DEPARTMENT OF LABOR AND ECONOMIC OPPORTUNITY  
DIRECTOR’S OFFICE  
IONIZING RADIATION RULES GOVERNING THE USE OF RADIATION  
MACHINES  
Filed with the secretary of state on March 13, 2024  
These rules become effective immediately after filing with the secretary of state unless  
adopted under sections 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969  
PA 306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become  
effective 7 days after filing with the secretary of state.  
(By authority conferred on the director of the department of labor and economic  
opportunity by sections 13515, 13521, 13522, and 13527 of the public health code, 1978  
PA 368, MCL 333.13515, 333.13521, 333.13522, and 333.13527, and Executive  
Reorganization Order Nos. 1996-1, 1996-2, 2003-1, 2011-4, and 2019-3, MCL 330.3101,  
445.2001, 445.2011, 445.2030, and 125.1998)  
R 333.5201, R 333.5202, R 333.5203, R 333.5204, R 333.5205, R 333.5206, R 333.5207,  
R 333.5208, R 333.5209, R 333.5210, R 333.5211, R 333.5212, and R 333.5213 of the  
Michigan Administrative Code are added, as follows:  
PART 5. OPERATOR QUALIFICATIONS  
R 333.5201 Purpose and scope.  
Rule 5201. (1) This part establishes the qualification requirements of individuals  
engaged in medical radiologic technology. Improper performance of medical radiologic  
technology results in unnecessary exposure to machine produced ionizing radiation and  
the unnecessary re-administration of machine produced ionizing radiation. Therefore, the  
qualification of these individuals to apply machine produced ionizing radiation to  
humans has a direct impact on the machine produced ionizing radiation burden of the  
patient.  
(2) Unless specifically exempt in accordance with R 333.5209, a registrant shall not  
employ an individual to perform medical radiologic technology who does not meet the  
requirements of this part or without the expressed written approval of the department.  
R 333.5202 Definitions; A.  
Rule 5202. (1) “ACRRT” means American Chiropractic Registry of Radiologic  
Technologists.  
(2) "Approved program" means a formal education program in the respective discipline  
of radiography or radiation therapy that is accredited by 1 or more of the following:  
(a) Joint Review Committee on Education in Radiologic Technology.  
October 19, 2023  
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(b) Regional institutional accrediting agencies.  
(c) Conjoint Secretariat of the Canadian Medical Association.  
(3) “ARRT” means American Registry of Radiologic Technologists.  
R 333.5203 Definitions; B.  
Rule 5203. "Bone densitometry" means the science and art of applying machine  
produced ionizing radiation to human beings for the determination of site-specific bone  
density.  
R 333.5204 Definitions; C.to G.  
Rule 5204. (1) “CAMRT” means Canadian Association of Medical Radiation  
Technologists.  
(2) “CBRPA” means Certification Board for Radiology Practitioner Assistants.  
(3) “CCI” means Cardiovascular Credentialing International.  
(4) "Chiropractic radiography" means the science and art of applying machine  
produced ionizing radiation to human beings for diagnostic evaluation of skeletal  
anatomy.  
(5) "Continuing education activity" means a learning activity that is planned,  
organized, and administered to enhance the professional knowledge and skills  
underlying professional performance that a medical radiologic technologist uses to  
provide services for patients, the public, or the medical profession. To qualify as  
continuing education, the activity must be planned and organized t o provide  
sufficient depth and scope of a subject area.  
(6) "CE credit" or continuing education credit means a unit of measurement for  
continuing education activities. One CE credit is awarded for 1 contact hour, which is  
50 minutes. Activities longer than 1 hour are assigned whole or partial credits based on  
the 50-minute hour.  
(7) “Direct supervision” means the required individual must be present in at least  
an adjacent area and immediately available to furnish assistance and direction  
throughout the procedure, and is responsible for the control of quality, radiation safety  
protection, and technical aspects of the application of radiation to human beings for  
diagnostic, therapeutic, or research purposes.  
(8) “General supervision” means the procedure is furnished under the overall  
direction and control of a licensed practitioner whose presence is not required during  
the performance of the procedure., and is responsible for the control of quality,  
radiation safety protection, and technical aspects of the application of radiation to  
human beings for diagnostic, therapeutic, or research purposes.  
