National Certified Medical Assistant (NCMA) Review & Study Guide

Essential Test Prep Tips to Help You Pass the NCMA Exam the First Time

We recently outlined a few of the best Medical Assistant certifications for MAs who wish to advance their careers. We also covered some of the benefits to becoming a Certified Medical Assistant, which can include higher wages, increased job stability, and a positive career outlook.

To help current and aspiring Medical Assistants achieve their goals, we are launching a series of test-prep tips and study guides for the various certifications we covered in our previous installment.

(Click here to learn how to become a Medical Assistant).

This study guide will focus on the NCMA, which stands for National Certified Medical Assistant. The NCMA exam is administered by the National Center for Competency Testing (NCCT), an organization that has tested healthcare professionals throughout the United States since 1989. They also offer reasonable exam fees as well as several certification routes for MAs.

If you are considering certification as an NCMA, we created this guide to offer you a roadmap to success while preparing for the exam.

How to Pass the NCMA (NCCT) Certification Exam

Our comprehensive NCMA study plan will cover the following questions and topics:

• What is the NCMA exam?
• How do you pass the NCMA?
• What is on the NCMA exam?
• Is the NCMA exam hard to pass?
• The NCMA exam requirements.
• NCMA exam sample questions.
• General tips and test strategies for passing the NCMA
• Information on NCMA test results.

But first, let’s begin with a brief refresher…

What Is the NCMA Exam?

The National Certified Medical Assistant (NCCT) credential attests that a candidate has the knowledge, skills, and abilities to safely practice as a Medical Assistant.

This credential is awarded to applicants who pass the NCMA Certification Exam.

How to Apply for the NCMA Exam

Applicants who meet one of the NCCT’s eligibility routes must complete the following steps to apply for the NCMA Exam:

Step 1. Determine your eligibility to take the exam.

Step 2: Submit your application and fee online.

Step 3: Prepare for the exam by utilizing NCCT study resources.

Step 4: Take the exam after you receive approval from NCCT.

You can learn more about each of these steps here.

Application Information

• In order for NCCT to process your application in a timely manner, your application and all required documentation must be submitted 14 days prior to your anticipated test date.
• Applications and payments are valid for one year from the date of submission to NCCT.
• The practice of some professions may be regulated in certain states and it is your responsibility to determine whether this certification meets your state requirements for practice before taking it.

NCMA Exam Requirements

What Are the Requirements to Take the NCMA Exam?

The NCCT’s NCMA requirements can vary depending on your situation. Each applicant must meet one of the following qualification routes from the NCCT.

Route 1A: Current Student

• You must be a United States high school current student, graduate or hold equivalent credentials (e.g., GED).
• You must submit a copy of your Medical Assistant diploma, certificate of completion, or official (signed) transcript with graduation date.
• All required documents must be submitted within two years after successful program completion for your certification to be released.

Route 1B: Graduate

• You must be a United States high school graduate or hold equivalent credentials (e.g., GED).
• You must submit a copy of your Medical Assistant diploma, certificate of completion, or transcript with graduation date. This includes U.S. Department of Labor Registered Apprenticeship programs.

Route 2: Experience

• You must be a United States high school graduate or hold equivalent credentials (e.g., GED).
• You must have two (2) years of full-time employment or equivalent (4,160 hours) as a Medical Assistant under the direct supervision of a certified/licensed physician or primary care provider within the past FIVE years.
• You must submit a copy of your high school diploma (or equivalent) and the Medical Assistant Certification Qualification by Experience form completed by your employer.
• Note: Working as an instructor is not equivalent to working as a practitioner.

Route 3: Military

• You must be a United States high school graduate or hold equivalent credentials (e.g., GED).
• You must provide a copy of a SMART transcript or DD214 indicating you have successfully completed a formal medical services training program of the United States Armed Forces relating to the discipline for which you are testing. The DD214 or SMART transcript must be current within the past FIVE years.

OR

• You must be a United States high school graduate or hold equivalent credentials (e.g., GED).
• You must have two (2) years of full-time employment or equivalent (4,160 hours) as a Medical Assistant under the direct supervision of a certified/licensed physician or primary care provider within the past FIVE years.
• You must submit a copy of your high school diploma (or equivalent) and the Medical Assistant Certification Qualification by Experience form completed by your employer.
• Note: Working as an instructor is not equivalent to working as a practitioner.

