ARRT – American Registry of Radiologic Technologists – A Rad Tech’s Perspective

American Registry of Radiologic Technologists – Everything You Need to Know About ARRT


In the medical world today, healthcare institutions are obligated to ensure patient safety and deliver an acceptable standard of care. Healthcare professionals such as doctors, nurses, pharmacists, dentists, surgeons, radiologists, and psychologists play a crucial role in achieving this. However, healthcare institutions must first ensure these healthcare providers are qualified, ergo credentialing from organizations like the ARRT. 


Credentialing is a process that uses established guidelines to obtain, verify, and evaluate a medical practitioner’s documentation of education, training, employment history, licensure, regulatory compliance, and malpractice history. To put it briefly, it is the process of assessing the educational qualifications and clinical practice history of a medical provider. Credentialing is thus a vital process in ensuring healthcare providers are qualified to provide clinical services in a healthcare organization.


There have been various reported cases of healthcare providers working in hospitals with a falsified experience certificate. Therefore, credentialing also assures patients that they are receiving care from competent medical practitioners. Interestingly, the concept of credentialing has been in practice for more than 1000 years. Physicians in Persia were required to demonstrate their skills and training before being allowed to practice their art.


The process has, however, evolved and is today more refined and thorough. Credentialing has also become complex primarily because of the expansion of the scope of practice, accrediting bodies, and the requirements of third-party payers like Medicare, Medicaid, and private insurance carriers. There are several national commissions dedicated to establishing the standards of verifying practitioners’ credentials. The National Committee for Quality Assurance (NCQA) is one such organization.


NCQA standards currently act as a guideline on how to accurately and efficiently credential healthcare providers. One of the fundamental guiding principles of NCQA, in regards to credentialing, is checking with the primary source to verify any certificate, diploma, or degree. Providing an original diploma or degree is no longer considered enough for credentialing. Additionally, the medical institution or Credential Verification Organization (CVO) must also obtain primary source verification of the practitioner’s education and training.


Besides verifying a healthcare provider’s education and training, an employer or CVO should also obtain and check information on, but not limited to:


  • Board certification
  • State license
  • DEA license
  • Hospital admitting privileges
  • Malpractice claims and insurance
  • Work history
  • Professional references
  • Criminal background


Today there are various Credentials Verification Organizations. CVOs conduct verification through the primary source, a recognized source, or a contracted agent of a primary source. One such organization is the American Registry of Radiologic Technologists (ARRT).


American Registry of Radiologic Technologists 


The American Registry of Radiologic Technologists (ARRT) is the leading credentials verification organization for individuals in medical imaging, interventional procedures, and radiation therapy. ARRT offers certification and registration in several disciplines for candidates that meet their education, ethics, and examination requirements. The organization also advocates for safety and advancement in radiological sciences careers by supporting initiatives such as the Image Gently Alliance and contributing to industry research studies.


ARRT Mission


The ARRT’s mission is to promote high standards of patient care by recognizing qualified individuals in medical imaging, interventional procedures, and radiation therapy. They achieve this by:


  • Adopting and upholding standards for educational preparation for entry into the profession
  • Adopting and upholding standards of professional behavior consistent with the level of responsibility required by professional practice
  • Developing and administering examinations that assess the knowledge and skills required by professional practice


Besides offering initial recognition, ARRT also provides a way to recognize individuals who continue to demonstrate their qualifications by adhering to the standards of professional behavior and by complying with continuing education requirements.


To ensure they succeed in their mission, ARRT applies this equation: Education + Ethics + Examination = The ARRT Equation for Excellence. ARRT recently trademarked this expression as it had become widely identified with the organization. We will discuss in depth the three elements that add up to excellence later in the article.


ARRT History


1922 saw various historical events throughout the world. Events such as the dedication of The Lincoln Memorial on May 30, the formation of the British Broadcasting Company (BBC), now British Broadcasting Corporation, on October 18th, and the formation of the Soviet Union on December 30. It was also the year insulin was first used to treat diabetes.


