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BOARDS AND COMMISSIONS

Board of Medical Imaging and Radiation Therapy

(Amendment)

201 KAR 46:010.Definitions for 201 KAR Chapter 46.

RELATES TO:

KRS 311B.020

STATUTORY AUTHORITY:

KRS 311B.010, 311B.050

CERTIFICATION STATEMENT:

This is to certify that this administrative regulation is in compliance with the requirements of 2025 RS HB 6, Section 8(2) because this administrative regulation is being promulgated to meet a deadline established by 2025 RS HB 72. The Board of Medical Imaging and Radiation Therapy is not one of the agencies that is directed by House Bill 6, Section 8(3) to include a certification by the Governor.

NECESSITY, FUNCTION, AND CONFORMITY:

KRS 311B.010 and 311B.050 require the Board of Medical Imaging and Radiation Therapy to promulgate administrative regulations to regulate medical imaging, radiation therapy, and related occupations. This administrative regulation establishes definitions for terms used in 201 KAR Chapter 46.

Section 1.

Definitions.

(1)

"Accredited educational program" means an educational program accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT), the Joint Review Committee on Educational Programs in Nuclear Medicine Technology (JRCNMT), or other accrediting agencies recognized by the American Registry of Radiologic Technologists (ARRT), which have been approved by the board.

(2)

"Advanced imaging professional" means an individual who holds credentialing by the American Registry of Radiologic Technologists (ARRT) or by the Nuclear Medicine Technology Certification Board (NMTCB) as a registered radiologist assistant (R.R.A.) or nuclear medicine advanced associate (NMAA).

(3)

"Alternate course of study" means an independent course of study that qualifies an individual to take an examination approved by the board.

(4)

"Authorized user" is defined by KRS 311B.020(4).

(5)

"Bedside radiography" means the use of portable x-ray equipment, mobile x-ray equipment, transportable x-ray equipment, or any other nonstationary piece of ionizing radiation emitting equipment used to perform medical imaging.

(6)(5)

"Board" is defined by KRS 311B.020(5).

(7)(6)

"Clinical education" means the component of the educational program that provides for supervised, competency-based, clinical education and experience.

(8)(7)

"Computed tomography" or "CT" means the process of using specialized radiation producing equipment to create cross-sectional images of any part of the body.

(9)(8)

"Computed tomography technologist" or "CT technologist" means an individual who has obtained a post-primary certification in computerized tomography from the American Registry of Radiologic Technologists (ARRT) or the Nuclear Medicine Technology Certification Board (NMTCB).

(10)(9)

"Continuing education" is defined by KRS 311B.020(7).

(11)(10)

"Continuing education unit" or "CEU" means fifty (50) contact minutes of participation in a continuing education experience completed by:

(a)

Attendance at a professional meeting;

(b)

Documenting completed, approved independent study; or

(c)

Documenting completed academic courses applicable to health care, medical imaging, radiation therapy, or related courses.

(12)(11)

"Contrast procedure" means a diagnostic or therapeutic procedure performed while administering contrast media into the human body to visualize anatomy not otherwise demonstrated on an image receptor.

(13)(12)

"Course of study" means a curriculum in radiologic technology, nuclear medicine technology, the advanced imaging profession, limited x-ray machine operation, or radiation therapy approved by the board.

(14)(13)

"Didactic education" means the component of the educational program that provides formal instruction with specific objectives and methods for assessing the student's progress for entry-level competency.

(15)(14)

"Direct supervision" means supervised by, and in the physical presence of, a licensed practitioner of the healing arts.

(16)(15)

"Educational program" means a board-approved, accredited educational program or limited x-ray machine operator program.

(17)(16)

"Facility" means a hospital, outpatient department, clinic, radiology practice, mobile unit, or office of a physician or portion thereof, in which medical imaging or radiation therapy are performed.

(18)(17)

"Indirect supervision" means supervised by a licensed practitioner of the healing arts who is immediately available in person or remotely via telecommunications device.

(19)(18)

"License" means the document issued to a licensee to work as an advanced imaging professional, a medical imaging technologist, a radiographer, a radiation therapist, a nuclear medicine technologist, or a limited x-ray machine operator in Kentucky.

