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Kentucky: radiation safety rules for fluoroscopy teams

What Kentucky's rules say about ALARA (as low as reasonably achievable), dose limits in millisieverts (mSv), dosimeters, aprons and training for the people who work in fluoroscopy labs.

  • Agreement State
  • Researched Nov 3, 2026
  • Not yet reviewed by a regulatory expert.

Please double-check this information. This is an ORSIF research summary, researched November 3, 2026. It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong. It is education, not legal advice. Not yet reviewed by a regulatory expert. Confirm each requirement at the source linked beside the answer, with the state program and with your facility's radiation safety officer. How this was made

In brief

ORSIF's research identified the Radiation Producing Machines Program, Radiation Health Branch, Division of Protection and Safety, Department for Public Health, Cabinet for Health and Family Services as the agency that regulates X-ray and fluoroscopy equipment in Kentucky. Kentucky is a U.S. Nuclear Regulatory Commission (NRC) Agreement State: it has signed an agreement with the NRC to regulate certain radioactive materials itself.

Kentucky requires ALARA for X-ray users in the shared general rule 902 KAR 100:015 §2 and in the registrant-only standards rule 902 KAR 100:019 (since December 2023); licensees follow 902 KAR 100:185 adopting 10 CFR Part 20. Dose limits are standard US limits, with a lens limit of 150 mSv per year. Everyone in the fluoroscopy room except the patient must wear an apron of at least 0.25 mm lead equivalent; engineered shielding alternatives and apron inspections are not addressed. Licensed practitioners need no imaging license; technologists need a KBMIRT license, and limited X-ray machine operators may not perform fluoroscopy.

ALARA for X-ray usersYesBoth Whole-body limit5 rem (50 mSv) total effective dose equivalent (TEDE) per year for adults. Eye-lens limit150 mSva year Apron inspectionNot found Alternatives to apronsNot found

The rules, question by question

Every answer names the rule it comes from. Open "Rule text and source" to read the citation, the source page and, where it could be matched, the exact wording.

Where the rules live

Which rules apply, and whether ALARA is among them.

Is Kentucky an NRC Agreement State?

Yes

Yes. Kentucky is not on the NRC's list of non-Agreement States, so it is an Agreement State; 902 KAR 100:185 makes radioactive-materials licensees follow 10 CFR Part 20.

Rule text and source
Rule
NRC list of Agreement States, updated October 29, 2026; 902 KAR 100:185 §2
Source
nrc.gov
apps.legislature.ky.gov
What it says
This administrative regulation shall apply to a licensee. The licensee shall comply with 10 C.F.R. Part 20 except as established in subsections (1) through (5) of this section.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Which rules cover X-ray and fluoroscopy equipment in Kentucky?

Yes

902 KAR Chapter 100: 100:105 (X-rays; general), 100:110 (registration), 100:115 (diagnostic), 100:125 (fluoroscopic); 100:019 standards for protection for X-ray registrants (eff. 12-13-2023); 100:185 for radioactive materials; shared rules 100:015 and 100:010.

Rule text and source
Rule
902 KAR 100:019; 100:105; 100:115; 100:125; 100:185; 100:015
Source
apps.legislature.ky.gov
What it says
This regulation shall apply to fluoroscopic x-ray systems and to persons, equipment and materials used in connection with the possession and use or operation of these such systems.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Does Kentucky require X-ray users to keep doses as low as reasonably achievable (ALARA)?

Yes

Yes. Registrants must use procedures and engineering controls to keep occupational doses ALARA, referencing the general rule in 902 KAR 100:015 §2.

Where ALARA lives in Kentucky: In a shared rule and in X-ray-specific language. ALARA appears in the shared general rule 902 KAR 100:015 §2 (licensees and registrants) and in the registrant-only 902 KAR 100:019 §2(2); licensees follow 100:185 adopting 10 CFR Part 20 by reference. The shared ALARA definition in 100:010 is written in licensee terms. (902 KAR 100:015 §§1-2; 100:019 §1(2), §2(2) and its impact analysis; 100:185 §2)

Rule text and source
Rule
902 KAR 100:019 §2(2); 902 KAR 100:015 §2
Source
apps.legislature.ky.gov
What it says
Use procedures and engineering controls based upon sound radiation protection principles, to the extent practical, to achieve occupational doses and doses to members of the public that shall be as low as reasonably achievable (ALARA) pursuant to 902 KAR 100:015, Section 2.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Dose limits

The annual limits for workers, written in millisieverts (mSv). Ten mSv equal one rem.

What is the annual eye-lens dose limit in Kentucky?

Yes

15 rem (150 mSv) per year; no lower lens limit adopted.

Rule text and source
Rule
902 KAR 100:019 §3(1)
Source
apps.legislature.ky.gov
What it says
A lens dose equivalent of fifteen (15) rems (0.15 Sv); and
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

What limit applies to a declared pregnant worker in Kentucky?

