Certification and registration in Radiation Therapy, awarded by the American Registry of Radiologic Technologists (ARRT), is the national credential for the radiation therapist who simulates, plans alongside the treatment team, and delivers prescribed radiation treatment to people with cancer. The PassProfessor ARRT Radiation Therapy program prepares candidates for the ARRT examination that stands behind the Registered Technologist in Radiation Therapy, R.T.(T), credential. The companion exam guide at /arrt-radiation-therapy-exam-guide/ works through the same verified facts in greater depth.
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What this credential certifies
The R.T.(T) certifies entry-level competence in radiation therapy: the knowledge and cognitive skills underlying the intelligent performance of the tasks a staff radiation therapist typically performs. In practice that means CT simulation and treatment volume localisation, prescription and dose calculation, safe and accurate treatment delivery across sites and techniques, radiation physics and radiobiology applied at the treatment unit, radiation protection for patient, staff, and public, equipment operation and quality assurance, and the sustained patient care — assessment, education, monitoring, documentation — that a course of daily treatment over several weeks demands.
ARRT certification and registration is not a state licence. ARRT itself draws the line plainly: earning the credential does not by itself authorise practice in a particular state, and most states license radiation therapists separately, commonly on the basis of the ARRT credential. The Radiation Therapy credential program is accredited by the National Commission for Certifying Agencies (NCCA). Candidates should hold both ideas at once from the start: one national examination, earned once through ARRT’s primary eligibility pathway, and a separate state permission to practise that follows it.
The examination at a glance
| Item | Verified position |
|---|---|
| Program | Certification and registration in Radiation Therapy, awarding the Registered Technologist in Radiation Therapy, R.T.(T), credential |
| Certifying body | American Registry of Radiologic Technologists (ARRT); the Radiation Therapy credential program is accredited by the National Commission for Certifying Agencies (NCCA) |
| Pathway | Primary eligibility pathway only. Radiation Therapy is one of ARRT’s primary disciplines; there is no postprimary route into Radiation Therapy |
| Examination | Computer-based at Pearson test centres; 230 items in total — 200 scored items and 30 unscored pilot items; 230 minutes of test time inside a 250-minute appointment |
| Passing standard | ARRT publishes the passing standard as a total scaled score of 75 on its scaled score range of 1 to 99; a scaled score is not a percentage |
| Application fee | $225 for a primary pathway application, as published in ARRT’s application fees; each further attempt requires a new application and fee |
| Eligibility | Education, ethics, and examination: completion of an ARRT-verified educational program in radiation therapy including its didactic and clinical competency requirements, an associate degree or higher from an institution accredited by an agency ARRT recognises, compliance with the ARRT Standards of Ethics, and a passing examination score; candidates have three years and three attempts to pass once eligible |
| Staying certified | Annual renewal of certification and registration; 24 approved continuing education credits every two years (a biennium); Continuing Qualifications Requirements every 10 years for technologists credentialed on or after January 1, 2011 |
| Administrator note | PassProfessor is independent and is not affiliated with ARRT |
Primary, postprimary, and why the distinction governs this credential
ARRT runs two eligibility pathways, and Radiation Therapy sits firmly on one side of the line. The primary eligibility pathway is the route for a first, discipline-defining credential: the candidate completes a full ARRT-verified educational program in the discipline, meets the degree and ethics requirements, and passes the examination. Radiation Therapy, Radiography, Nuclear Medicine Technology, Sonography, Vascular Sonography, and Magnetic Resonance Imaging are the primary disciplines. The postprimary eligibility pathway is different machinery for a different job: a technologist who already holds an ARRT credential in a supporting discipline adds a further credential — Mammography, Computed Tomography, Magnetic Resonance Imaging, Bone Densitometry, Cardiac Interventional Radiography, Vascular Interventional Radiography, Vascular Sonography, or Breast Sonography — by completing 16 hours of structured education targeted to that discipline’s content specifications, with at least one credit from each major content category, and by performing and documenting the discipline’s clinical experience procedures, both inside the 24 months before applying.
Radiation Therapy cannot be earned that way. Sixteen hours of structured education and a procedure log do not make a radiation therapist, and ARRT does not offer the attempt: an experienced radiographer who wants the R.T.(T) returns through the primary pathway and completes an ARRT-verified radiation therapy program like any other entrant. The postprimary rules still matter to this program’s readers in the other direction — the R.T.(T) is itself a supporting credential, so the radiation therapist who later adds Computed Tomography or Magnetic Resonance Imaging will meet ARRT’s structured education and clinical experience requirements then, on the postprimary side of the line.
What the examination covers
ARRT publishes the examination as content specifications with fixed scored-item counts, not percentages. The specifications in force — board approved January 2021, implemented January 1, 2022 — distribute the 200 scored items as follows, with a further 30 unscored pilot items in every sitting.
