Your Guide to the NCCT NCMA Exam

Are you ready to become a certified medical assistant? If you’ve completed a course of study for medical assistants, there’s just one final hurdle to clear: a medical assistant certification exam.

While most health professions involve some form of certification, becoming a medical assistant is a bit different. That’s because there’s no single form of certification: there are multiple exam options, and multiple paths you can take.

We’ve put together this extensive study guide to help you prepare for the National Center for Competency Testing’s (NCCT) National Certified Medical Assistant (NCMA) exam. We’ll start by giving you an outline of other exam possibilities. Then, we’ll briefly discuss the NCCT, and provide you with the information you need in order to determine whether or not you’re eligible to take the NCMA. Finally, we’ll dive into NCMA study guide itself. Just keep one thing in mind: while a study guide is an excellent place to start, you’ll ultimately need to do more if you want to score as high as possible on the exam itself. The best way to do that is with high quality, customized NCMA practice tests.

What are my options for becoming a certified medical assistant?

There’s no single option for becoming a medical assistant in the United States. Instead, there are a number of different paths you can opt to take. Aside from the NCCT NCMA exam, you can also opt for the National Healthcareer Association’s (NHA) Certified Clinical Medical Assistant (CCMA) exam; the American Medical Technologists’ (AMT) Registered Medical Assistant (RMA) exam; or the American Association of Medical Assistants’ (AAMA) Certified Medical Assistant (CMA) exam. Still trying to decide which one to choose? If so, take a look at our comparison guide.

What is the NCCT?

The National Center for Competency Testing is a for-profit entity that provides certification services for a variety of allied health careers. In addition to their certified medical assistant qualification, they also provide testing for insurance specialists, ECG technicians, surgical technologists, and other occupations within the allied health field.

Am I eligible to sit for the NCMA exam?

There are two pathways that will allow you to sit for the NCMA exam. First, you must have completed a high school diploma or its equivalent. Assuming you hold a high school diploma or equivalent, you must have either graduated from an NCCT-approved medical assisting program sometime within the last 10 years; or, have two years (4,160 hours) full-time, qualifying employment (or the equivalent in the form of part-time employment) as a medical assistant within the last 10 years.

How does re-certification work? Do I need to renew my certification yearly?

Medical assistants must apply for recertification on an annual basis. Recertification involves completing 14 hours of Continuing Education courses each year. If certification lapses for one year, your certification status becomes noncurrent. If you fail to renew for a period of three years, you must pay all past due fees and complete all Continuing Education hours before your certification can be reinstated. If more than five years lapse, your certification is revoked, and you must sit for the NCMA exam again. For more information on re-certification, click here.

Exam Overview: NCMA Study Guide

The National Certified Medical Assistant exam is comprised of 150 graded questions, plus 15 non-graded, pre-test questions. Test takers will have 3 hours to complete the exam in its totality. The NCMA test is divided into 8 separate categories: Pharmacology; Medical Procedures; Phlebotomy; ECG and Other Diagnostic Tests; General Office Procedures; Medical Office General Management; Medical Office Financial Management, Billing, and Insurance; and Medical Law and Medical Ethics.

Three of the test categories contain subcategories. Medical Procedures contains two subcategories: Infection, Exposure Control and Safety, and Patient Care. ECG and Other Diagnostic Tests is comprised of three sub categories: ECG Placement Techniques, Recording, and Interpretation; ECG Troubleshooting and Maintenance; and Other Diagnostic Tests. Finally, the General Office Procedures category is made up of four subcategories: Communication; Medical Office Computer Applications; Scheduling; and Medical Records.

Below, we’ve provided a thorough outline of the topics that might appear on the NCMA exam. For the categories that contain subcategories, we’ve provided an overview of the content that may be tested as part of each subcategory.


This section of the exam contains 13 questions, comprising roughly 9% of the total. These questions will assess your understanding of topics related to pharmacology. Topics tested may include: consulting desk references to check medications with respect to classification, contraindication and side effects, methods of administration, and so on; performing calculations related to medication; complying with regulatory guidelines; documenting errors; complying with the law with respect to prescription completion and authorization; identifying common medications; recognizing general therapeutic indications; demonstrating proper preparation, administration, and documentation; administering medications through various routes, including orally, intramuscularly, intradermally, subcutaneously, and so on; and documenting the administration of medication, along with any refills or initial prescriptions.

Medical Procedures

This section deals with your ability to perform various medical procedures. It contains two subcategories: Infection Safety, and Exposure Control, and Patient Care. Infection, Safety, and Exposure Control contains 13 questions, representing roughly 9% of the test. Patient Care contains 19 questions, making up almost 13% of the test.

