Getting certified to take X-rays requires completing an accredited educational program, passing a national exam, and in most states, obtaining a state license. The full process takes about two years for an associate degree, though limited-scope options exist in some states with shorter training timelines.
There are two main paths: becoming a fully registered radiologic technologist (R.T.) through the American Registry of Radiologic Technologists (ARRT), or pursuing a limited-scope X-ray certificate that restricts you to specific body parts or settings. The path you choose determines your training length, job flexibility, and earning potential.
The Three ARRT Requirements
The ARRT is the national credentialing body for radiologic technologists, and earning its certification comes down to three requirements: education, ethics, and examination.
Education: You need to complete a radiography program approved by ARRT. Most people do this through a two-year associate degree at a community college or technical school. These programs combine classroom instruction with hands-on clinical rotations where you practice positioning patients, operating equipment, and producing diagnostic images. During clinical training, you’ll need to demonstrate competency in a set of mandatory procedures, performing each one independently and effectively on real patients or in simulated scenarios. Programs also include elective competencies that give you flexibility to build skills in additional areas.
Ethics: ARRT conducts a background review as part of your application. Certain criminal convictions or ethical violations can delay or prevent certification, so it’s worth reviewing their ethics requirements before you start a program.
Examination: After completing your education, you sit for the ARRT radiography exam. The application fee is $225.
What the Exam Covers
The ARRT radiography exam has 200 scored questions plus 30 unscored pilot questions mixed in (you won’t know which are which). The content breaks down into four major areas:
- Procedures (66 questions): The largest section, covering imaging of extremities (28 questions), the thorax and abdomen (20 questions), and the head, spine, and pelvis (18 questions). This tests your knowledge of patient positioning, anatomy, and which views to take for specific clinical situations.
- Image Production (51 questions): Covers how to acquire high-quality images and evaluate them, plus equipment operation and quality assurance.
- Safety (50 questions): Includes radiation physics, radiobiology, and radiation protection. You’ll need to understand how radiation affects the body and how to minimize exposure for both patients and yourself.
- Patient Care (33 questions): Focuses on patient interactions, managing different clinical situations, and handling emergencies.
The exam is computer-based and taken at a testing center. Most graduates spend several weeks after finishing their program using review books and practice exams to prepare.
How Long It Takes and What It Costs
A typical associate degree in radiologic technology takes two years of full-time study, assuming you’ve already completed any prerequisites. At a community college like Dallas College in Texas, tuition runs around $5,940 for in-county residents, not including prerequisite courses. Private programs and university-based programs cost significantly more, sometimes $20,000 to $50,000 or higher depending on the institution.
Beyond tuition, budget for textbooks and supplies (some programs bundle these into tuition, others don’t), clinical uniform requirements, background checks, and the $225 ARRT exam fee. If your state requires a separate license, that comes with its own application fee.
The two-year timeline assumes full-time enrollment. Many programs are competitive and have waitlists, so the real timeline from “deciding to pursue this” to “working as a certified tech” can stretch to three years or more once you factor in prerequisites and admissions cycles.
State Licensing Requirements
Passing the ARRT exam is only part of the equation in most states. More than 75% of states have licensing laws that require you to obtain a state license before working as a radiologic technologist. The specific requirements vary: some states require ARRT certification as a prerequisite for the state license, while others administer their own exams or accept ARRT certification as equivalent.
States like New York, California, Texas, Florida, and most others have formal regulatory requirements, whether they call it a license, certification, or permit. A smaller group of states, including Alabama, Alaska, Idaho, Missouri, and Oklahoma, have no specific state-level licensing requirement, though employers in those states typically still expect ARRT credentials.
States like Colorado require you to hold a national credential, and several others classified as “standard” regulation states require some combination of education and national certification. Contact your state’s radiation control or health department to confirm exactly what you need before you start working.
The Limited-Scope Alternative
Not every X-ray job requires full ARRT certification. Many states allow limited-scope X-ray technicians (sometimes called limited X-ray machine operators) to perform basic radiographic exams on specific body parts, typically the chest and extremities. These positions are common in urgent care clinics, orthopedic offices, and chiropractic practices.
Limited-scope training programs are much shorter, often ranging from a few weeks to several months, and the scope of practice is restricted. You won’t be qualified to perform complex imaging, work in hospitals, or advance into specialties like CT or MRI. The trade-off is faster entry into the workforce at a lower training cost.
Availability depends entirely on your state. Some states have formal limited-scope permits with defined training requirements, while others don’t recognize this role at all. States that do offer it typically require you to pass a limited-scope exam (ARRT offers one) and may restrict which exams you can perform based on the specific permit you hold.
Keeping Your Certification Active
ARRT certification isn’t a one-time achievement. To maintain your credentials, you need to complete 24 approved continuing education credits every two years. This two-year cycle, called a biennium, ends on the last day of the month before your birth month. So if you were born in June, your CE deadline falls on May 31 every other year.
You report your completed credits during the renewal process, with the reporting deadline falling on the last day of your birth month. The 24-credit requirement stays the same regardless of how many ARRT credentials you hold, so picking up additional certifications in CT or MRI doesn’t double your CE burden.
CE credits can come from conferences, online courses, journal articles, and college coursework. Many employers offer CE opportunities as part of the job, and dozens of online platforms sell affordable CE packages designed for radiologic technologists.
Choosing the Right Program
When evaluating radiography programs, the most important factor is accreditation. Look for programs recognized by JRCERT (Joint Review Committee on Education in Radiologic Technology), as this ensures the program meets ARRT’s educational requirements. Graduating from a non-approved program means you won’t qualify to sit for the exam.
Beyond accreditation, compare programs on pass rates (JRCERT publishes these), clinical site variety, and job placement rates. A program that partners with multiple hospitals and outpatient clinics gives you broader clinical experience than one limited to a single facility. Also check whether prerequisites like anatomy, physiology, and college algebra are included in the two-year timeline or need to be completed beforehand, as this significantly affects your total time to completion.