R 333.5205 Definitions; L.  
Rule 5205. (1) "Licensed practitioner" means a health practitioner licensed under article  
15 of the public health code, 1978 PA 368, MCL 333.16101 to 333.18838.  
(2) “Limited diagnostic radiographer” means an individual, other than a licensed  
practitioner, who, while under the general supervision of a licensed practitioner, performs  
limited diagnostic radiography.  
(3) “Limited diagnostic radiography” means the science and art of applying machine  
produced ionizing radiation to human beings for limited diagnostic purposes.  
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R 333.5206 Definitions; M.  
Rule 5206. (1) "Medical radiologic technologist" means an individual, other than a  
licensed practitioner, who, while under the general supervision of a licensed  
practitioner performs medical x -radiation procedures involving the application of  
machine produced ionizing radiation to human beings for diagnostic, therapeutic, and  
research purposes.  
(2) "Medical radiologic technology" means the science and art of performing medical  
x -radiation procedures involving the application of machine produced ionizing  
radiation to human beings for diagnostic, therapeutic, and research purposes. The  
specialized disciplines of medical radiologic technology are medical radiography,  
radiation therapy technology, chiropractic radiography, limited diagnostic radiography,  
and radiologist assistant.  
(3) "Medical radiographer" means an individual, other than a licensed practitioner,  
who, while under the general supervision of a licensed practitioner, applies machine  
produced ionizing radiation to a part of the human body.  
(4) "Medical radiography" means the science and art of applying machine produced  
ionizing radiation to human beings for diagnostic, and research purposes.  
R 333.5207 Definitions; P.  
Rule 5207. (1) “Personal supervision” means the required individual i s in  
attendance in the room during the performance of a procedure, and is responsible for  
the control of quality, radiation safety and protection, and technical aspects of the  
application of radiation to human beings for diagnostic, therapeutic, or research  
purposes.  
(2) "Physician's assistant" means an individual who is licensed as a physician's assistant  
under part 170 or part 175 of the public health code, 1978 PA 368, MCL 333.17001 to  
333.17097 and 333.17501 to 333.17556.  
(3) "Podiatric" means a radiographic examination of the toes, foot, ankle, calcaneus, and  
distal tibia/fibula but does not include the knee joint.  
R 333.5208 Definitions; R.  
Rule 5208. (1) "Radiation therapy technology" means the science and art of  
applying radiation emitted from x-ray machines or particle accelerators to human  
beings for therapeutic purposes.  
(2) "Radiologist assistant" means an individual, other than a licensed practitioner, who  
as a medical radiographer with advanced-level training and certification, performs a  
variety of activities under the direct, general, or personal supervision of a radiologist,  
certified by the American Board of Radiology (ABR), the American Osteopathic  
Board of Radiology (AOBR), or Royal College of Physicians and Surgeons of Canada  
(RCPSC), in the areas of patient care, patient management, clinical imaging, and  
interventional procedures. The radiologist assistant shall not interpret images, make  
diagnoses, or prescribe medications or therapies.  
(3) "Radiology" means the branch of medicine that deals with the study and  
application of imaging technology to diagnose and treat disease.  
(4) "RCEEM" or “recognized continuing education evaluation mechanism” means a  
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mechanism used by the ARRT for evaluating the content, quality, and integrity of an  
educational activity. The evaluation shall include a review of education objectives,  
content selection, faculty qualifications, and educational methods and materials.  
R 333.5209 Exemptions.  
Rule 5209. (1) Nothing in this part shall be construed to limit or affect in any respect,  
the medical practice of individuals properly licensed under article 15 of the public health  
code, 1978 PA 368, MCL 333.16101 to 333.18838 with respect to their professions and  
scope of practice.  
(2) The following individuals are exempt from the requirements of this part:  
(a) A student enrolled in an approved program applicable to his or her profession who,  
as a part of his or her course of study, applies machine produced ionizing radiation to  
human beings while under the direct supervision of a licensed practitioner or medical  
radiologic technologist who meets the requirements of this part.  