Infection, safety, and exposure control

In this section, you’ll be tested on a number of competencies related to infection, occupational safety, and controlling disease exposure. Topics assessed may include: following standard CDC precautions related to disease transmission; complying with OSHA’s Standards for Health Care Workers; performing both general and surgical asepsis; cleaning, sterilizing, and disinfecting; handling and disposing of both chemicals and biohazardous wastes; using protective equipment such as masks, gloves, and gowns; following isolation protocols for patients; responding to emergencies; preventing infection spread; using medical equipment safely; employing proper body mechanics; and utilizing safety practices with respect to sharps.

Patient care

This subcategory will assess your ability to perform various tasks related to patient care, along with your general understanding of these tasks. Topics that may appear can include: measuring height, weight, and BMI for both adult and pediatric patients; taking vitals; recording a patient’s history; measuring a patient’s pain level using a pain scale; positioning patients for various procedures or examinations; measuring pulse oximetry; testing vision; removing sutures and staples; irrigating ears; assisting practitioners with various kinds of examinations; recognizing and recording abnormal test results; preparing and managing examination and treatment areas; adapting to patients with various impairments or particular needs; assisting practitioner with wound care, changing dressings, applying splints, and performing minor surgical procedures; educating patients; assisting with oxygen therapy, spirometry, and nebulizer treatment; and performing first aid and rapid response.


In this section, you’ll be assessed with respect to your understanding of phlebotomy. This section contains 20 questions, comprising 13% of the total. The following topics may be included as part of this section: adhering to standards related to patient identification and verification of orders; evaluating patient condition before testing; adhering to safe and aseptic techniques; selecting equipment; preparing patient for collection; taking action when sample is unsuccessful; drawing samples correctly; following recommendations for fill level and tube handling; implementing various precautions as needed; performing capillary and venipuncture; choosing bandages and performing aftercare; responding to emergencies and complications; correcting errors as needed; correctly handling lab specimens, including proper labeling; taking action to correct sample misidentification; and processing specimens correctly.

ECG and Various Diagnostic Tests

This section of the NCMA exam covers a range of diagnostic tests, including ECG. It’s divided into three subcategories: Techniques for ECG Placement, Recording, and Interpretation; ECG Maintenance and Troubleshooting; and Other Diagnostic Tests. The entire section is comprised of 23 questions, which accounts for approximately 15% of the total. Of these, 9 are related to ECG Placement, Recording, and Interpretation; 7 are related to ECG Maintenance and Troubleshooting; and 7 are related to Other Diagnostic Tests.

ECG: Techniques for placement, recording, and interpretation

In this subcategory, you’ll be tested on your understanding of ECG placement, recording, and interpretation of results. Topics may include: preparing ECG report for the primary practitioner; transmitting ECG report to the patient’s chart, EMR, or EHR; monitoring the patient’s vital signs while performing the test; recording ECG tracings; explaining the details of the procedure to the patient, and adapting your technique based on various considerations (physical, age-related, and so on); using extra resources when necessary; appropriately placing electrodes; and preparing the patient for testing.

ECG: Maintenance and troubleshooting

This section will evaluate your ability to maintain ECG equipment, and troubleshoot any issues that arise. Topics may include: identifying errors that occur during recordings; identifying the cause of any artifacts that accumulate; accounting for any special considerations involved in a particular patient’s care; correcting any errors as they occur; ensuring that the ECG machine is properly grounded; checking that the ECG is properly charged and supplied with paper; and both cleaning and properly storing the ECG machine after it’s been used.

Other diagnostic tests

In this subsection, you will be tested on your knowledge of a variety of other diagnostic tests that appear in a clinical setting. This section may include assessment of the following topics: performing waived testing, such as urinalysis, blood glucose, occult blood, hemoglobin and hematocrit, and so on; performing chain of custody collection; maintaining and calibrating lab equipment; collecting various types of specimens for culture such as stool, throat cultures, and so on; educating patients on how to properly collect specimens; processing specimens correctly; and performing necessary measures to ensure quality control.

General Office Procedures

In this test section, you’ll be evaluated based on your understanding of a topics related to general office procedures. This is the largest section of the exam: it contains 39 questions in total, comprising 26% of the total exam.

The General Office Procedures section is divided into four subcategories: Communication; Computer Applications for Medical Office Settings; Scheduling; and Medical Records. The Communication section includes 9 questions; the Computer Applications for Medical Office Settings section contains 7; Scheduling is comprised of 9 questions; and Medical Records contains 14 questions.


