- The Passing Standard: A Scaled 75, Not 75%
- How the Two-Session Exam Is Built
- Where Your Points Come From: The Eight Reporting Categories
- Why the Case Study Section Decides Close Outcomes
- Procedures Content and the Abdominal Section
- Test-Day Rules That Affect Your Score
- Attempts, Fees, and the Cost of Missing 75
- What the Pass Rate Does and Does Not Tell You
- Scheduling Your Prep Around the Score Structure
- Eligibility Gates That Come Before the Score
- Frequently Asked Questions
- The R.R.A. passing standard is a scaled score of 75 on a 1-99 scale, not 75% correct.
- Selected response contributes 75% of points; the objectively scored case study contributes 25%.
- Abdominal Section is the largest procedural category at 16%; Case Study is the largest single category at 25%.
- You get three attempts within three years; reapplication costs USD 200 after the initial USD 225 fee.
The Passing Standard: A Scaled 75, Not 75%
The single most common misunderstanding about the Registered Radiologist Assistant (R.R.A.) examination administered by the American Registry of Radiologic Technologists (ARRT) is the meaning of "75." The passing standard is a scaled score of 75 on a 1-99 scale. It is not a requirement to answer 75% of questions correctly.
Scaled scoring exists so that candidates who sit different forms of the exam are held to the same level of competence. Two forms can differ slightly in difficulty. Converting raw performance to a scale lets the registry apply one consistent standard regardless of which form you receive. In practice, this means two things for you:
- You cannot reverse-engineer a precise "number of questions I can miss" figure, because the conversion from raw points to the scale is not published as a simple percentage.
- Your preparation target should be broad, reliable competence across every reporting category rather than a calculated minimum.
If you are still orienting yourself to the credential, our guides on what RRA certification is and what RRA stands for cover the basics, and you can try a timed practice test to see how the question style feels before you commit to a plan.
How the Two-Session Exam Is Built
Your score is the product of a two-session, six-hour exam delivered at Pearson test centers. Understanding the structure helps you pace yourself and avoid giving away points to fatigue.
| Feature | Session 1 | Session 2 |
|---|---|---|
| Format | Selected-response questions | Case-study questions |
| Scored items | 200 | At least 30 |
| Pilot (unscored) items | 30 | Variable allocation |
| Time allowed | Four hours | Two hours |
| Share of points | 75% | 25% |
The 2026 handbook table displays 30+ scored and 20+ pilot items for Session 2 and labels the overall total approximately 280. Treat that figure as approximate: the pilot allocation in the case-study session varies, so you should not expect a fixed number of items. Older descriptions in the 2023 content specification mention a set number of unscored case items, but the current handbook is the better guide to what you will see.
Pilot items are unscored questions embedded among the real ones for future-exam development. You will not be told which are which, so answer every question with full effort.
Testing time versus appointment time
Pure testing time is six hours, but the handbook describes a full appointment of 410 minutes once the break and non-testing activities are included. Plan for a long day: eat beforehand, know your break strategy, and do not arrive depleted for the case-study session, which carries a quarter of your points.
Where Your Points Come From: The Eight Reporting Categories
ARRT's 2025 Annual Exam Report publishes the whole-exam reporting categories and their weights. These eight categories are what your score is built from, and they are summarized in the table below. For a deeper walk through each one, see our complete guide to all eight RRA content areas.
| Category | Weight |
|---|---|
| Patient Management | 14% |
| Pharmacology | 7% |
| Patient Safety, Radiation Protection, and Equipment Operation | 11% |
| Abdominal Section | 16% |
| Thoracic Section | 9% |
| Musculoskeletal and Endocrine Sections | 9% |
| Neurological, Vascular, and Lymphatic Sections | 9% |
| Case Study | 25% |
Because the weights are unequal, the exam rewards candidates who prioritize deliberately. Pharmacology at 7% is the lightest category, yet a weak showing there still costs points. Abdominal Section and Case Study together account for 41% of the exam, which makes them the two highest-leverage areas for most candidates.
Why the Case Study Section Decides Close Outcomes
Case Study is the largest separately reported weighted category at 25%, and it is the part of the exam most unlike what many candidates have practiced. A few facts matter here:
- It is objectively scored. Case-study responses are no longer the essay format used before January 2023. You select answers rather than composing written responses, so there is no subjective grader to worry about.
