- Some U.S. states require individuals to have a radiologic technologist state license to work as a radiographer. Meanwhile, ARRT certification and registration may help individuals develop their careers in the medical imaging and radiation fields(1).
- Radiologic technologist licensing requirements and fees depend on state laws, usually implemented by the state’s health department, medical boards, and other relevant agencies.
- The American Registry of Radiologic Technologists (ARRT) does not endorse any study material for ARRT-administered state licensing exams.
Licensing Exams and Handbooks
ARRT administers the state licensing exams for radiologic technologists.
Individuals with this job are sometimes referred to as radiology techs or radiographers(2).
These exams are held at Pearson VUE test centers, which have rules that individuals must follow for state licensure and ARRT certification and registration exams.
Individuals interested in taking state licensing exams must understand the following rules at the test center(3):
- Arrive 30 minutes before the scheduled appointment.
The test center can forfeit appointments of individuals who arrive 15 minutes late. Fees for forfeited exams are non-refundable.
- Upon check-in, information on the individual’s identification card (ID) should match ARRT records.
Test centers require exam takers to provide two IDs and a digital signature. Exam takers must also be photographed and have their palms scanned for authentication.
- As part of exam security, test centers prohibit individuals from bringing personal belongings into the test area. Instead, exam takers must leave these things inside a locker outside the examination room.
Personal belongings include calculators, study guides, cell phones, other electronic gadgets, and anything inside the pockets.
- Individuals with disabilities or conditions under the American Disabilities Act (ADA) may request test center accommodations upon application for registration and certification.
These requests must be approved before the test center can grant the accommodation.
- While the temperature inside the test centers can vary, the staff prohibits exam takers from wearing outerwear, such as jackets and hooded sweatshirts, inside the exam room.
Individuals may also request earplugs or noise-reducing headphones to minimize noise distractions.
- Exam takers must watch a 19-minute video tutorial before the exam. Afterward, they must respond to a nondisclosure agreement within two minutes.
Failure to accept the agreement within the allotted time can result in exam forfeiture.
- Exams are computer-based, and most questions are multiple-choice. The exam’s duration can vary depending on the discipline.
- Exam takers must answer each question before moving to the next one. Individuals may flag difficult questions before moving to the next item.
If the individual has time remaining after finishing the exam, they may review and answer the flagged questions.
- Individuals are prohibited from leaving their seats unless the test center staff gives authorization.
Exam takers may be permitted a 10-minute allowance to leave for personal reasons. However, the staff can file an incident report if the exam taker is gone for more than 10 minutes.
- After the exam, the computer provides an initial score. However, this may not necessarily be the exam taker’s final score.
The test center will mail the final results within three weeks after the exam.
The ARRT scores all ARRT-administered state licensing exams and sends the results to the states. Only the state licensing agencies, not the ARRT, can determine if the exam taker passes or fails.
Some state licensing agencies will mail notices of the exam results, while other agencies require individuals to check online.
States have varying rules regarding eligibility to retake the test should the exam taker fail. Some may allow multiple attempts within specific time windows, while others may have additional requirements.
Exam takers may acquire a state licensing handbook through the ARRT’s website to help them understand and prepare for the exam. These handbooks are published twice a year and may be subject to changes in content specifications, policies, and procedures.
State licensing handbooks may vary among states, such as California or Florida. For all other states, manuals for the following disciplines are also available(4):
- Radiography, nuclear medicine technology, and radiation therapy
- Postprimary pathway disciplines
- The limited scope of practice in radiography
- Bone densitometry equipment operator
- Fluoroscopy
Certificates and Permits
Radiologic technology (radtech) permits and certificates issued in the U.S. vary by state.
For example, California’s Department of Public Health – Radiologic Health Branch (CDPH-RHB) issues certified radiologic technologist (CRT) permits and certificates. These certificates and permits include the following(5):
- Diagnostic radiologic technologist certificate
- Therapeutic radiologic technologist certificate
- Mammography radiologic technologist certificate
- Radiologic technologist fluoroscopy permit
The CDPH-RHB can grant these certificates and permits to non-licentiates of healing arts that use X-rays to diagnose and treat illnesses.
Application Requirements and Fees
Requirements and fees for a radiologic technologist license may vary by state.