(20)(19)

"Licensed practitioner" or "licensed practitioner of the healing arts" is defined by KRS 311B.020(8).

(21)(20)

"Licensee" means an individual licensed to perform the duties of an advanced imaging professional, a medical imaging technologist, a radiographer, a radiation therapist, a nuclear medicine technologist, or a limited x-ray machine operator.

(22)(21)

"Licensure" means the process by which a license is issued by the board pursuant to 201 KAR Chapter 46 and in accordance with KRS Chapter 311B.

(23)(22)

"Limited radiographic procedures" means the following ~~procedures~~:

(a)

Static x-ray exams~~Radiography~~ of the thorax, lungs, and ribs;

(b)

Static x-ray exams~~Radiography~~ of the abdomen;

(c)

Static x-ray exams~~Radiography~~ of the skull and facial structures;

(d)

Static x-ray exams~~Radiography~~ of the upper and lower extremities;

(e)

Static x-ray exams~~Radiography~~ of the pectoral girdle, hips, and pelvis;

(f)

Static x-ray exams~~Radiography~~ of the cervical, thoracic, and lumbar spines; and

(g)

Bone densitometry ~~procedures~~exams utilizing dedicated Dual Energy X-ray Absorptiometry (DEXA or DXA) equipment.

(24)(23)

"Limited x-ray machine operator" is defined by KRS 311B.020(9).

(25)(24)

"Medical Imaging" means producing visual images of the human body utilizing various types of energy and technologies to determine the presence of disease and injury. Medical imaging is used for diagnostic, screening, treatment and monitoring purposes.

(26)(25)

"Medical imaging technologist" is defined by KRS 311B.020(10).

(27)(26)

"National organization" is defined by KRS 311B.020 (11).

(28)(27)

"Nuclear medicine advanced associate" means an individual certified by the Nuclear Medicine Technology Certification Board (NMTCB) as a nuclear medicine advanced associate (NMAA) who works under the supervision of a radiologist or nuclear medicine physician, in accordance with practice standards.

(29)(28)

"Nuclear medicine technologist" is defined by KRS 311B.020(12).

(30)(29)

"Nuclear medicine technology" means technology applied by a nuclear medicine technologist utilizing radioactive material and with the nuclear medicine technologist being under the supervision of an authorized user.

(31)(30)

"PET" means the positron emission tomography.

(32)(31)

"Positron emission tomography" means the utilization of positron-emitting radioactive material for medical imaging under the supervision of an authorized user.

(33)(32)

"Practice standards" means the standards established by board-approved professional organizations that define the practice expectations of individuals within the professions.

(34)(33)

"Primary discipline" means radiography, nuclear medicine, and radiation therapy.

(35)(34)

"Professional educational guidelines" means curriculum and educational standards established by national organizations and approved by the board.

(36)(35)

"Program director" means an individual designated by a sponsoring institution to assure that the educational programs for an advanced imaging professional, a medical imaging technologist, a radiographer, a radiation therapist, a nuclear medicine technologist, and a limited x-ray machine operator are properly conducted.

(37)(36)

"Provisional nuclear medicine technology license" means a license issued by the board to an individual participating in the alternate nuclear medicine course of study approved by the board.

(38)(37)

"Provisional training license" means a license issued to a nuclear medicine technologist or a radiation therapist pursuing post-primary certification in computed tomography or a license issued to a radiographer or radiation therapist pursuing post-primary certification in PET.

(39)(38)

"Radiation safety officer" means an individual who has the training, knowledge, and responsibility to apply appropriate radiation safety practices.

(40)(39)

"Radiation therapist" is defined by KRS 311B.020(15).

(41)(40)

"Radiation therapy" means the therapeutic administration of ionizing radiation by a radiation therapist.

(42)(41)

"Radioactive materials" means a solid, liquid, or gas that emits ionizing radiation spontaneously.

(43)(42)

"Radiographer" is defined by KRS 311B.020(16).

(44)(43)

"Radiography" means:

(a)

The utilization and administration of ionizing radiation to produce medically relevant images for the diagnosis of injury or disease; and

(b)

Includes a comprehensive scope of diagnostic-radiologic procedures.

