHR operations, workflows, HIPAA | Medical coding (entry-level) | Health information management (broad) |
| Exam fee | ~$125 | ~$199 member / $299 non-member | ~$229 member / $299 non-member |
| Questions | 100 scored + 25 pretest (125 total) | 90–105 | 130 scored + 20 pretest |
| Time | 125 min | 2 hours | 3.5 hours |
| Eligibility | HS diploma + training or work | HS diploma (recommended coding coursework) | Associate degree from CAHIIM-accredited HIM program |
| Best for | Clinic/hospital EHR roles, scribes, medical admin | Entry-level coders | Career in HIM management, coding supervision, data analytics |
| Typical salary | $45k–$70k | $40k–$55k | $50k–$75k |
| Renewal | 10 CE / 2 yrs | 20 CE / 2 yrs | 20 CE / 2 yrs |
Bottom line:
- Want to start working in under 6 months with no degree? → CEHRS.
- Want to focus specifically on medical coding? → CCA (or CPC from AAPC).
- Willing to earn an associate degree for higher ceiling? → RHIT.
Many professionals stack credentials — start with CEHRS to get hired, then pursue CCA or RHIT while working.
What the CEHRS Does NOT Cover
A CEHRS is not a medical coder. The exam touches ICD-10-CM and CPT at a conceptual level (what each code set is for, structure, and how it flows through the claim) but does not test you on assigning specific codes to clinical documentation. If your goal is to be a production coder, plan to add the CBCS (NHA), CPC (AAPC), or CCA (AHIMA) after — or instead of — the CEHRS.
A CEHRS is also not a clinician. You will not be tested on drug dosing, nursing care, anatomy beyond basic documentation vocabulary, or clinical decision-making. You are tested on how clinical data flows through the EHR and how you support clinicians, not on practicing medicine.
Exam Day Logistics
At a PSI test center:
- Arrive 30 minutes early with two forms of ID (one government-issued photo)
- Phones, watches, bags go in a locker — no personal items at the workstation
- You get an erasable whiteboard and marker; no scratch paper
- Breaks are unscheduled and the clock keeps running
- No food or drink in the testing room
Live online proctoring (through NHA's remote proctor):
- Quiet, private room with clear desk
- Webcam + microphone on continuously; you will show your room with the camera
- No second monitor, no headphones, no background people
- Hard-wired internet strongly preferred; check the system requirements 24 hours before
- Bathroom breaks require proctor approval and the clock keeps running
Results post to your NHA account within 2 business days. You will see a pass/fail and a domain-level score report that tells you which of the five areas were strongest and weakest — critical for planning a retake or targeted CE. Passed candidates can download a PDF certificate immediately and request a printed version.
Pass the CEHRS Exam With Confidence
Our 100% FREE CEHRS course includes:
- Full coverage of all 5 NHA domains — Non-Clinical, Clinical, Revenue Cycle, Compliance, Reporting
- 100+ practice questions in the exact NHA multiple-choice style
- AI-powered explanations for every wrong answer
- Domain-weighted quizzes so you practice what is heaviest on the test
- HIPAA + Cures Act deep dives updated for 2026
- Mobile-friendly study on any device
- No credit card, no email wall, no upsell
Start today and sit for your NHA CEHRS exam in 4–8 weeks.
Official Resources
- NHA CEHRS Certification Page — official overview
- NHA CEHRS Test Plan (PDF) — domain weights and task statements
- NHA Online Store — register for the exam and buy official study materials
- BLS: Medical Records Specialists — salary and job outlook
- HHS HIPAA Privacy Rule — official federal HIPAA guidance
- ONC 21st Century Cures Act — information blocking and patient access rules
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