The CMAA exam: what is on it, how it is scored, and how test day works

0 min

One sitting: 135 questions, 135 minutes

The clock gives you about a minute per question, and it never stops. There are no scheduled breaks, and the 25 pretest items look exactly like the scored 110, so treat every item as one that counts.

Pacing: at minute 45, be past question 45. Re-reading a billing calculation a third time? Pick your best answer and move on.

1 min

What is on the exam: the 7 domains

NHA’s test plan, built on a job analysis completed in 2021, splits the 110 scored items across 7 domains with no subdomains. No newer CMAA plan had been announced as of October 2026.

Section 1: the two 21-item domains

Communication and Professionalism and Patient Encounter hold 42 of the 110 scored items between them, more than a third of the score. D2 is judgment under pressure: an upset patient, a relative on the phone. D5 is the front desk with numbers: who pays first, what the patient owes today, which form a Medicare patient signs before a likely denial.

Section 2: law and the schedule, 33 items

Medical Law, Ethics, and Compliance (17) and Scheduling (16) come next. D3 rewards exact rules over a general sense of privacy; D4 rewards knowing the booking methods by name, because the stem describes one and the options name four.

Section 3: the three smallest, 35 items

Logistics (14), Billing (11) and Foundational Knowledge (10). Small one by one, but together they outweigh D2 or D5.

3 min

Question style

Every item is single-answer multiple choice, and most are short front-desk scenarios: a caller, an insurance card, a chart, a schedule. Some test recall; more test judgment, the next step that stays inside an administrative assistant’s scope. Stems that ask for the first or best action usually include two correct-sounding steps in the wrong order.

A sample item, written to the test plan

This is an original practice item in the style of D7, not a question from the exam.

A practice files charts by terminal digit. A new chart is numbered 47-62-19. Which group of digits decides the section of the file room it goes to?

1. A. 47, because filing starts at the left
2. B. 62, the middle group
3. C. 19, the last group
4. D. None of them: the patient’s last name decides, and the number is a cross-reference

Answer: C. Terminal-digit filing reads the groups right to left, so the last pair (19) is the primary section, 62 places the chart within it and 47 sets its order there. A describes straight numeric filing, D describes alphabetic filing, and B is the middle-digit system, a different method.

3 min

Scoring and results

The exam reports a scaled score, not a percentage. NHA’s candidate handbook states that every NHA certification exam uses a scaled range of 200–500 with 390 to pass. Scaling evens out the several versions of the exam in use at once.

The score report, per the handbook, gives pass or fail, your scaled score, and a band for each domain: above, near or below the passing standard. The bands show where to aim if you retest.

Where results show up: for online exams (PSI or remote), NHA posts them to your NHA account within two days of scoring. At a school site the handbook describes a preliminary report right after you finish. NHA does not give scores by phone.

4 min

Registering and test day

1. 1

   Create your own NHA account

   You apply personally, with your own email address, not a parent’s or teacher’s.

2. 2

   Apply for the CMAA and choose your pathway

   Training program or work experience; both are explained on the certification page.

3. 3

   Pay the exam fee

   Currently $134 per NHA (checked Oct 2026), paid as part of the application. Every attempt is paid separately.

4. 4

   Schedule where you test

   At your school if it hosts the exam, otherwise at a PSI testing center or by live remote proctoring. Individual registrants use PSI or remote.

5. 5

   Bring ID and test

   A current government-issued photo ID with your signature, such as a driver’s license or passport. If the address on it differs from your registration, the handbook asks for proof of address too.

• In person

  School or PSI center

  A proctor checks your ID and runs the room.

  • Leaving the room is at the proctor’s discretion; the clock keeps running
  • School sites: two sheets of scratch paper. PSI centers: a whiteboard (paper scratch ended there in June 2026)
  • Only the calculator built into the exam

• Remote

  Live remote proctoring

  Your own computer, with a webcam and an internet connection that supports voice calls.

  • No breaks at all, and nobody else in the room
  • A digital whiteboard instead of paper
  • The proctor checks your ID on camera

Need an accommodation such as extra time? The handbook asks for an ADA request with documentation and 30 days to process it, and an approved accommodation can rule out the remote option.

5 min

If you don’t pass

Retakes follow an NHA-wide rule. As of October 2026, the candidate handbook sets a 30-day wait after a failed attempt and allows three attempts at least 30 days apart; after a third failure, each further attempt waits a year. Every retake is a new registration at the full fee.

6 min

How to prepare

Study in the order the weights suggest. Start with the D2 guide and the D5 guide, the two 21-item domains; the study guide lays out all seven with a tactic for each. Then D3 and D4, then the three small domains.

Practice under the clock. The free practice test runs 60 original questions as a clinic day of 8-minute appointment slots from 8:00 AM. A miss is rebooked into a follow-up slot after 4:00 PM, so every wrong answer comes back once, and the end-of-day report shows your misses by domain. For a 9-question warm-up, the home page has a sampler, and the study guide has 19 more.

6 min

FAQ

• Practice testFree CMAA practice test with answer explanations
• Study guideCMAA study guide: what each of the 7 domains covers and how to study it
• CertificationHow to get CMAA certified as a medical administrative assistant