(a) Temporary Certificates.
  (1) A temporary certificate shall expire one year from the date of issue. A person whose temporary certificate has expired is not eligible to reapply for another temporary certificate.
  (2) A temporary certificate is not subject to a renewal or extension for any reason.
  (3) Persons who hold temporary certificates, either radiologist assistant, general, or limited, are not subject to continuing education requirements set forth under subsection (c) of this section.
(b) Biennial Registration and Fee Required.
  (1) Certificate holders and NCTs registered under the Act shall renew authorization to practice biennially and pay a fee. Upon notification from the board, unexpired authorization may be renewed by submitting the required form and documents and by paying the required renewal fee to the board on or before the expiration date of the authorization.
  (2) The fee shall accompany the required form which legibly sets forth the certificate or NCT registration holder's name, mailing address, business address, and other necessary information prescribed by the board. The certificate or NCT registration holder must include with the required forms and fee documentation of continuing education completed during the previous two years to the date of renewal ("biennial renewal period").
(c) Continuing education requirements.
  (1) Generally.
    (A) RA. As a prerequisite to the biennial renewal of a radiologist assistant certificate, the following must be completed:
      (i) a minimum of 23 hours of continuing education hours must be completed during each biennial renewal period. The hours must be in activities that are designated for Category A or A+ credits of continuing education evaluated by an organization recognized by ARRT as a Recognized Continuing Education Evaluation Mechanism (RCEEM) or RCEEM+ during the biennial renewal period; and
      (ii) a course in human trafficking prevention approved by the executive commissioner of the Texas Health and Human Services Commission.
    (B) MRT. As a prerequisite to the biennial renewal of an MRT certificate, a minimum of 24 hours of continuing education hours must be completed during each biennial renewal period. The continuing education must be completed as follows:
      (i) at least 12 hours of the required number of hours must be satisfied by completing activities that are designated for Category A or A+ credits of continuing education evaluated by an organization recognized by ARRT as a RCEEM or RCEEM+ during the biennial renewal period;
      (ii) the required hours must include a course in human trafficking prevention approved by the executive commissioner of the Texas Health and Human Services Commission;
      (iii) the remaining credits for the biennial renewal period may be composed of self-study or courses not approved for formal CE, and shall be recorded in a manner that can be easily transmitted to the board upon request; and
      (iv) any additional hours completed through self-study must be verifiable, through activities that include reading materials, audio materials, audiovisual materials, or a combination thereof.
    (C) LMRT. As a prerequisite to the biennial renewal of a limited certificate, a minimum of 18 hours of continuing education acceptable to the board must be completed during each biennial renewal period. The continuing education must be completed as follows:
      (i) at least nine hours of the required number of hours must be satisfied by completing activities that are designated for Category A or A+ credits of continuing education evaluated by an organization recognized by ARRT as a RCEEM or RCEEM+ during the biennial renewal period;
      (ii) the required hours must include a course in human trafficking prevention approved by the executive commissioner of the Texas Health and Human Services Commission; and the remaining credits for the biennial renewal period may be composed of self-study or courses not approved for formal CE, and shall be recorded in a manner that can be easily transmitted to the board upon request. The hours completed must be in the topics of general radiation health and safety or related to the categories of limited certificate held.
      (iii) Any additional hours completed through self-study must be verifiable, through activities that include reading materials, audio materials, audiovisual materials, or a combination thereof.
    (D) An RA, MRT, or LMRT who also holds a current Texas license, registration, or certification in another health profession may satisfy the continuing education requirement for renewal of a certificate with hours counted toward renewal of the other license, registration, or certification, provided such hours meet all the requirements of this subsection.
    (E) An RA or MRT who holds a current and active annual registration or credential card issued by ARRT indicating that the certificate holder is in good standing and not on probation satisfies the continuing education requirement for renewal of a certificate, except for the human trafficking prevention course, provided the hours accepted by ARRT were completed during the certificate holder's biennial renewal period and meet or exceed the requirements set out in this subsection. The board must be able to verify the status of the card presented by the certificate holder electronically or by other means acceptable to the board. The board may review documentation of the continuing education activities in accordance with paragraph (5) of this subsection.
