Title 201 | Chapter 046 | Regulation 081E
201 KAR 46:081REG
A proposed version of this document exists.
PREVIOUS VERSION
The previous document that this document is based upon is available.
STATEMENT OF EMERGENCY
201 KAR 46:081E
This emergency amendment to the existing administrative regulation is being promulgated under KRS 13A.190(1)(a)(3) to meet an imminent deadline for the promulgation of an administrative regulation that is established by state statute or federal law. KRS 311B.050 requires the Board for Medical Imaging and Radiation Therapy ("Board") to promulgate administrative regulations to administer and enforce this chapter. 2025 RS HB 72, effective June 27, 2025, updates the definition of a limited x-ray machine operator. The current administrative regulation needs to be updated to provide further clarification as a result; therefore, the Board requests to make emergency adjustments to the administrative regulation to comply with this update.
KERI LEAMY, Board Chair
ANDY BESHEAR, Governor
BOARDS AND COMMISSIONS
Board of Medical Imaging and Radiation Therapy
(Emergency Amendment)
201 KAR 46:081E.Limited X-Ray machine operator.
Section 1.
Applicability. This administrative regulation shall apply to individuals who perform limited diagnostic radiography while under the direct supervision or indirect supervision of a licensed practitioner of the healing arts.Section 2.
Pathway to the Limited X-ray Machine Operator License.(1)
An applicant shall complete a board-approved postsecondary educational program that meets the curricular standards of Section 6 of this administrative regulation and successfully pass the Kentucky Limited Scope Exam as referenced in Section 3 of this administrative regulation.(2)
If an applicant qualifies for licensure under KRS 12.245, 12.354, or 12.357, the applicant shall submit and satisfy the requirements of Section 4(1) through (6) of this administrative regulation, and shall submit form DD-214 or other proof of active or prior military service for the applicant or spouse of the applicant.Section 3.
Application for Temporary Limited X-ray Machine Operator License.(1)
An applicant who has completed an educational program shall submit:(a)
A completed and signed application Form KBMIRT Form 5;(b)
A nonrefundable, non-transferrable temporary limited x-ray machine operator application and license fee as mandated in 201 KAR 46:020, Section 5, unless the fee is waived in accordance with KRS 311B.140;(c)
The satisfactory results of a criminal background check completed within the past six (6) months in state of residence and employment and any other state of residence and employment within the past five (5) years; and(d)
A copy of a government-issued photo ID.(2)
The temporary limited x-ray machine operator license shall be effective for up to one (1) year from date of program completion and shall not be renewable.(3)
Upon completion of the limited x-ray machine operator educational program, individuals shall:(a)
Apply for the Kentucky Limited Scope Exam; and(b)
Submit the nonrefundable, non-transferrable limited x-ray machine operator examination fee as mandated in 201 KAR 46:020, Section 9.(4)
An individual shall successfully pass the Kentucky Limited Scope Exam, administered by the American Registry of Radiologic Technologists (ARRT) within one (1) calendar year of program completion and prior to the expiration date of the temporary license, except in the case of instances such as, disability, major illness, accident, or if an active duty member of the Armed Forces of the United States and at the discretion of the board.(5)
If a temporary licensee has successfully passed the Kentucky Limited Scope Exam prior to the expiration date of the temporary license, the licensee shall be issued a limited x-ray machine operator license, which shall expire on the last day of the licensee's birth month. If the limited x-ray machine operator license is first issued to an individual less than six (6) months before the individual's birth month, the license issued to the individual shall not expire on that date, but instead it shall expire at the last day of the individual's birth month in the following calendar year.Section 4.
