Welcome to the official MedicoExam syllabus guide for the AAPC Certified Professional Biller certification. This page delivers a clear, structured overview of the AAPC CPB exam, including key exam details, syllabus topics, and preparation references to support effective study planning. The AAPC Certified Professional Biller (CPB) is intended for professionals pursuing roles aligned with Core + Medical billing + International, with assessment centered on applied competencies such as Medical billing processes, insurance and payer requirements, reimbursement compliance and claims management within real-world settings like Provider billing offices, physician practices, revenue cycle and claims departments.
The syllabus outline below reflects the core domains and expectations defined by the official AAPC certification framework and aligns with the cognitive and professional standards assessed in the AAPC CPB exam. Candidates can use this guide alongside official vendor resources and structured practice to align their preparation with current exam standards and professional expectations for Medical billers, revenue cycle professionals, billing and coding support professionals and related roles
AAPC CPB Exam Summary and Key Details
| Exam Name | AAPC Certified Professional Biller |
| Credential | AAPC Certified Professional Biller (CPB) |
| Vendor | American Academy of Professional Coders (AAPC) |
| Exam Code | CPB » AAPC CPB Certification Practice Exam |
| Exam Delivery Mode | Live remote proctored exam or electronic testing-center exam |
| Exam Duration | 240 mins |
| Number of Questions | 135 |
| Passing Score | 70% |
| Exam Price |
$425 for one attempt $499 for two exam attempts |
| Scheduling Window | Exam voucher valid for one year from purchase |
| Schedule Exam | AAPC |
| Trainings/Resources | Certified Professional Biller (CPB) Medical Billing Training Course |
| Sample Questions | AAPC CPB Exam Sample Questions |
| Recommended Practice | AAPC CPB Certification Practice Exam |
AAPC CPB Exam Syllabus Topics and Weighting
| Topic Areas | Topic Details, Courses, Books | No. Of Questions |
|---|---|---|
| Types of insurance | - These questions will assess your knowledge of managed care, commercial payers, Medicare, Medigap, Medicaid, Blue Cross/Blue Shield, TRICARE/CHAMPUS, workers’ compensation, and third-party payers (automobile, liability, etc.). | 29 |
| Billing regulations | - These questions will address accountable care organizations (ACOs), the National Correct Coding Initiative (NCCI), local coverage determinizations (LCDs), national coverage determinations (NCDs), incident-to billing, global packages, unbundling, completion of the CMS-1500 and UB-04 forms, and payer payment policies. | 17 |
| HIPAA and compliance | - This section will test your knowledge of HIPAA privacy, billing compliance, medical record retention, financial policies, and fraud and abuse. | 7 |
| Reimbursement and collections | - This section will address RBRVs, payer and patient refunds, provider credentialing, accounts receivable, fair debt, patient statements, patient dismissal, professional courtesy, collection agencies, collections, bankruptcy, payment plans, preauthorizations, claim editing tools, and remittance advice. | 19 |
| Claims and billing | - This section will test your knowledge on appeals, denials, claims tracking and follow-up, timely filing, demographics, superbill/encounter forms, retention of records, balance billing, telephone courtesy, electronic claim submission, clean claims, and auditing the billing process. | 19 |
| Coding | - This section will assess your knowledge on CPT®, ICD-10-CM, and HCPCS Level II codes and modifiers. | 10 |
| Case analysis |
- In this section of the exam, source documents are provided for the examinee to review. Examinees will be provided with various policies and must be able to apply those policies. Documents provided include:
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34 |
The AAPC CPB certification exam is designed to assess both theoretical knowledge and applied professional judgment in Core + Medical billing + International. The exam evaluates competencies such as Medical billing processes, insurance and payer requirements, reimbursement compliance and claims management, ensuring candidates are prepared for real-world responsibilities as Medical billers, revenue cycle professionals, billing and coding support professionals and related roles working in settings such as Provider billing offices, physician practices, revenue cycle and claims departments.
To prepare effectively for the AAPC Certified Professional Biller exam, candidates are encouraged to review official vendor materials, complete structured practice assessments, and gain hands-on experience relevant to their professional role.