    (F) NCTs. As a prerequisite to the biennial renewal of a placement on the NCT registry, the individual must complete a minimum of 12 hours of continuing education during each biennial renewal period. The continuing education must be completed as follows:
      (i) at least six hours of the required number of hours must be satisfied by completion of activities that are designated for Category A or A+ credits of continuing education evaluated by an organization recognized by ARRT as a RCEEM or RCEEM+ during the biennial renewal period;
      (ii) the required hours must include a course in human trafficking prevention approved by the executive commissioner of the Texas Health and Human Services Commission; and
      (iii) the remaining hours for the biennial renewal period may be composed of self-study or courses not approved for formal CE, and shall be recorded in a manner that can be easily transmitted to the board upon request.
      (iv) Any additional hours completed through independent self-study must be verifiable, through activities that include reading materials, audio materials, audiovisual materials, or a combination thereof.
  (2) Content Requirements.
    (A) At least 50% of the required number of hours must be activities which are directly related to the use and application of ionizing forms of radiation to produce diagnostic images and/or administer treatment to human beings for medical purposes. For the purpose of this section, directly related topics include, but are not limited to: radiation safety, radiation biology and radiation physics; anatomical positioning; radiographic exposure technique; radiological exposure technique; emerging imaging modality study; patient care associated with a radiologic procedure; radio pharmaceutics, pharmaceutics, and contrast media application; computer function and application in radiology; mammography applications; nuclear medicine application; and radiation therapy applications.
    (B) No more than 50% of the required number of hours may be satisfied by completing or participating in learning activities which are related to the use and application of non-ionizing forms of radiation for medical purposes.
    (C) No more than 50% of the required number of hours may be satisfied by completing or participating in learning activities which are indirectly related to radiologic technology. For the purpose of the section, indirectly related topics include, but are not limited to, patient care, computer science, computer literacy, introduction to computers or computer software, physics, human behavioral sciences, mathematics, communication skills, public speaking, technical writing, management, administration, accounting, ethics, adult education, medical sciences, and health sciences. Other courses may be accepted for credit provided there is a demonstrated benefit to patient care.
  (3) Alternative Continuing Education Accepted by the Board. The following may not be applied toward compliance with the required human trafficking prevention course. The additional activities for which continuing education credit will be awarded are as follows:
Cont'd...
(A) successful completion of an entry-level or advanced-level examination previously passed in the same discipline of radiologic technology administered by or for the ARRT during the renewal period. The examinations shall be topics dealing with ionizing forms of radiation administered to human beings for medical purposes. Such successful completion shall be limited to not more than one-half of the continuing education hours required;
    (B) successful completion or recertification in a cardiopulmonary resuscitation course, basic cardiac life support course, or advanced cardiac life support course during the continuing education period. Such successful completion or recertification shall be limited to not more than:
      (i) three hours credit during a renewal period for a cardiopulmonary resuscitation course or basic cardiac life support course; or
      (ii) six hours credit during a renewal period for an advanced cardiac life support course;
    (C) attendance and participation in tumor conferences (limited to six hours), in-service education and training offered or sponsored by Joint Commission-accredited or Medicare certified hospitals, provided the education/training is properly documented and is related to the profession of radiologic technology;
    (D) teaching in a program accredited by a regional accrediting organization such as the Southern Association of Colleges and Schools; or an institution accredited by JRCERT, JRCNMT, JTCCVT, CCE, ABHES, ASRT, professional organizations or associations, or a federal, state, or local governmental entity, with a limit of one contact hour of credit for each hour of instruction per topic item once during the continuing education reporting period for up to a total of 6 hours. No credit shall be given for teaching that is required as part of one's employment. Credit may be granted in direct, indirect or non-ionizing radiation based on the topic; or
    (E) developing and publishing a manuscript of at least 1,000 words in length related to radiologic technology with a limit of six contact hours of credit during a continuing education period. Upon audit by the board, the certificate holder must submit a letter from the publisher indicating acceptance of the manuscript for publication or a copy of the published work. The date of publication will determine the continuing education period for which credit will be granted. Credit may be granted in direct, indirect or non-ionizing radiation based on the topic.