Toward the end of the year, on November 17, Sister M. Beatrice Merrigan of St. Anthony’s Hospital in Oklahoma City took her radiology exam, which she passed. Sister Merrigan was notified of her certification on December 26, making her the first Registered Technologist. Unlike today’s computer-based testing experience that covers several hundred items, her test included 20 essay questions and 10 actual radiographs.


ARRT was the Registry founded earlier that year by the Radiological Society of North America with the support of the America Roentgen Ray Society and the American Society of X-Ray Technicians. It was later incorporated as the American Registry of X-Ray Technicians in 1936, with its board nominated by the Radiological Society of North America and the American Society of X-Ray Technicians. By the end of the decade, the organization had registered more than 2,400 technologists.


Come 1944, the American College of Radiology and the American Society of Radiologic Technologists (ASRT) took over the responsibility of appointing board members. Four decades after its foundation, the Registry broadened its examination and certification program by adding exams in Nuclear Medicine Technology and Radiation Therapy. Additionally, the organization became known as The American Registry of Radiologic Technologists (ARRT).


By the end of the 1960s, ARRT had awarded 56,000 certificates. Of these, approximately 700 were in Nuclear Medicine Technology and about 300 in Radiation Therapy. The 90s saw ARRT extensively expand its offerings. They launched the Postprimary Pathway with certification in Cardiovascular-Intervention Technology and Mammography. More disciplines were included as technology advanced. As the Millenium came to an end, ARRT switched to computer-based testing from the traditional paper-and-pencil testing. ARRT has certified more than 330,000 technologists since being formed ninety-plus years ago.


ARRT Governance


ARRT has a 10-member Board of Trustees that governs the organization and establishes its policies. Here’s how the Trustees are selected.


The American Society of Radiologic Technologists (ASRT) appoints five board members. ASRT is the leading professional association for the medical imaging and radiation therapy community. A sixth member is nominated from a professional membership society, strategically chosen by the board.


The American College of Radiology (ACR) nominates the remaining Trustees. ACR is the leading professional medical society for diagnostic radiologists, interventional radiologists, radiation oncologists, nuclear medicine physicians, and clinical medical physicists. ARRT’s current board members are:



Lisa Bartenhagen, M.S., R.T.(R)(T)(ARRT)

University of Nebraska Medical Center’s College of Allied Health Professions, Omaha, Nebraska


Vice President

Elizabeth Romero, M.S., R.T.(N)(CT)(ARRT), PET, FSNMMI-TS

PharmaLogic Holdings



Barbara J. Smith., M.S., R.T.(R)(QM)(ARRT), FSART, FAEIRS

Portland Community College, Portland, Oregon


Paul A. Larson, M.D., FACR

Radiology Associates of the Fox Valley, Neenah, Wisconsin


Deborah J. Rubens, M.D., FACR, FAIUM, FSRU

University of Rochester Medical Center, Rochester, New York


Travis Prowant, M.S.H.S., R.R.A., R.T.(R)(CV)(CT)(ARRT)

Virginia Commonwealth University (VCU) Health System, Richmond, Virginia


Albert Blumberg, M.D., FACR

Retired Radiation Oncologist


Cheryl DuBose, R.T.(R)(CT)(MR)(QM)(ARRT)

Department of Medical Imaging and Radiation Sciences, Arkansas State University—Jonesboro


David C. Madoff, M.D., FSIR, FACR, FCIRSE

Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut


Beth Weber, MPH, R.T.(R)(ARRT), RDMS, CRA, FASRT

Avera Heart Hospital of South Dakota, Sioux Falls, South Dakota


The board, as mentioned earlier, is in charge of establishing the organization’s policies, including its governing documents:


  • ARRT By-laws
  • ARRT Rules and Regulations
  • ARRT Standards of Ethics
  • ARRT Continuing Education Requirements
  • ARRT Continuing Qualifications Requirements
  • ARRT Code of Ethics


Here’s a sneak peek of the ARRT By-laws, Rules and Regulations, and Code of Ethics.


