Frequently Asked Questions About NRDR

What is NRDR?

The ACR National Radiology Data Registry (NRDR) is an information system whose purpose is to enhance individual radiologist practices, the specialty of radiology and the care patients receive, by providing accurate and objective measures of practice processes and outcomes. Designed by radiologists for radiologists, NRDR offers a mechanism for comparing provider and facility performance at the local, regional and national levels, thereby aiding quality improvement in participating imaging facilities.

NRDR includes all of the registries listed below, which together provide the first national snapshot of radiology on a host of key fronts:

What facilities can join the registry?

Any facility performing radiology procedures can participate in NRDR. A NRDR participation agreement between ACR and the facility must be signed before the facility can begin participation.

Does my site need IRB approval to participate in NRDR?

Because the data are being collected for the purpose of quality assurance and peer review, it is not required that you obtain IRB approval. The ACR has obtained a document from its IRB stating that the registry activities qualify as an exemption. Even though it is not required, individual institutions may choose to request an exemption from their IRB.

How do I register my facility?

  1. Interested facilities may register by filling out the New Facility Registration Form online to obtain a valid account. Once the form is completed, you will receive a confirmation e-mail with information about logging in to the NRDR website.

    After completing the facility registration form, you must send an executed NRDR participation agreement, either by email to or by fax to 1-703-648-3240. Original documents are not required if you prefer to mail the participation agreement to us at the address below:

    American College of Radiology
    1891 Preston White Dr.
    Reston, VA 20191-4397
    Attn: Applications Processing

  2. Facilities will be charged a one-time $500 facility registration fee and an annual fee based on size of practice for registry participation (not including NOPR). Registration fees may be paid by credit card or check. Checks should be made payable to NRDR and mailed to the address listed above. Please include the facility ID# on the check.

    Please note: Due to NOPR’s separate function as part of the CMS reimbursement process, the registration procedure for NOPR is independent of the registration procedure for NRDR. Registrations for NOPR must be submitted separately. Fees for participating in NRDR do not include NOPR participation. To register, please use the NOPR online registration form.

Can a facility make changes to the posted NRDR Participation Agreement?

To complete your registration in a timely fashion, the participation agreement and BAA posted on the NRDR website must be executed without changes. We understand that you may wish to use your own BAA or modify the participation agreement. However, because of the number of facilities participating in NRDR, it is not practical for the ACR to provide legal review for different agreements to ensure compliance with HIPAA requirements. We are fully prepared to comply with the HIPAA requirements and believe the BAA on the NRDR website meets the requirements of the HIPAA privacy and security rules.

How much does it cost to participate in NRDR?

There is a one-time facility registration fee of $500 (not including NOPR). In addition, there is an annual fee based on the number of radiologists practicing at a facility and the number of registries in which a facility chooses to participate. Please see our registration process and fee schedule.

What are the facility's responsibilities?

The participation agreement describes the responsibilities of the facility in detail. To summarize, the facility identifies a facility administrator to be responsible for entering all relevant data into NRDR. These may include facility profile information, patient demographics, process and outcome measures and other data, depending on the registries in which the facility participates. Additionally, the facility is responsible for reviewing data quality reports provided by the registry and making sure that data entered into the registry meet its data quality and consistency standards.

Who has access to the NRDR data?

The ACR has access to all of the data entered into the registry, and will not disclose the Protected Health Information (PHI) in its possession to a third party except for the purpose of the ACR’s proper management and administration of the registry or to fulfill any legal responsibilities of the ACR, and only provided that the disclosures are required by law or that the ACR has received from the third party written assurances that the information will be (i) held confidentially and (ii) used or further disclosed only as required by law or for the purposes for which it was disclosed to the third party.

The ACR will use and disclose a limited data set for purposes of research or as otherwise permitted by the privacy standards or required by law. The ACR will not use a limited data set in such a way as to identify any individual and will not to contact any individual.

NRDR activities meet the definition of peer review. NRDR data collected and stored by the ACR are considered privileged and confidential peer review under Virginia Code Section 8.01-581.17 and not discoverable during legal proceedings unless so ordered by a court and then only upon a showing for good cause and for extraordinary circumstances. For information relative to your own state consult your state statutory authority.

Who owns the NRDR data?

Individual patient data submitted by a facility remain the exclusive property of the facility. However, such data once aggregated or data de-identified by ACR and any derivative works from de-identified data are the sole intellectual property of ACR.

What is CTC?

The CT Colonography Registry (CTC) is a database with measures critical to evaluating CT colonography procedures. Data collected in this registry will contribute to the evaluation of colonography as an alternative to colonoscopy. As with other registries in the NRDR, facilities can use CTC to compare their data to regional and national benchmarks.

Facilities participating in either DIR or GRID may participate in CTC at no additional charge.

What is DIR?

The Dose Index Registry (DIR) is a data registry that allows facilities to compare their CT dose indices to regional and national values. Information related to dose indices for all CT exams is collected, anonymized, transmitted to the ACR and stored in a database. Institutions are then provided with periodic feedback reports comparing their results by body part and exam type to aggregate results. Data collected from the registry will be used to establish national benchmarks for CT dose indices.

