NHA Certified Clinical Medical Assistant (CCMA)

Detailed Test Plan*

150 scored items, 30 pretest
Exam Time: 3 hours

*Based on the Results of a Job Analysis Study Completed in 2016


This document provides an outline of the topics and associated weighting that may be covered on the CCMA Certification Exam. A one-page summary of the plan is also available.

Within a given topic area, task and/or knowledge statements will be provided. Knowledge statements reflect information that a candidate will need to know, while task statements reflect duties that a candidate will need to know how to properly perform. Items on the exam may require recall and critical thinking pertaining to a knowledge statement, a task statement, or both.

Please note that some domains only contain knowledge statements.


  • Foundational Knowledge and Basic Science
  • Knowledge of:
    • Health care systems and settings
      • Role and responsibilities of the MA, other healthcare providers, and allied health personnel
      • Scope of practice
      • Titles and credentials
      • Licensing and certification
      • Healthcare delivery models (HMOs, PPOs, POS, PCMH, accountable care organizations/payment for performance [ACOs], hospice, collaborative care model)
      • General versus specialties and services offered
      • Ancillary services; alternative therapies
      • Insurance fundamentals
    • Medical terminology
      • Common abbreviations, acronyms, and symbols
      • Conditions, procedures, and instruments
      • Medical word building (prefixes, suffixes, plurals)
      • Positional and directional terminology
    • Basic pharmacology
      • Commonly prescribed medications and common approved abbreviations
      • Drug classifications and drug schedules
      • Side effects, adverse effects, indications, and contra-indications
      • Measurement (for both metric and household systems), mathematical conversions, and dosage calculations
      • Forms of medication (for example, pill, capsule, ointment)
      • Look alike/sound alike medications
      • Routes of administration
      • Pharmacokinetics (absorption, distribution, metabolism, excretion)
      • Rights of drugs/medication administration
      • Physicians’ Desk Reference and online resources
      • Principles of storage and disposal
    • Nutrition
      • Dietary nutrients
      • Dietary needs and patient education (general, and related to diseases and conditions)
      • Vitamins and supplements
      • Eating disorders
      • Food labels
    • Psychology
      • Developmental stages
      • End-of-life and stages of grief
      • Psychology of the physically disabled, developmentally delayed, and those with diseases
      • Environmental and socio-economic stressors
      • Mental health screening
      • Defense mechanisms
  • Anatomy and Physiology
  • Knowledge of:
    • Body structures and organ systems
      • 1. Anatomical structures, locations, and positions
      • 2. Structure and function of major body systems, including organs and their locations
      • 3. Interactions between organ systems, homeostasis
    • B. Pathophysiology and disease processes
      • Signs, symptoms, and etiology of common diseases, conditions, and injuries
      • Diagnostic measures and treatment modalities
      • Incidence, prevalence, and risk factors
      • Risk factors leading to high mortality and morbidity (for example, complications, accompanying diseases)
      • Epidemics and pandemics
    • C. Microbiology
      • 1. Cell structure (for example, nucleus, cell wall, cell membrane, cytoplasm, ribosomes, mitochondria, lysosomes, nucleolus)
      • 2. Common pathogens and non-pathogens
      • 3. Organisms and microorganisms
      • 4. Infectious agents; chain of infection; conditions for growth
  • Clinical Patient Care
    • General Patient Care
    • Tasks:
      • T1. Identify patient
      • T2. Prepare examination/procedure room
      • T3. Ensure patient safety within the clinical setting
      • T4. Complete a comprehensive clinical intake process, including the purpose of the visit
      • T5. Measure vital signs
      • T6. Obtain anthropometric measurements
      • T7. Identify/document/report abnormal signs and symptoms
      • T8. Assist provider with general physical examination
      • T9. Assist provider with specialty examinations
      • T10. Prepare patient for procedures
      • T11. Prepare and administer medications and/or injectables using nonparenteral and parenteral routes (excluding IV) (for example, oral, buccal, sublingual, intramuscular, intradermal, subcutaneous, topical, transdermal, and inhalation)
      • T12. Perform staple and suture removal