  (4) Reporting Requirements. A certificate holder or NCT must report on the biennial renewal application form if she or he has completed the required continuing education during the previous renewal period.
    (A) A certificate holder or NCT may carry forward continuing education credit hours that meet the requirements under this subsection and earned prior to the biennial registration renewal period which are in excess of the biennial hour requirement, and apply such hours to the subsequent renewal period requirements, except for the required course in human trafficking prevention.
    (B) For RAs or MRTs, a maximum of 48 total excess credit hours meeting the requirements under this subsection may be carried forward, except for the required course in human trafficking prevention. Excess continuing education credits may not be carried forward or applied to a report of continuing education more than two years beyond the date of the registration following the period during which the credits were earned.
    (C) For LMRTs, a maximum of 24 hours meeting the requirements of this subsection may be carried forward, except for the required course in human trafficking prevention. Excess continuing education credits may not be carried forward or applied to a report of continuing education more than two years beyond the date of the registration following the period during which the credits were earned.
    (D) For NCTS, a maximum of 12 total excess credit hours meeting the requirements of this subsection may be carried forward, except for the required course in human trafficking prevention. Excess continuing education credits may not be carried forward or applied to a report of continuing education more than two years beyond the date of the registration following the period during which the credits were earned.
  (5) Exemptions.
    (A) A certificate holder or NCT may request in writing an exemption for the following reasons, subject to the approval of the certification committee of the board:
      (i) catastrophic illness;
      (ii) military service of longer than one year's duration outside the United States;
      (iii) residence of longer than one year's duration outside the United States; or
      (iv) good cause shown on written application of the certificate holder that gives satisfactory evidence to the board that the certificate holder is unable to comply with the requirement for continuing medical education.
    (B) An exception under paragraph (5) of this subsection may not exceed one registration period, but may be renewed biennially, subject to the approval of the board.
  (6) A certificate holder or NCT who is a military service member may request an extension of time, not to exceed two years, to complete any continuing education requirements.
  (7) This subsection does not prevent the board from taking disciplinary action with respect to a NCT or certificate holder or an applicant for such authorization by requiring additional hours of continuing education or of specific course subjects.
  (8) The board may require written verification of continuing education credits from any certificate holder or NCT within 30 days of request. Failure to provide such verification may result in disciplinary action by the board.
  (9) Unless exempted under the terms of this subsection, a certificate holder or NCT's failure to obtain and timely report required hours of continuing education as required and provided for in this subsection shall result in the nonrenewal of the authorization to practice until such time as the certificate holder or NCT obtains and reports the required continuing education hours; however, the executive director of the Medical board may issue a temporary certificate or NCT registration numbered so as to correspond to the nonrenewed certificate or NCT registration. Such a temporary authorization to practice shall be issued at the direction of the executive director for a period of no longer than 90 days. A temporary authorization to practice issued pursuant to this subsection may be issued to allow the opportunity to correct any deficiency so as not to require termination of practice.
  (10) Determination of contact hour credits. A contact hour shall be defined as 50 minutes of attendance and participation. One-half contact hour shall be defined as 30 minutes of attendance and participation during a 30-minute period.
(d) Criminal History Requirement for Registration Renewal.
  (1) An applicant must submit a complete and legible set of fingerprints for purposes of performing a criminal history check.
  (2) The board may not renew the certificate or NCT registration of a person who does not comply with the requirement of paragraph (1) of this subsection.