Application for Initial Limited X-ray Machine Operator License. An Applicant shall submit:(1)
A completed and signed application, KBMIRT Form 4;(2)
A nonrefundable initial application and license fee as established in 201 KAR 46:020, Section 1, unless the fee is waived in accordance with KRS 311B.140;(3)
The results of a criminal background check completed within the past six (6) months in the state of residence and employment, and any other state of residence and employment within the past five (5) years;(4)
A copy of government-issued photo ID;(5)
Documentation of passing results of the Kentucky Limited Scope Exam within one (1) calendar year of program completion, except in the case of instances such as, disability, major illness, accident, or if an active duty member of the Armed Forces of the United States and at the discretion of the board; and(6)
Verification of graduation from an educational program for limited x-ray machine operators approved by the board.Section 5.
The issued license shall identify the licensee as a limited x-ray machine operator. The license shall also identify the category as general, bone densitometry, or podiatry.Section 6.
Curricular Standards for Educational Program. This administrative regulation applies to institutions offering a postsecondary educational program for limited x-ray machine operators.(1)
Programs for general limited x-ray machine operators shall:(a)
Meet the curricular standards established by the American Society of Radiologic Technologists (ASRT);(b)
Include a minimum of 240 classroom hours of didactic instruction and 360 clinical hours of education which shall include supervised practice and demonstration of clinical competency until June 30, 2027;(c)
Beginning July 1, 2027, include a minimum of 480 classroom hours of didactic instruction and a minimum of 700 clinical clock hours of education that shall include supervised practice and demonstration of clinical competency;(d)
Supply data requested for a complete evaluation of its administration, organization, faculty, physical facilities, student policies, and curriculum;(e)
Provide a structured curriculum with clearly written course descriptions, lesson plans, and objectives;(f)
Provide an adequate faculty, which shall be qualified through academic preparation or experience to teach the subjects assigned;(g)
Employ a program director who is a licensed radiographer with a minimum of three (3) years of clinical or teaching experience or a combination of clinical and teaching experience;(h)
Provide a one-to-one licensee-to-student ratio consistent with professional educational guidelines in the appropriate field of practice;(i)
Provide appropriate facilities, diverse patient populations, sufficient volume, and a variety of diagnostic exams to properly conduct the educational program;(j)
Prohibit students from applying radiation to human beings for diagnostic purposes until they have obtained practical experience and have had their performance evaluated as satisfactory by the program faculty;(k)
Provide direct or indirect supervision by a licensed practitioner of the healing arts or a licensee as required by the student's level of competency;(l)
Prohibit students from administering radiation to a human being unless under direct or indirect supervision as required by the student's level of competency;(m)
Maintain records of each student's attendance, grades, clinical competency, and subjects completed;(n)
Designate a radiation safety officer; and(o)
Permit site inspections by the board's representative.(2)
Programs for limited podiatry x-ray machine operators shall:(a)
Consist of instruction that reflects current modules of the Examination Content Specifications - Limited Scope of Practice in Radiography published by the ARRT. The curriculum shall include items such as:1.
Safety, including radiation physics; radiation protection, including personnel protection; radiation exposure, monitoring, and radiation units; biological effects of radiation; low-dose technique and minimizing patient exposure; applicable federal and state radiation regulations;2.
Image Production, including principle of the radiographic equipment; image acquisition and technical evaluation; equipment operation and quality assurance; developing and using technique charts; and3.
Patient Care, including patient interactions and management; and(b)
Consist of at least six (6) months of clinical experience of static x-ray exams of the foot and ankle while under the direct supervision of a licensed practitioner of the healing arts, a licensed radiologic technologist, or a licensed limited x-ray machine operator.(3)
Programs for limited bone densitometry x-ray machine operators shall:(a)
Consist of instruction that reflects current content categories of the Examination Content Specifications - Bone Densitometry Equipment Operator published by the ARRT. The curriculum shall include items such as:1.
Patient Care, including osteoporosis, bone physiology, bone health and patient education, and patient preparation;2.
Safety, including fundamental principles, biological effects of radiation, units of measurement, and radiation protection; and3.
Image Production, including fundamentals of x-ray production, quality control, measuring and determining quality in bone mineral density; and(b)
Consist of at least six (6) months of bone densitometry clinical experience under the direct supervision of a licensed practitioner of the healing arts, a licensed radiologic technologist, or a licensed limited x-ray machine operator.Section 7.
