What Are the Salary Trends for Medical Coding?
Medical coding salaries have maintained an upward trajectory throughout the last decade. In 2019, we saw a 5.8% pay increase over the previous year — almost double the 3.1% increase seen across all industries, according to the 2019 General Industry Salary Budget Survey.
But to understand 2020 salary trends for medical billers and coders requires looking at the pandemic economy.
COVID-19 & U.S. Job Loss
The quarantine economy disrupted employment and salary trends throughout the U.S. labor market. This disruption impacted the Health Care and Social Assistance sector, which saw a 16.5% decline in employment through April, as reported by University of Chicago's Becker Friedman Institute.
The Becker Friedman Institute measured changes in the U.S. labor market during the early months of the pandemic using weekly data pulled from the largest payroll processing company in the U.S. The overall trends observed reflected the expected fallout:
- Industries requiring direct employee interaction with customers and colleagues saw the biggest employment declines.
- Industries comprising small businesses were the hardest hit by the pandemic.
By April 25, 2020, when the U.S. economy bottomed, employment across all sectors had fallen by 21% (relative to early February).
For these weeks and a second, extended period, the Becker Friedman Institute calculated the pandemic impact on employment for each 2-digit NAICS industry, as seen in the following table.
Pandemic Effects on Employment by Industry
|Arts, Entertainment and Recreation
|Accommodation and Food Services
|Transportation and Warehousing
|Real Estate, Rental and Leasing
|Administrative and Support
|Health Care and Social Assistance
|Professional, Scientific, and Tech Services
|Finance and Insurance
For details and analysis, please see the Becker Friedman Institute at UChicago paper, " The U.S. Labor Market During the Beginning of the Pandemic Recession. "
In the second period of the study, all industries but Education Services saw partial recovery.
The Health Care and Social Assistance sector hadn’t been immune to the effects of COVID-19, but it was among the first industries to reopen, experiencing a 40% recovery of lost jobs by June 20.
Still, a 40% recovery leaves 10.3% of healthcare staff who had lost their jobs in February unemployed in June. This number supports the AAPC salary survey in which 10.5% of respondents reported being unemployed.
The 2020 unemployment rate among health information technicians is a departure from an otherwise healthy trend that averages 5.9% — or conversely, 94.1% employment of medical billers and coders, including newly certified apprentice coders (CPC-As). Employment for fully credentialled coders has held at 98% for ten years.
Salary Trends Routed by Economic Shutdown
During the worst economic crisis since the Depression, many business leaders opted to save jobs by cutting pay. Amid wage freezes and wage cuts ranging from 5 and 50%, the Becker Friedman Institute reported a 10% median wage reduction across industries.
In comparison, salaries for health information technicians dropped by just 2.9%, according to the AAPC Healthcare Salary Survey. Because the AAPC survey did not isolate wage cuts, the 2.9% drop also factors in annual earnings reduced by furlough, job loss, and cut hours. All the more, this statistic highlights the resiliency and stability of medical billing and coding as a career path.
Variability by State in Medical Coding Salary Trends
The quarantine economy impacted some states more than others, contributing to regional variability in 2020 medical coding and billing salary changes.
The District of Columbia, for example, confirmed its first cases of COVID-19 as early as March 7. Businesses and institutions began to curtail operations — including public transportation, which cut Metro ridership by 85%. Weeks later, shelter-in-place orders were issued.
With the nation’s capital still shut down in June, political unrest prompted business owners to board up storefronts. The daytime population of the Downtown D.C. Business Improvement District had dropped 90% from February. By July, economic activity was 12% what it had been in 2019.
Not surprisingly, medical billing and coding salaries in Washington D.C. fell sharply — 17.24% to be exact. This represents the steepest decline in the 50 states and U.S. territories.
In addition to D.C., five states saw coding salary reductions in disproportionate excess of the 2.9% mean. Utah, North Dakota, Idaho, California, and Kansas experienced salary decline at least twice as great. The pattern observed across the nation, however, was milder:
- 16 states incurred salary decline greater than 2.9%
- 20 states incurred salary decline less than 2.9%
- 16 states/regions experienced salary increase
The graph below illustrates the distribution of salary changes for medical billing and coding specialists, as influenced by COVID-19.
CODING SALARY CHANGES RELATIVE TO THE 2.9% MEAN
Roughly 30% of U.S. coding and billing staff sustained salary loss above the 2020 average of 2.9%. But 70% of medical coders and billers fared better. This insight is key to understanding the year-over-year trend in medical coding salaries.
In keeping with all U.S. industries, the pandemic altered the growth trajectory for coding incomes. But the altered course was minimal and somewhat contained, which underscores the reliability of the long-term trend. In fact, roughly 30% of coding and billing staff received salary increases in 2020.
U.S. territories reported the greatest salary increase at 6.48%. Given their isolation from continental U.S., we can infer that healthcare organizations abroad conducted business as usual.
A similar image was projected by Vermont, which averaged a 6.17% salary increase for health information technicians, the second highest of the country. Having averaged double-digit daily COVID-19 cases until late November 2020, Vermont was among the states least affected by the pandemic.
