# Title 114 — Medical Imaging and Radiation Therapy Board

## Article 114-02 — License Requirements

## Chapter 114-02-01 — Initial Licensure

### § 114-02-01-01. Requirements for licensure for primary modalities.

An individual may be licensed in one or more of the primary modalities. An individual shall meet the
following requirements for the primary modalities:
1. "Magnetic resonance imaging technologist" shall satisfactorily complete the academic
requirements of a magnetic resonance imaging technology accredited program or must have
satisfactorily completed a course of study including clinical experience requirements for
certification in magnetic resonance imaging or hold current certification and registration in
magnetic resonance imaging technology. The individual:
a. May perform such procedures while under the general supervision by a licensed
practitioner.
b. Shall hold current certification and registration by one of the following:
(1) American registry of magnetic resonance imaging technologists;
(2) American registry of radiologic technologists in magnetic resonance imaging
technology;
(3) Submits verification of actively working towards certification requirements in
magnetic resonance imaging technology;
(4) Has met other requirements established by the board and has successfully passed
the North Dakota state administered examination; or
(5) Has met the requirements of a successor organization or the equivalent as
recognized by the board.
c. Biennially shall complete the continuing education and other requirements set by the
applicable certification organization to maintain certification and registration.

d. Otherwise the individual shall meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
2. "Nuclear medicine technologist" shall satisfactorily complete an accredited education program
in nuclear medicine technology and must hold current certification and registration in nuclear
medicine technology. The individual:
a. May perform such procedures while under the general supervision by an authorized user
who is licensed to possess and use the radiopharmaceuticals involved.
b. Shall hold current certification and registration by one of the following:
(1) Nuclear medicine technologist certification board;
(2) American registry of radiologic technologists in nuclear medicine technology;
(3) Has met other requirements established by the board and has successfully passed
the North Dakota state administered examination; or
(4) Has met the requirements of a successor organization or the equivalent as
recognized by the board.
c. Biennially shall complete the continuing education and other requirements set by the
applicable certification organization to maintain certification and registration.
d. Otherwise the individual shall meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
3. "Radiation therapist" must have satisfactorily completed an accredited education program and
hold a baccalaureate or an associate degree or must hold a current certification and
registration in radiation therapy. The individual:
a. May perform such procedures:
(1) Using x-ray machines and particle accelerators while under the general supervision
by an authorized user for external beam radiation therapy as defined by the
requirements in North Dakota Century Code chapter 22.1-03; and
(2) Using sealed radioactive sources only while under the supervision of an authorized
user of radioactive material as defined by the requirements in North Dakota Century
Code chapter 23.1-03.
b. Shall hold current certification and registration by one of the following:
(1) American registry of radiologic technologists in radiation therapy or has met the
requirements of a successor organization or the equivalent as recognized by the
board.
(2) Has met other requirements established by the board and has successfully passed
the North Dakota state administered examination.
c. Biennially shall complete the continuing education and other requirements set by the
applicable certification organization to maintain certification and registration.

d. Otherwise the individual shall meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
4. "Radiographer'' shall satisfactorily complete an accredited education program and must hold a
baccalaureate or an associate degree or hold a current certification and registration in
radiography. The individual:
a. May perform such procedures while under the general supervision by a licensed
practitioner.
b. Shall hold current certification and registration by one of the following:
(1) American registry of radiologic technologists or has met the requirements of a
successor organization or the equivalent as recognized by the board.
(2) Has met other requirements established by the board and has successfully passed
the North Dakota state administered examination.
c. Biennially shall complete the continuing education and other requirements set by the
applicable certification organization to maintain certification and registration.
d. Otherwise the individual shall meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
5. "Radiologist assistant" shall satisfactorily complete an accredited education program and must
hold a baccalaureate or master's degree. The individual:
a. May perform such procedures while under general supervision of a radiologist.
b. Shall hold current certification and registration as a radiographer by American registry of
radiologic technologists; and
c. Shall hold advanced level current certification by one of the following:
(1) American registry of radiologic technologists as a radiologist assistant;
(2) Certification board of radiology practitioner assistants as a radiology practitioner
assistant; or
(3) Has met the requirements of a successor organization or the equivalent as
recognized by the board.
d. Biennially shall complete the continuing education and other requirements set by the
applicable certification organization to maintain certification and registration.
e. Otherwise the individual shall meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
6. "Sonographer" must hold a certificate, associate degree, or baccalaureate degree and shall
satisfactorily complete the academic requirements and fulfill the clinical ultrasound
requirements or hold current certification and registration in sonography. The individual:
a. May perform such procedures while under the general supervision by a licensed
practitioner.

b. Shall hold current certification and registration by one of the following or a successor
organization or the equivalent as recognized by the board:
(1) American registry for diagnostic medical sonography;
(2) American registry of radiologic technologists in sonography;
(3) Cardiovascular credentialing international;
(4) Sonography Canada; or
(5) Has met the requirements established by the board and has successfully passed
the North Dakota state administered examination.
c. Biennially shall complete the continuing education and other requirements set by the
applicable certification organization to maintain certification and registration.
d. Otherwise the individual shall meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
History: Effective April 1, 2018.
General Authority: NDCC 43-62
Law Implemented: NDCC 43-62-09(5), 43-62-14, 43-62-15(2)
### § 114-02-01-02. Limited x-ray machine operator.

