Mississippi Radiation Safety Rules for Fluoroscopy Teams

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 It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong.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 Mississippi State Department of Health (MSDH), Division of Radiological Health, X-ray Branch as the agency that regulates X-ray and fluoroscopy equipment in Mississippi. Mississippi is a U.S. Nuclear Regulatory Commission (NRC) Agreement State: it has signed an agreement with the NRC to regulate certain radioactive materials itself.

Mississippi adopts 'the current revision' of 10 CFR Part 20, including ALARA, by reference and applies it to X-ray registrants as well as materials licensees, so an NRC removal of ALARA could carry over; whether that happens automatically or needs state rulemaking is unsettled. Fluoroscopy workers have the federal dose limits, including the 150 mSv/year lens limit. Staff must be protected by aprons 'or whole body protective barriers' of at least 0.25 mm lead equivalent. The rules do not address apron inspection, thyroid shields, eyewear or engineered systems. Medical radiation technologists must register with MSDH; licensed practitioners and permitted Limited X-Ray Machine Operators working under a practitioner's direction are exempt. No fluoroscopy-specific operator permit or physician training rule was found.

ALARA for X-ray usersYesShared rule Whole-body limitTotal effective dose equivalent (TEDE) of 5 rem (50 mSv) per year, or 50 rem (500 mSv) to any organ other than the lens. 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 Mississippi an NRC Agreement State?

Yes

Yes, Mississippi is an NRC Agreement State; the rules also refer to the state-NRC agreement.

Rule text and source

Rule: NRC list of Agreement States, updated October 29, 2026; 15 Miss. Admin. Code Pt. 21, Subpt. 78, Ch. 1, Rule 1.1.1, footnote 1
Source: nrc.gov
sos.ms.gov
What it says: regulation by the State of source material, byproduct material, and special nuclear material in quantities not sufficient to form a critical mass is subject to the provisions of the agreement between State and the U.S. Nuclear Regulatory Commission
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 Mississippi?

Yes

Title 15, Part 21, Subpart 78, Chapter 1, 'Regulations for Control of Radiation in Mississippi'. X-ray/fluoroscopy rules are in Subchapter 6 (Rules 1.6.1-1.6.10; Rule 1.6.3 general requirements, Rule 1.6.5 fluoroscopic systems). Standards for protection against radiation are in Subchapter 4, Rule 1.4.1, which adopts most of 10 CFR Part 20 by reference. The Secretary of State PDF has file metadata dated 7 Oct 2024, but the text shows no overall effective date.

Rule text and source

Rule: 15 Miss. Admin. Code 21-78-1.4.1; 21-78-1.6.1 to 1.6.10
Source: sos.ms.gov
What it says: This Regulation adopts by reference the current revision of the following sections in Title 10 Code of Federal Regulations Part 20
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

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

Yes

Yes. Rule 1.4.1 adopts 10 CFR 20.1101(b), which requires ALARA. Rule 1.4.1(2) applies all of Subchapter 4 to registrants, and 'licensee' in Part 20 includes 'registrant'. Rule 1.1.2(14) also defines ALARA.

Where ALARA lives in Mississippi: Only in a rule shared with radioactive materials. The explicit ALARA requirement comes only through Subchapter 4, which adopts 10 CFR 20.1101 for licensees and registrants alike; the definition is in general Rule 1.1.2. Subchapter 6 does not use the term ALARA but requires procedures and equipment that minimize patient and personnel exposure (Rule 1.6.3(1)(i)). Because Rule 1.4.1 adopts 'the current revision' of Part 20, an NRC change could carry over to X-ray registrants; whether that happens automatically is unsettled. (Rule 1.4.1; Rule 1.1.2(14); Rule 1.6.3(1)(i))

Rule text and source

Rule: Rule 1.4.1 and 1.4.1(2); 10 CFR 20.1101(b) as adopted; Rule 1.1.2(14)
Source: sos.ms.gov
What it says: All of the requirements in Subchapter 4 apply to both licensees and registrants.
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 whole-body dose limit in Mississippi?

Yes

TEDE of 5 rem (50 mSv) per year, or 50 rem (500 mSv) to any organ other than the lens, whichever is more limiting (10 CFR 20.1201, adopted by Rule 1.4.1).

Rule text and source

Rule: Rule 1.4.1 adopting 10 CFR 20.1201 and 20.1208
Source: ecfr.gov

Why this matters, in ORSIF's FAQs

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

Yes

15 rem (150 mSv) per year. No lower limit (such as 20 mSv) has been adopted.