      • T13. Administer eye, ear, and topical medications
      • T14. Perform ear and eye irrigation
      • T15. Administer first aid and basic wound care
      • T16. Identify and respond to emergency/priority situations
      • T17. Perform CPR
      • T18. Assist provider with patients presenting with minor and traumatic injury
      • T19. Assist with surgical interventions (for example, sebaceous cyst removal, toe nail removal, colposcopy, cryosurgery)
      • T20. Review provider’s discharge instructions/plan of care with patients
      • T21. Follow guidelines for sending orders for prescriptions and refills by telephone, fax, or email
      • T22. Document relevant aspects of patient care in patient record
      • T23. Operate basic functions of an EHR/EMR system
      • T24. Enter orders into CPOE
    • Knowledge of:
      • K1. Patient identifiers
      • K2. Elements of a patient medical/surgical/family/social history
      • K3. Methods for obtaining vital signs (manual & electronic blood pressure; respiration, temperature, pulse, pulse oximetry)
      • K4. Normal and abnormal vital signs
      • K5. Methods for measuring height, weight, BMI; special considerations related to age, health, status, disability; growth chart
      • K6. Positioning and draping requirements for general and specialty examinations, procedures, and treatments
      • K7. Equipment, instruments, and supplies necessary to prepare the examination or procedure room
      • K8. Required equipment, supplies and instruments related to general physical examinations
      • K9. Required equipment, supplies, and instruments related to specialty examinations
      • K10. Patient instruction specific to procedures, including pre- and postprocedural instructions;
      • K11. Modifications to patient care depending on patient needs (for example, assisting with ambulation and transfers for frail and disabled patients; using terms a child can understand for pediatric patients)
      • K12. Consent requirements (written and verbal)
      • K13. Immunization schedules and requirements
      • K14. Allergies (for example, common drug and non-drug allergies such as latex, bee stings; type of reactions [mild, moderate and severe] how to respond to allergic reactions or anaphylactic shock)
      • K15. Signs of infection
      • K16. Sterile techniques related to examinations, procedures, injections and medication administration
      • K17. Dosage calculations related to oral medications and injectables
      • K18. Commonly used oral and parenteral medications, including forms, packaging, routes of administration; rights of medication administration
      • K19. Storage; labeling; and medication logs
      • K20. Techniques and injection sites
      • K21. Supplies and equipment related to injections
      • K22. Storage of injectables
      • K23. Techniques and instruments for suture and staple removal; types and sizes of sutures
      • K24. Methods of administration, techniques, procedures and supplies related to eye, ear, and topical medications
      • K25. Instruments, supplies, and techniques related to eye and ear irrigation
      • K26. Commonly occurring types of injuries (for example, lacerations, abrasions, fractures, sprains)
      • K27. Treatment for commonly occurring types of injuries, (for example, bandaging, ice, elevation)
      • K28. Commonly occurring types of surgical interventions
      • K29. Signs and symptoms related to urgent and emergency situations (for example, diabetic shock, heat stroke, allergic reactions, choking, syncope, seizure)
      • K30. Emergency action plans (for example, crash cart, emergency injectables)
      • K31. Procedures to perform CPR, basic life support and AED
      • K32. Computerized Physician Order Entry (CPOE)
      • K33. Referral authorizations; insurance authorizations
      • K34. Legal requirements for content and transmission of prescriptions
      • K35. Prior authorizations for medication; electronic prescribing software
      • K36. Required components of medical records
      • K37. Medical necessity guidelines
    • Infection control
    • Tasks:
      • T1. Adhere to regulations and guidelines related to infection control
      • T2. Adhere to guidelines regarding hand hygiene
      • T3. Perform disinfection/sanitization
      • T4. Perform sterilization of medical equipment
      • T5. Perform appropriate aseptic techniques for various clinical situations
      • T6. Dispose of biohazardous materials as dictated by OSHA (for example, sharps containers, red bags)
    • Knowledge of:
      • K1. Universal precautions
      • K2. Hand-washing techniques
      • K3. Alcohol-based rubs/sanitizer