ARRT By-laws


Some of ARRT by-laws state that:


  1. A person cannot serve as Trustee if he/she is serving as or has been elected as an officer, employee, director or Trustee of any of the following organizations:


  • American Medical Association;
  • American Society of Radiologic Technologists;
  • National organizations that offer accreditation or certification in one or more of the modalities in which ARRT offers certification and registration;
  • American College of Radiology;
  • Any other organization that nominates individuals for appointment to the ARRT Board.


  1. Appointed trustees shall serve for a term of four years.
  2. No Trustee shall serve more than two terms.
  3. The board’s duties and responsibilities include electing officers of the organization, removing officers and Trustees, employing an Executive Director, take disciplinary action against a holder of an ARRT certificate, and approve the annual budget.
  4. Any officer elected by the Board may be removed with or without cause at any time by a two-thirds vote of the entire Board.


ARRT Rules and Regulations


ARRT rules and regulations are quite elaborate. Here are some of the general ones:


  1. ARRT shall certify and register individuals who meet the qualifications it establishes for the various disciplines comprising the profession of radiologic technology. These disciplines include but are not limited to radiography, nuclear medicine technology, radiation therapy, mammography, computed tomography, magnetic resonance imaging, sonography, and radiologist assistants. 
  2. A candidate must meet the ethics, education, and examination requirements established by the ARRT to qualify for certification and registration. 
  3. Applications are to be filed with ARRT in a format and manner established by the organization. There will also be an application fee whose sum is fixed by the Board of Trustees.
  4. Certification and registration is renewable yearly as long as an individual continues to meet the requirements described in the ARRT Rules and Regulations. The individual is also expected to fulfill other requirements as set by the Board of Trustees from time to time.
  5. An individual may have their certification and registration reinstated if he/she meets the ARRT’s requirements for reinstatement.
  6. If an individual does not meet or fails to continue meeting the qualifications for certification and registration set out in the ARRT Rules and Regulations and or in the ARRT Standards of Ethics, the Board of Trustees may:


  • Reject or deny an application for certification and registration.
  • Refuse the renewal of certification and registration.
  • Suspend or revoke certification and registration.
  • Revoke eligibility to reinstate certification and registration.


ARRT Code of Ethics


ARRT Code of Ethics serves as a guide by which certificate holders and candidates may evaluate their professional conduct in connection with patients, healthcare consumers, employers, colleagues, and other members of the healthcare team. The Code of Ethics is meant to assist these individuals in maintaining a high level of ethical conduct while providing protection, safety, and comfort of patients. 


Below are random sections of the ARRT Code of Ethics.


  1. The radiologic technologist acts in a professional manner.
  2. The radiologic technologist delivers patient care without discrimination.
  3. The radiologic technologist acts in the best interest of the patient.
  4. The radiologic technologist continually strives to improve knowledge and skills.
  5. The radiologic technologist refrains from the use of illegal drugs and or any legally controlled substances.
  6. The radiologic technologist demonstrates expertise in minimizing radiation exposure to the patient, self, and other members of the healthcare team.
  7. The radiologic technologist acts as an agent through observation and communication to obtain pertinent information for the physician to aid in the diagnosis and treatment of the patient.




Reasonable science was applied when designing ARRT’s unique logo. In the center is an illustration of an X-ray tube and a sine wave. A sine wave is a waveform that represents smooth periodic oscillations. The sine wave on the logo represents one cycle of the alternating current generated on a one-pole generator through a full rotation. 

A rotation through 360 degrees is equal to 2π radians. Therefore, a one-pole generator moving the circumference of a circle with a radius of one would travel a distance of 0 to 2π. Looking at the ARRT logo, you will notice 0 and 2π generators at the beginning and end of the sine wave.


