How to Become a CT Tech After X-Ray: The ARRT Postprimary Path

If you want to know how to become a CT tech after X-ray, the short answer is this: keep your ARRT radiography credential, finish 16 hours of structured education, document at least 125 CT scans on real patients, then pass the ARRT CT exam. Most of the work is getting enough supervised scanner time, so the job you pick matters as much as the studying.

This guide walks through each step the way it actually plays out in a department, plus the mistakes that slow people down.

Why X-ray techs are moving into CT

CT is one of the hardest seats in imaging to fill right now. The ASRT's 2025 staffing and workplace survey put the CT vacancy rate at 19.4%, an all-time high, up from 17.7% in 2023. Radiography vacancies went the other way, falling from 18.1% to 15.6% over the same period (ASRT).

For you, that gap means more departments willing to cross-train a radiographer they already trust, and more open CT roles once you have the credential. It also means more variety: trauma, oncology follow-ups, CTAs, biopsies and outpatient work all need CT coverage.

The ARRT CT postprimary pathway, step by step

Radiographers earn the CT credential through ARRT's postprimary eligibility pathway. You do not need to go back for a second degree. Here is what the ARRT computed tomography page and its linked requirement documents lay out.

Step 1: Hold a supporting credential

You must already be certified and registered in Radiography, Nuclear Medicine Technology or Radiation Therapy. Keep it in good standing, along with compliance with the ARRT Standards of Ethics, the whole way through.

Step 2: Complete 16 hours of structured education

ARRT requires 16 hours of structured education targeted to the CT exam content specifications, with at least one credit in each major content category. A few details people miss:

• The hours must be completed within the 24 months before you submit your application.
• Activities must be approved by a recognized CE approver or state entity, or be an academic course from an accredited institution.
• You log them in your ARRT account using the postprimary tool.
• The same hours can count toward your biennial CE.

Online CT registry review courses are the most common route. Some community colleges also offer CT certificate programs that cover the education and help place you for clinical time.

Step 3: Document your clinical experience

This is the step that takes the longest. Under the CT clinical experience requirements that took effect September 1, 2026, you need to:

• Choose at least 25 different procedures from a list of 67.
• Perform each chosen procedure at least 3 times and no more than 5 times.
• Reach a minimum of 125 total repetitions.
• Include at least 30 repetitions that use iodinated IV contrast.

The 67 procedures fall into six groups:

Category	Procedures on the list
Head, spine and musculoskeletal	25
Neck and chest	14
Abdomen and pelvis	17
Additional procedures (biopsy, drainage, pediatric, surgical planning)	5
Image display and postprocessing	4
Quality assurance	2

A few rules shape how fast you can finish:

• Only one procedure per patient per day can be documented.
• You can log up to nine CT procedures per day.
• You must be physically present. Remote scanning does not count.
• Scans done only for PET or SPECT attenuation correction or radiation therapy planning are not eligible.
• Each procedure has to be verified by a registered technologist or an interpreting physician.
• Procedures older than 24 months expire until you apply. Once you apply and get an exam window, they lock in.

The requirements also expect you to independently handle the full exam: patient assessment, history and allergies, contrast prep or administration when indicated, positioning, protocol selection and starting the scan. ARRT notes that candidates are responsible for confirming their state allows them to do this part. Always check before you start logging.

Step 4: Apply and pass the ARRT CT exam

Once your education and clinical log are complete, you apply through the postprimary pathway and schedule your exam. The ARRT CT page links the current exam content specifications and task inventory. Study from those, not from an old review book, since ARRT updated the CT documents for 2026.

How long does it take?

It depends almost entirely on scanner access. A tech who is cross-training in a busy hospital CT department may finish clinical documentation in a few months. A tech who only gets occasional CT shifts can take a year or more. Since everything has to fit inside a 24-month window, plan your structured education so it does not expire before your clinicals are done.

How to actually get CT clinical time

This is where most people stall. The ARRT does not place you anywhere, so you have to find the scanner time yourself. Options that work:

1. Ask your current employer. Many departments cross-train internal X-ray techs into CT, especially where CT is short staffed. Bring a plan: your education is done or underway, and you know exactly what you need to log.
2. Pick up PRN or shift work in a facility that cross-trains. Some hospitals and imaging centers hire radiographers with an agreement to train them in CT.
3. Enroll in a CT certificate program that includes a clinical placement.
4. Work evenings, nights or weekends. Off-shift CT often runs with a small crew, which can mean more hands-on time once you are trained and supervised.

When you interview, ask who verifies your procedures, how many CT shifts you will realistically get per week, and whether contrast work is part of your role. Those three answers tell you how fast you will finish.

Skills that make the jump easier

Your radiography background already covers anatomy, positioning and radiation safety. The new skills that slow people down are:

• IV access and contrast. You need 30 contrast-enhanced repetitions, so comfort with IV starts and power injectors matters. Learn your facility's contrast reaction protocol early.
• Cross-sectional anatomy. Thinking in axial, coronal and sagittal slices takes practice. Review it alongside your scans, not just before the exam.
• Protocols and dose. Learn why a protocol is built the way it is, not just which button to press.
• Postprocessing. Reformats and 3D work are on the list, so ask to do them yourself.

State licensing: check before you scan

ARRT certification and state licensing are separate. Some states regulate CT operators on top of general radiography licensure, using a license, certificate or other standard. The ASRT keeps a state-by-state list of states that regulate. Use it as a starting point, then confirm current requirements with your state's licensing board before you start documenting scans, because rules change.

Common mistakes to avoid

• Finishing structured education too early, then running out of time on the 24-month window.
• Logging the same procedure more than 5 times and coming up short on variety.
• Skipping contrast cases until the end and scrambling for 30.
• Not confirming that your verifier is registered.
• Assuming your state allows you to scan as a trainee without checking.

FAQ

Can I become a CT tech without going back to school?

Yes. If you are a registered radiographer, the ARRT postprimary pathway lets you earn the CT credential with 16 hours of structured education, documented clinical experience and the CT exam. A full degree program is not required.

How many CT scans do I need for the ARRT CT exam?

Under the current requirements, at least 125 repetitions across at least 25 different procedures, with 3 to 5 repetitions each and at least 30 using iodinated IV contrast. Check the ARRT CT page for the latest version.

Do I need IV skills to work in CT?

You need to handle contrast exams, and at least 30 of your logged repetitions must use iodinated IV contrast. Whether you start IVs yourself depends on your facility and state, so ask during interviews.

Can my procedures expire?

Yes. Clinical procedures and structured education must fall within the 24 months before you apply. Once you apply and receive an exam window, your logged procedures lock in.

Is CT a good move for X-ray techs right now?

CT vacancies hit an all-time high of 19.4% in the ASRT's 2025 survey, and the BLS projects 5% growth for radiologic and MRI technologists from 2025 to 2035. Demand for CT-credentialed techs is strong.

Ready for your next step?

If you are a radiographer working toward CT, or already credentialed and looking for your first CT role, create your free profile. Tell us your modalities, the work type you want and how far you will drive, and we will only reach out when a job fits. You can also browse open radiology jobs or read our FAQ to see how we work.