      • K4. Infectious agents, modes of transmission, precautions for bloodborne pathogens
      • K5. Personal protective equipment (PPE)
      • K6. Sterilization techniques (autoclave, instrument cleaner, germicidal disinfectants, disposables)
      • K7. Techniques for medical and surgical asepsis
      • K8. Order of cleaning and types of cleaning products
      • K9. Safety Data Sheets (SDS)
      • K10. Cautions related to chemicals
      • K11. Disposal methods
      • K12. Exposure control plan
      • K13. Calibration of equipment
      • K14. Logs (for example, maintenance, equipment servicing, temperature (refrigerator), quality control)
    • Testing and Laboratory Procedures
    • Tasks:
      • T1. Collect non-blood specimens (for example, urine, stool, cultures, sputum)
      • T2. Perform CLIA-waived testing (labs)
      • T3. Perform vision and hearing tests
      • T4. Perform allergy testing
      • T5. Perform spirometry/pulmonary function tests (electronic or manual)
      • T6. Recognize, document, and report normal and abnormal laboratory and test values
      • T7. Match and label specimen to patient and completed requisition
      • T8. Process, handle, and transport collected specimens
    • Knowledge of:
      • K1. Point of care testing
      • K2. Information required on provider request or requisition form
      • K3. Specimen collection techniques and requirements
      • K4. CLIA-waived testing regulations
      • K5. COLA accreditation standards
      • K6. Controls/calibration/quality control
      • K7. Normal and abnormal lab values and test values
      • K8. Elements related to vision and hearing tests including color, acuity/distance, visual fields; tone, speech and word recognition, typanometry
      • K9. Peak flow rates
      • K10. Common allergens
      • K11. Scratch test and intradermal allergy test
      • K12. Requirements for transportation, diagnosis, storage, and disposal of specimens, including patient identifiers, site or test
      • K13. Content of requisition, including date and time, and ICD-10
    • Phlebotomy
    • Tasks:
      • T1. Verify order details
      • T2. Select appropriate supplies for test(s) ordered
      • T3. Determine venipuncture site accessibility based on patient age and condition
      • T4. Prepare site for venipuncture
      • T5. Perform venipuncture
      • T6. Perform capillary puncture
      • T7. Perform post-procedural care
      • T8. Handle blood samples as required for diagnostic purposes
      • T9. Process blood specimens for laboratory
      • T10. Match and label specimen to patient and completed requisition
      • T11. Recognize and respond to abnormal test results
      • T12. Prepare samples for transportation to a reference (outside) laboratory
      • T13. Follow guidelines in distributing laboratory results to ordering providers after matching patient to provider
    • Knowledge of:
      • K1. Patient identifiers, including site or test; and content of requisition
      • K2. Requirements related to patient preparation for phlebotomy, including fasting/non-fasting
      • K3. Assessment of patient comfort/anxiety level with procedure
      • K4. Blood vacuum tubes required for chemistry, hematology, and microbiology testing
      • K5. Blood-borne pathogens
      • K6. Medical conditions or history and medications impacting collection of blood order of draw for venipuncture
      • K7. Anatomy, skin integrity, venous sufficiency, contra-indications
      • K8. Phlebotomy site preparation including cleansing, wrapping, order of draw with micro-tubes
      • K9. Insertion and removal techniques
      • K10. Evacuated tube, syringe, and butterfly methods
      • K11. Types of tubes, tube positions, number of tube inversions, and fill level/ratios
      • K12. Additives and preservatives
      • K13. Bandaging procedures, including allergies and skin types
      • K14. Pre-analytical considerations pertaining to specimen quality and consistency
      • K15. Special collections (for example, timed specimens, drug levels, blood cultures, fasting)
      • K16. Centrifuge and aliquot
      • K17. Normal and abnormal test values, control values
      • K18. Equipment calibration
      • K19. Storage conditions related to sensitivity to light and temperature
      • K20. Requirements for transportation, diagnosis, storage, disposal
      • K21. Processing and labeling requirements
      • K22. External databases (for example, outside labs, reference sources)
    • EKG and Cardiovascular Testing
    • Tasks:
      • T1. Prepare patients for procedure
      • T2. Perform cardiac monitoring (EKG, ECG) tests
