Updated: Aug 16, 2026
No. of Questions: 245 Questions & Answers with Testing Engine
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| Certification Vendor: | AAPC |
| Exam Name: | Certified Professional Biller |
| Exam Number: | CPB |
| Related Certifications: | CPC (Certified Professional Coder) CIC (Certified Inpatient Coder) CRC (Certified Risk Adjustment Coder) |
| Passing Score: | 70% |
| Real Exam Qty: | 200 |
| Exam Format: | Multiple-choice |
| Available Languages: | English |
| Exam Price: | $299 (AAPC member) / $399 (non-member) |
| Certificate Validity Period: | Annual renewal required (with CEUs) |
| Exam Duration: | 240 minutes |
| Sample Questions: | AAPC CPB Sample Questions |
| Exam Way: | Online proctored exam (at approved testing centers or remote proctoring) |
| Pre Condition: | Recommended: High school diploma or equivalent; Not mandatory but recommended: Basic knowledge of medical terminology and healthcare billing concepts; AAPC membership required for exam registration |
| Official Syllabus URL: | https://www.aapc.com/certification/cpb |
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Healthcare Billing Fundamentals | 15-20% | - Healthcare documentation principles - Anatomy and physiology for billers - Medical terminology basics - Revenue cycle overview |
| Topic 2: Practice Management | 10-15% | - Accounts receivable management - Collections and payment posting - Insurance verification processes - Patient responsibility calculations - Patient registration and demographics |
| Topic 3: ICD-10-CM Diagnosis Coding | 15-20% | - Principal diagnosis selection - Code accuracy and specificity - Secondary diagnosis coding - ICD-10-CM structure and conventions - Chapter-specific guidelines |
| Topic 4: CPT Coding | 20-25% | - Surgical procedure codes - CPT code categories and structure - Evaluation and Management (E/M) codes - Modifiers and their appropriate use - Category II and III codes |
| Topic 5: Billing Compliance and Regulations | 10-15% | - HIPAA privacy and security requirements - Appeal and denial management - Fraud, waste, and abuse prevention - Stark Law and Anti-Kickback Statute basics - Documentation compliance |
| Topic 6: Insurance and Reimbursement | 20-25% | - Fee schedules and reimbursement methodologies - Government payers (Medicare, Medicaid, TRICARE) - Commercial insurance policies - Workers' compensation and no-fault billing - Claims submission and processing - Coordination of benefits |
1. CRI
A) Debt Collection Assistance Officer
B) Computed Tomography
C) Customized SubCapitation Plan
D) CHAMPUS Reform Initiative
2. Beneficiary counseling and assistance coordinator (BCAC) is individual available at military treatment facility (MTF) to answer questions, help solve healthcare related problems, and assist beneficiaries in obtaining medical care through TRICARE; was previously called health benefits advisor (HBA).
A) TRUE
B) FALSE
3. EMC
A) Exclusive provider organization
B) Electronic Medical Record
C) Electronic Media Claim
D) Explanation of Benefits
4. Which is the universal claim form used by physicians offices?
A) Health Insurance Claim
B) Centers of Medicare and Medicaid Services150 (CMS1500)
C) Hold Harmless Clause
D) Explanation of Benefits
5. When is an Advance Beneficiary Notice (ABN) required?
A) After the service is denied
B) For all Medicare services
C) Only for inpatient services
D) When a service is expected to be denied as not medically necessary
Solutions:
| Question # 1 Answer: D | Question # 2 Answer: A | Question # 3 Answer: C | Question # 4 Answer: B | Question # 5 Answer: D |
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