1. A limited license under this chapter may be issued provided the applicant was designated by
the state department of health as a limited x-ray machine operator prior to the effective date of
this section and is actively practicing immediately prior to that date and does not have an
encumbered license or other restricted practice in any jurisdiction and meets board
requirements, including continuing education requirements and training. The individual:
a. May perform limited series procedures only while under the general supervision by a
licensed practitioner.
b. Upon renewal biennially shall complete twelve hours of continuing education.
c. Otherwise the individual shall meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
2. After the date specified in subsection 1, an initial applicant for limited x-ray machine operator:
a. Must have satisfactorily completed the academic requirements of a structured limited
x-ray machine operator program recognized by the board;
b. Shall demonstrate practical clinical competency in limited x-ray machine operator
technology as verified by a licensed American registry of radiologic technologist
radiographer or other designee as approved by the board, on a form provided by the
board;
c. Has successfully passed the North Dakota state administered examination in limited
scope of practice radiography;
d. May perform limited series procedures only while under the general supervision by a
licensed practitioner;

e. Biennially shall complete twelve hours of continuing education;
f. The individual shall complete a criminal history record check as required in section
114-03-02-01; and
g. Shall meet other requirements established by the board. See Appendix A for practice
standards.
3. To be eligible for licensure as a limited x-ray machine operator after completing the
requirements of subsection 2, an applicant shall hold at least one of the following licenses:
a. Medical technologist, medical laboratory technician, or clinical laboratory technician;
b. Occupational therapist or occupational therapy assistant;
c. Physical therapist or physical therapy assistant;
d. Physician assistant or orthopedic physician assistant;
e. Registered nurse or licensed practical nurse;
f. Otherwise, an individual may petition the board for licensure if the individual's education
background is substantially similar to the above.
History: Contingent effective date. See Section 75 of 2017 Senate Bill No. 2327.
General Authority: NDCC 43-62
Law Implemented: NDCC 12-60-24, 43-62-14, 43-62-15
### § 114-02-01-03. Bone densitometry technologist.

1. "Bone densitometry technologist" shall satisfactorily complete a course of study in bone
densitometry. The individual:
a. May perform such procedures only while under the general supervision of a licensed
practitioner.
(1) Must hold current registration and certification in a primary modality; or
(2) Registration and certification from the international society for clinical densitometry
or has met the requirements of a successor organization or the equivalent as
recognized by the board; or
(3) Has successfully passed the North Dakota state administered examination in bone
densitometry.
b. Biennially shall complete the required continuing education.
c. The individual shall complete a criminal history record check as required in section
114-03-02-01.
d. Otherwise the individual shall meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
2. To be eligible for licensure as a bone densitometry technologist after completing the
requirements in subsection 1, the applicant shall hold at least one of the following licenses:
a. Medical technologist, medical laboratory technician, or clinical laboratory technician;

b. Occupational therapist or occupational therapy assistant;
c. Physical therapist or physical therapy assistant;
d. Physician assistant or orthopedic physician assistant; or
e. Registered nurse or licensed practical nurse.
3. Otherwise, an individual may petition the board for licensure if the individual's education or
research background is substantially similar to subdivisions a through e of subsection 2.
History: Contingent effective date. See Section 75 of 2017 Senate Bill No. 2327.
General Authority: NDCC 43-62
Law Implemented: NDCC 12-60-24, 43-62-14, 43-62-15
### § 114-02-01-04. Requirements for continuing education for other modalities recognized by the

board.
1. An individual must be continuing education compliant in each modality of practice and may
practice in more than one modality and all the modalities will be acknowledged on the license.
2. To practice in a modality other than primary modalities, an individual shall meet the following
requirements:
a. Biennially shall complete five hours of continuing education in each modality of current
practice; or
b. Otherwise the individual shall meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
3. The following modalities will be monitored for continuing education compliance only:
a. Cardiac-interventional technology;
b. Computed tomography technology;
c. Mammography technology;
d. Quality management technology;
e. Vascular-interventional technology; and
f. Other modalities as recognized by the board.
History: Effective April 1, 2018.
General Authority: NDCC 43-62
Law Implemented: NDCC 43-62-14(3)
### § 114-02-01-05. Cardiac electrophysiology specialist.

