Taking the CPCO® exam
The CPCO exam is a test of compliance proficiency consisting of 100 multiple-choice questions that assess several areas of knowledge, including the ever-growing compliance requirements of government laws, regulations, rules, and guidelines.
By passing the CPCO exam, you demonstrate an understanding of the key requirements necessary to effectively develop, implement, and monitor a healthcare compliance program for your practice based on governmental regulatory guidelines — including internal compliance reviews, audits, risk assessments, and staff education and training.
Who should take the CPCO exam?
You should register for the CPCO exam if you’ve completed certification training and/or have experience in compliance and are able to demonstrate an understanding of compliance requirements of government laws, regulations, rules, and guidelines.
What to expect on exam day
The exam has a total of 100 questions to be answered in four hours. People often wonder if the CPCO exam is hard. We'll say this: If you have taken the training course, studied, and are familiar with your CPCO resources, the test will be demanding, but not difficult.
Here's a quick overview of what you can expect:
Before you begin the test, take a moment and breathe. You have prepared for this. This is your opportunity to demonstrate your compliance expertise.
You'll have four hours to finish the exam, giving you approximately 2.4 minutes to answer each of the 100 multiple-choice questions. You can save time by reading the answer choices before reading each question and by saving the more difficult questions for last. It’s important to answer every question, even if you aren’t sure. Your best guess is better than no answer at all.
The questions assess several areas of knowledge, many of which are presented as scenarios to test application of knowledge about compliance requirements of government laws, regulations, rules, and guidelines.
If taking the exam in person, you will be able to reference approved resources during the exam. You can bring the OIG Supplemental Compliance Program Guidance for Hospitals, OIG Compliance Program for Individuals & Small Group Physician Practices, OIG Compliance Program Guidance for Third-Party Medical Billing Companies, and AAPC reference guides.
For in-person exams
When you register for the CPCO exam, you will be given detailed instructions on where the test will be taken, what time you should arrive, and what you need to bring.
You should arrive at your exam location 30 minutes early. Be sure to bring all necessary items (photo ID, #2 pencils, an eraser, resources, etc.) and listen carefully as the proctor provides instructions. You will then have the chance to ask any questions. If you are confused or concerned about anything, it’s important to clarify. After all, someone else might be wondering the same thing.
Location: Local chapter or licensed instructor site
Exam format: 100 multiple-choice questions
Time allowed: 4 hours
Proctor to examinee ratio: 1 to 25
Cancellation fee: Must be canceled 21 days prior exam date, service charge of $100
Reschedule fee: Must be rescheduled 21 days prior exam date, service charge of $100
No show fee: $100
Availability: Schedule now
For electronic exams
Our electronic exam is a four-hour live, remote-proctored* examination completed in one sitting and proctored by Examity). After purchasing or transferring your current exam voucher, you’ll receive a Notice to Schedule from our partner, Meazure Learning (formerly Scantron), and will be able to schedule your exam for a date and time convenient to you.
On the day of the exam, you will log into your Meazure Learning account, then connect with your Examity) proctor to complete a security check and take your exam. Your results will be posted within 7-10 business days from the date you complete your exam.
*Electronic exams taken outside of the US will be proctored at a local Testing Center. Please refer to the Test Center FAQs or ask your Career Counselor for more information.
Equipment required: Reliable internet connection and an external webcam that can be positioned to show your face, hands, keyboard, and the area around the keyboard (about 10 inches)
Location: At home in a quiet, private location
Exam format: 100 multiple-choice questions delivered in one sitting
Time allowed: 4 hours
Proctor to examinee ratio: 1 to 2
Cancellation fee: No fee charged if canceled 24 hours in advance
Reschedule fee: No fee charged if rescheduled 24 hours in advance
No show fee: If you do not show up to your scheduled exam OR you do not meet the requirements to take the exam, your exam voucher will be canceled, and you will need to purchase a new voucher in order to take the exam.
Availability: Schedule now
Passing grades
An overall score of 70% or higher is required to pass the certification exam. For a passing score of 70%, you must get at least 70 questions correct. If you incorrectly answer more than 30 questions, you will not pass. If you don’t pass, you will be notified of the categories/areas of study with sub-scores of 65% or less to help you prepare for retesting.