At each side of the logo is an energy bolt. These bolts represent the high voltage used in the production of X-rays. There’s an atomic symbol at the bottom of the logo, which represents primary and secondary radiation. Primary radiation is the radiation emitted directly on the patient from an X-ray source, while secondary radiation is the result of absorbing other radiation in matter. The symbol is also relevant to nuclear medicine (use of radiopharmaceuticals) and radiation therapy (application of ionizing radiation). 


To complete the logo are the letters “ARRT” written in white. ARRT, as you know, is the abbreviation for The American Registry of Radiologic Technologists. ARRT’s logo is a registered trademark under U.S. Reg. Nos. 0779203. According to The United States Patent and Trademark Office (USPTO), the logo was registered on October 27, 1964. Unauthorized use of the logo could lead to criminal prosecution and civil damages under federal and applicable state laws. ARRT uses the logo to indicate they’ve issued a particular document. Any document having the logo printed on it belongs to the organization.


ARRT Credential Options


You can pursue credential options through ARRT using one of three pathways: primary eligibility pathway, postprimary eligibility pathway, or Registered Radiologist Assistant eligibility pathway. The pathways share the same ethics and examination requirements but different educational requirements.


As has been noted in other parts of this article, for you to earn ARRT certification and registration, you will need to meet the organization’s education, ethics, and examination requirements. Earning an ARRT credential is challenging but achievable and worth it. It increases your job prospects as it confirms your qualifications to employers and patients as well.


To begin the certification and registration process, you will need to identify the eligibility path you’ll use and the discipline in which you’d like to earn a credential.


 Primary Eligibility Pathway Requirements


Most people earn their first ARRT credential through the primary eligibility pathway. You can earn credentials in the following disciplines using this pathway:


  • Magnetic Resonance Imaging
  • Nuclear Medicine Technology
  • Radiation Therapy
  • Radiography
  • Sonography


Note: You can also earn an MRI or Sonography credential using the postprimary eligibility pathway.


Education Requirement


Education gives you the foundation of knowledge and experience that you’ll need to become a Registered Technologist (R.T.) and pass an ARRT exam. To meet the education requirement for the primary eligibility pathway, you must have:


Earned an associate’s (or higher) degree from an institution accredited by an agency that ARRT recognizes. The degree doesn’t have to be in the radiologic sciences. And while you can earn prior to or after graduating from your radiological sciences educational program, you must receive it before taking your ARRT examination.


An associate’s (or more advanced) degree is important because the required general education courses provide a foundation that will support your evolving role as a technologist. Furthermore, they will help you shape and advance your role in health care. As will the communication skills, quantitative skills, and understanding of human behavior you acquire.


Completed an ARRT-approved educational program in the same discipline as the credential you are pursuing. As part of the program, you will need to demonstrate your competency in didactic coursework and clinical procedures. The Program Director will inform ARRT whether you meet the requirements once you complete the program. You will then have three years thereafter to establish eligibility and apply for ARRT certification and registration.


Ethics Requirement


To become a candidate for certification and registration, you must demonstrate good moral character. The ARRT Standards of Ethics has more detailed information on the types of behavior the organization expects of R.T.s and those they won’t tolerate. The Standards of Ethics, which is one of ARRT’s governing documents, includes:


  • Code of Ethics, which are a set of guidelines to which Registered Technologist and candidates aspire
  • Rules of Ethics, which are mandatory and enforceable standards
  • Information regarding ARRT’s ethics review process.


Examination Requirement


After you meet the education and ethics requirements, you’ll need to pass an exam before earning ARRT credentials. ARRT exams measure your knowledge of the daily tasks an entry-level technologist performs. We’ll dig deeper into exams in another section of the article.