(45)(44)

"Radiologist assistant" means an individual certified by the American Registry of Radiologic Technologists (ARRT) as a registered radiologist assistant (R.R.A.) who works under the supervision of a radiologist, in accordance with supervision guidelines jointly established by the American College of Radiology (ACR), the American Society of Radiologic Technologists (ASRT), and the ARRT.

(46)(45)

"Radionuclide" means a radioactive element or a radioactive isotope.

(47)(46)

"Radiopharmaceuticals" means radioactive drugs used for the diagnosis and treatment of disease.

(48)(47)

"Scope of practice" means the parameter of the specific practice.

(49)(48)

"Source of radiation" means a radioactive material, device, or equipment emitting or capable of producing ionizing radiation.

(50)(49)

"Sponsoring institution" means an institution recognized by the board to provide a post-secondary educational program in medical imaging, limited x-ray machine operation, radiation therapy, or advanced imaging professions.

(51)(50)

"Student" means an individual enrolled in a board-recognized educational program.

(52)(51)

"Supervision of students" means supervised by a licensed practitioner of the healing arts or a licensee in the appropriate field of practice who directs the activity of students.

(53)(52)

"Temporary license" means a nonrenewable license issued by the board as established in 201 KAR Chapter 46 permitting an individual to practice for a specified period of time.

(54)(53)

"Therapeutic procedures" means medical treatments that can help diagnose, cure, or treat a patient's condition.

KERI LEAMY, Board Chair

APPROVED BY AGENCY: June 10, 2025

FILED WITH LRC: June 30, 2025 at 4:15 p.m.

PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on September 25, 2025, at 10:00 a.m. Eastern time, in the office of the Board of Medical Imaging and Radiation Therapy, 2365 Harrodsburg Rd, Suite A220, Lexington, Kentucky 40504, (502) 782-5687. Individuals interested in being heard at this hearing shall notify this agency in writing by five workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing was received by that date, the hearing may be cancelled. A transcript of this hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through September 30, 2025. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.

CONTACT PERSON: Elizabeth Morgan, Executive Director, Board of Medical Imaging and Radiation Therapy, 2365 Harrodsburg Rd, Suite A220, Lexington, Kentucky 40504, phone (502) 782-5687; fax (502) 782-6495; email elizabeth.morgan@ky.gov.

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT

Contact Person:

Elizabeth Morgan

(1) Provide a brief summary of:

(a) What this administrative regulation does:

This administrative regulation defines essential terms applicable to the Medical Imaging profession and regulatory process.

(b) The necessity of this administrative regulation:

The Board of Medical Imaging and Radiation Therapy is authorized by KRS 311B.010 to 311B.190 to regulate licensees other than licensed practitioners of the healing arts, including but not limited to: the classification and licensure of medical imaging technologists, radiation therapists, radiologist assistants and limited x-ray machine operators; examinations; standards of education and experience; curricula standards for institutions teaching persons to perform medical imaging and radiation therapy procedures; issuance, renewal, and revocation of licenses; the establishment of a reasonable schedule of fees and charges to be paid by individuals for examinations, licenses and renewal licenses; and to set other standards as may be appropriate for the protection of health and safety. This administrative regulation defines terms used in 201 KAR Chapter 46.

The regulation is in conformity as the authorizing statute gives the board the ability to promulgate regulations regarding the requirements for licensure.

(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:

This regulation establishes definitions used in the requirements for the practice of medical imaging, radiation therapy and related occupations.

(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:

(a) How the amendment will change this existing administrative regulation:

The amendment updates the definition of limited radiographic procedures for clarity and also creates definition for bedside radiography.

(b) The necessity of the amendment to this administrative regulation:

This amendment is necessary to provide clarification of these terms to assure compliance with the scope of practice.

The regulation is in conformity as the authorizing statute gives the board the ability to promulgate regulations regarding the establishment of definition.

(d) How the amendment will assist in the effective administration of the statutes:

This amendment will ensure all "terms of art" used in the regulation have an appropriate definition.

(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:

Approximately 300 state health care organizations and approximately 8,000 licensees.

(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:

(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:

No action is required. The amendment merely defines the terms for 201 KAR Chapter 46.