All AAPC certification exams exclusively measure proficiencies relating to the one credential named in the exam. To earn additional medical coding credentials, you will be required to pass additional certification exams.
Your results will be shared with you online in your My AAPC Account Dashboard under My Exams. You can expect the results within 7-10 business days after taking the exam. Once you have passed, your certificate will be sent to you in the mail.
Materials allowed on the day of the exam
Approved code books
When taking the CPCO exam online, no references are allowed.
When taking the CPCO exam in person, these references can be used:
OIG Compliance Program for Individuals & Small Group Physician Practices
OIG Compliance Program Guidance for Third-Party Medical Billing Companies
AAPC reference guides
Note: Books/references allowed for the electronic exams may differ slightly from in-person exams because some references are built into the test. You will have access to the same information regardless of test administration method.
Calculator
Manual calculators are allowed on all exams (no smartphones, tablets, or smart watches). For electronic exams, an online calculator will be included for use during the exam.
Notes
Handwritten notes are acceptable only if they pertain to daily compliance activities. Notes are allowed only on the printed side of documents. Questions from the study guides, practice exams, or the exam itself are prohibited. Altering, whiting out, painting, or printing over any pages within the resources to supplement information is prohibited.
NOTE: Electronic devices with an on/off switch (phones, tablets, etc.) are not allowed into the examination room. Failure to comply with this policy may result in disqualification of your exam.
Breakdown of the 100-question CPCO exam
Passing the CPCO exam requires you to correctly answer a minimum of 70 questions from the domains below. The CPCO test will rely on a level of understanding that enables you to identify the domain.
Healthcare compliance program history (5 questions)
These questions will assess your knowledge of the history of healthcare laws in the United States, past healthcare industry investigations, federal sentencing guidelines, the implementation of compliance program guidance, key agencies involved in healthcare compliance, current statistics related to CERT reports and national healthcare expenditures, and the OIG five-principle strategy.
OIG compliance program guidance for physicians and small group practices (22 questions)
These questions will address general guidance information and the seven “steps” — standards of conduct and operational policies, oversight requirements, compliance training, monitoring and auditing, communications, disciplinary actions, and responding to detected offenses.
Compliance program guidance for third-party billing companies and clinical laboratories (3 questions)
This section will test your knowledge of lab orders and billing, the Balanced Budget Act of 1997 and diagnoses, and the use of outside billing companies.
OIG compliance program guidance for hospitals (3 questions)
This section will address supplemental hospital guidance.
Key and other risk areas (19 questions)
This section will test your knowledge of physician compliance program guidance risks, documentation, conflict of interest, gifts/gratuities, medical necessity, advance beneficiary notices, incident to, overpayments/credit balances, certificates of medical necessity, certifications for home health and therapy services, billing of non-covered services as if covered, teaching physicians, gainsharing arrangements, joint ventures, limiting charges for par and non-par practices, professional courtesy/discounts/adjustments, rental of office space, unlawful advertising, and state escheat laws.
Fraud and abuse laws (12 questions)
In this section of the exam, you will be tested on the difference between fraud and abuse, civil monetary penalties, the False Claim Act, the anti-kickback statute, Stark laws, the Fraud Enforcement and Recovery Act (FERA), and the Patient Protection and Affordable Care Act (PPACA/health reform).
Other laws and regulations (24 questions)
These questions will assess your knowledge of HIPAA, EMTALA, CLIA, OSHA, RICO, and mail/wire fraud.
Investigation process/audits (9 questions)
In this section of the exam, you will be tested on subpoenas and search warrants, use of legal counsel, self-disclosure protocol, qui tam and whistleblowers, corporate integrity agreements (CIAs), certification of compliance agreements (CCAs), excluded parties (OIG and GSA), and RACs, UPICs, MICs, PSCs, and MFCUs.
References/resources (3 questions)
These questions will assess your knowledge of federal regulations/citations/references, the Office of Inspector General, the Centers for Medicare & Medicaid Services, and Medicaid and workers’ compensation.