Diagnostic imaging accreditation is a review of an imaging facility's images, equipment testing, personnel qualifications and quality program by an accrediting organization such as the American College of Radiology (ACR) or the Intersocietal Accreditation Commission (IAC). For non-hospital suppliers of CT, MRI and nuclear medicine, including PET, Medicare requires it before payment. This service is for imaging center operators and hospital imaging administrators. Integral Healthcare Solutions (IHS) builds the requirements matrix, policies and evidence index for imaging accreditation; your radiologists and physicists own image quality and dose.

Last reviewed: October 2026. CMS, ACR and IAC pages checked on October 2, 2026.

What is diagnostic imaging accreditation?

For Medicare, the governing law is the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), section 1834(e) of the Social Security Act. CMS summarizes it this way: MIPPA "requires certain imaging suppliers to be accredited before they can receive Medicare payment for imaging services" (CMS, Accreditation of Advanced Diagnostic Imaging Suppliers).

The rule covers advanced diagnostic imaging (ADI), which CMS defines as "Magnetic Resonance Imaging (MRI), Computed Tomography (CT), [and] Nuclear medicine imaging, such as Positron Emission Tomography (PET)." CMS lists as excluded "X-ray, ultrasound, fluoroscopy procedures, [and] diagnostic and screening mammography" (CMS). CMS names four approved ADI accrediting organizations: ACR, IAC, The Joint Commission and RadSite (CMS).

Each accreditor applies its own text. ACR accredits by modality and lists nine, including CT, MRI, Nuclear Medicine and PET, Ultrasound, Breast Ultrasound, Mammography, Stereotactic Breast Biopsy and Radiation Oncology (ACR Accreditation). Its process is set out in "The Accreditation Process (Revised 8-4-2026)": "After your application is processed, an online testing package will be activated, which will contain all forms required for accreditation review," and facilities "Submit clinical images and (depending on the specific modality) scanning protocols, phantom images, and dose measurements" (ACR). IAC publishes modality standards such as the "IAC Standards & Guidelines for Nuclear/PET Accreditation," published and effective April 1, 2025, along with separate MRI and CT standards (IAC Nuclear/PET).

ACR also offers the Diagnostic Imaging Center of Excellence (DICOE) designation, described in "Diagnostic Imaging Centers of Excellence (Revised 11-12-25)." It sits on top of full accreditation: facilities must be "ACR-accredited in all modalities offered and maintain accreditation throughout the three-year designation" and "Participate in two applicable ACR NRDR registries." The levels are DICOE, DICOE with Distinction and DICOE Pinnacle (ACR DICOE).

Who needs it and what triggers it

• A non-hospital supplier billing Medicare for ADI. CMS states: "Any supplier that performs the technical component of ADI must be accredited." The requirement "doesn't apply to hospitals or critical access hospitals" (CMS).
• A new or added modality. ACR accredits each modality, and each unit or module is evaluated through the testing package (ACR process).
• A renewal. ACR states: "The 3-year period of accreditation extends from the date the first module or unit passes the full evaluation" (ACR process). IAC fees "cover each three-year accreditation cycle" (IAC).
• A validation site survey. ACR "conducts random image checks and on-site surveys to validate maintenance of accreditation criteria within the three-year accreditation period" (ACR process), and those visits "will be unannounced for MIPPA facilities" (ACR Validation Site Survey).
• A center-wide quality designation, such as ACR DICOE, for a facility already accredited in every modality it offers (ACR DICOE).

How IHS helps

IHS works from the requirements of the program you select: ACR, IAC, or DICOE on top of ACR. The process:

1. Gap assessment. IHS builds a modality-and-site requirements matrix for that program and sends questionnaires on personnel, equipment and quality assurance.
2. Document and evidence mapping. IHS crosswalks the answers to a personnel and physics evidence index, showing which record supports each requirement and which is missing.
3. Drafting. IHS drafts the policies, an equipment review calendar and quality-improvement records for your radiologists and physicists to review, change and approve.
4. Mock review. IHS runs a mock document review against what a validation site survey looks for, including the personnel and verification records ACR names.
5. Readiness support. IHS keeps the matrix and evidence index current through application, image submission and the accreditation term.

What you supply: the program requirements, the modality list, physicist reports, equipment records, and your radiologists, physicists and technologists.

The limit: image quality, phantom testing, dose and equipment acceptance are physics and radiology judgments. IHS organizes that evidence and does not perform or grade it. Your facility submits the application and images.

What to have ready

• A list of every modality and unit at each site, sorted against CMS's ADI definition of MRI, CT and nuclear medicine including PET (CMS).
• Your choice among the CMS-approved ADI accreditors: ACR, IAC, The Joint Commission or RadSite (CMS).
• The accreditor's current text for each modality, such as ACR's "The Accreditation Process (Revised 8-4-2026)" (ACR) or the "IAC Standards & Guidelines for Nuclear/PET Accreditation," effective April 1, 2025 (IAC).
• For ACR, the clinical images and, by modality, the "scanning protocols, phantom images, and dose measurements" the testing package asks for (ACR process).
• "Policies for primary source verification, verifying that personnel are not included on the Office of Inspector General exclusion list," which ACR lists among items surveyors often do not find (ACR Validation Site Survey).
• "Documentation of initial qualifications, continued education and continued experience for the interpreting physician and medical physicist" (ACR Validation Site Survey).
• Records kept survey-ready across the term, since validation visits at MIPPA facilities are unannounced (ACR) and ACR runs random image checks within the three-year period (ACR process).
• A renewal calendar keyed to the date the first module or unit passed full evaluation, which starts ACR's three-year term (ACR process).
• For DICOE, proof of ACR accreditation in every modality offered and participation in two applicable ACR NRDR registries (ACR DICOE).

