Home » Blog » Best States for Medical Billers and Coders

What are the Best States for Medical Billers and Coders?

woman typing medical information into laptop
Home » Blog » Best States for Medical Billers and Coders
sheila mickool

Written and reported by:
Sheila Mickool
Contributing Writer

According to the U.S. Bureau of Labor Statistics (BLS), this career field is expanding. Growth in medical records and health information specialist jobs, such as medical billing and coding jobs, is projected to be about 9% for the 10-year period 2020-2030, which is the average for all occupations nationally.

In this Article

That level of growth is substantial. More important is the number of job openings expected each year for the next 10 years. Today there are more than 335,000 medical records and health information jobs in the U.S., according to the BLS, and more than 34,000 of these jobs will need to be filled each year due to expansion of services, retirements, promotions, and increased use of telemedicine. The median annual wage for this position is $44,090.

More than 34,000 medical records and health information jobs will need to be filled each year, according to the BLS.

The profession is in high demand nationally, but some states are expected to experience much higher growth rates than others. Based on the BLS forecast of open jobs from year to year, some states will have thousands of jobs available each year that must be filled—while employment levels in other states are less than 1,000. So in addition to reviewing job responsibilities and required education, you should consider which states may be best for medical billers and coders—and for you personally.

Top 10 Best States for Medical Billers and Coders

Most people ask about salary first. So which state pays the highest annual median wage? Alaska does, with a median wage of $54,710. But you won’t find Alaska in the top 10 because there are only 1,000 medical billers and coders employed in the state. Affordability is often top-of-mind for job seekers. Which state has the highest cost-of-living index? That would be Hawaii, at 185.6. And while it may be a beautiful state, it didn’t make the Top 10 list either—because it’s almost twice as expensive as the national average to live there.

#1 Ohio

older downtown streetscape
  • Median salary: $42,620
  • Cost of living index: 92.9
  • Employment: 15,000
  • Location quotient (density of jobs): 1.28
  • Forecast for growth (2018-2028): 9.7%

State highlights: Ohio is one of the nation’s smallest states (ranking 34th in size), but it is densely populated and ranks seventh in population nationally. Think of Ohio as the “little state that can and does.” With Top 10 rankings like fourth in employment and sixth in location quotient—and a more affordable cost of living index than many states—Ohio packs a big punch and handily nabs the top spot as the best state for medical billers and coders. 

#2 Missouri

saint louis skyline with arch
  • Median salary: $44,860
  • Cost of living index: 91.2
  • Employment: 6,830
  • Location quotient (density of jobs): 1.11
  • Forecast for growth (2018-2028): 11.6%

State highlights: This midwestern state placed in the Top 10 by earning solid rankings from 12th to 18th in the categories used for determining the Top 10. In addition, the state’s forecast for growth is 11.6%, higher than the average of 9% projected for medical billers and coders nationally.

#3 Washington

seattle skyline with space needle and mount rainier
  • Median salary: $53,150
  • Cost of living index: 112.8
  • Employment: 8,120
  • Location quotient (density of jobs): 1.11
  • Forecast for growth (2018-2028): 15.6%

State highlights: Washington state shines as one of the best states for medical billers and coders with the highest median salary in the Top 10 and a second place ranking nationally for salary. In addition, it is a solid 10th in employment, has a strong location quotient, and a forecast for growth that is substantially higher than the national average. The only downside to Washington is that, with the exception of California, its cost of living index is the highest of the Top 10 states, making it one of the least affordable.

#4 Illinois

state capitol of illinois in springfield
  • Median salary: $46,510
  • Cost of living index: 90.5
  • Employment: 10,550
  • Location quotient (density of jobs): .82
  • Forecast for growth (2018-2028): 1.2%

State highlights: Illinois is attractive to medical coders and billers because the state ranks high in employment and affordability. Illinois is also one of the top 20 highest paying states. Less favorable: Illinois’ location quotient is only .82; well below the national average of 1.00.

#5 Georgia

atlanta georgia skyline and freeway at night
  • Median salary: $40,950
  • Cost of living index: 89.8
  • Employment: 9,580
  • Location quotient (density of jobs): .97
  • Forecast for growth (2018-2028): 19%

State highlights: With high rankings in both cost of living and employment, Georgia is an attractive option for medical billers and coders. Also of note: With its 19% forecast for growth, Georgia has the highest 10-year growth projection in the Top Ten Best States for Medical Billers and Coders.