Rule text and source

Rule: Rule 1.4.1 adopting 10 CFR 20.1201
Source: ecfr.gov
What it says: (i) A lens dose equivalent of 15 rems (0.15 Sv), and (ii) A shallow-dose equivalent of 50 rem (0.5 Sv) to the skin of the whole body or to the skin of any extremity.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

What is the annual limit for the skin, hands and feet in Mississippi?

Yes

50 rem (500 mSv) per year shallow-dose equivalent to the skin or any extremity.

Rule text and source

Rule: Rule 1.4.1 adopting 10 CFR 20.1201
Source: ecfr.gov
What it says: (i) A lens dose equivalent of 15 rems (0.15 Sv), and (ii) A shallow-dose equivalent of 50 rem (0.5 Sv) to the skin of the whole body or to the skin of any extremity.
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 Mississippi?

Yes

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

Rule text and source

Rule: Rule 1.4.1 adopting 10 CFR 20.1208
Source: ecfr.gov

Why this matters, in ORSIF's FAQs

Dosimeters

When a worker must wear a dosimeter, and where.

When must a worker in Mississippi wear a dosimeter?

YesCheck the source

Dosimeters are required for adults likely to receive more than 10% of the 20.1201(a) limits in a year, minors above set thresholds, and declared pregnant workers likely to receive more than 0.1 rem (1 mSv) deep dose over the pregnancy. Rule 1.6.3(1)(j) also makes everyone associated with operating an X-ray system subject to the monitoring rules.

Rule text and source

Rule: Rule 1.4.1 adopting 10 CFR 20.1502; Rule 1.6.3(1)(j)
Source: ecfr.gov

Why this matters, in ORSIF's FAQs

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

In part

When an apron is worn, at least one badge must be worn at the collar outside the apron. The whole-body dose, based on the maximum dose to the most critical organ, must be recorded. If more than one badge is used, each dose must be identified with where it was worn; no two-badge formula is set. Effective dose equivalent (EDE) requires a method approved by MSDH (substituted for NRC), but no named method was found. Rule 1.6.3(1)(j) cites rules 1.4.5-1.4.7, which no longer exist in Subchapter 4.

Rule text and source

Rule: Rule 1.6.3(1)(j)(i); Rule 1.4.1(3); 10 CFR 20.1201(c)
Source: sos.ms.gov
What it says: When an apron is worn, the monitoring device shall be worn at the collar outside of the apron.
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 Mississippi fluoroscopy rooms wear protective aprons or other apparel?

Yes

Staff in the room must be protected from direct scatter by aprons or whole-body barriers of at least 0.25 mm lead equivalent; body parts struck by the useful beam need at least 0.5 mm. Facilities must supply enough leaded aprons and gloves. For fluoroscopy, 0.25 mm lead equivalent is required against under-table scatter, and an additional 0.25 mm against above-table scatter on top of the apron unless the person is at least 120 cm from the beam center. Thyroid shields and eyewear are not mentioned in Subchapter 6.

Rule text and source

Rule: Rule 1.6.3(1)(e)(i)-(ii), (h)(vii); Rule 1.6.5(8)
Source: sos.ms.gov
What it says: shall be protected from the direct scatter radiation by protective aprons or whole body protective barriers of not less than 0.25 millimeter lead equivalent material.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Does Mississippi require protective aprons to be inspected?

Not foundLess certain

not found

Rule text and source

Rule: Searched Subchapter 6 (Rules 1.6.1-1.6.10 and appendices)
Source: sos.ms.gov

Why this matters, in ORSIF's FAQs

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

UnclearLess certain

Not addressed by name; there is no engineered-system or apron-free provision. The rule allows 'protective aprons or whole body protective barriers', and 'whole body protective barrier' is not defined beyond the general 'protective barrier' definition. Drapes, Bucky-slot covers and curtains are listed for above-table scatter in addition to the apron.

Rule text and source

Rule: Rule 1.6.3(1)(e)(ii); Rule 1.6.2(66); Rule 1.6.5(8)(b)(ii)
Source: sos.ms.gov
What it says: the radiation has passed through not less than 0.25 millimeter lead equivalent material including, but not limited to, drapes, Bucky-slot cover panel, or self-supporting curtains, in addition to any lead equivalency provided by the protective apron
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 Mississippi?