(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):

There will be no cost associated with this amendment.

Applicants and licensees benefit by having the definitions of terms used within the regulations to clarify the regulations and put the licensee on clear notice.

(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:

(a) Initially:

No new costs will be incurred by the changes.

(b) On a continuing basis:

No additional costs will be incurred by the changes.

(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:

The board’s operations are funded by fees paid by licensees and applicants.

(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:

No fees will increase as a result of this amendment.

(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:

There are no related fees associated with this administrative regulation.

(9) TIERING: Is tiering applied?

(Explain why tiering was or was not used): Tiering was not applied as the regulation is applicable to all licensees and applicants.

FISCAL IMPACT STATEMENT

(1) Identify each state statute, federal statute, or federal regulation that requires or authorizes the action taken by the administrative regulation:

KRS 311B.010 to 311B.190.

(2) State whether this administrative regulation is expressly authorized by an act of the General Assembly, and if so, identify the act:

Although amendment of this administrative regulation is not expressly authorized by an act by the general assembly, it is necessary to conform with 2025 Ky Acts Chapter 132, Section 1 (House Bill 72).

(3)(a) Identify the promulgating agency and any other affected state units, parts, or divisions:

Kentucky Board of Medical Imaging and Radiation Therapy.

(b) Estimate the following for each affected state unit, part, or division identified in (3)(a):

1. Expenditures:

For the first year:

None

For subsequent years:

None

2. Revenues:

For the first year:

None

For subsequent years:

None

3. Cost Savings:

For the first year:

None

For subsequent years:

None

(4)(a) Identify affected local entities (for example: cities, counties, fire departments, school districts):

None

(b) Estimate the following for each affected local entity identified in (4)(a):

1. Expenditures:

For the first year:

n/a

For subsequent years:

n/a

2. Revenues:

For the first year:

n/a

For subsequent years:

n/a

3. Cost Savings:

For the first year:

n/a

For subsequent years:

n/a

(5)(a) Identify any affected regulated entities not listed in (3)(a) or (4)(a):

None

(b) Estimate the following for each regulated entity identified in (5)(a):

1. Expenditures:

For the first year:

n/a

For subsequent years:

n/a

2. Revenues:

For the first year:

n/a

For subsequent years:

n/a

3. Cost Savings:

For the first year:

n/a

For subsequent years:

n/a

(6) Provide a narrative to explain the following for each entity identified in (3)(a), (4)(a), and (5)(a)

(a) Fiscal impact of this administrative regulation:

There is no cost associated with administering this regulation.

(b) Methodology and resources used to reach this conclusion:

This regulation merely defines terms used throughout the 201 KAR Chapter 46. There is no cost associated with administering this regulation.

(7) Explain, as it relates to the entities identified in (3)(a), (4)(a), and (5)(a):

(a) Whether this administrative regulation will have a "major economic impact", as defined by KRS 13A.010(13):

There is no cost associated with administering this regulation.

(b) The methodology and resources used to reach this conclusion:

This regulation merely defines terms used throughout the 201 KAR Chapter 46. There is no cost associated with administering this regulation.

BOARDS AND COMMISSIONS

Board of Medical Imaging and Radiation Therapy

(Amendment)

201 KAR 46:010.Definitions for 201 KAR Chapter 46.

RELATES TO:

KRS 311B.020

STATUTORY AUTHORITY:

KRS 311B.010, 311B.050

CERTIFICATION STATEMENT:

NECESSITY, FUNCTION, AND CONFORMITY:

Section 1.

Definitions.

(1)

(2)

(3)

"Alternate course of study" means an independent course of study that qualifies an individual to take an examination approved by the board.

(4)

"Authorized user" is defined by KRS 311B.020(4).

(5)

(6)

"Board" is defined by KRS 311B.020(5).

(7)

"Clinical education" means the component of the educational program that provides for supervised, competency-based, clinical education and experience.

(8)

"Computed tomography" or "CT" means the process of using specialized radiation producing equipment to create cross-sectional images of any part of the body.

(9)

(10)

"Continuing education" is defined by KRS 311B.020(7).

