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.
Before diving into the steps, it's worth flagging a distinction that trips up a lot of new practices:
1. Facility / machine registration — registering the actual x-ray equipment and the location where it's used with DSHS. This is what the rest of this guide covers.
2. Operator certification — a completely separate requirement for the people who take or supervise x-rays, licensed through the Texas Medical Board rather than DSHS. More on this below.
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:
| Information | Details |
|---|---|
| Entity / business name | Legal name as registered with the Texas Secretary of State, plus assumed name certificate if applicable |
| Business phone number | Main contact number for the registered entity |
| Physical & mailing address | Where the machine is actually installed and used, and where DSHS should send correspondence if different |
| Radiation Safety Officer (RSO) | Name and contact information of the designated RSO for the facility |
| Machine manufacturer & model | As shown on the equipment nameplate |
| Intended use category | Healing arts (medical, chiropractic, podiatric), veterinary, industrial, academic, or mobile service |
| Installation / acquisition date | Confirms you're within the 30-day window |
| Machine location | Room or suite where the unit physically sits on site |
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:
FDA Form 2579 (Report of Assembly) — this is a federal requirement, not a Texas-specific one. Whoever assembles or installs a certified diagnostic x-ray system must file Form 2579 within 15 days of completing assembly, with copies going to you (the purchaser) and to DSHS as the state radiation control agency. Keep your copy on file — it's often requested during inspections as proof the unit was assembled to federal performance standards.
Equipment Performance Evaluation (EPE) — a hands-on safety and performance test (radiation output, beam alignment, timer accuracy, image quality, and safety features) that must be performed on new installations within 30 days, and repeated periodically after that: every 4 years for intraoral, panoramic, and handheld units, and annually (within 14 months) for CBCT/3D systems. Only a registered service company holding its own DSHS Certificate of Registration can perform an EPE, and you should receive a formal report within 30 days of the test.
Texas splits renewal into two separate clocks, and it's easy to mix them up:
Biennial fees vs. technical renewal
Biennial fees are due every two years based on your certificate's expiration month. DSHS bills approximately 60 days before the due date — paying this fee alone does not issue a new certificate.
Technical renewal happens on a longer cycle (roughly every 8 years) and requires resubmitting your application, safety procedures, and fees. DSHS sends a reminder letter about 45 days before expiration.
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.
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:
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.
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:
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.
Standard registration covers most general-use x-ray systems, but DSHS requires additional authorization on top of basic registration for:
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.
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.
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:
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.
Before you start
To register
Ongoing
Bringing a new x-ray system into your practice?
Maven Imaging helps practices across the country source new and refurbished imaging equipment, arrange financing, and get systems installed and running — so registration paperwork is one of the few things left on your plate.
Talk to a Maven Imaging SpecialistThis 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.