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Understanding Ultrasound Credentials & The Importance of Becoming "Registered" In Ultrasound


The answer, for 46 out of 50 of the United States, is no.

You do not need to be credentialed in ultrasound to legally work in the field of ultrasound unless you live in New Hampshire, New Mexico, North Dakota or Oregon. Like nursing, these states require Ultrasound Technologists to hold a license to perform ultrasounds, which means they need to pass a credentialing exam in order to perform ultrasounds in those states.

In all other states, there is no state licensure requirement and you do not need to be credentialed to perform ultrasounds. Odds are, however, if you don’t hold a credential in ultrasound, that it will be much harder for you to find employment.

If I have an ultrasound credential and can perform ultrasounds pretty well, for example, and you are far superior in your ultrasound skills, but don’t have a credential, I will likely get the job. Even though you are clearly more technically skilled in the practical component of ultrasound, which is actually the job itself, because I hold a credential, employers will hire me first.

For more information, contact the Society of Diagnostic Medical Sonography.


The reason why employers hire credentialed sonographers before non-credentialed sonographers is two-fold:

One, the employer has an understanding that credentialed sonographers have passed a written test. The written test that defines what the medical community requires of Ultrasound Technologists. The test that says. “I understand the didactic portion of ultrasound.” At this time, the credentialing exams require applicants to verify written knowledge of ultrasound only. There aren’t any credentialing exams that require applicants to demonstrate practical abilities, so even though the job of an Ultrasound Technologist is practical and requires hands on skills, the written credentialing exam is currently the only test that holds merit with potential employers.

Two, the employer has a fiduciary responsibility to ensure that the ultrasound exams that are needed and performed are reimbursed by Medicare. In order for many ultrasound exams to be reimbursed by Medicare, the technologist must be credentialed. Employers who hire Ultrasound Technologists that are not credentialed may risk a decrease in Medicare reimbursements and, therefore, find it to be a common practice to hire credentialed Sonographers.


Many employers that have found a great benefit to hiring “registry eligible” sonographers rather than “registered” sonographers. What is the benefit? Saving on payroll costs. Credentialed sonographers are generally paid at a much higher rate of pay than non-credentialed sonographers. According to the American Society of Echocardiography, Echocardiographers that held three ARDMS credentials earned, on average, nearly eight dollars ($8.00) more per hour than non-credentialed sonographers.

These employers have learned that non-credentialed sonographers that are supervised by credentialed sonographers can be just as effective as credentialed sonographers, but cost thousands of dollars per year less than credentialed sonographers. These employers typically ensure that the registry eligible technologists have the appropriate supervision to alleviate any potential reimbursement issues.


Some employers prefer to hire new, registry eligible, graduates. If the sonographer has been trained in the skills of general, vascular, cardiac, musculoskeletal and pediatric ultrasound, and can perform these types of ultrasounds according to the standards and techniques of the employer fresh out of school, those companies can save a significant amount on payroll costs. Many employers stipulate that their “registry eligible” new hires obtain a credential within a certain number of years of employment.

With an increasing demand for ultrasound technologists, there is a collateral demand for markers to be in place that measure the abilities of each ultrasound technologist in the field of ultrasound. These markers are ensures that the technologists entering the field of ultrasound are prepared to provide accurate ultrasound imaging.


There are three societies that offer credentialing examinations for sonographers:

1) The American Registry of Diagnostic Medical Sonographers (ARDMS) – The ARDMS is known as the “gold standard” in “registry” examinations. They are actually responsible for the term “registry” as it technically pertains only to their examinations. Because of the popularity of their credential, the term “registry” has taken hold as the term used to define the ultrasound credential, even if given by another credentialing agency. The ARDMS credentials all aspects of ultrasound including general, vascular and cardiac. The ARDMS also has a credential for pediatric and musculoskeletal ultrasound.

The ARDMS exam is TWO exams: 1) Physics, also known as Sonography Principles and Instrumentation (SPI) and 2) The specialty examination. Passing BOTH examinations is required to achieve a credential from ARDMS. Credentials including RDMS, which stands for Registered Diagnostic Medical Sonographer. RVT, which stands for Registered Vascular Technologist. RDCS, which stands for Registered Diagnostic Cardiac Sonographer. Applicants must have a minimum of a Bachelor’s degree or verification of working full time (not volunteering) in the field of ultrasound for one year prior to taking the examination.

For more information, please visit

2) Cardiovascular Credentialing International (CCI) – CCI is a credentialing examination offered for those applicants who wish to become registered in cardiac and/or or vascular ultrasound. CCI does not offer credentialing examination for general ultrasound. Credentials include the RCS, which stands for Registered Cardiac Sonographer and RVS, which stands for registered Vascular Specialist. Applicants must have a minimum of a High School Diploma to apply.

For more information please visit

3) The American Registry of Radiologic Technologists (ARRT), is known for being the credentialing agency for Radiologic Technologists. They now have a credential for sonographers, the R.T.S., which stands for the Radiologic Technologist in Sonography. Applicants must have a minimum education of an Associate’s degree to apply.

For more information visit

New graduates of accredited ultrasound programs, such as those from CURE, Center for Ultrasound Research & Education, an ultrasound school in Westchester County, New York, are highly sought after for their training and clinical experience in all aspects of ultrasound. Every CURE graduate is eligible to take a credentialing exam upon graduation. For more information about CURE and CURE Ultrasound Credentialing Pathways, click here.

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