(b) An individual employed as a dental assistant or dental hygienist who performs  
radiography under the general supervision of a licensed practitioner.  
(c) A nurse, technician, or other assistant who, under the general supervision of a  
licensed practitioner, performs bone densitometry.  
(d) A medical radiologic technologist performing mammography who meets the  
qualification requirements of R 333.5630.  
(e) A computed tomography (CT) operator who meets the qualification requirements  
of R 333.5705.  
(f) A nuclear medicine technologist who, under the supervision of an authorized user,  
utilizes sealed and unsealed radioactive materials for diagnostic, treatment, and research  
purposes.  
R 333.5210 Categories and types of qualification.  
Rule 5210. (1) The department recognizes all of the following categories in the practice  
of medical radiologic technology:  
(a) Medical radiography.  
(b) Radiation therapy technology.  
(c) Radiologist assistant.  
(d) Chiropractic radiography.  
(e) Limited diagnostic radiography.  
(2) The department recognizes the following types of qualifications:  
(a) Active status for individuals who have passed an examination as indicated in R  
333.5211 and who maintain current registration status with the registry providing the  
examination.  
(b) Temporary status for individuals who have completed an approved program in  
medical radiography, radiation therapy technology, radiologist assistant, chiropractic  
radiography, or cardiac catheterization and interventional radiography and are eligible  
for the examination required to obtain the credential or credentials specified in R  
333.5211. Temporary status conveys the same rights as active status. Temporary status  
must not exceed 3 years after completion of the approved program.  
(c) Limited diagnostic radiography for individuals who have completed the training  
required in R 333.5212. Limited diagnostic radiography procedures that require specific  
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limited qualifications are as follows:  
(i) Limited diagnostic radiography – chest:  
(A) Posterior anterior upright.  
(B) Anterior posterior supine.  
(C) Lateral upright.  
(D) Lateral decubitus.  
(E) Anterior posterior lordotic.  
(F) Obliques.  
(ii) Limited diagnostic radiography – extremities:  
(A) Finger or fingers.  
(B) Forearm.  
(C) Shoulder.  
(D) Toes.  
(E) Tibia and fibula.  
(F) Femur.  
(G) Hand.  
(H) Elbow.  
(I) Clavicle.  
(J) Foot.  
(K) Knee.  
(L) Wrist.  
(M) Humerus.  
(N) Scapula.  
(O) Ankle.  
(P) Patella.  
(iii) Limited diagnostic radiography – spine:  
(A) Cervical spine.  
(B) Sacroiliac joints.  
(C) Thoracic spine.  
(D) Sacrum.  
(E) Lumbar spine.  
(F) Coccyx.  
(iv) Limited diagnostic radiography - skull and sinuses:  
(A) Skull.  
(B) Paranasal sinuses.  
(C) Mandible facial bones.  
(v) Limited diagnostic radiography – podiatric:  
(A) Foot.  
(B) Ankle.  
(d) Conditional status for individuals can occur during the 3 years immediately  
following the effective date of this part. A medical radiologic technologist that does not  
meet the requirements of subdivision (a), (b), or (c) of this subrule shall be considered  
qualified contingent upon a written statement of assurance that the individual is  
competent to apply machine produced ionizing radiation to human beings. This statement  
of assurance must be maintained for inspection by the department and must specify the  
nature of the equipment and procedures the individual is competent to utilize. The  
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statement of assurance must be provided by a licensed practitioner under whose general  
supervision the individual is employed or has been employed. Three years after the  
effective date of this part, a medical radiologic technologist shall meet the requirements  
of subdivision (a), (b), or (c) of this subrule.  
R 333.5211 Credentialing requirements.  
Rule 5211. Individuals who seek to qualify for active status in medical radiologic  
technology shall possess the appropriate credential or credentials as specified below or  
equivalent:  
(a) Medical radiography:  
(i) ARRT – radiography (R).  
(ii) CAMRT – registered technologist, radiation technology (RTR).  
(b) Radiation therapy technology:  
(i) ARRT – registered radiation therapists (RTT).  
(ii) CAMRT – registered radiation therapists (RTT).  
