What New York'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.
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 It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong.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
ORSIF's research identified the New York State Department of Health (NYSDOH), Center for Environmental Health, Bureau of Environmental Radiation Protection (BERP); within New York City, NYC Department of Health and Mental Hygiene (DOHMH) Office of Radiological Health as the agency that regulates X-ray and fluoroscopy equipment in New York. New York is a U.S. Nuclear Regulatory Commission (NRC) Agreement State: it has signed an agreement with the NRC to regulate certain radioactive materials itself.
New York requires everyone who uses an X-ray machine, including fluoroscopy, to keep workers' doses ALARA under §16.5(a), part of the General Provisions of 10 NYCRR Part 16 that apply to both X-ray registrants and radioactive-materials licensees. The fluoroscopy rules contain no ALARA wording of their own. Part 16 was repealed and replaced effective July 22, 2026. Dose limits match the federal ones: 50 mSv per year whole body, 150 mSv per year lens of the eye and 500 mSv per year skin and extremities. Everyone in the fluoroscopy room must wear garments of at least 0.25 mm lead equivalent, except around tabletop mini C-arms; a new 2026 provision allows an equivalent dose reduction method instead, if measurements show it works. Only practitioners, licensed technologists and supervised students may apply X-rays to patients. Radiographers may operate fluoroscopy only with a physician in the room, and PAs currently cannot (bill S352/A9148 is in committee). NYC runs its own program under Health Code Article 175, which adds annual apron inspection.
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.
Which rules apply, and whether ALARA is among them.
Yes. New York is an NRC Agreement State.
10 NYCRR Part 16, "Ionizing Radiation," effective 07/22/2026. The General Provisions (§§16.1-16.26) serve as the general radiation protection rules. The Radiation Equipment sections are §§16.50-16.70, with fluoroscopy in §16.58. In NYC, NYC Health Code Article 175 also applies.
Sections of this Part set forth under the heading "General Provisions" (sections 16.1-16.26) contain provisions applicable to radiation equipment operators and persons in possession of radioactive materials, including general radiation protection requirements.This quote was matched word for word to the source page.
Yes. Anyone operating a radiation installation or using a radiation source, including X-ray and fluoroscopy equipment, must keep occupational doses ALARA.
Where ALARA lives in New York: Only in a rule shared with radioactive materials. The ALARA duty is in §16.5(a), part of the General Provisions that apply to both X-ray equipment operators and radioactive-materials possessors. No ALARA wording was found in the X-ray sections §§16.50-16.70. A change to §16.5(a) to match an NRC compatibility change would therefore affect X-ray registrants too, unless the state wrote separate X-ray language. (10 NYCRR 16.0; 16.5(a); 16.50-16.70)
(a) achieves occupational doses, and doses to any member of the public, as low as is reasonably achievable (ALARA). Such effort shall include, to the extent practicable, the use of procedures and engineering controls which are based on sound radiation protection principles;This quote was matched word for word to the source page.
The annual limits for workers, written in millisieverts (mSv). Ten mSv equal one rem.
0.05 Sv (5 rem) = 50 mSv per year total effective dose equivalent. The organ limit is 500 mSv.
0.15 Sv (15 rem) = 150 mSv per year. No lower International Commission on Radiological Protection (ICRP)-style limit has been adopted.
Shallow dose equivalent of 0.50 Sv (50 rem) = 500 mSv per year to the skin of the whole body or any extremity.
5 mSv (0.5 rem) to the embryo/fetus of a declared pregnant worker over the whole pregnancy.
When a worker must wear a dosimeter, and where.
Dosimeters are required for: adults likely to exceed 10% of the limits; minors above set thresholds; declared pregnant workers likely to exceed 1 mSv over the pregnancy; and anyone operating fluoroscopy equipment, whatever their expected dose. Processing must be by a National Voluntary Laboratory Accreditation Program (NVLAP)-accredited processor.
(4) individuals entering a high or very high radiation area, or operating fluoroscopy equipment; andThis quote was matched word for word to the source page.
