- An RPA here is a Radiology Practitioner Assistant, certified by the CBRPA, not robotic process automation or an ARRT credential.
- The initial exam is 200 multiple-choice questions in 3 hours 30 minutes, scored on a scale where 75 passes.
- Anatomy, Physiology, Pathophysiology and Image Evaluation carries 75 of the 200 questions, the largest single component.
- Eligibility rules conflict on experience (five years versus three), so confirm with the CBRPA before applying.
What the Name Actually Means
If you searched "what is a RPA" and landed here, the first thing to settle is which RPA you mean. The acronym is shared by several unrelated credentials and technologies. On this site, RPA means Radiology Practitioner Assistant: an advanced-practice role in diagnostic imaging for registered radiographers who take on additional clinical responsibilities under radiologist supervision.
It is not robotic process automation, and it is not the ARRT's registered radiologist assistant designation (R.R.A.). It is a distinct credential with its own certifying board, its own exam, and its own renewal rules. If you want a broader orientation to the acronym, our explainers on what RPA stands for and RPA meaning cover the naming question, while this article focuses on what the Radiology Practitioner Assistant credential involves in practice.
Who Certifies the Credential
The credential is issued by the Certification Board for Radiology Practitioner Assistants (CBRPA). The CBRPA sets the eligibility standards, publishes the content specifications for the examination, administers the initial exam, and manages annual renewal and the separate ten-year recertification process. Successful candidates earn the designation RA(CBRPA).
The scope of this article is the initial certification. The separate recertification examination is a different product with different rules, which we cover later so you do not confuse the two.
Who Can Sit for It
Eligibility is built around existing radiography credentials plus advanced education and supervised clinical work. Published requirements include:
- Active ARRT radiographer status.
- Completion of a CBRPA-recognized academic program, which carries a baccalaureate requirement.
- Clinical competencies completed under radiologist supervision.
- Current ACLS certification.
Candidates who have finished the professional curriculum may test within six months before completing the baccalaureate degree. In that situation, results are held until the degree is complete.
For a fuller walkthrough of prerequisites, see our guide to RPA requirements and how to qualify.
What the Exam Looks Like
The initial examination is a secure, computer-delivered test. Here is what the published materials specify:
| Feature | Initial RPA Examination |
|---|---|
| Questions | 200 multiple choice |
| Time allowed | 3 hours 30 minutes |
| Passing standard | Scaled score of 75 (not 75% correct) |
| Image-based content | 20% of questions use actual cases |
| Case studies | Nine identified in the content specifications |
| Identification | Two IDs, one with a photograph |
| Prohibited items | Books and personal calculators |
| Test sites | Weber State University, or an approved off-site college or university with an institutional proctor |
Why the scaled score matters
A scaled passing score of 75 is not the same as answering 75% of items correctly. Scaling adjusts for form difficulty, so you cannot reverse-engineer a raw number of questions you need. Practice with the goal of broad mastery rather than targeting a particular count of misses. Our passing score guide unpacks this in more detail.
The image-based component
One in five questions is built on actual cases with images. That is roughly 40 of the 200 items, and it changes how you should prepare. Memorizing anatomy lists will not carry you through a question that shows a study and asks you to evaluate it. You need to practice reading images, recognizing normal versus abnormal, and connecting findings to the clinical picture and the next appropriate action.
The Ten Content Components
The CBRPA publishes content specifications that divide the exam into ten components. The names below reproduce the official summary-table headings. (Detailed-section labels in the specifications differ slightly for components 1, 7, 9 and 10; we use the summary-table names.) For a deeper component-by-component treatment, see our complete guide to all 10 RPA content areas.
Domain 1: Patient Education
Explaining procedures, preparation, risks, and aftercare to patients and families in terms they can act on.
- Consent-adjacent communication and what patients should expect
- Preparation and post-procedure instructions
Domain 2: Patient Assessment and Management
Evaluating patients before, during, and after imaging procedures and responding to changes in condition.
- Clinical history, vital signs, and readiness for a procedure
- Recognizing and managing adverse events
Domain 3: Professional Communication
Interacting with radiologists, referring clinicians, nursing staff, and other members of the care team.
Domain 4: Pharmacology and Contrast
Medications and contrast agents used in imaging, including how they are selected, administered, and monitored.
- Indications, contraindications, and reactions
- Patient factors that affect contrast decisions
Domain 5: Anatomy, Physiology, Pathophysiology and Image Evaluation
The core clinical knowledge domain and the one most tied to image-based cases. Expect to connect normal structure and function to disease processes and to evaluate images.
Domain 6: Medical Imaging Procedures
The procedures an RPA may assist with or perform under supervision, including indications, technique, and complications.
Domain 7: Radiation Biology and Health Physics
Biological effects of radiation, dose concepts, and protection principles for patients and staff.
Domain 8: Fluoroscopic Equipment and Operation
How fluoroscopic systems work and how to operate them safely and effectively.
Domain 9: Medical Documentation and Records
Accurate, complete clinical documentation and records practices.
Domain 10: Medical-Legal Circumstances
Legal and regulatory considerations affecting advanced practice in imaging, including scope, supervision, and liability awareness.