(c) Radiologist assistant:  
(i) ARRT – registered radiologist assistant (RRA).  
(ii) CBRPA – radiology practitioner assistant (RPA).  
(d) Chiropractic radiography provided through ACRRT.  
(e) Cardiac catheterization and interventional radiography:  
(i) ARRT – cardiovascular interventional radiography (CV).  
(ii) ARRT – cardiac interventional radiography (CI).  
(iii) ARRT – vascular interventional radiography (VI).  
(iv) CCI – registered cardiovascular invasive specialist (RCIS).  
R 333.5212 Limited diagnostic radiography requirements.  
Rule 5212. (1) Individuals who perform limited diagnostic radiography shall pass an  
approved program or obtain a minimum of 40 hours of training relevant to the radiologic  
science within the limited scope of practice. This training must include both clinical and  
didactic components.  
(2) The following general categories must be included in limited diagnostic radiography  
training or program:  
(a) Fundamentals of healthcare.  
(b) Medical terminology.  
(c) Patient care and management.  
(d) Human anatomy and physiology.  
(e) Imaging production and evaluation.  
(f) Imaging equipment and radiation production.  
(g) Radiation protection and radiobiology.  
(3) In addition to the categories in subrule (2) of this rule, the curriculum must include  
the following:  
(a) Limited chest radiography programs must include instruction on chest radiography  
procedures.  
(b) Limited extremity programs must include instruction on extremity radiographic  
procedures.  
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(c) Limited spine programs must include instruction on spine radiographic procedures.  
(d) Limited skull and sinus programs must include instruction on skull and sinus  
radiographic procedures.  
(e) Limited podiatry programs must include instruction on foot, ankle, and leg below  
the knee radiographic procedures.  
(4) Limited diagnostic radiography programs must be competency-based educational  
programs.  
(5) All limited diagnostic radiographers are required to maintain proof of completion of  
approved program or training.  
R 333.5213 Continuing education requirements.  
Rule 5213. (1) The required number of CE credits for limited diagnostic radiography  
is 12 CE credits.  
(2) CE credits required by subrule (1) of this rule must be completed within 24 months  
after the effective date of these rules and every 24 months after their initial completion.  
(3) The options for meeting CE requirements are any of the following:  
(a) Activities approved by an RCEEM. Among the requirements for qualification as  
an RCEEM, an organization shall be national in scope, non-profit, radiology based, and  
willing to evaluate CE activity developed by a medical radiologic technologist within a  
given discipline. Organizations with current RCEEM status include:  
(i) American College of Radiology.  
(ii) American Healthcare Radiology Administrators.  
(iii) American Institute of Ultrasound in Medicine.  
(iv) American Roentgen Ray Society.  
(v) American Society of Nuclear Cardiology.  
(vi) American Society of Radiologic Technologists.  
(vii) Association of Vascular and Interventional Radiographers.  
(viii) Canadian Association of Medical Radiation Technologists.  
(ix) Medical Dosimetrist Certification Board.  
(x) Radiological Society of North America.  
(xi) Society of Diagnostic Medical Sonography.  
(xii) Section for Magnetic Resonance Technologist of the International Society for  
Magnetic Resonance in Medicine.  
(xiii) Society of Nuclear Medicine Technologist Section.  
(xiv) Society of Vascular Ultrasound.  
(b) Approved academic courses offered by a post-secondary educational institution  
that are relevant to the radiologic sciences or patient care, or both. Courses in the  
biologic sciences, physical sciences, verbal and written communication, mathematics,  
computers, management, or education methodology are considered relevant. Credit is  
awarded at the rate of 12 CE credits for each academic quarter or 16 CE credits for  
each academic semester credit.  
(c) Advanced cardiopulmonary resuscitation (CPR) certification, including advanced  
life support, instructor, or instructor trainer, through the American Red Cross, the  
American Heart Association, or the American Safety and Health Institute is awarded  
6 CE credits.  
(4) All limited diagnostic radiographers are required to maintain proof of participation  
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in continuing education activities. P roof may be in the form of a certificate or an  
itemized list from an ARRT-approved record-keeping mechanism.  
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