Registered Radiologist Assistant (RRA)

The American College of Radiology® (ACR®) continues to actively oppose imaging supervision or interpretation by non-physician providers. In 2002, to meet growing demand for imaging exams and optimize radiologist workload, the ACR began working with the American Society of Radiologic Technologists, American Registry of Radiologic Technologists (ARRT) and Society of Radiology Practitioners Assistants (now the Society for Radiology Physician Extenders) to create the Registered Radiologist Assistant (RRA) profession. The ACR continues to work with these organizations to ensure that these extenders work as part of a radiologist-led team.

RRA Overview

RRAs  are certified radiology technologists who have graduated from a formal radiologist assistant or radiology practitioner assistant (RPA) education program and are certified under ARRT. RRAs are very different from other physician extenders in education, training and experience, and commit to the following:

  • RRAs cannot supervise nor interpret exams.
  • RRAs are not independent practitioners.
  • RRAs always practice under the supervision of a radiologist.
  • RRAs function as part of a radiologist-led team.

It is ACR policy to support the RRA.1 RRA language is included in numerous ACR Practice Parameters and Technical Standards written and approved by the ACR Council, and the ACR has a category of membership for RRAs.2

RRA Training

RRAs are trained radiographers who can extend the reach of on-site radiologists and allow radiologists to focus on services only these highly trained physicians can provide — including imaging recommendation, supervision and interpretation.

  • RRAs complete advanced education and training that includes a defined didactic program with a nationally recognized curriculum and a radiologist-directed clinical preceptorship (total two years).
  • RRAs must pass a nationally recognized certification examination and complete continuing education programs.
  • Nurse Practitioners and Physician Assistants do not have national standards for radiology training and rely on individual practices.

RRAs’ advanced education and training are reviewed on a regular basis by their national credentialing body with input from the ACR.


The ACR has yet to take an official position on the 2021 Medicare Access to Radiology Care Act (MARCA) which was introduced in June 2021. The bill would provide reimbursement only to radiologists and practices for services in which RRAs participated for Medicare patients under the supervision of radiologists (performed as part of a radiologist-led team).

1 American College of Radiology (ACR) Digest of Council Actions, Section 2J, items 11 and 12.
2 American College of Radiology (ACR) Bylaws, Article II, Section I (Categories of Membership).