Becoming a certified X-ray tech requires completing an accredited radiography program, passing a national certification exam, and in most states, obtaining a separate state license. The entire process typically takes two to three years from enrollment to certification, depending on whether you pursue an associate or bachelor’s degree.
The credential you’re working toward is the R.T.(R), issued by the American Registry of Radiologic Technologists (ARRT). That “R” stands for radiography, and it’s the standard qualification employers expect to see on your resume. Here’s what each step looks like.
Complete an Accredited Radiography Program
To qualify for ARRT certification, you need at minimum an associate degree from an ARRT-approved educational program in radiography. Bachelor’s programs also satisfy this requirement and share much of the same professional coursework, but they require more prerequisite credits. The professional component of either degree path can be completed in about 21 months, though the total time depends on how many general education courses you’ve already finished.
Your program will cover radiation physics, anatomy, patient positioning, image evaluation, and radiation safety. Just as important is the clinical portion: you’ll rotate through hospitals or imaging centers performing supervised exams on real patients. Before graduating, you must demonstrate competency in all mandatory clinical procedures plus a percentage of elective procedures. Mandatory competencies cover the imaging exams every radiographer needs to perform, while electives let you build skills in additional areas like pediatric or surgical imaging.
When choosing a program, confirm it’s on the ARRT’s approved list. Graduating from a non-approved program means you won’t be eligible to sit for the certification exam, regardless of how good the education was.
Handle the Ethics Requirement Early
ARRT holds applicants to an ethics standard that goes beyond academic performance. If you have any of the following in your background, you’ll need to disclose them:
- Misdemeanor or felony charges or convictions
- Military courts-martial
- Disciplinary actions from a state or federal regulatory authority
- Serious academic honor code violations, such as patient abuse, violating patient confidentiality, or cheating
You don’t need to report minor issues like poor grades or falling asleep in class. But if anything on that list applies to you, ARRT offers an ethics review preapplication that lets you get a decision before you’ve invested years in a program. You submit the preapplication form, supporting documents, and a nonrefundable fee, and the ARRT Ethics Committee reviews your case and issues a written decision. Be patient with this process: it can take three months or longer. A negative outcome could mean you’re ineligible to apply for certification for a set period of time, so it’s worth finding out early.
Pass the ARRT Certification Exam
Once you’ve graduated and met the ethics requirement, you can apply to take the ARRT radiography exam. The application fee is $225.
The exam is a multiple-choice test covering five major content areas: radiation protection, equipment operation and quality control, image acquisition and evaluation, imaging procedures, and patient care and education. Scores are reported on a scale of 1 to 99, and you need a 75 or higher to pass. That 75 is a scaled score, not a percentage of questions answered correctly, so it accounts for slight variations in difficulty between different versions of the exam.
If you don’t pass on your first attempt, you can retake the exam. Most candidates who prepared through their accredited program and reviewed the ARRT’s content specifications pass on the first try, but having a study plan that targets your weaker content areas makes a meaningful difference.
Get Your State License
Passing the ARRT exam doesn’t automatically mean you can start working. More than 75% of states have licensing laws covering radiologic technology, and in those states you need a separate state license before you can practice. Many states use your ARRT exam score or credential as part of their licensing decision, so the two processes overlap, but they aren’t the same thing.
Requirements vary significantly by state. Some require ARRT certification as a prerequisite for state licensure. Others administer their own exams or have additional application steps. Contact your state’s radiation control or health department directly to find out exactly what’s needed. If you’re planning to work in a different state from where you went to school, check that state’s requirements before you move.
Keep Your Certification Active
ARRT certification isn’t a one-time achievement. Every two years (called a biennium), you must complete and report 24 approved continuing education credits to maintain your credential. This requirement stays the same regardless of how many ARRT credentials you hold. Activities that count toward those 24 credits include conferences, online courses, journal articles with post-tests, and academic coursework.
Falling behind on continuing education can lapse your certification, which means you’d need to go through reinstatement before you could practice again. Most R.T.s spread their credits across the two-year window rather than cramming them in at the end.
Build Toward Specialization
Your initial R.T.(R) credential qualifies you to work as a general radiographer, but the field has several post-primary certifications that can increase your earning potential and open doors to specialized roles. The most common next steps are CT (computed tomography) and MRI, both of which require additional clinical experience and a separate ARRT exam. Some techs also pursue credentials in mammography, interventional radiography, or nuclear medicine.
Employers notice these additional credentials. A typical radiologic technologist resume lists the R.T.(R) alongside any post-primary certifications, the relevant state license number, and CPR certification. Even one or two years of experience combined with a CT or MRI credential makes you significantly more competitive for higher-paying positions in hospitals and outpatient imaging centers.
Realistic Timeline From Start to Finish
If you’re starting from scratch with no college credits, expect the full path to take roughly two and a half to three years: one to two semesters of prerequisite courses, then 21 months of the professional radiography program, followed by a few weeks to schedule and take the ARRT exam. If you already have prerequisite coursework completed, you could be certified in under two years from the day you start clinicals.
The biggest variable is getting into a program. Accredited radiography programs are competitive, and many have waitlists. Applying to multiple programs and completing all prerequisites before you apply gives you the best shot at starting without a gap year. Once you’re in, the path from enrollment to exam day is structured and predictable.