Badge placement: whole-body badge at the unshielded spot likely to get the highest dose; lens badge at the neck outside the apron or closer to the eye; fetal badge at the waist under the apron. For physicians wearing aprons during fluoroscopy, effective dose may be calculated as one neck badge outside the apron × 0.3, or as (waist badge under the apron × 1.5) + (neck badge outside × 0.04). Otherwise, deep dose stands in for effective dose unless a department-approved method is used. National Council on Radiation Protection and Measurements (NCRP) 122 and the Webster method are not named.
(a) When only one individual monitoring device is used and it is located at the neck outside the protective apron, the reported deep dose equivalent value multiplied by 0.3 shall be the effective dose equivalent for external radiationThis quote was matched word for word to the source page.
Protective apparel, how it is checked, and whether other systems are addressed.
Everyone in the fluoroscopy room must wear garments of at least 0.25 mm lead equivalent, except with tabletop mini C-arms. Part 16 has no thyroid shield or eyewear requirement.
Other than tabletop mini C-arms, protective garments of at least 0.25 mm lead equivalent material each shall be worn by the physician, nurse, radiologic technologist and all other persons within the fluoroscopic room.This quote was matched word for word to the source page.
Not found in state rules. NYC Article 175 requires annual inspection of protective garments; garments used by fluoroscopy operators must be checked by visual, tactile and X-ray imaging methods. The NYC section number is uncertain.
Protective garments that are used by operators conducting fluoroscopic procedures must be checked using all three methods listed.This quote was matched word for word to the source page.
Yes. Since 07/22/2026, a dose reduction method equivalent to protective garments may be used instead of garments if measurements show it works. The method, measurements and any approval process are not defined. NYC §175.53 separately allows movable 0.25 mm lead-equivalent shields where sterile fields or special procedures prevent normal barriers.
In lieu of wearing protective garments, the use of a method of dose reduction equivalent to protective garments is acceptable, provided that measurements are made demonstrating its effectiveness.This quote was matched word for word to the source page.
Who may use fluoroscopy equipment and what training the rules ask for.
Only professional practitioners, people licensed under PHL Article 35 working within their scope, and supervised students may apply X-rays to patients. Licensed radiographers may operate fluoroscopy only under the personal supervision of a physician, who must be in the room. PAs and NPs may order X-rays but may not operate fluoroscopy unless they also hold an Article 35 license.
(5) operating fluoroscopy equipment under the personal supervision of a physician, except where direct supervision is required by this part;This quote was matched word for word to the source page.
Technologists need an NYSDOH license under Part 89, with continuing education equal to 12 credit hours per year of the registration cycle; there is no separate fluoroscopy permit. No physician-specific fluoroscopy training requirement was found. Registrants must ensure personnel are supervised, instructed and competent, give radiation safety instruction before work and at least annually, and run an in-service training program.
Instruction shall be given before an individual begins work likely to result in receiving an occupational dose or before an individual begins work in a restricted area and at least annually thereafter.This quote was matched word for word to the source page.
Rules, bills and guidance the research found from 2025 and 2026, with the ones that touch fluoroscopy teams first.
Adopted; effective July 22, 2026
Renamed "eye dose" to "lens dose"; removed planned special exposures; added annual radiation protection program review and acceptance testing, recording of high patient fluoroscopy doses, patient dose management in fluoroscopy following ACR-AAPM / NCRP Report 168, air-kerma display rules for fluoroscopes, and the apron-alternative language. About 154 public comments were received.
REFERRED TO HEALTH; has not passed either house (Jan 7, 2026)
Would let PAs use fluoroscopy after 40 hours of didactic training, 40 hours of clinical training and a competency exam.
Questions the research could not settle. If you know the answer, tell us.
Copies saved earlier. Rules change, so check the current text at the source.
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.
Found something wrong or missing? Tell ORSIF.
Found something out of date or wrong? Tell ORSIF. Corrections are checked against the rule text and the page is updated.