  (3) A certificate holder or NCT is not required to submit fingerprints under this section for the renewal of the certificate or registration if the holder has previously submitted fingerprints for the initial issuance or prior renewal of a certificate or NCT registration.
(e) Report of Impairment on Registration Form.
  (1) A certificate holder or NCT who reports an impairment that affects his or her ability to actively practice shall be given written notice of the following:
    (A) based on the individual's impairment, he or she may request:
      (i) to be placed on retired status pursuant to §194.10 of this title (relating to Retired Certificate or NCT Registration);
      (ii) to voluntarily surrender the certificate or NCT registration pursuant to §194.33 of this title (relating to Voluntary Relinquishment or Surrender of Certificate or Permit); or
      (iii) to be referred to the Texas Physician Health Program pursuant to Chapter 180 of this title (relating to Texas Physician Health Program and Rehabilitation Orders); and
    (B) that failure to respond to the written notice or otherwise not comply with paragraph (1) of this subsection within 45 days shall result in a referral to the board's investigation division for possible disciplinary action.
  (2) The board shall provide written notice as described in paragraph (1) of this subsection within 30 days of receipt of the renewal application form indicating the impairment.
(f) The board shall deny an application for renewal of an authorization to practice upon notice of the certificate or NCT registration holder's default of child support payments, as provided under Chapter 232 of the Texas Family Code.
Cont'd...
(g) The board shall deny an application for renewal of a certificate or NCT registration or take and/or impose other disciplinary action against such an individual who falsifies an affidavit or otherwise submits false information to obtain renewal of a certificate or NCT registration, pursuant to the Act, §601.302.
(h) If the renewal fee and completed application form are not received on or before the expiration date of the certificate or NCT registration, the fees set forth in Chapter 175 of this title (relating to Fees and Penalties) shall apply.
(i) Except as otherwise provided, the board shall not waive fees or penalties.
(j) The board shall stagger biennial renewal of a certificate or NCT registration proportionally on a periodic basis.
(k) Expired Biennial Renewal.
  (1) Generally.
    (A) If a certificate or NCT registration has been expired for less than one year, the certificate or NCT registration may be renewed by submitting to the board a completed renewal application, and the renewal and penalty fees, as set forth under Chapter 175 (relating to Fees and Penalties).
    (B) If a certificate or NCT registration has been expired for one year or longer, the certificate or NCT registration will be automatically canceled, unless an investigation is pending, and the certificate or NCT registration may not be renewed.
    (C) A person whose certificate or NCT registration has expired may not engage in activities that require a certificate or NCT registration until the authorization has been renewed. Performing activities requiring a certificate or NCT registration during the period in which the authority has expired has the same effect as, and is subject to all penalties of, practicing radiologic technology in violation of the Act.
    (D) If a certificate or NCT registration has been expired for one year or longer, it is considered to have been canceled, unless an investigation is pending. A new certificate or NCT registration may be obtained by complying with the requirements and procedures for obtaining an original certificate or NCT registration.
  (2) Renewal for technologists on active military duty with expired certificate or NCT registration. A holder of a certificate or NCT registration that has been expired for longer than a year may file a complete application for another certificate or NCT registration of the same type as that which expired.
    (A) The application shall be on official board forms and be filed with required fees.
    (B) An applicant shall be entitled to a certificate of the same type as that which expired based upon the applicant's previously accepted qualification and no further qualifications or examination shall be required.
    (C) The application must include a copy of the official orders or other official military documentation showing that the holder was on active duty during any portion of the period for which the applicant was last certified or registered as an NCT with the board.
    (D) An applicant for a different type of certificate than that which expired must meet the requirements of this chapter generally applicable to that type of certificate.

Source Note: The provisions of this §194.7 adopted to be effective April 3, 2017, 42 TexReg 1763; amended to be effective September 16, 2018, 43 TexReg 5778; amended to be effective November 10, 2019, 44 TexReg 6883; amended to be effective December 31, 2020, 45 TexReg 9526