"Cardiac electrophysiology specialist" shall satisfactorily complete all requirements as set by a
certification organization recognized by the board or hold current certification and registration. The
individual:
1. May assist with the performance of fluoroscopy procedures only while under personal
supervision by a licensed practitioner; and

a. Must hold current certification and registration as a cardiac electrophysiology specialist
by the cardiovascular credentialing international;
b. Shall submit verification of actively working towards certification requirements as a
cardiac electrophysiology specialist; or
c. Shall meet the requirements of a successor organization or the equivalent as recognized
by the board.
2. Biennially shall complete twelve hours of fluoroscopy safety and relevant radiation protection
continuing education.
3. The individual shall complete a criminal history record check as required in section
114-03-02-01.
4. Otherwise the individual shall meet the unique licensure or practice standard requirements
established by the board under subsection 7 of North Dakota Century Code section 43-62-14.
History: Effective April 1, 2018.
General Authority: NDCC 43-62
Law Implemented: NDCC 12-60-24, 43-62-09(15), 43-62-14(4)(7)
### § 114-02-01-06. Cardiovascular invasive specialist.

"Cardiovascular invasive specialist" shall satisfactorily complete all requirements as set by a
certification organization recognized by the board or hold current certification and registration. The
individual:
1. May assist with the performance of fluoroscopy procedures only while under personal
supervision by a licensed practitioner; and
a. Must hold current certification and registration as a cardiovascular invasive specialist by
the cardiovascular credentialing international;
b. Shall submit verification of actively working towards certification requirements as a
cardiac invasive specialist; or
c. Shall meet the requirements of a successor organization or the equivalent as recognized
by the board.
2. Biennially shall complete twelve hours of fluoroscopy safety and relevant radiation protection
continuing education.
3. The individual shall complete a criminal history record check as required in section
114-03-02-01.
4. Otherwise the individual shall meet the unique licensure or practice standard requirements
established by the board under subsection 7 of North Dakota Century Code section 43-62-14.
History: Effective April 1, 2018.
General Authority: NDCC 43-62
Law Implemented: NDCC 12-60-24, 43-62-09(15), 43-62-14(4)(7)
### § 114-02-01-07. Qualifications of applicants for initial licensure for a primary modality.

1. An applicant for initial licensure under this chapter may not have an encumbered license or
other restricted practice in any jurisdiction, shall meet board requirements, and submit the
following:

a. A completed application and the nonrefundable fee required in chapter 114-01-03;
b. An official transcript from an accredited program;
c. Other documents that verify successful completion of medical imaging or radiation
therapy education approved in a jurisdiction which meets or exceeds those requirements
in chapter 114-02-01 for each modality. The applicant is applying for licensure as defined
in sections 114-02-01-01, 114-02-01-02, or 114-02-01-03;
d. Primary source verification of current certification and registration recognized by the
board in each primary modality of practice; and
e. Otherwise an applicant shall meet the unique licensure or practice standard requirements
established by the board under subsection 7 of North Dakota Century Code section
43-62-14.
2. An applicant shall complete a criminal history record check as required in section
114-03-02-01.
3. The expiration date of an initial license must be consistent with the two-year cycle. An
individual who is licensed after September first of a two-year cycle will be issued a license that
will expire at the conclusion of the following two-year cycle.
History: Effective April 1, 2018.
General Authority: NDCC 43-62
Law Implemented: NDCC 12-60-24, 43-62-02, 43-62-14
### § 114-02-01-08. Requirements for temporary license.

An applicant for a temporary license under this chapter may not have an encumbered license or
other restricted practice in any jurisdiction, must meet board requirements; and
1. An applicant shall submit a completed application and the nonrefundable fee required in
chapter 114-01-03; and:
a. Provide evidence of currently meeting all education requirements to include a completed
official transcript or notarized letter from program director; and
b. Shall complete a criminal history record check as required in section 114-03-02-01; and
2. An applicant shall submit evidence that the applicant:
a. Will provide services in a medically underserved area of North Dakota; or
b. Provide documentation of registration time frame for taking the examination or the
applicant is awaiting registration and certification examination results.
3. The temporary license expires at the earlier of one hundred eighty days from issuance or
when the board grants or denies a regular license.
History: Effective April 1, 2018.
General Authority: NDCC 43-62
Law Implemented: NDCC 12-60-24, 43-62-09(15), 43-62-14, 43-62-16(2)
### § 114-02-01-09. Requirements for conditional license.

