in the industry
procedures and document competency to
fulfill their educational program requirements and gain eligibility for the certification exam. The procedures for which RAs
document clinical competency can be
found on ARRTs website and they span
the spheres of abdominal, thoracic, mus-culoskeletal, cardiovascular, peripheral
vascular, neurological, and breast imaging. 1 Radiology administrators should visit
the ARR T website, click on the link for the
“R.R.A. Certification Handbook” and
examine the sections titled “Entry Level
Clinical Activities” as well as the “
Summary of Clinical Experience and Competence Assessments.” 1 There is a wealth of
information about what expertise RAs can
provide to an imaging department, radiologists, and most importantly the customers of radiology services. The RA scope of
practice is located in the ASRTs Radiologist Assistant Practice Standard document.
Although many RA functions may appear
to overlap with those of PAs and NPs, only
the RA curriculum provides such a comprehensive skill set for practicing the fine
art of medical imaging procedures with an
ingrained knowledge of imaging modality
equipment operation and radiation safety
practices. State laws also vary on who may
operate fluoroscopy equipment.
The scope of practice and level of autonomy for the RA is strongly supported by
major professional organizations including the ARRT, ASRT, ACR, and SRPE. In
addition, the CMS imposed supervision
rules contradict the scope of practice recognition of all the states that license RAs.
The aforementioned professional
organizations are working together to
promote HR 3032 Medicare Access to
Radiology Care Act (MARCA), which
would amend the Social Security Act to
allow for “payment of services of qualified
radiologist assistants under the Medicare
program” and refer to the states to define
scope of practice and supervision levels. 3
MARCA is a bipartisan bill which seeks
to accomplish the following3-4:
• Define a qualified RA as either certi-
fied by the ARRT as a registered radi-
ologist assistant or by the CBRPA as a
radiology practitioner assistant
• Allow qualified RAs to “perform radio-
logic procedures under the supervision
(as determined by State Law) of a radi-
• Provide an 85% reimbursement level
for procedures performed by an RA
The lead sponsor of the MARCA bill is
from Washington and there are currently
28 cosponsors from the following states:
California, Florida, Illinois, Iowa, Loui-
siana, Michigan, New Jersey, New York,
North Carolina, Ohio, Pennsylvania,
Tennessee, Texas, Utah, and Virginia. 5
For successful passage of the MARCA
bill, this list needs to grow.
1American Registry of Radiologic Technologists. Registered Radiologist Assistant
(R.R.A.) Certification Handbook and
Application Materials. 2012. Available at:
https://www.arrt.org/pdfs/RRA/RRA-Handbook.pdf#page= 16. Accessed May 30,
2Certification Board for Radiology Practitioner
Assistants. Content Specifications for the
Radiology Practitioner Assistant Examination. Available at: http://www.cbrpa.org/
cations.pdf. Accessed May 30, 2012.
3American Society of Radiologic Technologists. H.R. 3032. 2011. Available at: https://
MARCA_092211.pdf. Accessed May 10,
4Society of Radiology Physician Extenders.
Current Medicare Policy Limits Options
for Providing Access to Quality, Safe, and
Cost-Effective Medical Imaging Services.
2010. Available at: http://www.radiologypa.
Brief%20Final.pdf. Accessed May 10, 2012.
5American Society of Radiologic Technologists. MARCA Cosponsors. 2012. Available
Accessed May 30, 2012.
Leslie Partridge, RRA, MS, R T(R) completed her
baccalaureate degree and radiographer training at
The Ohio State University. She also earned a master of
science degree from The Ohio State University with
specialization in the radiologist assistant and adult
education tracts. She is certified as a registered
radiologist assistant by the ARRT and licensed by the
state of Ohio. She is currently employed at The Wexner
Medical Center at The Ohio State University. She can
be contacted at firstname.lastname@example.org.