Where the Points Sit
The content specifications publish question counts for each component rather than percentage weights, and we have not converted them into percentages here. In listed order, the counts are 6, 25, 10, 20, 75, 40, 8, 8, 4 and 4, which total 200.
| Component | Published question count |
|---|---|
| 1. Patient Education | 6 |
| 2. Patient Assessment and Management | 25 |
| 3. Professional Communication | 10 |
| 4. Pharmacology and Contrast | 20 |
| 5. Anatomy, Physiology, Pathophysiology and Image Evaluation | 75 |
| 6. Medical Imaging Procedures | 40 |
| 7. Radiation Biology and Health Physics | 8 |
| 8. Fluoroscopic Equipment and Operation | 8 |
| 9. Medical Documentation and Records | 4 |
| 10. Medical-Legal Circumstances | 4 |
Key Takeaway
Components 5 and 6 together account for 115 of the 200 questions. A candidate who is strong everywhere except those two will struggle; a candidate who is strong there has a large cushion against the small components. Still, do not ignore the four-question components, since a thin foundation in documentation or medical-legal topics can cost points you cannot afford to lose.
Registration and Money Mechanics
This is where candidates most often get tripped up, so read carefully.
The initial exam fee: unverified
We could not verify the current initial examination fee. The CBRPA's "RPA Exam Fees and Policy" link on its Join Us hub returned a 404 error at the time of our review, and the linked application does not state an amount. We have not substituted any other charge for the initial fee. Confirm the current amount directly with the CBRPA before budgeting. Our certification cost breakdown tracks what is and is not confirmed.
Charges that are published
- Off-site proctoring: USD 200, in addition to the examination fee. This covers four billed proctor hours, which is not the same as four hours of written-exam time.
- Retest application: USD 200, per the Candidate Handbook.
- Annual renewal: USD 150, due during your birth month.
For timing, see our overview of testing windows and scheduling, and confirm current dates with the CBRPA.
Life After Certification
Certification is not a one-time event. Maintaining RA(CBRPA) status involves two distinct layers.
Annual renewal
Annual renewal costs USD 150 and falls in your birth month. It requires continued ARRT standing, current ACLS, and continuing-education compliance. The published CE rules are not perfectly aligned: the Candidate Handbook specifies 24 CE credits per two years, while the separate recertification policy specifies 12 relevant credits annually. Treat these as two different schedules and do not assume they are interchangeable. If you are unsure which governs your situation, ask the CBRPA.
Ten-year recertification
Separate from annual renewal, there is a ten-year recertification examination. Its published specifications are a 50-question, three-hour, open-book exam, with a listed fee of USD 75 and a 75% raw-score passing criterion. These details describe recertification only. They do not describe the initial examination, which is 200 questions, closed-book, and scaled-scored. Mixing the two is a common source of confusion.
| Feature | Initial Exam | Ten-Year Recertification |
|---|---|---|
| Questions | 200 | 50 |
| Time | 3 hours 30 minutes | 3 hours |
| Format | Secure, proctored; books prohibited | Open book |
| Passing standard | Scaled score of 75 | 75% raw score |
| Listed fee | Unverified | USD 75 |
Who Hires RPAs
Radiology Practitioner Assistants work in settings where radiologists delegate imaging-related clinical tasks and where advanced radiographer skills add capacity. That typically means hospital radiology departments, outpatient imaging centers, and radiology practices that perform fluoroscopic and other procedures requiring supervised assistance. Because the role depends on radiologist supervision and on local scope-of-practice rules, how the position is structured varies by employer and by state.
We do not publish salary figures here because we cannot support a number from the certifying body's published materials. For a qualitative look at earnings and job-market considerations, see our salary guide and RPA jobs overview. If you are weighing whether the investment pays off, our ROI analysis walks through the trade-offs.
Sequencing Your Preparation
You do not need a generic study system so much as a plan that mirrors where the questions are. Because the point distribution is so uneven, sequence your effort accordingly rather than giving every component equal time.
Build the heavy core (Components 5 and 6)
- Anatomy, physiology, and pathophysiology tied to imaging findings
- Image evaluation practice, since about 20% of items are image-based
- Procedure indications, technique, and complications
Mid-weight clinical safety (Components 2 and 4)
- Patient assessment and management scenarios
- Contrast and pharmacology, including reactions and contraindications
Technical and communication components
- Radiation biology, health physics, and fluoroscopic equipment
- Professional communication and patient education
Small components and integration
- Documentation and medical-legal topics
- Mixed practice under timed conditions of roughly 200 questions in 3 hours 30 minutes
For a fuller plan, see our RPA study guide, and use the one-page review sheet close to exam day. To gauge where you stand, try our RPA practice test, then return to the main practice site to drill weak components. If you are wondering about difficulty, our difficulty guide and pass rate article address what is and is not publicly known.
Frequently Asked Questions
A Radiology Practitioner Assistant is a certified advanced-practice radiographer who assists radiologists with delegated clinical imaging tasks under supervision. The credential is issued by the Certification Board for Radiology Practitioner Assistants (CBRPA).
No. Here RPA means Radiology Practitioner Assistant only. It is separate from robotic process automation and from the ARRT's R.R.A. designation, and it uses its own exam and renewal rules.
It has 200 multiple-choice questions and a 3 hour 30 minute time limit. Passing requires a scaled score of 75, which is not the same as 75% correct. About 20% of questions use image-based actual cases.
Anatomy, Physiology, Pathophysiology and Image Evaluation has 75 of the 200 questions, followed by Medical Imaging Procedures with 40. Together they make up more than half the exam.
The current initial exam fee could not be verified, as the CBRPA's fee page returned an error. Off-site proctoring adds USD 200, a retest application is USD 200, and annual renewal is USD 150. Confirm the initial fee with the CBRPA directly.
Because eligibility thresholds, fees, and policies can change, treat this article as an orientation and verify every requirement against the CBRPA's current published materials and Candidate Handbook before you apply.