1. A conditional license under this chapter may be issued provided the applicant does not have
an encumbered license or other restricted practice in any jurisdiction, and provide evidence of

meeting board requirements, including continuing education requirements and training. The
individual shall:
a. Submit a completed application and the nonrefundable fee as required in chapter
114-01-03; and
(1) An official transcript from an accredited educational program; or
(2) Other documents that verify pending or successful completion of a medical imaging
or radiation therapy education program, which:
(a) Has been approved in any jurisdiction that has substantially equivalent
standards; and
(b) Meets or exceeds those requirements in chapter 114-02-01 for each modality
in which the individual is applying for licensure as defined in sections
114-02-01-01, 114-02-01-02, 114-02-01-03, 114-02-01-04, 114-02-01-05, or
114-02-01-06.
b. Submit verification of actively working towards completion of the program requirements.
2. An applicant for a conditional license also shall submit verification of actively working toward
certification and registration; and
a. Meets standards specifically set by the board on a case-by-case basis for continuing
education requirements and training for each modality; or
b. Has met other requirements as established by the board and is actively working toward
meeting the requirements to take the North Dakota state administered examination.
c. Otherwise an applicant must meet the unique licensure or practice standard
requirements established by the board under subsection 7 of North Dakota Century Code
section 43-62-14.
3. A conditional license may be issued to an applicant who began practice after December 31,
2016.
4. The conditional license expires two years from the date of issuance and may be renewed one
time or as otherwise approved by the board.
5. A conditional license may not be renewed if the applicant has attained a license in a primary
modality.
History: Effective April 1, 2018.
General Authority: NDCC 43-62
Law Implemented: NDCC 12-60-24, 43-62-09(15), 43-62-14
### § 114-02-01-10. Grandfather clause.

1. A license may be issued provided the applicant does not have an encumbered license or other
restricted practice in any jurisdiction. The individual:
a. Is eligible to be licensed only within the scope of the individual's current practices;
b. Shall submit verification from a department manager or employer that the individual has
been practicing medical imaging and radiation therapy in a primary modality:
(1) That began practice prior to January 1, 2017; and

(2) Has practiced for three or more of the five years preceding; and
c. Shall be in compliance with the certification organization's continuing education and other
requirements for the modality in which the individual is currently practicing.
2. Otherwise the applicant shall meet the unique licensure or practice standard requirements
established by the board under subsection 7 of North Dakota Century Code section 43-62-14,
which may include one or more of the following:
a. Additional education requirements, such as academic courses or courses of study;
b. A limitation of scope of practice;
c. Evidence of continuing education seminars or workshop;
d. Evidence of departmental accreditation in the relevant modalities of practice, such as
American college of radiology or intersocietal accreditation commission;
e. Onsite evaluation for assurance of meeting the professional guidelines;
f. Verification of on-the-job training; or
g. Other requirements as determined by the board to protect the public health, safety, and
welfare.
3. A grandfathered license is eligible for renewal of such license under the conditions and
standards prescribed in this chapter.
History: Effective April 1, 2018.
General Authority: NDCC 43-62
Law Implemented: NDCC 43-62-02, 43-62-14(7)

Practice Standards Related to Limited X-Ray Machine Operators
Limited x-ray machine operators are limited in scope of practice to only those procedures approved
by the board. Limited x-ray machine operators may not perform fluoroscopic procedures or administer
contrast media or radiopharmaceuticals. Specific procedures or examinations that are allowed in the
scope of practice for limited x-ray machine operators include the following:
Chest: PA, lateral, decubitus
Ribs: AP, PA, obliques
Abdomen: KUB, upright abdomen
Hand and fingers: PA, lateral, oblique
Wrist: PA, lateral, oblique
Forearm: AP, lateral
Elbow: AP, lateral
Humerus: AP, lateral
Shoulder: AP, internal and external rotation, y-view
Clavicle: AP, AP axial
Pelvis: AP
Hips: AP, frog leg lateral, cross-table lateral
Femur: AP, lateral
Knee: AP, lateral, obliques
Patella: AP, lateral, sunrise
Tibia-fibula: AP, lateral
Ankle: AP, lateral, obliques
Calcaneus: Plantodorsal, lateral
Foot and toes: AP, lateral, obliques
Sinuses: Water's, lateral
Skull: AP/PA, lateral
Facial bones: PA, lateral
Nasal bones: Water's, lateral
C-spine: AP, lateral, odontoid, (not trauma), swimmer's (not trauma)
T-spine: AP, lateral, swimmer's (not trauma)
L-spine: AP, lateral, L5-S1 lateral
Any other procedure or examination performed during an emergency and requiring a limited x-ray
machine operator to perform requires a written order from a licensed practitioner with personal
supervision.
Licensees may petition the board to perform procedures and examinations not currently identified
above. One of the criterion utilized by the board includes frequency of performance to consider
approval or justification of expansion of the procedures and examination outlined above.

History: Contingent effective date. See section 75 of 2017 Senate Bill No. 2327.
General Authority: NDCC 43-62
Law Implemented: NDCC 43-62-14(4)(7), 43-62-15(2)