#6 North Dakota

two bison in a meadow with blue sky
  • Median salary: $50,710
  • Cost of living index: 97.8
  • Employment: 1,150
  • Location quotient (density of jobs): 1.26
  • Forecast for growth (2018-2028): 15.3%

State highlights: With only 1,150 people employed as medical coders and billers, North Dakota ranks 44th in employment nationally, and the limited number of jobs may be a concern for many. However, North Dakota pays well, location density is well above the national average, and the forecast for growth is well above the national average of 9%.

#7 California

california shoreline with palm trees
  • Median salary: $49,820
  • Cost of living index: 146.9
  • Employment: 38,920
  • Location quotient (density of jobs): 1.04
  • Forecast for growth (2018-2028): 12.8%

State highlights: California’s number one ranking in employment and its top 10 ranking in salary appeal to many. The state also boasts a solid location quotient and substantial forecast for growth. With beautiful beaches, vibrant cities, and spectacular mountains—not to mention fan favorites like the Redwoods, Napa Valley, Sonoma, and the Hollywood Bowl, the lifestyle is alluring—but the sticker shock is not. California’s cost of living index is 146.9, placing the state 49th out of 50.

#8 Minnesota

red canoe on shore of lake
  • Median salary: $52,010
  • Cost of living index: 99.6
  • Employment: 5,790
  • Location quotient (density of jobs): .94
  • Forecast for growth (2018-2028): 10.4%

State highlights: Known as the land of 10,000 lakes (actually, they have more than 11,842), Minnesota has more lakes than employees working in medical billing and coding positions. However, those working in the field are paid well; Minnesota ranks third nationally for median salary.

#9 Texas

dallas skyline at night
  • Median salary: $39,990
  • Cost of living index: 92.6
  • Employment: 28,500
  • Location quotient (density of jobs): 1.03
  • Forecast for growth (2018-2028): 18.5%

State highlights: Of all the Top Ten Best States for Medical Billers and Coders, Texas pays the lowest median salary—and actually ranks 42nd nationally out of the 50 states in pay. What boosts Texas into the Top 10 is its second place ranking for employment, as well as solid rankings for job density and cost of living. 

#10 Wisconsin

wisconsin field with red barn
  • Median salary: $44,260
  • Cost of living index: 95.5
  • Employment: 6,350
  • Location quotient (density of jobs): 1.02
  • Forecast for growth (2018-2028): 6.3%

State highlights: It’s solid and steady going in Wisconsin, with rankings generally in the 20s for all categories, with the exception of employment, where the state ranks 16th. Forecasted growth is below the projected national average, but good salaries and a high affordability offset that negative.

11-50 State Ranking for Medical Billers and Coders

StateMedian SalaryEmploymentLocation Quotient (density of jobs)
#11 Mississippi$35,3003,3401.36
#12 Pennsylvania$42,33013,1801.05
#13 Nebraska$43,5402,5501.18
#14 North Carolina$38,49011,6301.19
#15 Louisiana$35,8805,7501.40
#16 West Virginia$38,9502,1401.44
#17 Michigan$42,9108,0900.90
#18 Alaska$54,7101,0401.53
#19 Florida$39,08022,4801.16
#20 Iowa$43,1103,2100.96
#21 Nevada$43,4303,4701.21
#22 Kentucky$40,0204,9501.21
#23 Kansas$40,3703,2301.06
#24 Virginia$44,8107,8400.93
#25 Oklahoma$41,1303,6001.01
#26 New Mexico$42,2401,9901.11
#27 Tennessee$40,3606,2500.94
#28 Idaho$43,0001,9301.18
#29 Indiana$41,4305,9200.89
#30 South Dakota$41,5001,2001.28
#31 Massachusetts$52,0006,7900.89
#32 Arizona$41,3107,1401.10
#33 New York$50,22014,2800.72
#34 Oregon$50,5903,9500.96
#35 Alabama$36,3904,1300.95
#36 Arkansas$36,5603,0001.12
#37 Colorado$47,4505,0900.86
#38 Maine$41,5901,8101.37
#39 Maryland$48,1205,3200.92
#40 Montana$42,0201,2401.19
#41 Vermont$43,0807901.24
#42 South Carolina$38,3404,3400.94
#43 New Jersey$48,0804,9400.57
#44 Rhode Island$49,1109600.95
#45 Delaware$47,5209200.94
#46 Wyoming$45,2504500.75
#47 Connecticut$49,0002,4500.70
#48 Utah$42,0902,6200.77
#49 New Hampshire$43,4001,2300.87
#50 Hawaii$50,5901,1010.77

About the Job

According to the American Academy of Professional Coders, medical billing and coding is the process of identifying diagnoses, medical tests, treatments, and procedures and translating this patient data into standardized codes to bill the government (Medicare and Medicaid) and insurance companies for reimbursement.

