How to Register an X-Ray System in Texas: A Step-by-Step Guide

Whether you're outfitting a new practice or adding a machine to an existing one, here's exactly what Texas requires before you can put an x-ray system to use — and the one requirement almost everyone underestimates.

If you've just purchased, leased, or otherwise taken possession of an x-ray machine in Texas, there's a clock running: the state gives you 30 days from first use to obtain a certificate of registration. Miss it, and you're operating out of compliance before you've taken your first image.

The good news is that the process itself is well-documented once you know what's expected. Here's a complete walkthrough of how registration works with the Texas Department of State Health Services (DSHS) Radiation Control Program — the agency that oversees every radiation machine in the state, from dental and chiropractic offices to hospitals, veterinary clinics, academic institutions, and industrial inspection equipment.

Two Separate Requirements — Don't Confuse Them

Before diving into the steps, it's worth flagging a distinction that trips up a lot of new practices:

Who Needs to Register

Under Title 25 of the Texas Administrative Code, any business or entity that operates a radiation machine must obtain a certificate of registration from DSHS within 30 days of first use. That requirement applies across the board:

• Medical, dental, chiropractic, and podiatric practices
• Veterinary clinics and hospitals
• Hospitals, urgent care centers, and imaging centers
• Academic and research institutions
• Industrial, analytical, and cabinet x-ray system operators
• Mobile x-ray service providers and self-referred screening programs
• Companies that assemble, install, repair, rent, demonstrate, or sell x-ray machines

The Registration Process, Step by Step

1. Gather your information before you start (see the checklist below — it'll save you a second trip through the paperwork).
2. Register your business with the Texas Secretary of State (or file an assumed name certificate) if you haven't already — DSHS requires proof you're authorized to do business in Texas.
3. Complete RC Form 226-1 (Business Information Form) and RC Form 226-2 (Radiation Machine Application) for each location.
4. Designate a Radiation Safety Officer (RSO) and document it on RC Form 42-R. Every registered facility must have one.
5. Submit your application and initial fee within 30 days of first operating the machine. This is a hard regulatory deadline, not a suggestion.
6. Receive your certificate of registration from the DSHS Radiation Machine Source Unit.
7. Keep DSHS notified. Any change to your facility name, address, use location, or RSO must be reported within 30 days.

What You'll Need on Hand

Two Things Most People Forget on a New Machine

Registration gets most of the attention, but two additional requirements kick in the moment a new x-ray unit is assembled and installed — and both are easy to miss if your installer doesn't flag them:

Renewal, Validity & Verification

Texas splits renewal into two separate clocks, and it's easy to mix them up:

You can verify a facility's registration status anytime through the DSHS Regulatory Services online licensing system, and pay biennial fees online by credit card or ACH.

Don't Forget the Operator

Registering the machine doesn't authorize anyone to use it. In Texas, operator credentials are issued by the Texas Medical Board (not DSHS), across three tiers:

• Medical Radiologic Technologist (MRT) — an unrestricted license covering full-scope diagnostic imaging.
• Limited Medical Radiologic Technologist (LMRT) — a restricted permit for a narrower set of imaging procedures.
• Non-Certified Technician (NCT) — an entry-level classification requiring completion of an approved 120-hour classroom program covering radiation safety, image production, equipment operation, and anatomy.

All three credential types require 24 hours of continuing education every 24 months to stay active. If you're bringing a new x-ray system online, confirm your operators' credentials are squared away before the machine ever gets used.

Personnel Monitoring: Who Needs a Dosimeter Badge

Under 25 TAC §289.231, you're required to supply individual monitoring devices (dosimeter badges) to certain staff — this is a facility obligation, not an optional precaution:

• Adults likely to receive more than 10% of the annual occupational dose limit from external radiation sources
• Minors likely to receive more than 0.1 rem in a year
• Declared pregnant workers likely to receive more than 0.1 rem during the pregnancy
• Anyone entering a high or very high radiation area, regardless of expected dose

Badges must be processed by a dosimetry processor accredited under the National Voluntary Laboratory Accreditation Program (NVLAP), worn by one individual only, and returned for processing on a regular schedule. You're also required to keep dose records (DSHS uses RC Form 231-3 for this) and review them at least once a year, within 90 days of year-end. Personnel operating only the lowest-output, minimal-risk machines are generally exempt — but don't assume that applies to you without checking with your RSO or DSHS first.

A Few Situations Need Extra Sign-Off

Standard registration covers most general-use x-ray systems, but DSHS requires additional authorization on top of basic registration for:

• Mobile x-ray services
• Self-referred screening programs

If either applies to you, contact the DSHS Radiation Control Program before completing registration to confirm the extra forms required for that type of service.

Fees

Initial application fees vary by equipment type — from around $420 for podiatric radiographic units up to $1,910 for accelerators, CT, and simulators — and each initial application must be accompanied by the appropriate non-refundable biennial fee. Because amounts are updated periodically, confirm the current fee schedule directly with DSHS rather than budgeting off an old number.

Staying Compliant After You're Registered

Every registered facility must maintain written safety procedures under Texas Administrative Code §289.227 and §289.229 (DSHS regulatory guides 4.3 and 4.6 provide templates). To stay in good standing:

• Keep your Radiation Safety Officer designation current and notify DSHS of any change within 30 days
• Pay biennial fees on time and respond to technical renewal notices before the deadline
• Keep operator certifications current alongside the machine registration
• Keep manufacturer documentation, safety procedures, and installation records on file in case of an inspection

Non-compliance is expensive: penalties under Texas Health and Safety Code Chapter 401 start at $5,000 per violation for registered facilities and $10,000 for operating unregistered, with continuing violations accruing daily up to $10,000 per day.

Quick-Reference Checklist

Helpful Links

• X-Ray Machines and X-Ray Services – Texas DSHS
• Medical and Academic X-Ray Machine Registration
• Business Registration Requirements
• Applications & Forms Library
• Fee Schedules & Payment of Fees
• Medical Radiologic Technologist Licensing – Texas Medical Board
• FDA Form 2579 – Report of Assembly of a Diagnostic X-Ray System
• Equipment Performance Evaluation (EPE) Guidance – Texas DSHS

This post summarizes publicly available Texas DSHS Radiation Control Program information as of July 2026 for general planning purposes and is not legal advice. Requirements, fees, and portal details can change — always confirm current steps and fees directly with DSHS and the Texas Medical Board before relying on this guide for a filing.