Approved Limited Radiographic Procedures. An individual who holds a limited x-ray machine operator license is limited to performing the procedures authorized for his or her license as described in subsections (1), (2), and (3) of this section.(1)
An individual holding a general limited x-ray machine operator license shall perform only 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; and(f)
Static x-ray exams of the cervical, thoracic, and lumbar spines.(2)
An individual holding a limited podiatry x-ray machine operator license shall perform static x-ray exams on the foot and ankle only.(3)
An individual holding a limited bone densitometry x-ray machine operator license shall perform bone densitometry exams utilizing dedicated Dual Energy X-ray Absorptiometry (DEXA or DXA) equipment only.(4)
A limited x-ray machine operator shall comply with the Limited X-ray Machine Operator Practice Standards as incorporated by reference in 201 KAR 46:035, Section 4.(5)
A limited x-ray machine operator shall not:(a)
Perform contrast, fluoroscopy, mammography, computed tomography, magnetic resonance imaging, bedside radiography, nuclear medicine, positron emission tomography, or radiation therapy procedures;(b)
Operate or manipulate equipment utilized in fluoroscopy, mammography, computed tomography, magnetic resonance imaging, bedside radiography, nuclear medicine, positron emission tomography, or radiation therapy procedures.Section 8.
Continuing Education Requirements. Licensees shall complete and document twelve (12) hours of continuing education biennially as required by 201 KAR 46:060. A minimum of six (6) hours shall be related to radiation safety or medical imaging.Section 9.
Continuing Education Audit Process.(1)
The board shall select a sample of twenty-five (25) percent of limited x-ray machine operator licensees to audit for continuing education compliance annually.(2)
The board shall send each licensee selected for audit a notification of audit.(3)
Each licensee shall maintain his or her personal files such as certificates or records of credit from approved continuing education programs from the current biennium and immediate prior biennium.(4)
A licensee selected for audit shall complete KBMIRT Form 8, as incorporated by reference in 201 KAR 46:060, and provide the board with a copy of his or her certificates or records of completion.(5)
Failure to comply with an audit may result in nonrenewal, suspension or revocation of license.Section 10.
Renewal of License. A licensee shall renew annually prior to the expiration of his or her current license, which is the last day of the licensee's birth month, by:(1)
Completing KBMIRT Form 6; and(2)
Submitting the Renewal License Fee in accordance with 201 KAR 46:020, Section 2, unless the fee is waived in accordance with KRS 311B.140.Section 11.
Reinstatement of Lapsed License. A licensee who has allowed the license to lapse for up to twelve (12) months is eligible to be reinstated upon submission of KBMIRT Form 6, documentation of twelve (12) hours of continuing education, and the payment of reinstatement and renewal fees pursuant to 201 KAR 46:020, Sections 2 and 7, unless the fees are waived in accordance with KRS 311B.140. A licensee whose license has lapsed for more than twelve (12) months shall:(1)
Successfully pass the Kentucky Limited Scope Exam;(2)
Submit a completed and signed application KBMIRT Form 4;(3)
Submit a nonrefundable initial application and license fee and reinstatement fee as mandated in 201 KAR 46:020, Sections 1 and 7, unless the fees are waived in accordance with KRS 311B.140;(4)
Submit satisfactory results of a criminal background check completed within the past six (6) months in state of residence and employment and any other state of residence and employment within the past five (5) years; and(5)
Submit a copy of a government-issued photo ID.Section 12.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
KBMIRT Form 4, "Limited X-ray Machine Operator License Application", October 2023;(b)
KBMIRT Form 5, "Temporary Limited X-ray Machine Operator License Application", October 2023;(c)
KBMIRT Form 6, "Limited X-ray Machine Operator Renewal Application", October 2023;(d)
"Examination Content Specifications - Limited Scope of Practice in Radiography", January 2023; and(e)
"Examination Content Specifications - Bone Densitometry Equipment Operator", January 2023.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Board of Medical Imaging and Radiation Therapy, 2365 Harrodsburg Road, Suite A220, Lexington, Kentucky 40504, Monday through Friday, 8 a.m. to 4:30 p.m. This material is also available on the board's website at https://kbmirt.ky.gov.HISTORY: COMPILER'S NOTE: 2025 RS HB 6, enacted by the General Assembly on March 27, 2025, altered the information to be provided at the time an administrative regulation is filed. Aside from formatting changes necessary to upload the regulation into the LRC's publication application, this regulation has been published as submitted by the agency.