Medical billers and coders are found in every healthcare setting and are the professionals in charge of processing patient data, treatment records, and insurance information. Both are involved in the revenue cycle for the organization or department in which they work. The financial health of a practice depends on the effectiveness of these professionals.

The financial health of a practice depends on the effectiveness of medical billers and coders.

Medical billing and coding are two different jobs. Medical coders translate the care a patient receives into codes by interpreting healthcare provider notes and updating patient records with procedure and diagnosis codes that reflect the care received. Medical billers analyze the records, and prepare and submit invoices on behalf of healthcare providers for reimbursement from government entities and insurance companies. In smaller organizations, such as a physician’s office, one person often handles both functions. In larger organizations, billing and coding are generally considered two separate functions.

Medical billers and medical coders are actually two different jobs, although many times the same person holds both roles.

Those who are good with numbers, comfortable with financial matters, and precise with detail do well in these roles. Analytic skills are essential, as are interpersonal skills. Medical billers and coders work with physicians, financial personnel, government and insurance company representatives, and patients as needed to clarify information.

Can I Advance my Salary by Advancing by Education?

Most medical biller and coder positions require a postsecondary certificate or degree. You’ll need to learn medical terminology, health data requirements, and classification and coding systems. At minimum, you’ll need a high school diploma and some experience in a healthcare setting to be an entry-level medical biller or coder. The more comprehensive your training, the better you’ll do on the job. Those who aspire to supervisory or management positions will find that earning an associate or bachelor’s degree helpful in achieving those goals. Any of these programs can be completed online.

Many employers prefer or require that you be certified as a medical biller or medical coder, or have dual certification in both roles. There are a number of certifications available for different levels of experience and expertise, including:

  • Certified Coding Associate (CCA)
  • Certified Professional Coder (CPC)
  • Certified Professional Biller (CPB)
  • Certified Professional Medical Auditor (CPMA)
  • Certified Professional Compliance Officer (CPCO)

The salary of medical billers and coders can vary, depending on your level of education, experience, where you work, and certification.

Top States Ranking Methodology


We started with the four main questions you might ask yourself when thinking about which states are best for medical billers and coders:

  • Where are the jobs?
  • How much can I earn?
  • What is the cost of living?
  • What is the job outlook?

To answer these questions, we pulled data for each state from three sources:

Employment, annual median wage, and location quotient: From the U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Medical Records and Health Information Technicians.

Cost of living index: From the Missouri Economic Research and Information Center’s (MERIC) Cost of Living Data Series

10-year job growth percentage of change: From the U.S. Department of Labor’s Projections Central site for state employment projections, recommended by the BLS for state employment projections

To determine the rank of each state:

  1. We loaded employment, annual median wage, location quotient, and cost of living index data for each state
  2. We ranked each data element in relation to all states
  3. We totaled the rankings for each state
  4. In the event of ties in ranking, we used the 10-year job growth percentage-of-change as a tie breaker

Definition of the data elements:

Employment: The current number of medical billing and coding jobs in each state

Annual median wage: The mid-point for annual earnings of all medical billers and coders; half earn below this midpoint and half earn above the midpoint

Location quotient: The ratio of medical biller and coder employment in a state compared to the national average concentration. A location quotient greater than one indicates that surgical techs in the state have a higher share of employment concentration than the national average, and a location quotient less than one indicates the occupation is less prevalent in the state than it is nationally.

Cost of living index: Derived by averaging costs in each state for living expenses, including housing, groceries, transportation, and health. One hundred is the national average. Because they are more affordable compared to the national average, states with an index below 100 are ranked higher than those with an index above 100 (which are more costly than the national average).

10-year job growth percentage: Indicates the projected percentage of growth over a 10-year period. This data element is used in reporting and as a tie-breaker for rankings.