Tennessee Radiology License: Requirements, Exam, and Renewal

To work as an x-ray operator in a Tennessee physician’s office, you need a Tennessee radiology license issued by the Board of Medical Examiners, and the Board offers two versions: a limited certification for a defined list of anatomical exams, and a full certification for holders of national ARRT credentials. The governing statute is Tenn. Code Ann. 63-6-224, and once your file is complete the Board takes about six weeks to process an application.¹

Which Certification You Need

The choice between limited and full certification is really a choice about what you’ll be allowed to do at the machine. It’s worth settling before you spend anything on training or exams.

A limited certification covers static diagnostic radiography in specific anatomical areas listed on your certificate: chest, extremities, skull, sinuses, and spine. Limited holders cannot perform CT, fluoroscopy (including C-arm work in surgery), any procedure using oral or IV contrast, MRI, ultrasound, or any invasive radiologic procedure. The application fee is $100 plus a $10 state regulatory fee.

A full certification is available to anyone holding current, unrestricted ARRT certification or an equivalent national credential the Board accepts. Full certification allows any radiographic procedure within the American Society of Radiologic Technologists’ scope of practice for radiographers. Bone densitometry sits outside the Board’s scope even for full holders. The application fee is $50 plus the $10 regulatory fee.²

Regardless of which certificate you hold, x-ray procedures may only be performed when ordered by a licensed physician and under the supervision of a licensed practitioner.³

Education Requirements

For full certification, the education requirement is satisfied by completing an accredited radiologic technology program and earning ARRT credentials. The Board treats ARRT certification as proof you meet the educational bar, so there is no separate Tennessee training program to complete on top of it.

For limited certification, you must complete a Board-accredited educational program that covers the specific anatomical areas you plan to practice in. The Board sets the minimum curricula and hours through its administrative rules and maintains its own accreditation of these training courses; it can withdraw accreditation from programs that don’t meet standards.³

Every applicant must also demonstrate U.S. citizenship or federal work authorization, verified through the SAVE program.⁴

The Exam

Tennessee doesn’t administer a separate state exam. The Board relies on ARRT.

Full certification applicants take the ARRT primary Radiography examination. Limited certification applicants take the ARRT Limited Scope of Practice in Radiography exam, which pairs a core module everyone completes with procedure modules matching the anatomical areas you want on your certificate (chest, extremities, skull and sinuses, spine, or podiatric).

Both exams use a scaled scoring system from 1 to 99, and you need at least 75 to pass. That figure is not a percentage of correct answers; the raw number of questions you need right varies by form so difficulty stays consistent.⁵

Once ARRT has established your eligibility, you get three attempts within three years. Miss that window and you’ll have to complete the professional education requirements again before re-establishing eligibility.⁶ The current ARRT primary examination fee is $225.⁷

How to Apply

Applications go through the Tennessee Department of Health’s online Licensure and Regulatory System (LARS). You’ll provide personal information, educational history, and documentation of your training or ARRT credentials. If you’ve been certified in another state, plan on requesting verification from that state’s licensing board.

Fees:

Limited certification: $100 application fee plus $10 state regulatory fee
Full certification: $50 application fee plus $10 state regulatory fee

Fees are non-refundable.²

h3>Background Check

Tennessee law authorizes the Board to require a fingerprint-based criminal background check before issuing any health-care certification. Fingerprints go through the Tennessee Bureau of Investigation and on to the FBI.⁸ Disclose any criminal history on the application. A conviction that surfaces later in the background check and wasn’t disclosed can be a denial in itself, separate from the underlying offense.

Timeline

Materials mailed to the Board take about 14 working days to be received and filed. After a complete application is on file, average processing runs six weeks.¹ Missing documents, unresolved background-check issues, or questions about out-of-state credentials are the usual reasons an application stalls.

Working While You Wait

Tennessee builds in narrow windows for practicing without a certificate in hand. Students in a Board-recognized training program can perform procedures within or under the auspices of that program. After completing training, you have up to six months to sit for the exam while continuing to practice. And after taking the exam, you can work up to 75 days while waiting for scores.³ Outside those windows, performing x-ray procedures without certification is illegal.