- It integrates domains. A case typically asks you to apply patient assessment, pharmacology, procedural knowledge, and safety reasoning to a single clinical scenario, rather than recalling an isolated fact.
- It is the second session. You face it after four hours of Session 1, so mental stamina matters.
Case Study (25%)
Expect clinical vignettes that require you to connect findings to decisions, not just recall definitions.
- Practice reading a scenario and identifying what is actually being asked before you look at the options.
- Rehearse cross-domain reasoning: a contrast decision may hinge on pharmacology, patient condition, and procedure type at once.
- Build endurance by practicing case-style questions after a long block of selected-response study.
Because the case section is a quarter of your points, a strong performance can offset a modest weakness elsewhere, and a poor performance can sink an otherwise solid Session 1. The difficulty profile is discussed further in how hard the RRA exam really is.
Procedures Content and the Abdominal Section
Within the selected-response specification, Procedures is the largest parent category, with 116 scored items. This is where the day-to-day substance of the radiologist assistant role lives: the examinations and interventions you would perform or assist with under radiologist supervision.
Of the separately reported procedural categories, Abdominal Section is the largest at 16%. That makes it the single biggest block of pure content knowledge, after Case Study overall. The remaining procedural sections each carry 9%:
Abdominal Section (16%)
The heaviest procedural category. Candidates should be fluent in the procedures, indications, contraindications, and complications associated with abdominal imaging and intervention.
- Know the indications and contraindications for abdominal studies and related contrast use.
- Understand patient preparation and post-procedure monitoring.
- Be able to recognize and respond to complications.
Thoracic, Musculoskeletal/Endocrine, and Neurological/Vascular/Lymphatic (9% each)
Three categories of equal weight that together make up 27% of the exam. Do not neglect them because each is smaller than Abdominal.
- Treat each as a distinct block with its own anatomy, procedures, and risk profile.
- Pay attention to vascular and lymphatic content, which can be less familiar to candidates from general radiography backgrounds.
For a structured approach to covering all of this, see our RRA study guide.
Test-Day Rules That Affect Your Score
Several administration rules directly shape how you should approach the exam:
- No personal reference materials or personal calculator. An approved calculator is supplied on screen, so practice with a basic on-screen calculator rather than your own device.
- Session 1 is closed once Session 2 begins. You cannot return to Session 1 to change answers after you start the case-study session. Use your Session 1 time, including flagging and review, before you advance.
- Four hours for Session 1, two hours for Session 2. Budget your pacing against 200 scored items plus pilot questions in the first session.
Key Takeaway
Because Session 1 locks when Session 2 begins, treat your final review pass in Session 1 as non-negotiable. Spend any remaining time revisiting flagged items, then move on with confidence.
Attempts, Fees, and the Cost of Missing 75
The practical consequence of the passing standard is financial and temporal. You are allowed three examination attempts within three years. The initial application and examination fee is USD 225, and reapplication costs USD 200 per additional attempt. No member/nonmember differential is listed. Once certified, annual renewal is USD 65, and the ordinary annual renewal fee covers your ARRT credentials rather than charging separately for each discipline.
| Fee | Amount |
|---|---|
| Initial application/examination | USD 225 |
| Reapplication | USD 200 |
| Annual renewal | USD 65 |
Beyond the fees, a failed attempt costs you time against the three-year clock and delays your ability to practice with the credential. For a full financial view, see the RRA certification cost breakdown, and for how the credential pays off, read whether RRA certification is worth it.
Testing windows are published by ARRT. ARRT announced an additional October 2026 administration, and the next published window after October 14, 2026 is January 13-16, 2027, with an application postmark deadline of November 11, 2026. Check the current RRA exam dates and deadlines before you plan your attempt, since missing a deadline can push your attempt back.
What the Pass Rate Does and Does Not Tell You
The calendar-2025 first-time pass rate was 75.0% among 24 first-time candidates. That is a small cohort, which has two implications:
- A single candidate represents a large share of the percentage, so year-to-year swings can be dramatic without reflecting a real change in difficulty.
- The figure of 37 total administrations is not the first-time cohort size. Total administrations include repeat attempts, so only the 24 first-time candidates define the first-time rate.