What Is on the NCMA Exam?

Certification with the NCCT can be a fantastic step for your career, but it doesn’t have to be a stressful experience. Furthermore, NCCT provides several study resources, such as: exam fees, pass rate report, and sample items.

The NCCT also provides a detailed content outline for the exam. It highlights the following major categories of the test:

1. Pharmacology / Number of items: 21

• • Consult pharmaceutical desk references to check medications (e.g., drug classification, contraindications, side effects, action, routes of administration, and adverse reactions).
  • Perform basic medication related calculations.
  • Comply with DEA and other regulatory agency guidelines for ordering, dispensing, documenting, and storing drugs.
  • Document medication administration errors.
  • Comply with legal requirements for completion of prescriptions and authorization of refills.
  • Identify commonly used medications by generic and brand names.
  • Recognize general indications for common therapeutic medications used (e.g., insulin for diabetics, etc.).
  • Demonstrate safe medication preparation, administration, and documentation (e.g., dosage calculation, route, types of injections, and injection sites).
  • Administer medication orally.
  • Administer medication subcutaneously (SQ).
  • Administer medication intramuscularly (IM).
  • Administer medication intradermally (ID).
  • Respond to adverse reactions.
  • Administer medication transdermally.
  • Administer medication topically.
  • Adhere to e-prescribing protocols.
  • Translate prescription abbreviations.
  • Administer medication sublingually (SL) or bucally.
  • Administer medication by inhalation.
  • Instill ophthalmic medication (e.g., eye drops).
  • Instill medication aurally (e.g., ear drops).
  • Document medication administration and reactions.
  • Document prescriptions and refills.

2. Clinical Medical Procedures / Number of items: 28

• • A. Infection, Exposure Control, and Safety

• • • Follow CDC Standard Precautions and transmission precautions (e.g.,airborne, contact, droplet, hand hygiene).
    • Comply with OSHA standards for Health Care Workers (e.g., blood borne pathogens, SDS, needlesticks, bodily fluids).
    • Perform general medical asepsis.
    • Perform surgical asepsis.
    • Implement cleansing, disinfection, and sterilization as needed.
    • Handle and dispose of biohazardous waste.
    • Handle and dispose of chemicals.
    • Use personal protective equipment (e.g., gloves, gown, mask).
    • Follow patient isolation procedures (e.g., radiation, reverse, TB).
    • Respond to emergency situations (e.g., fire, biological hazard).
    • Prevent the spread of healthcare acquired (nosocomial) infection.
    • Practice safety procedures when using medical equipment and supplies (e.g., lock wheels, gait/transfer belts).
    • Transfer patients using correct body mechanics.
    • Activate safety mechanisms for sharps.
  • B. Patient Care
    • Perform adult and pediatric height, weight, and BMI measurements (e.g., standing, wheelchair).
    • Obtain patient vital signs.
    • Take a patient history.
    • Use a pain scale to report patient pain levels.
    • Position a patient for an exam or procedure (e.g., Flowler’s, lithotomy).
    • Perform a pulse oximetry measurement.
    • Perform vision screening tests (e.g., Snellen, Ishihara, Pelli-Robson).
    • Perform allergy testing.
    • Perform suture and staple removal.
    • Perform auditory acuity tests.
    • Perform ear irrigation.
    • Perform eye irrigation.
    • Assist the provider with patient examinations (e.g., physical, gynecological).
    • Recognize and appropriately report abnormal measure/screening results (e.g., pain assessment and monitoring).
    • Prepare and manage patient exam/treatment areas.
    • Adapt care to patients with special needs (e.g., physically, mentally impaired).
    • Perform wound care and/or dressing changes.
    • Assist with immobility support/splint applications (e.g., elastic bandage, wrist splint).
    • Assist with minor surgical procedures (e.g., skin prep).
    • Perform therapeutic modalities as instructed (e.g., crutch training, hot/cold compress, ROM exercises).
    • Provide basic patient instruction/education (hemoccult, breast/testicular self-exams, nutrition).
    • Assist with oxygen therapy (e.g., nasal cannula).
    • Assist patients with spirometry (e.g., peak flow, PFT).
    • Assist with patient-administered nebulizer treatments.
    • Assist patients with orthotic or prosthetic devices.
    • Perform first aid, BLS, and rapid response procedures.