Variability in Salary Trends by Medical Coding Credentials
In past years, salaries for certified billing and coding specialists have consistently increased in a trend reflecting the value placed on certification as a measure of proficiency. Certified professionals have established a reputation of excellence within the healthcare industry, one that is attributed to quality training and on-the-job experience.
2019 stayed the course, with salaries increasing above the general industries average of 3.1% for all AAPC coding credentials. But such was not the case in 2020, as seen in the table below.
AVERAGE ANNUAL SALARY CHANGE BY CREDENTIAL
|Certified Professional Biller (CPB)
|Certified Professional Coder (CPC)
|Certified Outpatient Coder (COC)
|Certified Professional Coder-Payer (CPC-P)
|Certified Inpatient Coder (CIC)
|Certified Risk Adjustment Coder (CRC)
|Certified Professional Medical Auditor (CPMA)
|Certified Documentation Expert-Outpatient (CDEO)
|Certified Professional Coder-Instructor (CPC-I)
|Certified Professional Practice Manager (CPPM)
|Certified Professional Compliance Officer (CPCO)
The percent pay changes listed above show the commonality in the 2020 experience. Although the AAPC survey did not ask COVID-specific questions, we can speculate that many health information technicians encountered a disruption in the typical work week that affected their compensation.
A closer look to compare average salary by professional certification suggests additional details resulting from the shutdown.
CICs, the hardest hit by the pandemic, incurred a 14.84% decline in 2020 earnings. In view of the ban on elective and non-urgent procedures, it’s reasonable to assume that the average acute healthcare facility was forced to furlough a significant portion of CIC staff — possibly for the duration of the ban in their state.
While COCs weren't affected as greatly as certified inpatient coders, a 5.53% cut in annual income is consequential. Delaying elective procedures likely had a similar effect on outpatient departments and ambulatory surgery centers, requiring them to cut hours or furlough their COC staff for a period of weeks or months.
Medical Coding and Billing Salaries Based on Trends in Employer Types
Heightened reimbursement pressure on independent physicians has given rise to a trend of consolidation between hospitals and physician practices. Nationwide, physicians are leaving private practice and entering into employment arrangements with health systems.
In less than a decade, the percentage of hospital-employed physicians increased by more than 70%. During the same period, all U.S. regions saw an increase from 91% to 303% in hospital-owned practices, according to data compiled by the Physicians Advocacy Institute.
Employed physicians now outnumber self-employed physicians. And this trend is observed in the AAPC Healthcare Salary Survey.
Only 11.2% of respondents reported working for small physician practices in 2020. This number represents a tremendous shift from 37.2% in 2015. Of the most predominant employer types listed below, more than 50% of medical coders and billers now work for the largest employer types.
As demonstrated earlier, the larger the employer, the more likely its employees receive a higher salary. As more doctors forgo their independence for the steady paycheck offered by health systems, the medical coding professional will bank higher pay. This trend will trickle down to affect salary ranges for small organizations, as entry-level positions receive compensation based on national averages.
Average 2020 Salary Across Patient Care Settings
As seen in the chart above, salary decline occurred among all employer types, but the medical coding professional employed by a health system, the largest of healthcare organizations, continued to receive the highest pay in 2020.
Medical Coding Salary Trends Based on Educational Background
Although certification carries the most weight with employers, and does not require higher education to obtain, our survey shows an influence of education on medical billing and coding salaries.
Health information technicians with no college education average $24.22 per hour, while a certified coding specialist with some college or an associate degree averages $25.57 per hour — 3.5% more money annually. The hourly wage rises to $26.58 for professionals with a bachelor’s degree and $30.70 for coding specialists with a master’s degree.
Average Medical Coder Salary by Education
The graph above shows that a gap of more than $30,000 has occasionally separated the highest earners with master’s degrees from the lowest earners without an associate degree. But this salary gap has narrowed to as little as $10,000.
For the certified medical coder who bypassed the university route and trained solely in a certification program, this trend is welcomed news.
Does the Future Outlook Include Medical Coding Job Growth?
Medical coding and billing careers come with reliable job prospects. The demand is so high that the U.S. Bureau of Labor Statistics lists medical coding among the 20 fastest growing occupations.
The Affordable Care Act has played a role in the demand for medical coders by ensuring that more people are eligible for medical care. Considering that all patient encounter by every healthcare provider requires coded documentation and records, it's not surprising that medical coding is among the most sought-after healthcare careers.
Job security factors into quality of life, which is one reason why medical coding is a smart career choice.
Not only has the U.S. Baby Boomer generation — 20% of our population — reached its golden years, but the U.S. Census Bureau estimates that 78 million people age 65 and over will increase 55% by 2030. Given the rise in chronic conditions prevalent among this population, the Association of American Medical Colleges (AAMC) anticipates a shortfall of nearly 105,000 physicians by 2030. This shortage extends to medical coders and billing specialists who support hospitals and physician-based practices.
While legislation could potentially reverse the Affordable Care Act, the demand for medical billers and coders will continue to rise “much faster than the average for all occupations,” in keeping with our aging population, according to the U.S. Bureau of Labor Statistics.