What Your Certificate Lets You Do

A limited certificate holder is restricted to static diagnostic radiography in the anatomical areas printed on the certificate. The Board’s rules place hard boundaries around limited practice: no contrast media (oral or IV), no CT or fluoroscopy including surgical C-arm work, no MRI or ultrasound, and no invasive radiologic procedures.

Full certificate holders can perform any radiographic procedure within the ASRT’s scope of practice for radiographers, again with bone densitometry excluded from the Board’s scope.² Practicing beyond your scope is grounds for losing the certificate you have.

Contrast procedures and sedation have historically carried the strictest supervision rule under Tenn. Comp. R. & Regs. 0880-05-.12: the ordering physician must be physically present at the site during the procedure. In November 2025 the Board approved an amendment that would align contrast supervision with the CMS direct-supervision framework and incorporate training requirements referencing ACLS and contrast-allergy training. The amendment is still moving through the state rulemaking process and has not yet been published as a final rule, so the physical-presence requirement remains in effect.

Renewal and Continuing Education

Tennessee certifications renew every two years. The biennial renewal fee is $50 plus a $10 state regulatory fee. Renewal notices are mailed 60 days before expiration to the address on file, but keeping that address current is your responsibility; not receiving a notice doesn’t excuse a late renewal.⁹

Every certified operator must complete 20 hours of radiologic-related continuing education per biennium. At least two of those hours must cover Tennessee statutes, rules, and regulations, including penalties for noncompliance. For fully certified holders, that regulatory portion must also address the ARRT’s Standards of Ethics.¹⁰

ARRT separately requires 24 Category A or A+ credits per biennium to maintain national registration.¹¹ Full certificate holders have to satisfy both requirements. In practice, courses that count toward one usually count toward the other, but check that your CE plan includes the Tennessee-specific regulatory hours ARRT courses may not cover.

Falsely claiming CE you didn’t complete is grounds for decertification. So is simply failing to earn the hours. The Board audits and can require proof of completion.

Reinstating a Lapsed Certification

If your certification lapses, reinstatement requires documentation of all required continuing education for every year you didn’t renew, payment of all past-due renewal fees, and a $100 late renewal/reactivation fee.² The longer the lapse, the more back CE and fees accumulate. Reinstatement forms must be printed, completed, and mailed to the Board; the online portal doesn’t handle them.

If the Board Disciplines or Denies You

The Board investigates complaints and can discipline x-ray operators under the same authority and procedures used for medical licenses. Common triggers are practicing without a valid certification, working outside your certified scope, falsifying records, and failing to comply with supervision requirements. Sanctions range from fines and mandatory remedial training to suspension or revocation, and fraud or patient harm can be referred for criminal prosecution. Disciplinary actions are public record.

If the Board takes an adverse action, you have the right to a contested-case hearing before an administrative law judge under the Tennessee Administrative Procedures Act, where you can present evidence and cross-examine witnesses.¹² If the hearing goes against you, you can petition for judicial review in chancery court within 60 days of the Board’s final order. The petition can be filed in the chancery court nearest your residence, nearest where the cause of action arose, or in Davidson County, at your choice.¹³

1
Tennessee Department of Health. Medical X-Ray Operator Application and Checklist
2
Tennessee Secretary of State. Tennessee Board of Medical Examiners – General Rules and Regulations Governing the Utilization of X-Ray Operators in Physicians Offices
3
Justia. Tennessee Code 63-6-224 – Board Authority on X-Ray Equipment – Certificates and Accreditations – Requirements to Perform X-Ray Procedures – Limitations
4
Justia. Tennessee Code 4-58-103 – Verification of Citizenship of Applicants for Benefits
5
American Registry of Radiologic Technologists (ARRT). Exam Scoring
6
American Registry of Radiologic Technologists (ARRT). Three Year Rule
7
American Registry of Radiologic Technologists (ARRT). Application Fees
8
Justia. Tennessee Code 63-1-116 – Criminal Background Checks for Health Care Providers
9
Tennessee Department of Health. X-Ray Operators
10
Legal Information Institute. Tennessee Compilation of Rules and Regulations 0880-05-.09 – Continuing Education
11
American Registry of Radiologic Technologists (ARRT). Continuing Education and Renewal Registered
12
Justia. Tennessee Code 4-5-312 – Procedure at Hearing
13
Justia. Tennessee Code 4-5-322 – Judicial Review