Postprimary Eligibility Pathway Requirements


The Postprimary eligibility pathway is for those who are currently certified and registered with the ARRT and would like to pursue an additional credential. The pathway may also be used by those who hold a credential from the American Registry for Diagnostic Medical Sonography (ARDMS) or the Nuclear Medicine Technology Certification Board (NMTCB). You can earn credentials in the following disciplines using this pathway:


  • Bone Densitometry
  • Breast Sonography
  • Cardiac Interventional Radiography
  • Computed Tomography
  • Magnetic Resonance Imaging
  • Mammography
  • Sonography
  • Vascular Interventional Radiography
  • Vascular Sonography


Note: A Sonography credential will no longer be earned using the Postprimary Eligibility Pathway after Dec. 31, 2019.


Education Requirement


The education requirement for earning a credential using the postprimary eligibility pathway includes:


  • Being ARRT certified and registered in an appropriate supporting category. In some cases, your certification by NMTCB or ARDMS can count as your supporting category.
  • Meeting the structured education requirement, which requires you to complete 16 hours of structured educational activities.
  • Meeting the clinical experience requirement. You must also perform and document a specific number of clinical procedures. The procedures will depend on your discipline.


Ethics Requirement


You must prove that you are of good moral character to become a candidate for certification and registration.


Examination Requirement


Once you meet the education and ethics requirements, you’ll be required to pass an exam before earning ARRT credentials. 


Registered Radiologist Assistant Eligibility 


Education Requirement


To apply for the R.R.A. credential, you’ll have to meet the following educational requirements: 


  • Earn a bachelor’s degree from an institution accredited by an agency that ARRT recognizes. You can find a list of ARRT-recognized accreditation agencies on the ARRT website.
  • Be certified and registered with ARRT in Radiography
  • Have at least one year of acceptable clinical experience in radiography
  • Complete an ARRT-approved radiologist assistant educational program, where you’ll be required to demonstrate competencies in didactic coursework and clinical procedures.


Ethics Requirement


For ARRT to certify and register you, you must demonstrate good moral character.


Examination Requirement


And just like with the primary and postprimary eligibility pathways, you will need to pass an exam to earn ARRT credentials. More on ARRT exams below.


ARRT Exams


Taking an examination in your discipline is the last step in the ARRT certification and registration process. ARRT exams test whether you have the knowledge and skills required of today’s entry-level technologists. To ensure their exam questions mirror current practice standards, ARRT routinely surveys each discipline. These surveys are conducted by an in-house examination whose members include among others practicing technologists, physicists, and practicing physicians.


Based on the results from the surveys, the committee creates a task inventory, which lists tasks that entry-level technologists perform regularly. The team then creates content specifications to identify the areas to cover in each exam. The next step is writing exam questions. For this, ARRT enlists the help of practicing Registered Technologists to create exam items (questions). Accepted questions are placed in an item bank from which trained Exam Development Coordinators select questions to assemble an exam.


The current examination committee then reviews the selections to ensure new exams are nearly as difficult as previous exams and that they cover the content from the discipline’s most current content specifications. Various exam drafts are produced before a final version to be used as the certification and registration exam is approved.


ARRT exams are computer-based. There’s a tutorial at the start of each exam that allows you to answer practice questions, familiarizing you with the process and question formats. The length of an exam is determined by various factors including the skills needed in a particular discipline and the number of categories in the content specifications. Whereas the number of questions determines how much time you’re allowed to complete an exam.


After you take an exam, you should receive your final test score within four weeks. ARRT exam scoring scale ranges from 1 to 99, and you’ll need a total score of 75 to pass (not a percentage). The number of correct answers needed to obtain a scaled score of 75 will always vary due to various factors. For one, different disciplines have a different number of exam questions. Secondly, some versions might need fewer correct answers to receive a 75 scaled score than others due to the level of exam difficulty.


You’re allowed three attempts to pass an ARRT certification and examination exam within three years. So if you fail, you’ll still have two more opportunities to retake the exam. If you fail the exam thrice or three years lapse, whichever comes first, you lose eligibility. Fortunately, you may regain eligibility to apply for ARRT certification and registration.