3. Phlebotomy / Number of items: 21

• • Adhere to standards for patient introduction, identification, and order verification.
  • Evaluate pre-test conditions for patient prior to collection (e.g., fasting, medications).
  • Adhere to patient safety, infection control, and aseptic technique standards.
  • Select appropriate venipuncture equipment for the test ordered and type/age of patient.
  • Prepare the patient and the selected site for blood collection (e.g., micro-sampling, venipuncture, bacterial culture).
  • Select appropriate capillary puncture equipment for the test ordered and type/age of patient.
  • Take appropriate action when blood return is not established (e.g., collapsed vein, missed vein).
  • Follow the correct order of draw for blood samples (e.g., capillary, venous).
  • Identify additives in evacuated blood collection tubes.
  • Follow the manufacturer recommendations for fill level/ratio and tube inversion.
  • Implement precautions for patients with special needs (e.g., mastectomy, IV, burns, dementia, bleeding disorders, other).
  • Perform venipuncture on patients of all ages.
  • Perform capillary punctures by fingerstick.
  • Perform capillary punctures by heelstick.
  • Select appropriate bandaging supplies (e.g., age, allergy, skin type).
  • Perform phlebotomy aftercare.
  • Recognize and respond to complications (e.g., hematoma, excessive bleeding, other).
  • Anticipate pre-analytical errors and complications (e.g., inadequate collection amount, wrong order of draw).
  • Take corrective actions for problems with test requests, specimen transport, or specimen processing.
  • Perform blood culture collections.
  • Handle laboratory specimens per protocol (e.g., preservatives, light sensitivity, temperature).
  • Label specimens appropriately.
  • Take appropriate actions for misidentified patients or samples.
  • Process specimens for the laboratory appropriately (e.g., centrifuge, aliquot, storage).
  • Perform special collections (e.g., trace elements, newborn screen, chain of custody).

4. ECG and Other Diagnostic Tests / Number of items: 18

• • A. Other Diagnostic Tests
    • Perform CLIA waived point of care testing (POCT) (e.g., urinalysis dip stick, hemoglobin and hematocrit, coagulation, glucose, pregnancy test, fecal occult blood).
    • Perform chain of custody collections (e.g., urine drug screening, paternity testing).
    • Perform lab instrument maintenance and calibration.
    • Collect specimen cultures (e.g., wound, sputum, viral, stool, throat).
    • Instruct patients in specimen collection (e.g., 24-hour urine, clean catch, stool, sputum).
    • Process specimen collections accurately.
    • Perform and record quality control, procedures for CLIA waived point of care testing.
  • B. ECG Placement Techniques
    • Prepare and position the patient for ECG testing (e.g., gowning, skin preparation).
    • Place electrodes on the patient appropriately for the test (e.g., stress, Holter, telemetry).
    • Use additional resources as needed for specific diagnostic tests (e.g., blood pressure cuff, treadmill, Holter monitor).
    • Adapt technique to patients with special considerations (e.g., amputee, right sided heart, pacemaker).
    • Adapt technique for special populations (e.g., age appropriate, isolation, special needs).
    • Explain the ECG procedure to the patient (e.g., movement, talking, electronics).
    • Provide patient instruction regarding the Holter monitor
  • C. ECG Recording
    • Provide ongoing monitoring of the patient during stress testing.
    • Capture and record ECG tracings on a patient.
    • Distinguish between regular and irregular rhythms.
    • Initiate response to life threatening arrhythmias per protocol.
    • Monitor patient vital signs and tolerance during testing.
    • Prepare the report for the physician.
    • Transmit the report to the patient’s EMR/EHR or chart.
  • D. ECG Troubleshooting and Maintenance
    • Identify recording errors (e.g., improper tracing, standardization mark out of range, improper lead placement).
    • Identify causes of artifact (e.g., somatic tremor, patient movement, wandering baseline, AC interference, seizures).
    • Account for patients with special considerations (e.g., shunts, piercings, scars, pacemaker/AICD-failure to pace).
    • Correct artifacts and recording errors (e.g., paper placement, lead reversal, power loss, remove electronic devices, calm the patient).
    • Ensure proper grounding of the ECG machine.
    • Check battery charge and paper supply.
    • Clean and store the ECG machine after use