Patient Care — 46 scored items. Patient Interactions and Management (29): ethical and legal aspects — patients’ rights, consent, confidentiality, the AHA Patient Care Partnership, legal issues including verification of patient, site, and prescription, common legal terminology and doctrines, and the ARRT Standards of Ethics; interpersonal communication and its challenges; patient education on the treatment, its preparation, and its instructions; physical assistance, ergonomics, and monitoring, including patients with infusion lines, oxygen, and tubes; medical emergencies; infection control; handling and disposal of toxic and hazardous material; and pharmacology centred on contrast media. Patient and Medical Record Management (17): evaluation of the case — epidemiology and etiology, screening, signs and symptoms, history and examination, imaging and other diagnostic studies; assessment of treatment side effects and blood studies; dietary counselling; and documentation — what belongs in the treatment record and how records are kept.
Safety — 51 scored items. Radiation Physics and Radiobiology (21): sources of radiation, the principles of radiation physics — attenuation, the inverse-square law, beam quality, interactions with matter — the biological effects of radiation in SI units, and radiation tissue tolerance. Radiation Protection, Equipment Operation, and Quality Assurance (30): personnel and facility monitoring, shielding and protection practice, the operation of treatment and simulation equipment, and the quality assurance programme that keeps output honest.
Procedures — 103 scored items. More than half the paper. Treatment Sites and Tumors (26): the diseases treated and the sites at which they are treated. Treatment Volume Localization (18): simulation and localisation, including CT simulation. Prescription and Dose Calculation (24): the prescription read correctly and the dose computed correctly — monitor units, dose distributions, and the arithmetic of delivery. Treatments (35): treatment delivery itself — set-up, immobilisation, beam arrangement and modification, techniques including advanced and specialised treatments, and verification of the delivered treatment.
ARRT board-approved revised specifications, published in January 2026, take effect February 1, 2027: Patient Care 47, Safety 51, and Procedures 102 scored items, with the same 200 scored and 30 pilot structure. The shift is small — one item moves from Procedures to Patient Care, and the Safety subcategories rebalance toward physics and radiobiology — and candidates sitting either side of that date should prepare to the specifications ARRT applies to their sitting.
What makes this examination demanding
The Radiation Therapy paper is demanding in three distinct ways. First, scale: at 230 items in 230 minutes it is a long sitting that allows roughly a minute per item across material ranging from legal doctrine to dose arithmetic, and pacing is a trained skill rather than a hope. Second, weight: Procedures carries more scored items than Patient Care and Safety combined, so a candidate cannot compensate for weak simulation, localisation, prescription reading, and dose calculation with strong general knowledge — the paper is decided inside treatment practice. Third, precision: dose calculation and physics items are exact-answer items wearing clinical dress, worked in SI units, and the safety content — tissue tolerance, protection, equipment operation, and quality assurance — is examined as the working system that prevents a catastrophic error, not as background theory. Underneath all three sits the eligibility structure: by the time a candidate sits, ARRT has already required a full verified programme with demonstrated didactic and clinical competencies, so the examination assumes a trained therapist and examines at that level.
The route, in order
ARRT states its route as an equation — education plus ethics plus examination — and the order matters. Education first: complete an ARRT-verified educational program in radiation therapy, demonstrating competency across the programme’s formal classroom (didactic) coursework, its clinical requirements, and ARRT’s list of clinical competencies for the discipline; and earn an associate degree or higher, in any subject, from an institution accredited by an agency ARRT recognises — the degree may be earned before, during, or after the programme, but the degree must be conferred and the application submitted no more than three years after completing the programme. Ethics throughout: comply with the ARRT Standards of Ethics from application onward, report violations within the required window, and undergo an ethics review where ARRT requires one — candidates with a charge, conviction, or regulatory matter in their history should use ARRT’s ethics review process early rather than discovering its timetable at application. Examination last: create an ARRT account, apply for certification and registration in Radiation Therapy with the $225 fee, receive the Candidate Status Report with its assigned one-year examination window, schedule at a Pearson centre, and sit inside the window. Once eligibility is established the candidate has three years and three attempts to pass, each attempt on a new application and fee, with reapplication received at least 30 calendar days before the eligibility period expires. Passing completes the credential only together with the education and ethics requirements already met — ARRT is explicit that a passing score alone does not make a candidate eligible for certification and registration. State licensure, where the state requires it, is a separate application to the state after the credential is earned.