Individuals applying for a state license in California must accomplish the following requirements:
- Submission of required application form and non-refundable application fee
- Diploma or certificate from a CDPH-RHB-approved California radiologic technology school or evidence of current ARRT certification in either radiography or radiation therapy
In 2022, California-based examinees must pay the following fees(6):
- Application fee: $112.00 per category
- Renewal fee: $104.00 per category
- Examination fee: To be determined by ARRT
California licenses can be renewed every two years. Individuals may print a valid temporary authorization through the radiologic health branch during renewal processing.
The validity of this temporary authorization is based on the new expiration date and only when attached to the expired certificate or permit.
Differences Between State Licensing and ARRT
Some U.S. states require individuals to obtain a state license before working as radiologic technologists.
On the other hand, ARRT certification and registration aim to recognize and help individuals working in the medical imaging and radiation field and further develop their careers(7).
Thus, state licenses are state-specific work requirements, while ARRT certifications are for career development.
Individuals who want to become ARRT-certified and registered radiologic technologists should apply to ARRT and take its certification exams. Meanwhile, individuals who plan to obtain a state license should apply directly to the state.
Legislation, Regulations, Requirements, and Advocacy by State
The regulations, requirements, laws, and advocacy for various U.S. states that require state licensure for radiologic technologists are as follows(8):
Alaska
Alaska’s state public health laboratories are responsible for implementing the state’s radiological health program and maintaining the safe use of radiation sources.
Under Alaska law, the program is responsible for developing policies on evaluating radiation standards and conducting training and surveys.
These evaluation and training activities include(9):
- Using and measuring radiation in a safe manner
- Reviewing of plans and specifications for radiation sources
- Inspecting facilities that use radiation sources
- Cooperating with other agencies to address radiation hazards
Arizona
On August 27, 2019, Arizona enacted House Bill 2569 to reduce the legal barriers and regulatory burden for medical radiology technology (MRT) applicants and licensees(10).
Additionally, House Bill 2257, enacted on August 3, 2018, places the regulation and certification of medical radiologic technologists under the Arizona Department of Health Services (ADHS) through its Bureau of Special Licensing (BSL).
Arkansas
The Arkansas Department of Health implements a radiologic technology licensure program requiring individuals operating medical equipment that detects or emits ionizing radiation to be appropriately educated.
This program also regulates such operators to help keep radiation doses on individuals as low as reasonably achievable(11).
California
Under California’s Radiologic Technology Act, the state’s radiologic health branch (RHB) certifies medical personnel who operate X-ray machines on humans(12). The RHB also administers exams to personnel applying for X-ray permitting and certification.
Colorado
Through its X-ray certification unit, the Colorado Department of Public Health and Environment (CDPHE) acknowledges regulatory barriers and provides exemptions to help facilitate and streamline the agency’s responses(13).
Amid the COVID-19 pandemic, CDPHE offers extensions to certification evaluations and provides requirement exemptions to temporary health care facilities that need to use radiation-producing machines.
Connecticut
Connecticut requires radiographer licensure applicants to complete a radiologic technology course accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT) or an equivalent course accredited by the ARRT.
The state requires individuals to send supporting documentation to the Connecticut Department of Public Health’s mailing address at 410 Capitol Ave., MS #12 APP, P.O. Box 340308, Hartford, CT 06134.
Florida
Florida’s Department of Health, through the state’s Council on Radiation Protection, educates, licenses, monitors, and disciplines individuals using radiation and radiation-emitting equipment to ensure safety and competency to practice in the state(14).
Idaho
Through the Idaho Bureau of Laboratories, the Idaho Department of Health and Welfare provides X-ray and mammography regulations and licensure forms.
X-ray facilities, such as those used in medical, dental, industrial, and veterinarian settings, are evaluated based on the state’s radiation control regulations to help reduce radiation exposure to Idahoans(15).
Indiana
The Indiana Department of Health (IDOH) Division of Radiology and Weights and Measures provides registration and licensing of medical radiology professionals within the state(16).
The IDOH website provides professional licensing requirements and regulations for Indiana-based radiologic technologists.
Iowa
Iowa’s Department of Public Health provides various permits and specifies the requirements for individuals operating X-ray or radiation therapy machines in medical facilities within the state.
The state considers these permits part of the minimum standards for formal education, examination, and continuing education requirements to help maintain Iowans’ radiological health and safety(17).
