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CDC considers letting nurse practitioners, physician assistants read X-rays under federal program

Marty Stempniak | January 07, 2025 | Radiology Business | Policy & Regulations


The Centers for Disease Control and Prevention is exploring whether to expand a federal program to allow nurse practitioners and physician assistants to read certain X-rays. 


Currently, the CDC’s “B Reader Program” trains and certifies physicians to classify chest radiographs of workers participating in federal health surveillance programs. Participating docs classify X-rays for the presence and severity of pneumoconiosis, a type of dust-induced lung disease seen in workers exposed to asbestos and coal mine dust. 


As of October, 184 U.S. physicians across 35 states and two territories were certified as B Readers. But the CDC’s National Institute for Occupational Safety and Health (NIOSH) is now considering whether to let other providers participate. 


“NIOSH is interested in ensuring that B Readers are available to classify chest radiographs obtained in all states and territories,” the agency said in a notice published Dec. 17 in the Federal Register. “To meet this goal, NIOSH is requesting information from parties interested in allowing nurse practitioners and physician assistants to be eligible to take the NIOSH B Reader examination and become certified…”


The American College of Radiology—which helped develop the NIOSH exam—shared an update on the CDC initiative Dec. 19, noting that it plans to submit feedback. As of Monday, the CDC had received three responses to its request for information. One voiced opposition to allowing nonphysicians to serve as B Readers, fearing this could increase error rates. The other two, meanwhile, came from NPs in favor of the expansion. 


“The task of applying a prescribed method of determination to an image aligns well within the scope and practice of experienced nurse practitioners in occupational health. I strongly support the change,” wrote Nathaniel D. Collins, a North Carolina-based NP. 


Those interested have until March 17 to submit feedback. 


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