Do You Need the CCMA in Your State? Washington, California and Florida Rules, and How to Check

Passing the CCMA makes you nationally certified by the National Healthcareer Association. It doesn't, by itself, decide what you may do at work. NHA's Candidate Handbook says its eligibility rules "are separate and distinct from any eligibility to practice requirements set forth under state law," that the rules vary by state, and that "NHA certification does not guarantee your ability to meet any or all regulatory requirements." Its Help Center adds that some states require allied health professionals to be certified and others require a license.

This guide covers three states whose own laws and boards Passy read on October 28, 2026: Washington, California and Florida. It isn't legal advice, and rules change, so confirm with the state before you rely on them.

Washington: the medical assistant-certified credential

Of the three states here, Washington is where the CCMA connects most directly to state law. Under RCW 18.360.020, no one may practice as a medical assistant-certified unless certified by the Department of Health, and the Department's FAQ says a national certification alone isn't enough if you perform the clinical duties in RCW 18.360.050 or use a state medical assistant title.

Washington issues several medical assistant credentials. The ones a CCMA candidate is most likely to meet:

For the MA-C, WAC 246-827-0200 accepts training from an ABHES- or CAAHEP-accredited program, from an accredited postsecondary school with at least 720 clock hours including a 160-hour externship, from a state-approved apprenticeship, or, with the secretary's approval, from other postsecondary education or a career and technical education program approved by the Office of Superintendent of Public Instruction, either one with the same 720 and 160 hours and proof of training in every MA-C duty. The approved exam must come from an NCCA-accredited program and cover the clinical and administrative duties in state law. The Department's recognized exams list includes NHA's clinical medical assistant exam, alongside the AAMA, AMT, NCCT and AMCA exams. Applicants also attest to completing high school or its equivalent.

Three Washington details that surprise people:

• Renewal is separate from NHA's. The state credential renews every two years on your birthday, with no continuing education requirement
• You don't have to keep the CCMA current for the state. The Department's FAQ says passing an approved exam within five years is required to apply, but maintaining national certification isn't required to renew the MA-C
• A rule change is under consideration, not adopted. The Department filed a preproposal notice (CR-101) on April 13, 2026 to clarify proof of high school education and align rules with the medical assistant-EMT credential, according to its rules in progress page

Whatever your state, the national exam is the same, and planned CCMA practice covers vitals, injections, phlebotomy and EKG across Clinical Patient Care.

California: minimum training, not state certification

The Medical Board of California's medical assistants page describes medical assistants as unlicensed individuals who perform basic administrative, clerical and technical supportive services under the supervision of a licensed physician, podiatrist, physician assistant, nurse practitioner or nurse midwife, who must be on the premises. The Board's FAQ is direct: "Medical assistants are not required to be licensed or certified by the State of California," although an employer or malpractice insurer may require certification.

What California does regulate is training. Before giving intradermal, subcutaneous or intramuscular injections, performing skin tests, or drawing blood by venipuncture or skin puncture, a medical assistant must complete minimum training, which the Board's FAQ lists as including:

• At least 10 clock hours of training in administering injections and performing skin tests, with at least 10 of each type of injection and 10 skin tests
• At least 10 hours of training in venipuncture and skin puncture, with at least 10 venipunctures and 10 skin punctures
• Instruction in anatomy, equipment, technique, hazards, aftercare, emergency procedures and California law

The Board also lists tasks a medical assistant may not do in California, including starting or disconnecting IVs, inserting urinary catheters, independently performing telephone triage and interpreting test results.

Which certifications count in California, and the January 1, 2027 deadline

Certification matters in one California situation: the Board's FAQ says a medical assistant who trains other medical assistants must be certified by a Board-approved certifying organization. (The regulation's definition of a "qualified medical assistant," quoted on the Board's medical assistants page, also accepts a credential to teach in a community college medical assistant program or authorization to teach medical assistants at an accredited or approved private postsecondary school.) As of October 28, 2026, the Board's page lists five approved organizations: the American Association of Medical Assistants, the American Medical Certification Association, American Medical Technologists, the California Certifying Board of Medical Assistants and the Multiskilled Medical Certification Institute. NHA isn't among them.

If you won't be training others, the same FAQ says any certification your employer or its malpractice insurer requires can come from any national or private association, so a CCMA can meet that kind of requirement.

The regulation behind that list changed in 2022. The Office of Administrative Law approved amendments, effective April 1, 2022, that require approved organizations to be NCCA-accredited and give organizations approved before that requirement until January 1, 2027 to reapply and be approved, or lose approval. If you plan to train other medical assistants in California, check the Board's list after that date.

NHA's handbook has its own California rules for the CCMA: residents applying on work experience need two years as a medical assistant in the last five, and California CCMAs who train other medical assistants need 60 continuing education hours every five years. Both match standards that 16 CCR 1366.31(b) sets for Board-approved organizations (two years of experience in the five years before the exam, and 60 hours of continuing education over five years), but matching them doesn't put NHA on the Board's list. If training others is part of your job, confirm with the Board whether your certification qualifies.

Florida: duties under a physician's direct supervision

Florida's Medical Practice Act defines medical assistants in section 458.3485 of the 2026 Florida Statutes (unchanged from the 2025 edition) as multiskilled professionals working "under the direct supervision and responsibility of a physician." The duties it lists include performing aseptic procedures, taking vital signs, preparing patients for the physician's care, "performing venipunctures and nonintravenous injections," collecting routine laboratory specimens, administering medication as directed by the physician, and general administrative work.

On certification, the statute says that "to obtain the designation of a certified medical assistant," a medical assistant must be certified by a program accredited by the National Commission for Certifying Agencies (NCCA), a national or state medical association, or an entity approved by the board. NHA's handbook says all NHA certification programs, the CCMA included, are NCCA-accredited. The section itself doesn't make certification a condition of working as a medical assistant; employers set their own requirements.

Can a CCMA draw blood? It depends on the state

The CCMA exam includes 12 phlebotomy questions, but the right to draw blood at work comes from state law and your employer:

In every case, the task is delegated and supervised. Your employer can be stricter than the law, so ask what your role includes.

How to check medical assistant rules in another state

For any state not covered here, a method that works:

1. Find the oversight body. Look for the state medical board or health department. NHA's handbook advises exactly this, and checking it regularly, because rules change often
2. Search its site for "medical assistant." Look for a statute, a regulation, an FAQ or a scope-of-practice page
3. Check whether a credential is required. Washington's model (a state-issued credential) is different from California's (training rules, no state certification)
4. Check named exams or organizations. Some states list the exams or certifying bodies they accept
5. Check task rules. Injections, blood draws and IVs are where the three states above differ
6. Note the date you checked and the page. Then confirm with your employer

If your state names the CCMA, the exam you prepare for doesn't change, and the planned CCMA question bank follows NHA's national test plan, not any one state's rules.

Your next step with state rules and the CCMA

Once you know what your state expects, check your NHA route in the CCMA eligibility guide, and compare the other national credentials your state may accept in the CCMA vs CMA vs RMA guide. To get a feel for the exam, try the 20 free CCMA practice questions, then choose a 30-, 90- or 180-day CCMA prep period planned for launch around your application date.