What is GRID?

The General Radiology Improvement Database (GRID) is a quality improvement tool that collects information about imaging facilities. The information provided by participating facilities is aggregated to establish benchmarks for use in quality improvement goals. GRID allows facilities and physicians to compare turnaround times, patient wait times, incident rates and many other process and outcome measures with other facilities and practices of similar size and type.

What is meant by “gold” level and “green” level?

GRID offers two levels of participation, green and gold. Facilities that wish to take advantage of the full range of metrics provided by GRID participate at the gold level. These facilities provide all data elements requested by GRID and receive a complete report at the end of each reporting period. The green level offers an alternative for facilities that are unable to provide outcomes data. Green-level participants supply a subset of GRID data elements and receive a report of all GRID metrics other than those reflecting outcomes.

Is there an extra charge to participate at the gold level?

No. The cost for participation is the same for each level.

What is ICE?

ICE is the IV Contrast Extravasation Registry, a quality improvement project sponsored jointly by the Society of Abdominal Radiology and the ACR. Participating groups report on extravasation events over a six-month period and receive a feedback report comparing their extravasation rate to national benchmarks. After reviewing the report, a participating group develops and implements an improvement plan. The group then reports on extravasation events for another six-month period. By comparing the results of the two periods, it determines whether the plan was successful.

Facilities participating in either DIR or GRID may participate in ICE at no additional charge.

What is NMD?

NMD is the National Mammography Database, a registry that leverages data that radiology practices are already collecting under federal mandate by providing them with comparative information for national and regional benchmarking. Participants receive semiannual feedback reports that include important benchmark data such as true positive rates, positive predictive value rates and recall rates.

NMD participation is available to BI-RADS Centers of Excellence (BICOE facilities) at no charge. Facilities participating in either DIR or GRID may also participate in NMD at no additional charge.

Can I use an NRDR data registry as an ABR-approved PQI project?

Yes. All of our registries have been approved by the ABR for use as a PQI project. In order to get started please read additional information provided for each registry in the links provided below.

Why must I supply my date of birth in a PQI project?

The ABR requires the date of birth in order to identify the participant.

How do I register multicenter facilities?

  1. In order to register entities that practice at multiple locations, you are required to register each practice location as a separate facility. In addition, you are required to create a dummy master facility as an umbrella facility to capture the information collected at all of the individual locations.

  2. Register your master facility first using the new facility registration form. In section 1 under Should the invoice for this Facility ID Physician Group / Corporate Entity be sent to this Facility ID or a different Facility ID?, select This Facility ID. A facility ID will be generated and sent to the facility administrator (the person submitting the information). Use this number for the child facilities in step 3 below. Continue with the master facility online application by selecting a specific registry in which to participate (CTC, DIR, etc.).

  3. Register your child facilities. On the main facility registration page, in section 1 under Should the invoice for this Facility ID Physician Group / Corporate Entity be sent to this Facility ID or a different Facility ID?, check A different Facility ID. In the field labeled Facility ID to which invoice should be sent, enter the facility ID number that was generated for the master in step 2 above. This will allow us to treat all your related locations as a single entity when calculating your invoice.


How to choose registries

Master facility: Pick your registries of interest. At the specific registry page, enter the number of interpreting physicians and residents (this includes both full-time and part-time status) for Q2.

Child facility: For each child facility, pick the registries of interest. At the specific registry page, complete the short questionnaire but you do not need to enter any information for number of participating radiologists.

For DIR only, if you intend to submit data for all your facilities from one central location, use the following instructions:

Master facility: If you intend to submit data for all your facilities from a single location or PACS system or node, make sure to check the box for Q3, This account will be used to submit data for more than one facility. This action will designate this facility to serve as the central location from which data will be sent for all other facilities within your health care system that you plan to register and which will submit data.

Child facility: If you intend to submit data centrally through your master facility, do not check the box for Q3. Instead, type the facility ID number that was generated for the master into the Q4 text box. This action will designate this facility as a child facility contributing data which will be directed through the master facility.

NRDR Multicenter Registration
DIR Master-Child Registration Page

What is a master facility?

A master facility is necessary when two or more facilities will be contributing data and are located at separate geographic locations. A master facility is a "dummy" account through which we are able to consolidate billing, receive your data transmissions, and house interactive and aggregate reports for all your facilities contributing data. The multiple facilities contributing data are referred to as child sites. A master facility does not submit any data if its own; it submits data for all the locations covered under the same practice or corporate entity or PACS system. Each location that provides patient care should be registered independently in addition to the master facility.

What is a child facility?

A child site contributes patient exam data such as the RDSR and localizer which are performed at that location. All data transmissions submitted will travel through the master facility (if you choose to submit data that way) using software we provide to your facility once registration and the participation agreement are complete. Some facilities choose to submit data from each of the child facility locations. In addition, billing and invoicing will be managed through the master facility unless otherwise indicated.