Note: Some states use ARRT exams in their licensing process. However, passing this exam as a state candidate doesn’t mean you’re certified and registered with the ARRT. 


Ongoing Requirements


When you become a Registered Technologist (R.T.), it is important to maintain your certification and registration as it ensures you always have the knowledge and skills needed to provide patients with the highest level of care. You achieve this by fulfilling various requirements. For starters, you’ll be required to remain compliant with ARRT Rules and Regulations and ARRT Standards of Ethics.


You will also need to renew your certification and registration annually. To achieve this, you must be up to date with your biennial Continuing Education (CE) requirements. You’ll have to report your CE activities every two years as part of the annual renewal process. Such activities include classroom learning, approved online classes, lectures at professional society meetings, self-study readings and modules, et cetera.


Additionally, all Registered Radiologist Assistants and Registered Technologists who earned their credentials on/after January 1, 2011, must complete ARRT’s Continuing Qualifications Requirements (CQR) every 10 years. CQR helps bring your knowledge and skills up to date with today’s entry-level qualifications while refreshing your understanding and abilities.


Note: Your annual renewal deadline is always the last day of your birth month. 


ARRT Application Fees


  • Primary (R, N, T, MR, S): $200
  • Postprimary (M, CT, MR, BD, CI, VI, S, VS, BS, R.R.A.): $200
  • Postprimary (CT, MR, BD, S, or VS—using NMTCB as supporting category): $400
  • Postprimary (MR, S, VS, or BS—using ARDMS as supporting category): $400
  • Reinstate certification and registration by re-examination: $200
  • Online reinstatement (for those who don’t have to re-examine): $75


Discipline Abbreviations


R— Radiography

N— Nuclear Medicine Technology

T— Radiation Therapy

MR— Magnetic Resonance Imaging

S— Sonography

M— Mammography

CT— Computed Tomography

BD— Bone Densitometry

CI— Cardiac Interventional Radiography

VI— Vascular Interventional Radiography

VS— Vascular Sonography

BS— Breast Sonography

R.R.A.— Registered Radiologist Assistant


ARRT Census


As of October 2019, the top ten states with the highest number of ARRT Registered Technologists (R.T.s) are:


  • Texas with 25,982 R.T.s. 
  • California with 24,512 R.T.s.
  • Florida with 24,310 R.T.s
  • NewYork with 17,569 R.T.s
  • Pennsylvania with 16,830 R.T.s
  • Ohio with 15,267 R.T.s
  • Illinois with 14,277 R.T.s
  • North Carolina with 12,043 R.T.s
  • Michigan with 11,016 R.T.s
  • Georgia with 10,984 R.T.s


Here are the states with the highest number of ARRT credentials held by R.T.s in each Discipline.


  • Texas – 24,027 R.T.s in Radiography
  • Florida – 1,236 R.T.s in Nuclear Medicine Technology
  • Florida – 1,772 R.T.s in Radiation Therapy
  • Florida – 3,291 R.T.s in Magnetic Resonance Imaging
  • Texas – 369 R.T.s in Sonography
  • California – 3,279 R.T.s in Mammography
  • Texas – 6,622 R.T.s in Computed Tomography
  • Florida – 101 R.T.s in Quality Management
  • Florida – 275 R.T.s in Bone Densitometry
  • California – 105 R.T.s in Cardiac Interventional Radiography
  • Florida – 447 R.T.s in Vascular Interventional Radiography
  • Florida – 217 R.T.s in Cardiovascular Interventional Radiography
  • Texas – 33 R.T.s in Vascular Sonography
  • Texas – 106 R.T.s in Breast Sonography
  • Florida and Pennsylvania – each with 29 Registered Radiologist Assistants 


ARRT has not been left behind on the social media front as it has a Facebook Page with a following of nearly 40,000. You can connect with the organization on Facebook here.

You made it to the end! I bet you now know more about ARRT than you did when you first started reading this. Let’s see, when was ARRT founded?