NHA CMAA Exam Overview

Key Takeaways

  • The NHA CMAA exam contains 135 total questions: 110 scored items plus 25 unscored pretest items
  • Candidates have 2 hours and 15 minutes (135 minutes) to complete the entire exam
  • A scaled passing score of 390 out of 500 is required, which corresponds to approximately 78% of scored items answered correctly
  • The exam is divided into 7 domains weighted by the number of items each contributes to the total score
  • Communication and Professionalism (21 items) and Patient Encounter (21 items) are the two highest-weighted domains
  • The 2024 NHA annual report shows a 63% pass rate across 9,390 exams administered
  • Certification is valid for 2 years and requires 10 CE credits plus a \$185 renewal fee to maintain
Last updated: March 2026

NHA CMAA Exam Overview

The National Healthcareer Association (NHA) Certified Medical Administrative Assistant (CMAA) certification is one of the most widely recognized credentials for healthcare front office professionals. The CMAA validates that you possess the administrative knowledge and skills required to work effectively in medical offices, clinics, hospitals, and other healthcare settings.


What Is the NHA CMAA Certification?

The CMAA credential demonstrates competence in:

  • Patient scheduling and appointment management
  • Medical office communication (in-person, telephone, written)
  • HIPAA compliance and medical law/ethics
  • Insurance verification and billing basics
  • Medical records management and EHR systems
  • Medical terminology and foundational healthcare knowledge

The NHA developed the CMAA test plan based on a 2021 job analysis that surveyed practicing medical administrative assistants nationwide to determine the tasks and knowledge most critical for entry-level success.


Exam Structure at a Glance

ComponentDetails
Total Questions135 (110 scored + 25 pretest)
Time Limit2 hours and 15 minutes (135 minutes)
Question FormatMultiple-choice (single best answer)
Passing Score390 on a 200–500 scaled score
Approximate Pass Threshold~78% of scored items correct
DeliveryComputer-based (school sites, PSI testing centers, or live remote proctoring)
2024 Pass Rate63% (9,390 exams administered)
Active Certifications17,616 as of December 31, 2024

Important: The 25 pretest questions are experimental items being evaluated for future exams. They are randomly distributed throughout the exam and are not identified — you should answer every question with full effort since you cannot tell which are scored and which are pretest.


The 7 CMAA Exam Domains

The NHA CMAA test plan organizes content into 7 domains, each weighted by the number of scored items:

DomainScored ItemsWeight
1. Foundational Knowledge109%
2. Communication and Professionalism2119%
3. Medical Law, Ethics, and Compliance1715%
4. Scheduling1615%
5. Patient Encounter2119%
6. Billing and Revenue Cycle1110%
7. Medical Practice Administrative Procedures and Logistics1413%
Total Scored110100%

Domain Weighting Strategy

The two heaviest domains — Communication and Professionalism and Patient Encounter — together account for 38% of scored items (42 out of 110). This means that nearly 4 out of every 10 scored questions will test your ability to communicate effectively with patients and manage patient encounters. These are high-value areas where focused study delivers the greatest return.


Scoring and Passing

The CMAA exam uses a scaled scoring system ranging from 200 to 500:

  • Minimum passing score: 390
  • Scaling adjusts for the difficulty of the specific exam form you receive
  • There is no penalty for guessing — answer every question
  • Your score report will show performance by domain so you can identify strengths and weaknesses

Understanding Scaled Scoring

A scaled score of 390/500 does not mean you need to answer exactly 78% of questions correctly on every exam form. The scaling process accounts for slight variations in difficulty between different versions of the exam. On an easier form, you may need a slightly higher raw percentage; on a harder form, a slightly lower raw percentage. The key takeaway: aim for 80%+ correct to have a comfortable margin.


Eligibility Requirements

To sit for the CMAA exam, you must meet one of these pathways:

PathwayRequirement
EducationHigh school diploma or GED plus completion of a CMAA training/education program within the last 5 years
Experience (Option A)High school diploma or GED plus 1 year of supervised work experience in medical administration within the last 3 years
Experience (Option B)High school diploma or GED plus 2 years of supervised work experience in medical administration within the last 5 years

Exam Registration and Cost

ItemCost
Exam application fee$117
NHA study guide (optional)$50–$80
NHA practice tests (optional)$30–$45
Certification renewal$185 every 2 years + 10 CE credits

Registration Process

  1. Create an account at nhanow.com
  2. Submit your exam application with documentation of eligibility
  3. Pay the $117 exam fee
  4. You have 6 months from registration to schedule and take the exam
  5. Schedule your exam at a PSI testing center, your training school, or via live remote proctoring

Retake Policy

AttemptWaiting Period
1st retake (after initial fail)30 days
2nd retake30 days after 1st retake
3rd retake30 days after 2nd retake
After 3 failed retakesMust wait 12 months before next attempt

Each retake requires a new exam fee of $117.


Certification Maintenance

The CMAA certification is valid for 2 years from the date you pass the exam. To renew:

  • Complete 10 Continuing Education (CE) credits within the 2-year period
  • Pay the $185 renewal fee
  • NHA offers free CE courses to current certification holders through their online platform

If you let your certification lapse, you will need to retake the full exam.

Test Your Knowledge

How many scored items are on the NHA CMAA exam?

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Test Your Knowledge

What is the minimum scaled score required to pass the NHA CMAA exam?

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Test Your Knowledge

Which two CMAA exam domains have the highest weighting with 21 scored items each?

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