In partLess certain

X-ray use is by or under the supervision of a licensed healing-arts practitioner, and fluoroscopy is run by a switch held by 'the fluoroscopist'. Medical radiation technologists must be registered with MSDH. Exempt are licensed practitioners acting within their scope, supervised students, and Board of Medical Licensure 'Limited X-Ray Machine Operator' permit holders working under a licensed practitioner's specific direction. PA/NP fluoroscopy rules and whether limited operators may do fluoroscopy were not found.

Rule text and source

Rule: Rule 1.6.1; Rule 1.6.5(2); 15 Miss. Admin. Code 19-60-7.6.1 (authority Miss. Code Ann. §41-58-3)
Source: law.cornell.edu
What it says: No person shall practice medical radiation technology unless he is registered by the Department, except as otherwise provided in this section.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

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

In partLess certain

Operators must be adequately instructed and competent; Appendix A lists the subjects, including personnel protection and dosimetry, and MSDH may check by interview, observation or testing. No fluoroscopy permit, training-hours rule or physician fluoroscopy training rule was found. A secondary source says technologist registration rests on American Registry of Radiologic Technologists (ARRT) credentials with 24 hours of continuing education (CE) every 2 years; this is unconfirmed.

Rule text and source

Rule: Rule 1.6.3(1)(b); Subchapter 6 Appendix A
Source: sos.ms.gov
What it says: Individuals who will be operating the x-ray systems shall be adequately instructed in the safe operating procedures and be competent in the safe use of the equipment.
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.

Proposed ruleNRC proposed ALARA rule
Proposed (Jul 15, 2026)
If finalized, it would reach Mississippi registrants through the 'current revision' wording in Rule 1.4.1.
OtherMiss. Code §41-58-3 sunset
Justia's 2024 code lists it as repealed effective 7/1/2028; HB 259 (2023) was titled as deleting the sunset (Jul 1, 2028)
Possible sunset of the medical radiation technologist law; status unresolved.
Source: law.justia.com
OtherMSDH final revisions to radiation subchapters (NRC review, Tracking Ticket 25-25)
Sent to NRC 1 Apr 2025; NRC replied 21 Jan 2026 with three comments (Jan 21, 2026)
One NRC comment says Mississippi's own definitions in Rule 1.1.2 (which include the state ALARA definition) duplicate or conflict with the adopted federal definitions and should be removed from one place or the other. These are radioactive-materials compatibility items, not X-ray changes.
Source: nrc.gov

Also worth knowing

Appendix C automatically exempts certain procedures (angiograms, myelograms, arthrograms, biliary drainage, nephrostomies, fluoroscopic biopsies) from the above-table scatter shielding rule 1.6.5(8)(b); MSDH may not grant the exemption where pre-fitted sterile barrier covers are practical.
A qualified expert must measure and post fluoroscopic entrance exposure rates every year.
Fluoroscopes need a 5-minute cumulative timer with an audible signal.
Rule 1.6.3(1)(j) cross-references Rules 1.4.5-1.4.7, which no longer exist in Subchapter 4.
No 2025-2026 X-ray rule changes or 2026 fluoroscopy/apron bills were found, based on limited searching.

What ORSIF could not confirm

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

Does Rule 1.4.1's adoption of 'the current revision' of Part 20 pick up later NRC changes automatically under Mississippi law, or must MSDH re-adopt them? Ask MSDH Radiological Health or check Miss. Code §25-43.
What is the effective date of the current Chapter 1 text, and did MSDH re-file it after the NRC's January 2026 comments? Check the Administrative Bulletin and msdh.ms.gov/page/resources/7544.pdf.
What authority do PAs/NPs and limited operators have for fluoroscopy, and what are the ARRT and continuing-education requirements? Needs MSDH Chapter 7 (7.1.2, 7.3, 7.5), Board of Medical Licensure Part 2621, and Miss. Code §41-58-1 to -5.
Is there a technologist law sunset? HB 259 (2023) was titled as deleting it, but Justia lists a 7/1/2028 repeal.
Does MSDH read 'whole body protective barriers' to include engineered systems used instead of aprons?

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

The rule itself. Open "Rule text and source" under any answer, or read the sources listed below.
The state. Mississippi State Department of Health (MSDH). Program contacts in the CRCPD directory.
Your radiation safety officer. They know the federal, accreditation and facility requirements that apply at your site, which the state rules do not cover.

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
EDE: Effective dose equivalent
ARRT: American Registry of Radiologic Technologists
CE: Continuing education

All 9 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.