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 August 27, 2025, at 1:00 p.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 August 31, 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 establishes the qualifications and process for licensure of a limited x-ray machine operator.
(b) The necessity of this administrative regulation:
This administrative regulation is necessary to establish the standards and qualifications for licensure of a limited x-ray machine operator.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS Chapter 311B authorizes the board to determine and establish the standards and qualifications for licensure of a limited x-ray machine operator.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This regulation establishes standards and qualifications for licensure of a limited x-ray machine operator.
(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 revises 201 KAR 46:081 to remove the employment prohibition of the limited x-ray machine operator, provide updated curricular standards for the board-approved education programs, and clarify the scope of practice for the limited x-ray machine operator.
(b) The necessity of the amendment to this administrative regulation:
The necessity of the amendment is to conform with 2025 Ky Acts Chapter 132, Section 1 (House Bill 72) as limited x-ray machine operators commence practice in settings previously not authorized.
(c) How the amendment conforms to the content of the authorizing statutes:
(d) How the amendment will assist in the effective administration of the statutes:
This administrative regulation establishes the procedures for the board to issue and renew the licenses of limited x-ray machine operators.
(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, approximately 6 educational entities that provide board-approved education, and approximately 8,000 licensees, of which approximately 800 are limited x-ray machine operators.
(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:
The regulated entities will need to take the following actions to comply: Healthcare organizations: While these organizations may employ the limited x-ray machine operator in facilities where advanced imaging equipment is also present, the organizations should note the licensee’s limited scope of practice; Education providers for the limited x-ray machine operator: Current board-approved education providers will be required to adjust curriculum standards to comply with amendments and will have approximately two (2) years to implement these changes; and Licensees: All licensees should be aware of the limited scope of practice as the limited x-ray machine operator may be employed in facilities where advanced imaging equipment is also present.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There is no foreseen cost associated with the entities identified in question 3.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Limited x-ray machine operators will benefit by being able to seek employment in facilities where advanced imaging equipment is also present. (5) Provide an estimate of how much it will cost to implement this administrative regulation: No additional cost will be incurred as a result of amending this administrative regulation.
(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 ongoing 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 increase in fees will be necessary to implement this administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This amendment will not increase any fees.
(9) TIERING: Is tiering applied?
Tiering was not applied. This regulation does not distinguish between similarly situated individuals on the basis of any factor.
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.
STATEMENT OF EMERGENCY
201 KAR 46:081E
This emergency amendment to the existing administrative regulation is being promulgated under KRS 13A.190(1)(a)(3) to meet an imminent deadline for the promulgation of an administrative regulation that is established by state statute or federal law. KRS 311B.050 requires the Board for Medical Imaging and Radiation Therapy ("Board") to promulgate administrative regulations to administer and enforce this chapter. 2025 RS HB 72, effective June 27, 2025, updates the definition of a limited x-ray machine operator. The current administrative regulation needs to be updated to provide further clarification as a result; therefore, the Board requests to make emergency adjustments to the administrative regulation to comply with this update.
KERI LEAMY, Board Chair
ANDY BESHEAR, Governor
BOARDS AND COMMISSIONS
Board of Medical Imaging and Radiation Therapy
(Emergency Amendment)
201 KAR 46:081E.Limited X-Ray machine operator.
Section 1.
Applicability. This administrative regulation shall apply to individuals who perform limited diagnostic radiography while under the direct supervision or indirect supervision of a licensed practitioner of the healing arts.Section 2.
Section 3.