To go through the list with IHS, book the introductory call below.

How it compares

The options below come from CMS and the accreditors' own pages. Which one fits depends on your modalities, your setting and your payers.

What it costs

ACR's "Fees and Payments" article lists, among others: CT "First unit for up to four modules $3,200"; MRI "First unit with up to four modules $3,200"; Nuclear Medicine "First unit with one module $2,300"; PET "First unit with one module $2,300"; and Ultrasound "One module $1,600." ACR adds: "When a single practice site location applies for three or more modalities (excluding mammography), it will receive a 10-percent discount on the final calculated fee for that site" (ACR Fees and Payments, read October 2, 2026).

ACR DICOE lists "Initial/Renewal (1-5 locations): $4,000," and for an onsite survey the facility pays surveyor travel and expenses (ACR DICOE). IAC lists for Nuclear/PET a "$3,800 application base fee (includes one testing area/module)" (IAC Nuclear/PET fees), and states that "IAC application fees cover each three-year accreditation cycle" (IAC). Verify current fees with ACR and IAC. IAC MRI and CT fees, The Joint Commission and RadSite were not among the pages we reviewed; fees depend on scope.

IHS scopes each engagement after a free introductory call.

What this is not

• IHS is not an accrediting organization and does not grant, predict or influence an accreditation decision.
• IHS does not contact, submit to or speak for your facility to ACR, IAC, CMS or any other accreditor. IHS drafts; your facility submits.
• IHS does not perform physics testing, phantom evaluation, dose measurement or image interpretation, and this page is not legal or clinical advice.

Frequently asked questions

What is diagnostic imaging accreditation, and which accreditors does CMS recognize?

It is a review of an imaging facility's images, equipment testing, personnel and quality program by an accrediting organization. For Medicare advanced diagnostic imaging, CMS lists four approved accreditors: the American College of Radiology, the Intersocietal Accreditation Commission, The Joint Commission and RadSite.

Does my imaging center need accreditation to bill Medicare for CT, MRI or PET?

If it is a non-hospital supplier, yes. CMS states that MIPPA requires certain imaging suppliers to be accredited before they can receive Medicare payment, and that any supplier that performs the technical component of advanced diagnostic imaging must be accredited. CMS defines that imaging as MRI, CT and nuclear medicine, including PET.

Do hospitals need MIPPA advanced diagnostic imaging accreditation?

No. CMS states that the requirement does not apply to hospitals or critical access hospitals. This page does not address payer or state rules.

Is ultrasound or X-ray accreditation required for Medicare?

Not under the MIPPA advanced diagnostic imaging rule. CMS lists X-ray, ultrasound, fluoroscopy and diagnostic and screening mammography as excluded. Mammography has its own federal program under MQSA (FDA, Facility Accreditation and Certification); see the mammography page.

ACR vs IAC imaging accreditation: what is the difference?

Both are CMS-approved ADI accreditors. ACR uses an online application followed by a testing package of clinical images and, by modality, scanning protocols, phantom images and dose measurements. IAC publishes modality standards, such as its Nuclear/PET standards effective April 1, 2025, and says its review generally takes 8 to 10 weeks. Which fits depends on your modalities and your own requirements.

How long does ACR accreditation last?

ACR states that the three-year period of accreditation extends from the date the first module or unit passes the full evaluation. During that period ACR conducts random image checks and on-site surveys to validate that accreditation criteria are maintained.

What happens during an ACR validation site survey, and is it unannounced?

ACR says the visits will be unannounced for MIPPA facilities. Among the items ACR says surveyors often do not find are policies for primary source verification and OIG exclusion checks, and documentation of qualifications, continued education and continued experience for the interpreting physician and medical physicist.

How much does ACR CT or MRI accreditation cost per unit?

ACR's Fees and Payments article lists $3,200 for the first CT unit with up to four modules and $3,200 for the first MRI unit with up to four modules. A single site applying for three or more modalities, excluding mammography, receives a 10-percent discount on the final fee for that site. Verify current fees with ACR.

What is the ACR Diagnostic Imaging Center of Excellence and who qualifies?

DICOE is an ACR designation on top of accreditation. A facility must be ACR-accredited in all modalities offered, keep that accreditation through the three-year designation, and participate in two applicable ACR NRDR registries. The levels are DICOE, DICOE with Distinction and DICOE Pinnacle.

Does IHS submit our application or grade our images?

No. Your facility submits the application and images. Your radiologists and physicists own image quality, phantom testing, dose and equipment acceptance; IHS builds the requirements matrix, drafts the policies and organizes the evidence for them to approve.