      • T3. Ensure proper functioning of EKG equipment
      • T4. Recognize abnormal or emergent EKG results (for example, dysrhythmia, arrhythmia, versus artifact)
      • T5. Assist provider with non-invasive cardiovascular profiling (for example, stress test, Holter monitoring, event monitoring)
      • T6. Transmit results or report to patient’s EMR or paper chart, and provider
    • Knowledge of:
      • K1. Procedures and instructions to minimize artifacts
      • K2. Artifacts, signal distortions, and electrical interference (for example, fuzz and wandering baseline)
      • K3. Preparation, positioning, and draping of patient
      • K4. Supplies (paper, proper leads)
      • K5. Placement of limb and chest electrodes
      • K6. Techniques and methods for EKGs
      • K7. Signs of adverse reaction during testing (for example, signs of distress, elevated BP and respiration)
      • K8. Calibration of equipment
      • K9. Abnormal rhythms or dysrhythmias associated with cardiovascular testing
      • K10. Waveforms, intervals, segment
  • Patient Care Coordination and Education
    • Tasks:
      • T1. Review patient record prior to visit to ensure health care is comprehensively addressed
      • T2. Collaborate with healthcare providers and community-based organizations
      • T3. Assist providers in coordinating care with community agencies for clinical and non-clinical services
      • T4. Facilitate patient compliance (for example, continuity of care, follow up, medication compliance) to optimize health outcomes
      • T5. Participate in transition of care for patients
      • T6. Participate in team-based patient care (for example, patient centered medical home [PCMH], Accountable Care Organization [ACO])
    • Knowledge of:
      • K1. Preventive medicine and wellness
      • K2. Education delivery methods and instructional techniques and learning styles
      • K3. Resources and procedures to coordinate care outpatient services
      • K4. Available resources for clinical services (for example, home health care)
      • K5. Available community resources for non-clinical services (for example, adult day care, transportation vouchers)
      • K6. Specialty resources for patient/family medical and mental needs
      • K7. Referral forms and processes
      • K8. Barriers to care (for example, socio-economic, cultural differences, language, education)
      • K9. Tracking and reporting technologies
      • K10. Roles and responsibilities of team members involved in patient centered medical home
  • Administrative Assisting
    • Tasks:
      • T1. Schedule and monitor patient appointments using electronic and paper-based systems
      • T2. Verify insurance coverage/financial eligibility
      • T3. Identify and check patients in/out
      • T4. Verify diagnostic and procedural codes
      • T5. Obtain and verify prior authorizations and pre-certifications
      • T6. Prepare documentation and billing requests using current coding guidelines
      • T7. Ensure that documentation complies with government and insurance requirements
      • T8. Perform charge reconciliation (for example, correct use of EHR software, entering charges, making adjustments, accounts receivable procedures)
      • T9. Bill patients, insurers, and third party payers for services performed
      • T10. Resolve billing issues with insurers and third party payers, including appeals and denials
      • T11. Manage electronic and paper medical records
      • T12. Facilitate/generate referrals to other healthcare providers and allied healthcare professionals
      • T13. Provide customer service and facilitate service recovery (for example, follow up patient calls, appointment confirmations, monitor patient flow sheets, collect on accounts, make up for poor customer service)
      • T14. Enter information into databases or spreadsheets (for example, Excel, EHR & EMR, billing modules, scheduling systems)
      • T15. Participate in safety evaluations and report safety concerns
      • T16. Maintain inventory of clinical and administrative supplies
    • Knowledge of:
      • K1. Filing systems
      • K2. Scheduling software
      • K3. Recognition of urgency of appointment needs
      • K4. Requirements related to duration of visits (for example, purpose of visit, physician preferences)
      • K5. Telephone etiquette
      • K6. Records management systems and software (for example, manual filing systems – alphabetical, numeric, office storage for archived files, EMR/EHR software applications)
      • K7. Legal requirements related to maintenance, storage, and disposal of records
      • K8. Categories of the medical record (for example, administrative, clinical, billing, procedural, notes, consents)