Pathway to the Limited X-ray Machine Operator License.(1)
An applicant shall complete a board-approved(2)
If an applicant qualifies for licensure under KRS 12.245, 12.354, or 12.357, the applicant shall submit and satisfy the requirements of Section 4Section 3.Section 4.
Application for Temporary Limited X-ray Machine Operator License.(1)
An applicant who has completed an(a)
A completed and signed application Form KBMIRT Form 5;(b)
A nonrefundable, non-transferrable temporary limited x-ray machine operator application and license fee as mandated in 201 KAR 46:020, Section 5, unless the fee is waived in accordance with KRS 311B.140;(c)
The satisfactory results of a criminal background check completed within the past six (6) months in state of residence and employment and any other state of residence and employment within the past five (5) years; and(d)
A copy of a government-issued photo ID.(2)
The temporary limited x-ray machine operator license shall be effective for up to one (1) year from date of program completion and shall not be renewable.(3)
Upon completion of the limited x-ray machine operator educational(a)
Apply for the Kentucky Limited Scope Exam(b)
Submit the nonrefundable, non-transferrable limited x-ray machine operator examination fee as mandated in 201 KAR 46:020, Section 9.(4)
An individual shall successfully pass the Kentucky Limited Scope Exam, administered by the American Registry of Radiologic Technologists (ARRT)(5)
If a temporary licensee has successfully passed the Kentucky Limited Scope ExamSection 4.Section 5.
Application for Initial Limited X-ray Machine Operator License. An Applicant shall submit:(1)
A completed and signed application, KBMIRT Form 4;(2)
A nonrefundable initial application and license fee as established in 201 KAR 46:020, Section 1, unless the fee is waived in accordance with KRS 311B.140;(3)
The results of a criminal background check completed within the past six (6) months in the state of residence and employment, and any other state of residence and employment within the past five (5) years;(4)
A copy of government-issued photo ID;(5)
Documentation of passing results of the Kentucky Limited Scope Exam(6)
Verification of graduation from an educationalSection 5.Section 6.
The issued license shall identify the licensee as a limited x-ray machine operator. The license shall also identify the category as general, bone densitometry, or podiatry.Section 6.Section 7.
Curricular Standards for (1)
Programs for general limited x-ray machine operators shall:(a)
Meet the curricular standards established by the American Society of Radiologic Technologists (ASRT);(b)
Include a minimum of 240 classroom hours of didactic instruction and 360 clinical hours of education which shall include supervised practice and demonstration of clinical competency until June 30, 2027;(c)
Beginning July 1, 2027, include a minimum of 480 classroom hours of didactic instruction and a minimum of 700 clinical clock hours of education that shall include supervised practice and demonstration of clinical competency;(d)(c)
Supply data requested for a complete evaluation of its administration, organization, faculty, physical facilities, student policies, and curriculum;(e)(d)
Provide a structured curriculum with clearly written course descriptions, lesson plans, and objectives;(f)(e)
Provide an adequate faculty, which shall be qualified through academic preparation or experience to teach the subjects assigned;(g)(f)
Employ(h)(g)
Provide a one-to-one licensee-to-student ratio consistent with professional educational guidelines in the appropriate field of practice;(i)(h)
Provide appropriate facilities, diverse patient populations, sufficient volume, and a variety of diagnostic exams to properly conduct the educational program;(j)(i)
Prohibit students from applying radiation to human beings for diagnostic purposes until they have obtained practical experience and have had their performance evaluated as satisfactory by the program faculty;(k)(j)
Provide direct or indirect supervision by a licensed practitioner of the healing arts or a licensee as required by the student's level of competency;(l)(k)
Prohibit students from administering radiation to a human being unless under direct or indirect supervision as required by the student's level of competency;(m)(l)
Maintain records of each student's attendance, grades, clinical competency, and subjects completed;(n)(m)
Designate a radiation safety officer; and(o)(n)
Permit site inspections by the board's representative.(2)
Programs for limited podiatry x-ray machine operators shall:(a)
Consist of instruction that reflects current modules of the Examination Content Specifications - Limited Scope of Practice in Radiography published by the ARRT. The curriculum shall include items such as:1.