(11)

"Continuing education unit" or "CEU" means fifty (50) contact minutes of participation in a continuing education experience completed by:

(a)

Attendance at a professional meeting;

(b)

Documenting completed, approved independent study; or

(c)

Documenting completed academic courses applicable to health care, medical imaging, radiation therapy, or related courses.

(12)

"Contrast procedure" means a diagnostic or therapeutic procedure performed while administering contrast media into the human body to visualize anatomy not otherwise demonstrated on an image receptor.

(13)

(14)

(15)

"Direct supervision" means supervised by, and in the physical presence of, a licensed practitioner of the healing arts.

(16)

"Educational program" means a board-approved, accredited educational program or limited x-ray machine operator program.

(17)

"Facility" means a hospital, outpatient department, clinic, radiology practice, mobile unit, or office of a physician or portion thereof, in which medical imaging or radiation therapy are performed.

(18)

"Indirect supervision" means supervised by a licensed practitioner of the healing arts who is immediately available in person or remotely via telecommunications device.

(19)

(20)

"Licensed practitioner" or "licensed practitioner of the healing arts" is defined by KRS 311B.020(8).

(21)

(22)

"Licensure" means the process by which a license is issued by the board pursuant to 201 KAR Chapter 46 and in accordance with KRS Chapter 311B.

(23)

"Limited radiographic procedures" means the following:

(a)

Static x-ray exams of the thorax, lungs, and ribs;

(b)

Static x-ray exams of the abdomen;

(c)

Static x-ray exams of the skull and facial structures;

(d)

Static x-ray exams of the upper and lower extremities;

(e)

Static x-ray exams of the pectoral girdle, hips, and pelvis;

(f)

Static x-ray exams of the cervical, thoracic, and lumbar spines; and

(g)

Bone densitometry exams utilizing dedicated Dual Energy X-ray Absorptiometry (DEXA or DXA) equipment.

(24)

"Limited x-ray machine operator" is defined by KRS 311B.020(9).

(25)

(26)

"Medical imaging technologist" is defined by KRS 311B.020(10).

(27)

"National organization" is defined by KRS 311B.020 (11).

(28)

(29)

"Nuclear medicine technologist" is defined by KRS 311B.020(12).

(30)

(31)

"PET" means the positron emission tomography.

(32)

"Positron emission tomography" means the utilization of positron-emitting radioactive material for medical imaging under the supervision of an authorized user.

(33)

"Practice standards" means the standards established by board-approved professional organizations that define the practice expectations of individuals within the professions.

(34)

"Primary discipline" means radiography, nuclear medicine, and radiation therapy.

(35)

"Professional educational guidelines" means curriculum and educational standards established by national organizations and approved by the board.

(36)

(37)

"Provisional nuclear medicine technology license" means a license issued by the board to an individual participating in the alternate nuclear medicine course of study approved by the board.

(38)

(39)

"Radiation safety officer" means an individual who has the training, knowledge, and responsibility to apply appropriate radiation safety practices.

(40)

"Radiation therapist" is defined by KRS 311B.020(15).

(41)

"Radiation therapy" means the therapeutic administration of ionizing radiation by a radiation therapist.

(42)

"Radioactive materials" means a solid, liquid, or gas that emits ionizing radiation spontaneously.

(43)

"Radiographer" is defined by KRS 311B.020(16).

(44)

"Radiography" means:

(a)

The utilization and administration of ionizing radiation to produce medically relevant images for the diagnosis of injury or disease; and

(b)

Includes a comprehensive scope of diagnostic-radiologic procedures.

(45)

(46)

"Radionuclide" means a radioactive element or a radioactive isotope.

(47)

"Radiopharmaceuticals" means radioactive drugs used for the diagnosis and treatment of disease.

(48)

"Scope of practice" means the parameter of the specific practice.

(49)

"Source of radiation" means a radioactive material, device, or equipment emitting or capable of producing ionizing radiation.

(50)

(51)

"Student" means an individual enrolled in a board-recognized educational program.

(52)

"Supervision of students" means supervised by a licensed practitioner of the healing arts or a licensee in the appropriate field of practice who directs the activity of students.

(53)

"Temporary license" means a nonrenewable license issued by the board as established in 201 KAR Chapter 46 permitting an individual to practice for a specified period of time.

(54)