      • K9. Required documentation for patient review and signature
      • K10. Chart review
      • K11. E-referrals (for example, how they are created, required information, how they are sent)
      • K12. Financial eligibility, sliding scales, and indigent programs
      • K13. Government regulations (for example meaningful use, MACRA)
      • K14. CMS billing requirements
      • K15. Third party payer billing requirements
      • K16. Advanced beneficiary notice (ABN)
      • K17. Specialty pharmacies (for example, compounding and nuclear pharmacies; forms of medication available such as liquid, elixir, balm, ointment)
      • K18. Insurance terminology (for example, co-pay, co-insurance, deductible, tier levels, explanation of benefits
      • K19. Aging reports, collections due, adjustments and write-offs
      • K20. Online banking for deposits and electronic transfers
      • K21. Authorizations to approve payment processing
      • K22. Auditing methods, processes, and sign-offs
      • K23. Data entry and data fields
      • K24. Equipment inspection logs, required schedules, and compliance requirements, including inspection by medical equipment servicers
  • Communication and Customer Service
    • Tasks:
      • T1. Modify verbal and non-verbal communication for diverse audiences (for example providers, coworkers, supervisors, patients and caregivers, external providers)
      • T2. Modify verbal and non-verbal communications with patients and caregivers based on special considerations (for example pediatric, geriatric, hearing impaired, vision impaired, mentally handicapped or disabled)
      • T3. Clarify and relay communications between patients and providers
      • T4. Communicate on the telephone with patients and caregivers, providers, third party payers
      • T5. Prepare written/electronic communications/business correspondence
      • T6. Handle challenging/difficult customer service occurrences
      • T7. Engage in crucial conversations (with patients and caregivers/heath care surrogates, staff, and providers)
      • T8. Facilitate and promote teamwork and team engagement
    • Knowledge of:
      • K1. Communication styles
      • K2. Patient characteristics impacting communication (for example, cultural differences and language barriers, cognitive level, developmental stage; sensory and physical disabilities; age)
      • K3. Medical terminology and jargon, laymen’s terms
      • K4. Therapeutic communication
      • K5. Interviewing and questioning techniques, including screening questions, open-, closed-, probing questions
      • K6. Scope of permitted questions and boundaries for questions
      • K7. Active listening
      • K8. Communication cycle (clear, concise message relay)
      • K9. Coaching and feedback, positive reinforcement of effective behavior
      • K10. Professional presence (for example, appearance, demeanor, tone
      • K11. Patient satisfaction surveys
      • K12. When to escalate problem situations
      • K13. Techniques to deal with patients (for example, irate clients, custody issues between parents, chain of command)
      • K14. Incident/event/unusual occurrence reports; documentation of event
      • K15. Cause-and-effect analysis (for example, anxiety increases blood pressure or heart rate; risk management related to patient and employee safety [reviewing the design, setting/population, protocols, measurements of a facility to ensure overall patient and employee safety])
      • K16. Email étiquette
      • K17. Business letter formats
      • K18. Telephone étiquette
  • Medical Law and Ethics
    • Tasks:
      • T1. Comply with legal and regulatory requirements
      • T2. Adhere to professional codes of ethics
      • T3. Obtain, review, and comply with medical directives
      • T4. Obtain and document healthcare proxies and agents
      • T5. Provide, collect, and store MOLST forms (medical order for life sustaining treatment)
      • T6. Protect patient privacy and confidentiality, including medical records
      • T7. Adhere to legal requirements regarding reportable violations or incidents
      • T8. Identify personal or religious beliefs and values and provide unbiased care
    • Knowledge of:
      • K1. Informed consent
      • K2. Advanced directives (for example, living will, DNR/DNI)
      • K3. Power of attorney
      • K4. Storage of medical records
      • K5. Conditions for sharing information/release of information
      • K6. Criminal and civil acts, and medical malpractice
      • K7. Mandatory reporting laws, triggers for reporting and reporting agencies
      • K8. Hippocratic Oath