Safety, including radiation physics; radiation protection, including personnel protection; radiation exposure, monitoring, and radiation units; biological effects of radiation; low-dose technique and minimizing patient exposure; applicable federal and state radiation regulations;2.
Image Production, including principle of the radiographic equipment; image acquisition and technical evaluation; equipment operation and quality assurance; developing and using technique charts; and3.
Patient Care, including patient interactions and management; and(b)
Consist of at least six (6) months of clinical experience of static x-ray exams of the foot and ankle(3)
Programs for limited bone densitometry x-ray machine operators shall:(a)
Consist of instruction that reflects current content categories of the Examination Content Specifications - Bone Densitometry Equipment Operator published by the ARRT. The curriculum shall include items such as:1.
Patient Care, including osteoporosis, bone physiology, bone health and patient education, and patient preparation;2.
Safety, including fundamental principles, biological effects of radiation, units of measurement, and radiation protection; and3.
Image Production, including fundamentals of x-ray production, quality control, measuring and determining quality in bone mineral density; and(b)
Consist of at least six (6) months of bone densitometry clinical experience under the direct supervision of a licensed practitioner of the healing arts, a licensed radiologic technologist, or a licensed limited x-ray machine operator.Section 7.Section 8.
Approved Limited Radiographic Procedures(1)
An individual holding a general limited x-ray machine operator license shall perform only the following:(a)
Static x-ray exams(b)
Static x-ray exams(c)
Static x-ray exams(d)
Static x-ray exams(e)
Static x-ray exams(f)
Static x-ray exams(2)
An individual holding a limited podiatry x-ray machine operator license shall perform static x-ray exams(3)
An individual holding a limited bone densitometry x-ray machine operator license shall perform bone densitometry exams utilizing dedicated Dual Energy X-ray Absorptiometry (DEXA or DXA) equipment(4)
A limited x-ray machine operator shall comply with the Limited X-ray Machine Operator Practice Standards as incorporated by reference in 201 KAR 46:035, Section 4.(5)
A limited x-ray machine operator shall not:(a)
Perform contrast, fluoroscopy, mammography, computed tomography, magnetic resonance imaging, bedside radiography, nuclear medicine, positron emission tomography, or radiation therapy procedures;(b)
Operate or manipulate equipment utilized in fluoroscopy, mammography, computed tomography, magnetic resonance imaging, bedside radiography, nuclear medicine, positron emission tomography, or radiation therapy procedures.Section 8.Section 9.
Continuing Education Requirements. Licensees shall complete and document twelve (12) hours of continuing education bienniallySection 9.Section 10.
Continuing Education Audit Process.(1)
The board shall select a sample of twenty-five (25) percent of limited x-ray machine operator licensees to audit for continuing education compliance annually.(2)
The board shall send each licensee selected for audit a notification of audit.(3)
Each licensee shall maintain his or her personal files such as certificates or records of credit from approved continuing education programs from the current biennium and immediate prior biennium.(4)
A licensee selected for audit shall complete KBMIRT Form 8, as incorporated by reference in 201 KAR 46:060, and provide the board with a copy of his or her certificates or records of completion.(5)
Failure to comply with an audit may result in nonrenewal, suspension or revocation of license.Section 10.Section 11.
Renewal of License. A licensee shall renew annually prior to the expiration of his or her current license, which is the last day of the licensee's birth month, by:(1)
Completing KBMIRT Form 6; and(2)
Submitting the Renewal License Fee in accordance with 201 KAR 46:020, Section 2, unless the fee is waived in accordance with KRS 311B.140.Section 11.Section 12.