Yes

0.5 rem (5 mSv) to the embryo/fetus of a declared pregnant woman for the whole pregnancy.

Rule text and source
Rule
902 KAR 100:019 §7(1)
Source
apps.legislature.ky.gov
What it says
does not exceed five-tenths (0.5) rem (5 mSv).
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Dosimeters

When a worker must wear a dosimeter, and where.

When must a worker in Kentucky wear a dosimeter?

Yes

Monitoring required for adults likely to exceed 10% of limits (0.5 rem TEDE, 1.5 rem lens, 5 rem skin/extremity); minors likely to exceed 0.1 rem deep, 0.15 rem lens, or 0.5 rem skin/extremity; declared pregnant women likely to exceed 0.1 rem; anyone entering high or very high radiation areas. National Voluntary Laboratory Accreditation Program (NVLAP)-accredited processor required.

Rule text and source
Rule
902 KAR 100:019 §11(2)
Source
apps.legislature.ky.gov
What it says
Adults likely to receive, in one (1) year from radiation sources external to the body, a dose in excess of ten (10) percent of the limits in Section 3(1) of this administrative regulation;
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Where must the dosimeter be worn in Kentucky when a protective apron is worn?

In partLess certain

If an apron is worn, at least one badge must be worn at the neck outside the apron; with multiple badges each dose must be labeled with body location. No approved effective-dose method (NCRP 122, Webster) found.

Rule text and source
Rule
902 KAR 100:105 §2(2)(f); 902 KAR 100:019 §3(3)
Source
apps.legislature.ky.gov
What it says
If an apron is worn, the monitoring device shall be worn at the neck area outside of the apron; and
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Aprons and alternatives

Protective apparel, how it is checked, and whether other systems are addressed.

Must staff in Kentucky fluoroscopy rooms wear protective aprons or other apparel?

Yes

Aprons of at least 0.25 mm lead equivalent required for fluoroscopist and everyone in the room except the patient; 0.25 mm Pb gloves must be readily available; scatter shielding requirements for table and above-table. Thyroid shields and eyewear not addressed.

Rule text and source
Rule
902 KAR 100:125 §§12, 13(3), 13(7); 902 KAR 100:115 §14
Source
apps.legislature.ky.gov
What it says
Protective aprons of at least 0.25 mm lead equivalence shall be worn by the fluoroscopist and by persons in the fluoroscopic room except the patient during each examination;
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Do the rules in Kentucky address engineered protection systems used in place of aprons?

UnclearLess certain

Not addressed for fluoroscopy; 100:125 requires aprons with no alternative and drapes are in addition to aprons. 100:115 §14(2) allows aprons or whole body protective barriers for radiographic exposure, but applicability to fluoroscopy is unclear. Exemptions may be granted on request.

Rule text and source
Rule
902 KAR 100:125 §12(2)(b), §13(7); 902 KAR 100:115 §14(2); 902 KAR 100:015 §7
Source
apps.legislature.ky.gov
What it says
Staff and ancillary personnel shall be protected from direct scatter radiation by protective aprons or whole body protective barriers of not less than 0.25 mm lead equivalent;
This quote was matched word for word to the source page.

About ALARA+

Who operates the equipment

Who may use fluoroscopy equipment and what training the rules ask for.

Who may operate fluoroscopy equipment in Kentucky?

In partLess certain

Licensed practitioners of the healing arts (physicians, dentists, chiropractors, podiatrists, veterinarians) are exempt from imaging licensure; others need a KBMIRT license. Limited X-ray machine operators may not perform fluoroscopy. Technologist fluoroscopy requires supervision; PA/APRN status unsettled.

Rule text and source
Rule
KRS 311B.090; KRS 311B.020(8)-(9); 902 KAR 100:125 §13(1)-(2); 201 KAR 46:035 §§1-2
Source
apps.legislature.ky.gov
What it says
This chapter shall not apply to any individual licensed in the Commonwealth of Kentucky as a licensed practitioner of the healing arts, any student enrolled in an approved educational program in medical imaging technology or radiation therapy,
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

What training or credentials does Kentucky require to operate fluoroscopy equipment?

In partLess certain

Technologists need a KBMIRT license (credentialing by recognized national organization such as American Registry of Radiologic Technologists (ARRT); continuing education required). No physician fluoroscopy training requirement found; operators must be adequately instructed and competent. Specific hours not confirmed.

Rule text and source
Rule
KRS 311B.100, 311B.110, 311B.020; 902 KAR 100:105 §2(2)(b)
Source
apps.legislature.ky.gov
What it says
The following individuals are required to apply for and receive a license from the Commonwealth of Kentucky before performance of any procedures utilizing radiation for either medical imaging or radiation therapy:
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Changes on the way, and recent ones

Rules, bills and guidance the research found from 2025 and 2026, with the ones that touch fluoroscopy teams first.

