Scope of Practice

Proper supervision and interpretation of imaging exams by highly trained radiologist physicians is critical to the accurate diagnosis and treatment of disease, injury and illness.

To protect patient access to safe, high-quality care, the ACR® tracked and acted on hundreds of bills nationwide in 2020 and 2021 — including those regarding scope of practice.

The ACR works with our state chapters to advocate at the legislative, regulatory and administrative levels for clear, sensible definition of scope for allied health professionals.
The American College of Radiology Association® has established a fund to safeguard patients and patient access to radiologist expertise.

Why We Fight

Patients are best served when medical imaging is provided only under a physician's supervision and when radiologist physicians interpret medical imaging studies.

Radiologist physicians are uniquely educated, trained and qualified to practice radiology, including imaging supervision and interpretation. Non-physician providers do not have comparable training, competence or experience and should not independently supervise or interpret imaging exams.

Most radiologists undergo 10 years of comprehensive training beyond their undergraduate degree:

  • Graduate from medical school.
  • Serve one-year clinical internship.
  • Complete four-year residency.
  • Interpret tens of thousands of exams under practicing radiologist supervision.
  • Train in radiation safety, anatomy, pharmacology, pathophysiology and more.
  • Complete four-week (130 lecture hours) intensive radiologic pathology correlation course.
  • Pass a state licensing exam.
  • Complete a 1–2-year fellowship of specialized training in a radiology subspecialty.

There is no equivalency in education between a physician and a non-physician health professional, particularly regarding radiology practice and imaging supervision and interpretation.

Non-physician personnel can serve essential roles in radiology practice. However, their education and training are no substitute for the intensive and specialized training and experience of a radiologist.

Recent ACR Communications

Advocacy in Action articles

  • Hear from chapter leaders in Kansas, New York and Wisconsin around some recent scope battles in their state.
  • Read about the advocacy success of Gregg Bogost, MD, FACR, and the Wisconsin Radiological Society in their most recent scope fight.
  • Hear from Ezequiel “Zeke” Silva III, MD, FACR, FSIR, FBRMA, RCC, on how to achieve advocacy success in your state

Joint Communications With Other Organizations

Sign-On Letters


ACR signed a letter led by the American Society of Anesthesiologists regarding a bill in Arizona that would remove the requirement for physician involvement in anesthesia care.


ACR sent a letter opposing SSB 1046.


ACR signed on to a letter led by the Spine Intervention Society in opposition to HB 941.


ACR and the Maryland Radiological Society sent a letter opposing SB 673 & HB 727. Both bills would allow a physician assistant (PA) to perform “x-ray duties” without a license or supervision.

South Dakota

ACR and the South Dakota Radiological Society sent a letter opposing SB 175.


ACR signed on to a letter led by the American Society of Anesthesiologists regarding the Governor of Utah considering to opt-out of the Medicare supervision patient safety standard.


ACR signed a letter to the Wyoming Board of Medicine regarding a proposed rule to opting out of the CMS requirement for supervision of nurse anesthetists by the operating physician in hospitals to hospitals with 25 or fewer beds.

Radiology Specific Resources

Non-ACR Resources

Track Scope of Practice Legislation

Track the progress of bills related to Scope of Practice with the map below.