Updated October 2026.
If you’re an experienced radiologic technologist looking for more responsibility, the radiologist assistant (RA) role is one of the most advanced paths in imaging. It’s also one of the least known, with only a handful of training programs in the country. Here’s what RAs do, what it takes to become one and how to decide whether it’s worth it for you.
Key takeaways
- A radiologist assistant is an advanced-level radiologic technologist who works under the supervision of a radiologist, performing procedures such as fluoroscopy and patient assessments.
- To earn ARRT’s Registered Radiologist Assistant (R.R.A.) credential, you need R.T.(R) certification, two years of clinical experience, a master’s degree and completion of an ARRT-recognized RA program.
- As of February 2026, only six RA programs were recognized by ARRT.
- Programs are costly. One online master’s program lists about $70,700 in tuition and fees.
- Pay can be high, but national data are limited, and the role isn’t recognized or used the same way everywhere.
What does a radiologist assistant do?
Radiologist assistants extend the work of radiologists. Under radiologist supervision, they may:
- Perform fluoroscopic procedures, such as swallow studies, upper GI series and joint injections, depending on state rules and facility policies.
- Assess and manage patients before, during and after procedures.
- Review images and share initial observations with the radiologist.
- Help with patient education, consent and follow-up.
RAs do not give official interpretations of images. The radiologist remains responsible for the final report.
Requirements for the R.R.A. credential
According to ARRT, you need:
| Requirement | Details |
|---|---|
| Supporting credential | Current ARRT certification and registration in radiography, R.T.(R) |
| Degree | A master’s or doctoral degree (a bachelor’s was accepted only for people who started before January 1, 2023) |
| Clinical experience | Two years of clinical experience in radiography (one year for those who finished an RA program before January 1, 2025) |
| Education | Completion of an ARRT-recognized radiologist assistant program |
| Ethics and exam | Meet ARRT ethics requirements and pass the R.R.A. exam |
The recognized RA programs
In February 2026, ARRT listed six recognized radiologist assistant programs:
- Loma Linda University (California)
- Midwestern State University (Texas)
- Quinnipiac University (Connecticut)
- Rutgers, The State University of New Jersey
- University of North Carolina at Chapel Hill
- Weber State University (Utah)
Two examples of how they work:
- Loma Linda University: an online master’s program (MSRS) that takes 21 months. It requires a bachelor’s degree, ARRT certification and two years of experience. Tuition and fees for 2026–27 are listed at $37,181 for the first year and $33,478 for the second.
- Weber State University: a hybrid master’s program (MSRS) with an RA emphasis, 62 credit hours including clinical preceptorships. Students attend campus a few times a semester and must find their own radiologist preceptor and clinical site.
How much do radiologist assistants earn?
In the ASRT’s 2024 wage survey, radiologist assistants reported an average full-time base pay of $126,428, compared with $73,274 for radiographers. But only 15 RAs answered, so this figure could be off by a wide margin. Treat it as a rough indication, not a guarantee.
The BLS doesn’t publish separate data for radiologist assistants.
Where RAs can work
State rules matter. According to the ASRT, 36 states and Washington, D.C. have some form of regulation for radiologist assistants, such as a license or certificate. What RAs are allowed to do varies by state and facility.
Federal payment rules also shape the role. Since a 2019 Medicare rule change, RAs can perform certain fluoroscopy procedures under direct supervision, meaning the radiologist must be available but not necessarily in the room. Medicare doesn’t currently have a specific payment pathway for RA services. A bill to create one, the Medicare Access to Radiology Care Act, was reintroduced in 2026.
Pros and cons
Pros:
- More responsibility and patient interaction than most technologist roles.
- Potentially higher pay.
- Variety: procedures, patient care and teamwork with radiologists.
- A master’s degree that can also open doors to teaching or leadership.
Cons:
- High cost and time commitment, often while working.
- Very few programs, so you may need online or hybrid study and to find your own clinical preceptor.
- The role isn’t available at every facility, and some employers don’t know what RAs can do.
- State rules and Medicare payment limits can restrict what you’re allowed to do.
Is it worth it?
It can be, if:
- You enjoy procedures and patient care and want more clinical responsibility.
- There are RA jobs, or a radiology group interested in hiring one, where you want to live.
- You can manage the cost, for example with employer tuition help.
It may not be the best fit if you mainly want higher pay with less education. Adding CT or MRI credentials, or moving into travel or leadership roles, can raise your pay with far less cost.
Some technologists also compare the RA path with becoming a physician assistant (PA). PAs have broader scope across medicine, but PA school means starting a new program from scratch.
Before you apply: talk with working RAs and radiologists in your area, and ask local employers whether they hire RAs.
Frequently asked questions
Is a radiologist assistant the same as a radiology practitioner assistant (RPA)? They’re similar. The RPA was a separate credential. ARRT opened a pathway for RPAs to earn the R.R.A. in 2017.
Can a radiologist assistant read X-rays? RAs can review images and share initial observations, but they don’t issue official interpretations. The radiologist makes the final report.
How long does it take to become an RA? Usually at least two years of experience as a radiographer, plus about two years in a master’s-level RA program.
Do I need a bachelor’s degree first? Yes. Master’s programs require a bachelor’s degree for admission.
Sources
- American Registry of Radiologic Technologists (ARRT): Registered Radiologist Assistant eligibility requirements; ARRT extends recognition of three R.R.A. programs (February 5, 2026).
- Loma Linda University: Radiologist Assistant MSRS (online).
- Weber State University: Master of Science in Radiologic Sciences, Radiologist Assistant emphasis.
- American Society of Radiologic Technologists (ASRT): Radiologic Technologist Wage and Salary Survey 2024; Individual state licensure.
- Reed Smith: Proposal to provide Medicare payment to radiologists for RA services (May 2026).
Requirements, costs and laws change. Check with ARRT, programs and your state before you decide.