  • Adopted rule201 KAR 46:035 amendment

    Effective 2-5-2025 (Feb 5, 2025)

    Updated incorporated practice standards, including ACR-AAPM fluoroscopy standard revised 2023.

    Source: apps.legislature.ky.gov

  • Bill2025 HB 72 (2025 Ky. Acts ch. 132)

    Signed March 31, 2025; effective June 27, 2025

    States limited X-ray machine operators may not perform fluoroscopy; allows them to work at fluoroscopy facilities only for limited diagnostic radiography.

    Source: apps.legislature.ky.gov

  • Other902 KAR 100:015, 105, 115, 125 certification

    Certification notation "Crt eff. 4-21-2026"; no text changes found (Apr 21, 2026)

    Certification notation of uncertain meaning; no text changes found.

    Source: apps.legislature.ky.gov

2 other items the research logged (radiation therapy, industrial machines, fees and other subjects)
  • Proposed rule902 KAR 100:190 (licensing of source material)

    Proposed

    Radioactive materials only; the only proposed rule shown in the 902 KAR 100 index.

    Source: apps.legislature.ky.gov

  • Bill2026 HB 89 (medical imaging licensure overhaul)

    01/14/26: to Licensing, Occupations, & Administrative Regulations (H); not confirmed whether it died (Jan 14, 2026)

    Would add MRI and sonography licensure and criminal background checks, among other changes.

    Source: apps.legislature.ky.gov

Also worth knowing

  • The shared ALARA definition in 902 KAR 100:010 (last amended 2015) is tied to 100:019 limits and the "licensed activity," though 100:019 applies only to registrants since 2023.
  • The fluoroscopy rule (100:125) dates from 1992, still names the "Cabinet for Human Resources," and covers non-image-intensified systems.
  • 100:125 requires a five-minute cumulative timer with audible alarm, entrance exposure rate limits of 10 R/min (5 R/min without high-level control) measured at least annually, and bans hand-held fluoroscopic screens.
  • Registrants must review their radiation protection program annually (100:019 §2(3)) and post KR441 "Notices to Employees."
  • No Kentucky response to the NRC's proposed ALARA rewrite was found.

What ORSIF could not confirm

Questions the research could not settle. If you know the answer, tell us.

  • Technologist qualifications in 201 KAR 46:040 and continuing education hours in 46:060 were not read.
  • Whether PAs and APRNs may operate or activate fluoroscopy is unresolved.
  • Confirm whether 2026 HB 89 died when the session ended.
  • Whether 902 KAR 100:185 adopts 10 CFR Part 20 as of a fixed date or automatically picks up later federal changes.
  • Meaning of the "Crt eff. 4-21-2026" notation and whether any 2026 rule review proposes changes.
  • Whether the Radiation Health Branch has guidance on effective-dose calculation, apron inspection, eyewear, or engineered shielding systems.
  • Whether 100:115 §14 (aprons or whole body protective barriers) applies in fluoroscopy rooms.
  • Whether the cabinet still enforces 100:125 §13(1) radiologist-direction requirement alongside KBMIRT's broader supervision standard.

Who regulates, and where to read the rules

Double-check before you rely on this page

ORSIF compiled this page from the sources linked on it and did its best. It is not comprehensive and it is not always accurate. Rules change, a rule may have been missed or misread, and the sources themselves can be out of date. Treat this page as a starting point.

Where to check

What may be missing here

  • 2 of 14 answers on this page are "Not found" or "Unclear". That means ORSIF did not find the answer in the rules it reviewed, not that no rule exists.
  • 5 answers carry a flag or a lower confidence ("Check the source" or "Less certain").
  • Researched November 3, 2026. Rules may have changed since.
  • Only the state's rules for X-ray and fluoroscopy equipment were reviewed.

Found something wrong or missing? Tell ORSIF.

Sources and terms

Terms used on this page
ALARA
As low as reasonably achievable: keep radiation doses as low as is reasonable, below the legal limits.
Agreement State
A state that has signed an agreement with the U.S. Nuclear Regulatory Commission to regulate certain radioactive materials itself.
mSv
Millisievert, a unit of radiation dose. Ten mSv equal one rem, the older unit some rules still use.
Dosimeter
A badge or device worn to measure a worker's radiation dose.
Lead equivalent
The thickness of lead (mm Pb) that would give the same protection as the material described.
NRC
U.S. Nuclear Regulatory Commission
TEDE
Total effective dose equivalent
ARRT
American Registry of Radiologic Technologists
NVLAP
National Voluntary Laboratory Accreditation Program
All 19 sources the research read

Found something out of date or wrong? Tell ORSIF. Corrections are checked against the rule text and the page is updated.