Kansas
The Kansas Board of Healing Arts provides active, temporary, and military radiologic technology licenses(18).
Active licensees must maintain and submit evidence that they completed a continuing education program satisfactorily.
Temporary licensees may practice their profession within the temporary license’s limits until the licensee is issued an active license.
A military license is issued to individuals in active military service. Military licensees are not required to renew their license or pay a renewal fee while in the service.
Maine
Maine’s Office of Professional and Occupational Regulation established the Radiologic Technology Board of Examiners to protect the state’s citizens from improper and excessive exposure to ionizing radiation(19).
The board examines and licenses qualified applicants, makes rules and standards for radiologic practitioners, and investigates complaints against licensees.
Massachusetts
Individuals may apply for a radiologic technologist license through Massachusetts’ radiation control program(20).
New applicants must submit their completed and signed application form with their ARRT or Nuclear Medicine Technology Certification Board (NMTCB) certification card.
Reapplicants whose licenses have expired for more than six months must submit their continuing education unit (CEU) credits documentation from the last biennium and documentation of one monthly CEU credit from the start of the current biennium.
Minnesota
The Minnesota Department of Health (MDH) issued a notice that starting August 1, 2020, the X-ray unit will no longer accept ARRT fees(21).
Instead, X-ray operators must download the registration application from the MDH website and include a $25 cashier’s check or money order payable to MDH. Afterward, MDH will review the application and send a mail about the next steps and ARRT payment to the applicant.
New York
In New York, licensees who need continuing education credits must submit an ARRT or NMTCB certification.
Because ARRT no longer issues paper credential cards since December 31, 2020, individuals should verify their credentials online through ARRT’s website(22). Individuals must print the online credential information and attach it to their renewal.
Oklahoma
The Oklahoma Medical Board accepts online applications for new licensures and reinstatements for radiologist assistants (RA).
RAs are advanced-level radiologic technologists who help improve patient care by extending the radiologist’s capacity in the diagnostic imaging field(23).
Rhode Island
The Rhode Island Department of Health (DOH) accepts applications and renewals for various radiologic technology licenses, including nuclear medicine technologist, radiation therapist, radiographer, and supplemental computed tomography (CT) licenses.
Licensees will receive a renewal notice 60 days before their license’s expiration date. Online renewal is available on the state’s official Department of Health website(24).
Tennessee
Tennessee’s Board of Radiologic Imaging and Radiation Therapy implemented new license application and renewal rules effective June 6, 2022.
Licenses expiring on May 31, 2022, must be renewed by March 23, 2022. Failure to renew by the specified date may delay the license renewal process(25). However, the license will remain active.
Texas
Senate Bill 202 transferred four occupational programs to the Texas Medical Board (TMB) from the Department of State Health Services (DSHS)(26).
The bill was enacted on September 1, 2015(27).
These occupations include medical physicists, radiologic technologists, perfusionists, and respiratory care practitioners. These programs are now regulated by their respective board or advisory committee and the TMB.
Virginia
Virginia’s Department of Health Professions (DHP) Board of Medicine enacted emergency regulations from January 1, 2022, to June 30, 2023(28).
In these regulations, licensees are exempted from continuing competency requirements for the first biennial renewal that follows the individual’s initial licensure in Virginia.
Wisconsin
Wisconsin’s Department of Safety and Professional Services requires radiographer applicants to be at least 18 years old and have passed the appropriate ARRT-administered exams.
According to the Wisconsin Statute § 440.08(2), the required renewal date for licensed radiographers is August 31 of every even-numbered year.
States Without Personnel Licensing
The American Society of Radiologic Technologists notes that several states and districts, such as Alabama, the District of Columbia, Georgia, Missouri, North Carolina, and South Dakota, have not implemented licensing or lack formal standards for radiographers(29).
Regulatory Authority
Radiologic technologist licensing follows various regulatory laws and statutes depending on the state. These laws are typically implemented by authorities such as the state’s health department, medical boards, and other relevant agencies.
While generally working with the ARRT, these authorities also establish programs to guide applicants and licensees in the state’s licensing processes.
FAQs
1. What state licensing exam-related questions can an individual ask?
Individuals can ask about state licensing requirements and eligibility, exam results, name or address changes, and window extension requests(30).