5. General Office Procedures / Number of items: 21

• • A. Communication
    • Communicate effectively verbally and in writing.
    • Direct patients and visitors to the appropriate team member or location (e.g., greet, screen, prioritize).
    • Answer, evaluate, and direct incoming calls to team members using effective telephone techniques.
    • Describe the policies and procedures of the practice to patients.
    • Address possible telephone emergencies appropriately.
    • Initiate the emergency response system (e.g., violent person in the office, fire).
    • Route or transmit medical office correspondence to the appropriate team member via mail, fax or email.
    • Proofread and/or edit office correspondence.
    • Process medical office mail and correspondence via the appropriate shipper and postage classification (e.g., incoming, outgoing).
    • Ensure the availability of patient informational materials (e.g., pamphlets, patient education brochures).

• • B. Medical Office Computer Applications
    • Maintain the integrity and confidentiality of computer-stored information.
    • Maintain electronic medical office data (e.g., data entry, retrieval, backup).
    • Use standard office software (e.g., word processing, spreadsheet, database, email, internet browsers, presentation graphics applications).
    • Use medical office software applications (e.g., billing, scheduling, electronic medical records, electronic health records, financial).
    • Perform basic operator level troubleshooting on medical office computer equipment and software.
    • Manage medical office electronic data using devices other than computers (e.g., tablets, mobile phones, bar code scanners, card readers/scanners, kiosks).
    • Use peripheral devices (e.g., printers, copiers, scanners, fax, digital cameras).
  • C. Scheduling
    • Matrix healthcare schedules (e.g., facility, resources, providers).
    • Set up patient and visitor appointments using standard scheduling techniques (e.g., modified wave, double booking).
    • Set up patient appointments using telemedicine and/or home monitoring.
    • Manage appointment dates and times with scheduled patients (e.g., confirm, cancel, reschedule, missed appointments).
    • Maintain daily appointment schedules with team members.
    • Generate daily encounter forms for scheduled patients.
    • Manage referrals (e.g., schedule, obtain, verify).
    • Schedule patients for hospital admissions and surgery.
    • Schedule patients for out-patient diagnostic tests and procedures.
    • Manage the patient reminder system (e.g., tickler, recall).
  • D. Medical Records
    • Require all patients to complete and/or update necessary paperwork/forms.
    • Copy/scan picture identification and insurance card and obtain required signatures.
    • Enter patient information into the medical record.
    • Maintain confidentiality of medical records (e.g., HIPAA compliance).
    • Recognize the stages of meaningful use and merit-based payment (e.g., MIPS).
    • Manage documents and patient charts using paper methods.
    • Manage documents and patient charts using computerized/electronic methods.
    • Respond to legal requests/subpoenas for medical records (e.g., release requests, file transfers).
    • Respond to patient requests for medical records.
    • Make corrections and additions to medical records per state and federal guidelines.
    • Protect and retain medical records per state and federal guidelines.
    • Move medical records between active, inactive, and closed status.
    • Prepare charts for audits and external reviews.

6. Medical Office Management / Number of items: 25

• • A. Medical Office General Management
    • Open and close the medical office for the day.
    • Handle relationships with associated health care provider offices or business associates.
    • Comply with accreditation and licensure requirements.
    • Maintain files on the providers’ professional status (e.g., licensure or certification, continuing educational requirements, renewal dates, fees and dues).
    • Maintain the office manuals (e.g., policy and procedures, medical office safety, SDS).
    • Comply with Occupational Safety and Health Act (OSHA) guidelines and regulations.
    • Comply with the Clinical Laboratory Improvement Act (CLIA) guidelines and regulations.
  • B. Office Financial Management, Billing, Insurance
    • Explain the financial policies and procedures of the practice to patients and/or responsible parties.
    • Collect payment, copayment, coinsurance, or deductible owed by the patient at the time of service.
    • Provide fee schedules for the patients.
    • Use Current Procedural Terminology (CPT) and Health Care Financing Administration Common Procedure Coding System (HCPCS) codes to bill for services.
    • Use International Classification of Diseases (ICD) codes to bill for services.
    • Comply with fraud and abuse regulations related to insurance and billing.
    • Manage pre-authorizations, pre-certifications, and pre-determinations (e.g., prepare., obtain, verify).