The Occupational Outlook Handbook published by the U.S. Department of Labor, estimates:
- Employment of health information technicians is projected to grow 8% from now to 2029, faster than the average for all occupations.
- Additional records, coupled with widespread use of electronic health records (EHRs) by all types of healthcare providers, will lead to an increased need for technicians to organize and manage the associated information in all areas of the healthcare industry.
How much does a medical coder make year over year? If you’re considering becoming a certified coder or a medical billing specialist and want to learn more about salary trends for this career, you’ll find comprehensive details in past AAPC Healthcare Salary Surveys.
How Can Medical Coders and Billers Increase Their Salary Potential?
The quickest route to making a higher medical coding salary is education. Depending on your circumstances, you may have additional options as well.
Non-certified medical billers and coders perform the same work as their certified counterparts but earn substantially less. If you’ve learned the health information profession through on-the-job experience, getting certified — and earning potentially 39% more money each year — may be as simple as taking the CPB or CPC exam .
Newly certified professional coders receive the CPC-A credential. The “A” indicates apprenticeship status. Removing this status typically requires two years of coding experience. In 2019, 85% of surveyed CPC-As found employment. While this was a higher success rate than the 53% national average across all occupations, it still falls short of the 98% employment rate for CPCs.
But CPC-As can boost their employment value and potentially bypass entry-level positions by taking advantage of Practicode. This platform, created by AAPC, is an online tool designed to reinforce medical coding proficiency with concentrated, hands-on coding practice. The experience gained with Practicode equates with one year of on-the-job medical coding, allowing CPC-As to fast-track their apprenticeship status.
Specialty coders. If you’re a CPC working in a specialized physician’s office, consider adding specialty certification to your credentials. The median salary for medical coders with a specialty credential is $62,175. This is 10.3% higher than the median salary of $56,164 for non-specialized CPCs. Specialty certifications include:
Broaden your role with advanced certification. In addition to specialty training, certified professional coders can branch into inpatient and outpatient coding , bringing more diversity to their role in health systems, as well as opening the door to working in other healthcare settings.
Risk adjustment coding is also a key skillset you can bring to the table. Used in all healthcare settings (inpatient, outpatient, physician practice), risk adjustment coding plays a monumental role in securing optimal reimbursement, as well as MACRA incentive pay . Employers profit greatly from staffing CRCs, and professional coders leveraging this opportunity stand to raise their salary potential by 13.43%.
Career longevity for medical coders and billers should encourage those who have recently chosen the profession. Survey respondents in 2020 report a median 12 years in the industry. And with medical coding experience comes skills and knowledge that crossover into in several high-paying healthcare business roles, including practice management, medical auditing, compliance, and clinical documentation improvement .
If you’re willing to take on broader responsibilities, you might consider pursuing a supervisory role or training to become a Certified Professional Practice Manager (CPPM). While salary ranges vary based on employer type, medical and health services managers earned a median annual salary of $104,280 in 2020, according to the Bureau of Labor Statistics .
Backing your experience with advanced certification is a smart move and will deliver greater financial rewards.
Top 4 Health Information Technician Earners in 2020
New Employment Opportunities. Annual pay increases could be restricted by your current base salary, and you may need to consider changing jobs if you’re not getting the raise you deserve. This is a truism applicable to all industries. Potential employers aren’t bound by previous salaries, and the biggest gains are typically won during the hiring process.
But the advantages of changing jobs within the medical coding industry are even more promising, given that salaries vary by employer type and employer location. Deciding to leave a small group practice for a large group practice, for example, automatically elevates your earning potential by 14%.
You also have location opportunities to consider. As you know, salaries among the 50 states can vary by almost 50%. Does that mean you need to move from Alabama to California to earn more? Not in today’s world.
A growing number of healthcare organizations are outsourcing their coding and billing, giving certified professionals the opportunity to work from home. According to last year’s survey, 33.8% of respondents reported working remotely, and most of these were employed by out-of-state organizations. This trend has remained consistent for several years. Health information technicians living in rural regions can earn urban wages.
Steps to Becoming a Medical Coder
Why Choose AAPC for Your Billing and Coding Training?
AAPC is the world’s largest association representing medical coders, billers, auditors, compliance officers, and practice managers. For more than three decades, AAPC-trained CPBs and CPCs have established an unwavering reputation of excellence. The titles of certified professional biller and certified professional coder come with high expectations, trust, and respect. AAPC's billing and coding programs will prepare you to earn your credential — and help you to maintain your expertise with numerous resources exclusively available to our members. Additionally, you’ll become part of a large nationwide network of professional coders through our local chapters and online forums.
Prepare for your certification exam today and get your future started!
Visit our medical billing and coding training pages to learn more about a career in medical billing and coding — or contact an AAPC career counselor online , via email , or by calling 800-626-2633 for a free consultation.
You can also view AAPC’s latest salary survey report for additional insights into medical coding salary trends. Employers and employees can use this survey or our Medical Coding Salary Calculator to determine appropriate compensation plans based on specific parameters. You can also take the salary survey to contribute your data to our findings.