Staying certified: annual renewal, biennial education, and the ten-year check
An ARRT credential is maintained on three clocks that never merge. Annual renewal: every registrant renews certification and registration every year, by the last day of the registrant’s birth month, and annual renewal requires the biennial education position to be current. Biennial continuing education: 24 approved Category A or A+ continuing education credits in every two-year biennium, completed by the last day of the month before the birth month and reported with the renewal in the biennium year; credits do not carry forward between biennia. Continuing Qualifications Requirements: technologists who earned their credentials on or after January 1, 2011 — and all Registered Radiologist Assistants — complete CQR every 10 years for each credential, a structured self-assessment followed by any prescribed continuing education it identifies, worked through in the compliance period at the end of the ten-year cycle. Compliance with the ARRT Rules and Regulations and Standards of Ethics runs underneath all three clocks, and a credential held through the postprimary pathway additionally requires the supporting discipline’s certification and registration to be maintained. Employers verify standing in ARRT’s directory; a lapsed renewal is therefore a public professional fact within days, not a private oversight.
What the PassProfessor program will cover
Built to ARRT’s content specifications, at their published counts. The program is organised on the three content categories at the weights ARRT itself fixes — Patient Care, Safety, and the Procedures majority — and is maintained against the specifications in force for the candidate’s sitting, including the revised specifications ARRT has approved for February 1, 2027. Dose calculation is practised as a discipline in its own right, in SI units, inside clinical scenarios rather than as bare arithmetic, because that is the form in which the examination presents it.
The pathway rules taught accurately. The program states the primary pathway as the only route into Radiation Therapy, teaches the didactic and clinical competency structure of the verified programme as ARRT frames it, and explains the postprimary structured education and clinical experience requirements in their correct place — as the machinery by which an existing R.T., including an R.T.(T), later adds a further credential.
Independence, stated plainly. PassProfessor is an independent preparation provider, not affiliated with ARRT, and this program is not an ARRT-verified educational program and satisfies no part of ARRT’s education requirement. Completing it confers no credential and no eligibility; ARRT alone certifies and registers, and candidates apply through ARRT and test through Pearson.
Tell me when enrollment opens. The ARRT Radiation Therapy program is in the works as PassProfessor expands its catalog of health examination preparation, and enrollment is not yet open. Leave an email address and PassProfessor will write to you when the program is ready — and only about this program. No date is promised, because the program will open when it meets the standard described above, not before.
Frequently asked questions
Who awards the R.T.(T) credential?
The American Registry of Radiologic Technologists (ARRT), as certification and registration in Radiation Therapy. The credential holder is a Registered Technologist in Radiation Therapy, R.T.(T).
How many questions are on the ARRT Radiation Therapy examination, and how long does it take?
230 items in 230 minutes of test time, inside a 250-minute appointment. Of the 230, 200 are scored and 30 are unscored pilot items that do not affect the score.
What score passes the ARRT Radiation Therapy examination?
A total scaled score of 75, on ARRT’s scaled score range of 1 to 99. ARRT uses scaled scores so that 75 represents the same standard on every version of the examination; it is not a percentage.
Can an experienced radiographer earn Radiation Therapy through the postprimary pathway?
No. Radiation Therapy is a primary discipline only. The postprimary pathway — 16 hours of structured education plus documented clinical experience procedures, each completed inside the 24 months before applying, on top of a supporting ARRT credential — applies to Mammography, Computed Tomography, Magnetic Resonance Imaging, Bone Densitometry, Cardiac Interventional Radiography, Vascular Interventional Radiography, Vascular Sonography, and Breast Sonography. A radiographer seeking the R.T.(T) completes an ARRT-verified radiation therapy program through the primary pathway.
What education does the primary pathway require?
An ARRT-verified educational program in radiation therapy, including demonstrated didactic and clinical competencies, plus an associate degree or higher from an institution accredited by an agency ARRT recognises. The degree may be earned before, during, or after the programme, but the degree must be conferred and the application submitted within three years of completing the programme.
How many attempts does an eligible candidate get?
Three attempts inside three years once eligibility is established, each on a new application and fee, inside the assigned examination windows.
Is ARRT certification the same as a state licence?
No. ARRT certification and registration is the national credential; most states license radiation therapists separately, commonly on the basis of the ARRT credential. Earning the credential does not by itself authorise practice in a particular state.
What does staying certified require?
Renewal of certification and registration every year by the last day of the birth month; 24 approved continuing education credits every two-year biennium; Continuing Qualifications Requirements every 10 years for technologists credentialed on or after January 1, 2011; and continuing compliance with the ARRT Standards of Ethics.
When do the revised content specifications take effect?
February 1, 2027. The board-approved January 2026 specifications set Patient Care at 47, Safety at 51, and Procedures at 102 scored items, within the same 200 scored and 30 pilot structure. Candidates should prepare to the specifications ARRT applies to their sitting.
Is PassProfessor affiliated with ARRT?
No. PassProfessor is an independent preparation provider. ARRT alone certifies and registers, and this program is not an ARRT-verified educational program.
When does enrollment open?
The program is in the works and enrollment is not yet open. Leave an email address on this page and PassProfessor will write to you when the program is ready — and only about this program.