Medical Billing and Coding Programs in North Dakota

North Dakota's healthcare industry serves a geographically dispersed population across a large, predominantly rural state. If you're considering this career here, you'll find that the average salary of $55,047 is about 10% above the national BLS median of $50,250 (AAPC 2023 Salary Survey). While that's moderate compared to coastal states, North Dakota's cost of living is among the lowest in the nation, so your purchasing power is considerably stronger.

The state's healthcare sector is anchored by Sanford Health (headquartered in Fargo), one of the largest rural health systems in the United States. Essentia Health, CHI St. Alexius Health in Bismarck, and Altru Health System in Grand Forks are other major employers. Critical access hospitals in rural communities also depend on billing and coding professionals, and many of these positions are filled by remote workers.

With 64.8% of medical coders nationwide working remotely (AAPC, 2025), North Dakota residents can access positions with employers across the state and country without relocating. For an overview of this career path, see our guide to medical billing and coding.

North Dakota doesn't currently have dedicated campus-based MBC programs listed in IPEDS. However, employers don't distinguish between online and campus-based training when hiring, so online programs work just as well. You may also qualify for workforce training assistance through Job Service North Dakota, which can help offset tuition costs. For a broader comparison of online providers, see our online programs guide.

Certification is the key credential you'll need in North Dakota. No state licensure is required, but employers strongly prefer candidates with a recognized credential. Here are your three main options:

CPC (Certified Professional Coder) from AAPC: The most widely recognized credential nationally. It's 100 questions over 4 hours with a 70% passing threshold. Cost is $425 for one attempt or $499 for two, plus AAPC membership ($222/yr, $157 for students).

CCA (Certified Coding Associate) from AHIMA: An entry-level credential suited to hospital and HIM settings. The exam is 105 questions over 2 hours, costing $199 for members or $299 for non-members.

CBCS (Certified Billing and Coding Specialist) from NHA: Covers both billing and coding with 100 scored questions plus 20 pretest questions at roughly $117. It's the most affordable option and pairs well with Penn Foster's training. All three exams can be taken via remote proctoring, which is especially convenient if you live far from testing centers. For detailed comparisons, see our certification comparison guide.

Your earning potential in North Dakota sits at $55,047/yr ($26.46/hr), about 10% above the national BLS median (AAPC 2023 Salary Survey). While the raw number is moderate, housing costs in Fargo, Bismarck, and Grand Forks are a fraction of what they are in coastal cities, so your dollars go further.

Certification drives meaningful salary gains. Nationally, certified professionals average $66,979, and those with 3+ credentials average $81,227 (AAPC 2025). Remote work opens you to positions with employers in higher-paying states, potentially boosting your earnings above the local average. For a full salary breakdown, visit our salary guide.

Key employers include Sanford Health (Fargo, one of the largest rural health systems in the U.S.), Essentia Health (Fargo), CHI St. Alexius Health (Bismarck), Altru Health System (Grand Forks), and the Department of Veterans Affairs medical facilities in Fargo. Federal employers like the VA offer competitive pay scales and benefits.

For maximum earnings, remote work is particularly valuable in North Dakota. Working remotely for an employer in a higher-paying state while living in low-cost ND can produce a significant advantage in purchasing power. Advancement paths include coding specialization, auditing, compliance, and health information management. See our step-by-step career guide for more on growth opportunities.