This subsection will evaluate your understanding of various models of professional communication. Topics may include communicating effectively in verbal and written form; proofreading and editing correspondence in an office setting; transmitting correspondence properly by means of mail, email, or fax; initiating emergency response as necessary; addressing telephone emergencies; educating patients on various policies and procedures; answering and directing telephone calls as appropriate; and directing patients to the proper member of the team of location in the office.

Computer applications for medical office settings

This subsection will assess your knowledge of the various computer applications involved in conducting a medical practice. Topics might include any of the following: using various devices such as printers, copiers, and scanners; managing electronic data on various devices such as tablets, scanners, and kiosks; effectively troubleshooting issues with computer equipment and software; using various software applications related to finances, electronic health and medical records, scheduling, and billing; using general office software related to word processing, databases, and so on; maintaining electronic data via backup, retrieval, and data entry; and ensuring the integrity of information stored on computers.


This subsection will test your understanding of scheduling procedures in a medical practice. The following topics may be included in this subcategory: managing patient reminders; scheduling outpatient tests and procedures; scheduling surgery; managing referrals; generating necessary forms and maintaining appointment schedules; managing patient appointments; setting up patient appointments using various scheduling techniques; and arranging appointments via telemedicine.

Medical records

In this section, you’ll be evaluated based on your knowledge of medical records. Topics might include any of the following: preparing charts; changing the status of medical records; protecting and retaining records according to legal guidelines; correcting records according to legal guidelines; responding to patient record requests; responding to legal requests for records; organizing chart contents; managing charts electronically; filing records correctly; managing paper documents; transcribing physician records; adhering to HIPAA regulations and maintaining confidentiality; entering information into a patient’s medical record; scanning a patient’s identification and insurance card; obtaining signatures as needed; and ensuring that patients complete the necessary paperwork.

Medical Office Management

This category covers the various aspects of managing a medical office. It contains 8 questions, and accounts for 5% of the test. You may be tested on the following topics: complying with Clinical Laboratory Improvement Act (CLIA) and Occupational Safety and Health Act (OSHA) regulations; maintaining Material Safety Data Sheets (MSDS); following safety guidelines and maintaining an office procedures manual; maintaining professional status filings; complying with requirements related to accreditation and licensure; communicating with other providers and offices; and opening and closing the office each day.

Financials, Billing, and Insurance in a Medical Office Setting

In this section, your knowledge of office financials and insurance billing will be tested. This category contains a total of 7 questions, which comprise roughly 5% of the total exam. The following topics may be covered: understanding pre-determinations and pre-authorizations; complying with various regulations related to fraud and abuse; using ICD, CPT, and HCPCS codes correctly for insurance billing; reconciling financial transactions; updating records related to patient payments; collecting payment, including deductibles, copayments, and coinsurance; and educating patients about financial policies.

Medical Law and Medical Ethics

The final section will evaluate your understanding of topics related to medical law and medical ethics. It contains a total of 8 questions, representing roughly 5% of the total test. Topics might include any of the following: adhering to AHA and HIPAA; conforming to reportable incident laws; obtaining proper patient consent; following protocols for termination of care; responding to medical law violations; identifying and responding properly to unethical practices; and identifying a medical assistant’s scope of practice and legal responsibilities.

ScopeNotes: Your NCMA Exam Prep Solution

If you’re looking to ace the NCMA exam, this study guide is a great place to start. But, there’s an even better way to prepare for the exam: taking NCMA practice tests. Studies show that practice tests are the best way to prepare for standardized exams. ScopeNotes is the #1 provider of NCMA test prep, especially when it comes to practice tests. Here’s what makes ScopeNotes the best:

A ton of practice questions

With ScopeNotes, you get access to more than 2,500 individual practice questions. That’s more than any other competitor out there.

Practice tests are unlimited

Here’s the bottom line: the more NCMA practice tests you take, the higher your grade will be on the exam itself. That’s why ScopeNotes gives you unlimited access to as many practice tests as you like.

Review material is animated

Going through review material can be dull. To keep you focused and motivated, ScopeNotes offers animated review courses.

Custom content

Everyone’s educational background is a little different. This means that you’ll find certain areas of the test come easier to you than others. With this in mind, you’ll need to spend more time studying areas that are difficult for you. ScopeNotes makes this easy: our content is customized based on your performance, which means you’ll be prompted with more questions in subject areas that are challenging for you. The end result? A higher grade on the NCMA exam.

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