Reinstatement of Lapsed License. A licensee who has allowed the license to lapse for up to twelve (12) months is eligible to be reinstated upon submission of KBMIRT Form 6, documentation of twelve (12) hours of continuing education, and the payment of reinstatement and renewal fees pursuant to 201 KAR 46:020, Sections 2 and 7, unless the fees are waived in accordance with KRS 311B.140. A licensee whose license has lapsed for more than twelve (12) months shall:(1)
Successfully pass the Kentucky Limited Scope Exam(2)
Submit a completed and signed application KBMIRT Form 4;(3)
Submit a nonrefundable initial application and license fee and reinstatement fee as mandated in 201 KAR 46:020, Sections 1 and 7, unless the fees are waived in accordance with KRS 311B.140;(4)
Submit satisfactory results of a criminal background check completed within the past six (6) months in state of residence and employment and any other state of residence and employment within the past five (5) years; and(5)
Submit a copy of a government-issued photo ID.Section 12.Section 13.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
KBMIRT Form 4, "Limited X-ray Machine Operator License Application", October 2023;(b)
KBMIRT Form 5, "Temporary Limited X-ray Machine Operator License Application", October 2023;(c)
KBMIRT Form 6, "Limited X-ray Machine Operator Renewal Application", October 2023;(d)
"Examination Content Specifications - Limited Scope of Practice in Radiography", January 2023(e)
"Examination Content Specifications - Bone Densitometry Equipment Operator", January 2023(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Board of Medical Imaging and Radiation Therapy, 2365 Harrodsburg Road, Suite A220, Lexington, KentuckyHISTORY: COMPILER'S NOTE: 2025 RS HB 6, enacted by the General Assembly on March 27, 2025, altered the information to be provided at the time an administrative regulation is filed. Aside from formatting changes necessary to upload the regulation into the LRC's publication application, this regulation has been published as submitted by the agency.
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 August 27, 2025, at 1:00 p.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 August 31, 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 establishes the qualifications and process for licensure of a limited x-ray machine operator.
(b) The necessity of this administrative regulation:
This administrative regulation is necessary to establish the standards and qualifications for licensure of a limited x-ray machine operator.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS Chapter 311B authorizes the board to determine and establish the standards and qualifications for licensure of a limited x-ray machine operator.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This regulation establishes standards and qualifications for licensure of a limited x-ray machine operator.
(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 revises 201 KAR 46:081 to remove the employment prohibition of the limited x-ray machine operator, provide updated curricular standards for the board-approved education programs, and clarify the scope of practice for the limited x-ray machine operator.
(b) The necessity of the amendment to this administrative regulation:
The necessity of the amendment is to conform with 2025 Ky Acts Chapter 132, Section 1 (House Bill 72) as limited x-ray machine operators commence practice in settings previously not authorized.
(c) How the amendment conforms to the content of the authorizing statutes:
(d) How the amendment will assist in the effective administration of the statutes:
This administrative regulation establishes the procedures for the board to issue and renew the licenses of limited x-ray machine operators.
(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, approximately 6 educational entities that provide board-approved education, and approximately 8,000 licensees, of which approximately 800 are limited x-ray machine operators.
(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:
The regulated entities will need to take the following actions to comply: Healthcare organizations: While these organizations may employ the limited x-ray machine operator in facilities where advanced imaging equipment is also present, the organizations should note the licensee’s limited scope of practice; Education providers for the limited x-ray machine operator: Current board-approved education providers will be required to adjust curriculum standards to comply with amendments and will have approximately two (2) years to implement these changes; and Licensees: All licensees should be aware of the limited scope of practice as the limited x-ray machine operator may be employed in facilities where advanced imaging equipment is also present.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There is no foreseen cost associated with the entities identified in question 3.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Limited x-ray machine operators will benefit by being able to seek employment in facilities where advanced imaging equipment is also present. (5) Provide an estimate of how much it will cost to implement this administrative regulation: No additional cost will be incurred as a result of amending this administrative regulation.
(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 ongoing 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 increase in fees will be necessary to implement this administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This amendment will not increase any fees.
(9) TIERING: Is tiering applied?
Tiering was not applied. This regulation does not distinguish between similarly situated individuals on the basis of any factor.
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.