7. Law and Ethics / Number of items: 16

• • Recognize legal responsibilities and the scope of practice for the medical assistant.
  • Recognize unethical practices and respond in an ethical manner for situations in the medical office.
  • Recognize and respond to violations of medical law.
  • Follow the protocol on terminating patient care (e.g., non-compliance, collections).
  • Comply with disclosure laws (e.g., HIPAA, HITECH).
  • Obtain patient consent for examinations and treatment.
  • Adhere to laws regarding reportable incidents and communicable diseases.
  • Advocate for the patient (e.g., patient navigator).
  • Adhere to A Patient’s Bill of Rights (AHA).
  • Adhere to advanced directives (e.g., power of attorney, living will, donor preferences).

Recap: Essential Knowledge Base

Apply a working understanding of these integrated concepts:

• Medical Law and ethics
• Sterilization techniques
• Patient assessment and vital signs
• Specialty examination preparation and assistance (e.g., eye, ear, pediatric, geriatric, reproductive, G/U, ECG)
• Minor procedure assistance (e.g., surgical)
• Infection control (e.g., PPE, Biomedical Waste Handling)
• Anatomy, Physiology, Pathophysiology, and Disorders
• Preanalytical errors (e.g., hemolysis, hemoconcentration, air in the cuevette)
• Specimen collecting, handling, and transporting (e.g., blood, urine, cultures)
• Venipuncture techniques
• Patient education
• Quality assurance
• Patient safety and first aid
• Healthcare regulation (e.g., OSHA, CLIA, CDC, HIPAA, Patient’s Bill of Rights)
• Chain of custody
• Customer service, complaint resolution, (e.g., de-escalation technique)
• Medical equipment quality control, operation, and maintenance
• Medical history
• Pharmacology (e.g., administration, interactions, dosages, properties)
• Medical practice software
• Administrative procedures (e.g., registration, payment, insurance, financial, mail processing)
• Emergency preparedness
• Medical terminology/abbreviations
• Therapeutic modalities (e.g., wound care, suture removal, crutch training, splinting, bandaging)

What Is the Best Way to Prepare for the NCMA (NCCT)?

To help you prepare for the NCMA (NCCT) exam, let’s begin by answering some of the most frequently asked questions about the exam itself.

When can you schedule a testing administration time?

All applications for testing must be received by the NCCT a minimum of 14 days prior to the requested test date. NCCT certification staff will review and process all applications and supporting documentation within three to five business days.

According to NCCT’s candidate handbook, “Applications completed and approved are scheduled for testing and will receive, via email or USPS mail, an authorization confirming the requested test date, location, and instructions.”

How much time do you have to complete the NCMA exam?

You’ll have three hours to complete this exam.

How many questions are on the NCMA exam?

The exam consists of about 150 questions as well as 15 pretest items. It covers topic areas that are listed in the NCMA (NCCT) exam outline. The format is both computer and paper based. It includes multiple-choice questions and innovate item types (i.e. multiple select, hotspot, drag and drop, etc.)

What is the passing score for the NCMA exam?

Each candidate’s performance is measured against a predetermined standard. This means that you are not graded on a curve and do not compete against other candidates or against a quota.

NCCT reports certification exam scores on a scale of 0-100, with all pass points scaled to a score of 70. Even if the questions on one examination form are harder or easier than on another, the same level of performance is required to meet the scaled passing score of 70 regardless of which form of the exam a candidate takes. Learn more from the candidate handbook here.

How many people pass the exam?

According to NCCT, the 2019 pass rate was 62%.

How much does it cost to take the NCMA exam?

The cost of the NCMA exam depends on the route you take.

• Route 1A, Current Student: $90.
• Route 1B, Graduate.
  • $90 if taken within six months of graduation.
  • $135 if taken after six months of graduation.
• Route 2, Experience: $135.
• Route 3, Military: $90.

When do you receive your NCMA exam results?

Paper-based examination results are sent via USPS within two to four weeks after receipt of examinations by the NCCT. Computer-administered examination results are provided on-site immediately following the examination.