2. Where can examinees get study material?
ARRT does not endorse any study material for ARRT-administered state licensing exams.
However, individuals can consider reviewing exam content specifications for a particular discipline in which the individual is taking the exam(31).
3. How do examinees schedule an ARRT-administered exam?
After applying and paying the exam fee to the state, the ARRT will send a candidate status report and a handbook with instructions on scheduling an exam(32).
- What Is ARRT Certification and How Do I Get It?
https://www.cambridgehealth.edu/blog/what-is-arrt-certification-and-how-do-i-get-it/ - What Does a Radiologic Technologist Do? An Inside Look at the Job
https://www.rasmussen.edu/degrees/health-sciences/blog/what-does-radiologic-technologist-do/ - What to Expect on Exam Day
https://www.arrt.org/pages/earn-arrt-credentials/initial-requirements/exam/exam-day - State Licensing Handbooks
https://www.arrt.org/pages/about-the-profession/state-licensing/state-licensing-handbooks - License Information for California Radiologic Technologist (CRT)
https://www.labormarketinfo.edd.ca.gov/OccGuides/LicenseDetail.aspx?LicId=297 - Ibid.
- What Is ARRT Certification and How Do I Get It?
https://www.cambridgehealth.edu/blog/what-is-arrt-certification-and-how-do-i-get-it/ - Individual State Licensure Information
https://www.asrt.org/main/standards-and-regulations/legislation-regulations-and-advocacy/individual-state-licensure - Radiological Health
https://dhss.alaska.gov/dph/Labs/Pages/radiological/default.aspx - Special Licensing
https://azdhs.gov/licensing/special/index.php#mrt - Radiologic Technology Licensure Program
https://www.healthy.arkansas.gov/programs-services/topics/radiologic-technology–licensure-program - Radiologic & Nuclear Medicine Technology Certification & Permitting
https://www.cdph.ca.gov/programs/ceh/drsem/pages/rhb-certification/xraynucmed.aspx - X-ray Certification Unit
https://cdphe.colorado.gov/xray - Radiologic Technology
https://www.floridahealth.gov/licensing-and-regulation/radiologic-technology/index.html - X-ray Licensure
https://healthandwelfare.idaho.gov/providers/idaho-laboratories-and-testing/x-ray–licensure - Radiology and Weights & Measures
https://www.in.gov/health/cshcr/medical-radiology-services/ - Permits to Operate
https://idph.iowa.gov/Permits-To-Operate - L.R.T. Licensure Types/Designations
http://www.ksbha.org/departments/licensing/licensetypes/lrtlicensetypes.shtml - Radiologic Technology Board of Examiners
https://www.maine.gov/pfr/professionallicensing/professions/radiologic-technology-board-examiners - Apply for a Radiologic Technologist License
https://www.mass.gov/how-to/apply-for-a-radiologic-technologist-license - X-Ray Program
https://www.health.state.mn.us/communities/environment/radiation/xray/index.html - Radiologic Technology: Frequently Asked Questions
https://www.health.ny.gov/professionals/doctors/radiological/faq_radtech.htm - Oklahoma Radiologist Assistants
https://www.okmedicalboard.org/radiologist_assistants - Radiologic Technology
https://health.ri.gov/licenses/detail.php?id=242 - Board of Radiologic Imaging and Radiation Therapy
https://www.tn.gov/health/health-program-areas/health-professional-boards/xray-board.html - Transfer of Occupational Programs from DSHS (S.B. 202)
https://www.tmb.state.tx.us/page/Medical_Radiologic_Technologist_Overview - Texas Legislature Online – 84(R) History for SB 202
https://capitol.texas.gov/BillLookup/History.aspx?LegSess=84R&Bill=SB202 - Emergency Regulations – Effective 1/1/22 to 6/30/23
http://www.dhp.virginia.gov/media/dhpweb/docs/med/leg/Emergency_OTCompact.pdf - Individual State Licensure Information
https://www.asrt.org/main/standards-and-regulations/legislation-regulations-and-advocacy/individual-state-licensure - State Licensing Exam
https://www.arrt.org/pages/about-the-profession/state-licensing/state-licensing-exam - State Licensing Questions
https://www.arrt.org/pages/contact/frequent-questions/state-licensing-public - Ibid.