The Registered Radiologist Assistant (RRA) is certified through the American Registry of Radiologic Technologists (ARRT) and the Radiology Practitioner Assistant (RPA) is certified through the Certification Board of Radiology Practitioner Assistants (CBRPA).  In many states we are recognized together under the same title as Radiologist Assistant (RA).

How RA's practice in states without RA licensure:

1. The RA must maintain and remain certified as a Radiologic Technologist (RT) through the ARRT.
2. RA must have completed an accredited RRA/RPA program and be certified by the ARRT and/or CBRPA.
3. RA must maintain mandated ACLS and BLS certifications per the ARRT and/or CBRPA.
4. RA must continue to meet State and/or certification Continuing Education Credits and be in good standing with the the certification boards (ARRT and/or CBRPA) as an RT and an RA.
5. Facility/Hospital bylaws (as per Federal Law) approve and credential various healthcare professionals (including Physicians and Extenders).  Through those bylaws and committees, medical staff offices are able to approve the RA role, privileges/procedures, and assign each privilege/procedure a level of supervision. (CMS explains levels of supervision in Transmittal 11901).
   1. "General Supervision: means the procedure is furnished under the physician's overall direction and control, but the physicians presence is not required during the performance of the procedure.  Under general supervision, the training of the nonphysical personnel who actually performs the diagnostic procedure and the maintenance of the necessary equipment and supplies are the continuing responsibility of the physician"
   2. Direct Supervision: In the office setting means the physician (or other supervising practitioner) must be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the procedure.  It does not mean the physician (or other supervising practitioner) must be present in the room when procedure is performed.
   3. Personal Supervision: means the physician must be in attendance in the room during the performance of the procedure.
6. Physician Right to Delegate Act
7. Scope of practice is defaulted to the ASRT and/or CBRPA practice standards.

How RA's practice in states with RA licensure:

1. As described in 1-6 (as seen above).
2. State law passed licensing and recognizing the certification and education to practice as a RRA/RPA.
   1. If State Law has no scope of practice parameters; scope is defaulted to the practice standards set forth by the ASRT.

Important Facts To Know:

• Regardless of State Law and/or Scope of Practice; the facility/hospital credentialing supervision MUST be followed at each separate facility.
  • If State Law requires a lesser degree of supervision, RA MUST  still follow facility/hospital level of credentialed  supervision.
• If a facility/hospital doesn't credential RA for specific procedures, the RA CANNOT perform unapproved procedures (even if Scope of Practice and State Law allow them).
  • To further obtain unapproved procedures RA must meet with Medical Staff and get procedures approved 
• Billing and Supervision are two separate items.  
  • Please refer to your companies billing team to better understand guidelines to meet federal, private and state billing requirements.
    • If practice is not billing for physician procedure codes; supervision then defaults to State Law and/or facility/hospital assigned supervision level (for each procedure).