You may also access your results on the NCCT website by logging into your account. Score reports will include a “pass” or “fail” result and a total scaled score. Score reports for failing candidates will also include information on candidate performance in each content domain area.

How long is your NCMA application good for?

Your certification remains valid for five years. During this period, you may choose to maintain certification in active or inactive status. Annual maintenance of active status, and therefore continuous learning, is encouraged.

To maintain active status, you’re required to recertify every year by earning continuing education credits, adhering to the Code of Ethics, notifying the NCCT of any felony convictions, and submitting a recertification fee.

NCMA Test Prep

NCMA Sample Quiz Questions

To help you gauge some of the topics on the exam, we compiled a few sample questions taken directly from Test-Guide’s online practice test.

(You can find the answers to these questions at the bottom of the article).

1. Which of these applies to a person issued with a subpoena in a medical law case?

a) They must appear in court

b) They may appear in court if they wish

c) They do not have to appear in court

d) They must stay away from the court

2. In a medical context, which of these would constitute invasion of privacy if done without consent?

a) Performing a medical procedure on an unconscious person

b) Reading a person’s prior medical records

c) Discussing a person’s case with another medical practitioner

d) Releasing a person’s photograph to the press

3. If a letter is addressed “Dear Sir/Madam,” what should the signoff be?

a) Yours sincerely

b) Yours faithfully

c) Kind regards

d) Any of the above

4. Computer screens should always be positioned so that…?

a) They are accessible to everybody

b) They can only be seen by the user

c) They are facing the main part of the office

d) They are facing the main light source

5. At the beginning of each working day, you should check appointments…?

a) Against patient records

b) Against billing schedules

c) With each team member

d) With the head of the practice

6. When a physician asks you to write up their record consultation, you are acting as a…?

a) Recordist

b) Clerk

c) Transcriptionist

d) Secretary

7. A discharge summary report must include what?

a) The patient’s financial account

b) The patient’s final condition

c) The patient’s insurance details

d) The patient’s next of kin

8. Who is generally responsible for making sure that medical personnel keep their professional status up-to-date?

a) The personnel themselves

b) The office administrator

c) The state medical board

d) All of the above

9. Petty cash may NOT be used for which of these purposes?

a) Purchasing office sundries

b) Advances on staff salaries

c) Paying excess delivery charges

d) Paying cab fares for staff on office business

10. What does the Department of Health say that the chance of catching HIV from a single needlestick injury is?

a) 3 in 1000

b) 10 in 1000

c) 100 in 1000

d) 200 in 1000

NCMA Test Strategies

What to Do on Exam Day

Here are a few tips from the NCCT to help you on the exam. Remember to take deep breaths—you’re going to do great!

• Make sure your name, user ID, and other information are correct.
• Note the allotted time for the exam; determine the midway mark.
• Read the “stem” of the question carefully before reading the possible responses.
• Be sure to answer all questions before time is up. There is no penalty for guessing.
• Questions and responses are in random order. There are no patterns.
• If testing on paper, be certain there are no stray marks or incomplete erasures.
• If testing online, be familiar with how to go back to review questions before closing out of the exam.

Retaking the NCMA (NCCT) Certification Exam

Candidates who do not pass the exam on their first and second attempts may retest after 30 days.

How many times can you fail the NCMA Exam?

After a third test failure, candidates must wait one year for a fourth and final attempt. The time between unsuccessful test challenges were established by the Board to ensure candidates had sufficient time for additional preparation.

You can learn more about this process here.

How to Renew Your NCMA Certification

Recertification with the National Center for Competency Testing (NCCT) is required annually and includes just two steps.

1. Log in to your Recertification/CE Dashboard to pay your recertification fee ($77).
2. And complete the required CE (14CH of CE annually).

Advance Your Career as a Medical Assistant

Our goal for this article was to provide you with practical tips on how to pass the NCMA (NCCT) Certification Exam. We hope it gives you the knowledge and confidence to take that next step forward in your career.

One benefit of becoming a National Certified Medical Assistant can be increased opportunities for advancement within the field. Some enjoy lifelong careers as MAs, while others build on their experience to apply to nursing school.

Remember: It’s never too late to take that first step. Change your future, today!

 

 

Answers: 1)A  2)D  3)A  4)B  5)C  6)C  7)B  8)B  9)B  10)A