Do not conflate the 75.0% pass rate with the scaled passing score of 75. They are coincidentally similar numbers measuring entirely different things: one is the share of first-time candidates who passed, the other is the score threshold you must reach. For more on the data, see what the RRA pass rate data shows.
Scheduling Your Prep Around the Score Structure
Since your score is built from weighted categories, your calendar should reflect those weights. A sensible RRA-specific sequence front-loads the heaviest content and reserves time for integration practice. This sample allocation is tied directly to the category structure rather than a generic template:
Abdominal Section
- Largest procedural category at 16%, so start here while energy is highest.
- Cover procedures, indications, contraindications, and complications.
Patient Management and Safety/Radiation Protection
- Together 25% of the exam and foundational to the case studies.
- Include equipment operation and radiation protection principles.
Thoracic, Musculoskeletal/Endocrine, Neuro/Vascular/Lymphatic
- Three 9% categories; give vascular and lymphatic content extra attention.
- Fold in Pharmacology (7%) alongside the procedures it supports.
Case Study Integration
- Practice cross-domain vignettes under timed conditions.
- Simulate the long day: a full selected-response block followed by case-style questions.
You can adapt the length to your own timeline, and our one-page RRA cheat sheet is useful for last-week review. When you are ready to measure yourself, take a full-length RRA practice exam and review results by category rather than by overall percentage.
Eligibility Gates That Come Before the Score
The passing score only matters once you are cleared to sit. The R.R.A. has demanding prerequisites, and understanding them prevents wasted effort. Standard eligibility requires current ARRT Radiography certification and registration, completion of a recognized RA program, applicable graduate-degree and clinical-experience requirements, a clinical portfolio, current ACLS certification, and ethics compliance.
- Degree: For program completion on or after January 1, 2023, a master's or doctoral degree is required. Earlier degree exceptions are separate from the current graduate-degree route.
- Experience: For completion on or after January 1, 2025, two years of full-time patient-care-related medical-imaging experience after your Radiography credentials is required and cannot be earned concurrently with RA-program activities. The published pre-2025 exception was one year with concurrent experience permitted.
- Timing: Ordinary eligibility, including degree completion, must be established within three years of completing the professional program.
There is also a separate RPA-to-R.R.A. admission pathway. It leads to this same R.R.A. examination, not a replacement credential. It requires current CBRPA and ARRT Radiography credentials and current clinical practice, plus a master's or doctorate, or a bachelor's plus two years of imaging experience, or an associate degree plus four. The ordinary three-year post-program deadline is waived for that route. Full detail is in our RRA requirements guide.
Staying certified after you pass
Passing is the start of ongoing obligations. Annual renewal is normally due by the end of your birth month, and supporting Radiography credentials must be maintained. Biennial continuing education is 50 credits, including at least 25 Category A+ and at least 35 RRA-relevant credits. These are overlapping requirements, not additive totals, so a single qualifying credit can count toward more than one requirement. All RRA credentials have ten-year CQR.
Looking ahead to practice, the RRA salary guide and RRA jobs overview describe where credentialed radiologist assistants work and how the role is compensated.
Frequently Asked Questions
The passing standard is a scaled score of 75 on a 1-99 scale. This is not 75% correct. The scaled score accounts for differences between exam forms so every candidate is held to the same standard.
Selected response contributes 75% of points and case study contributes 25%. The eight published reporting categories are Patient Management (14%), Pharmacology (7%), Patient Safety, Radiation Protection, and Equipment Operation (11%), Abdominal Section (16%), Thoracic Section (9%), Musculoskeletal and Endocrine Sections (9%), Neurological, Vascular, and Lymphatic Sections (9%), and Case Study (25%).
You are allowed three examination attempts within three years. The initial application and examination fee is USD 225, and each reapplication is USD 200.
No. Session 1 cannot be reopened once Session 2 begins, so use your Session 1 time to review flagged questions before you advance to the case-study session.
No. Case-study responses are objectively scored and are not the essay format used before January 2023. Expect clinical scenarios that require integrating several areas of knowledge, with at least 30 scored items in that session.
Your target is clear: reach a scaled 75 by building dependable competence across all eight reporting categories, with particular strength in Abdominal Section and Case Study. For the broader picture of the credential, start with our overview of RRA certification and build your preparation from there.