Nuclear Medicine Advanced Associate (NMAA) Exam

The NMTCB's Nuclear Medicine Advanced Associate (NMAA) Examination is a time-limited exam. A successful candidate's certification will last ten (10) years from the exam date, and will expire thereafter. In order to recertify, the certificant must pass a recertification examination in order to maintain the credentials. NMAA certificants are allowed to take the recertification exam any time between years 8-10 of their current certification period.

Please note: there is no penalty for recertifying early. If an NMAA certificant chooses to take the recertification exam early and passes the exam, the subsequent certification period is extended to include and reflect the end date of the first 10 year period. Example: if a certificant passes the recertification exam at 8.5 years the new certification period will then be 11.5 years.

What is NMAA?

A Nuclear Medicine Advanced Associate (NMAA) is a physician extender working under the supervision of a licensed physician who is also an authorized user of radioactive materials, to enhance patient care in the diagnostic imaging and radiotherapy environments.

The Nuclear Medicine Advanced Associate is an NMTCB, ARRT or CAMRT-certified nuclear medicine technologist who has successfully completed an advanced academic program encompassing a nationally recognized NMAA curriculum and a clinical preceptorship directed by a nuclear medicine physician, nuclear cardiologist or radiologist. To view the NMAA Curriculum guide, please click here. Any NMAA Program that would like to have its graduates sit for the NMTCB's NMAA certification exam should meet the guidelines listed in the NMAA Educational Program Recognition Guidelines document and complete the application to the NMTCB. The guidelines document can be found here.

The NMAA degree is unique in that it can be obtained through online courses while the student continues to be employed full-time. Clinical hours can be obtained during the student's 40 hour work week. Students are currently required to travel to campus only twice during the program.

Under physician supervision, the NMAA performs patient assessment, patient management and selected nuclear medicine procedures as summarized below.

  1. Perform and document a comprehensive review of clinical information, such as pertinent lab work, including blood, urine and other tissue samples and pathology studies, as well as correlative imaging studies to facilitate optimal interpretation of the nuclear medicine procedure by the supervising physician.
  2. Perform, update, and document a 'history and physical' in the medical record, obtaining a comprehensive clinical history from the patient or medical record to optimize the clinical value of the requested nuclear medicine procedure.
  3. Assist the supervising physician in obtaining informed consent for invasive and therapeutic procedures, as well as procedures involving more than minimal risk, as defined by state law and institutional policy.
  4. Furnish adjunctive and interventional medications that enhance diagnostic imaging and therapeutic procedures, as defined by state regulations and institutional policy.
  5. Perform minimal sedation (anxiolysis) and moderate sedation (as defined by the American Association of Anesthesiology) under the direct supervision of an appropriately credentialed physician as determined by state law and institutional policy.
  6. Educate the patient undergoing invasive procedures, therapeutic procedures, and procedures involving more than minimal risk regarding pre-procedural preparation and post- procedural care, as defined by state law and institutional policy and documenting appropriately in the patient's medical record.
  7. Perform pre- and post-procedure assessment and monitoring in patients undergoing invasive and therapeutic procedures, as well as procedures involving more than minimal risk, as defined by state law and institutional policy.
  8. Under the direction of the supervising physician, perform invasive or therapeutic procedures as recognized through institutional policy and defined by state and federal law.
  9. Monitor and supervise cardiac exercise or pharmacologic stress testing in association with diagnostic nuclear medicine imaging procedures.
  10. Assess imaging procedure for quality, recommend additional views as necessary, and order additional diagnostic procedures as necessary to provide additional information to optimize the nuclear medicine procedure.
  11. Analyze the imaging, correlative and laboratory data provided and prepare a preliminary description of findings for the supervising physician to use when interpreting the results and formulating the written report.
  12. Communicate report findings in the physician's finalized and authenticated reports to the referring physician and provide necessary documentation.

The NMAA should actively participate in a practice-based improvement activities as well as facility quality assurance programs. They should be competent in overseeing compliance with all local, state, regional, and federal requirements for laboratory operations and accreditation, and provide education for technologists, students, and staff. They will be expected to participate in maintenance of certification (MOC) activities and be credentialed by the institution in which they practice.

The education of the nuclear medicine advanced associate is granted through nationally accredited academic programs offered at the master's degree level and that lead to certification through the NMTCB. To view the NMAA Scope of Practice, please click here.

Exam Update

The first offering of the NMAA Exam was held in conjunction with the SNMMI (formerly SNM) Annual Meeting in San Antonio, Texas, June 4, 2011 at 12:00 noon at the Henry B. Gonzalez Convention Center.

Since that date, a total of 16 technologists are now certified Nuclear Medicine Advanced Associates.

Exam Date & Location

The NMTCB is excited to announce that, beginning in 2012 administration of the NMAA Examination has been assigned to our testing company, IQT, Inc. This means that the NMAA Examination will be administered online at local testing centers. Candidates will not be required to go to one specific city and sit for a paper and pencil exam. Once an application has been approved, information will be sent to the candidate that includes a list of available testing centers and instructions for registration.

The NMTCB is also pleased to announce that the NMAA Examination is now available twice per year. Starting in 2013, the NMAA Examination has been offered in January and in July.

Eligibility Requirements

A candidate for examination must show documented evidence of the following:

  1. Active NMTCB, ARRT(N), or CAMRT(RTNM) certification -and-
  2. Successful completion of a recognized NMAA Education Program.

Exam Content

The NMAA Specialty Exam will consist of ~200 multiple choice items with a stem and 4 or 5 response choices.

The following is an abbreviated list of the content areas for the NMTCB's NMAA Specialty Exam.

  1. Patient Care
  2. Clinical Procedures
  3. Diagnostic and Therapeutic Pharmaceuticals
  4. Radiation Safety and Radiobiology in Clinical Practice

Click here to see the more detailed exam content outline.

NMAA Content Outline - Appendix A - Procedures List

NMAA Content Outline - Appendix B - Drug Classifications

NMAA Content Outline - Appendix C - Radiopharmaceuticals

NMAA Content Outline - Appendix D - Contrast Agents

Click here to see a General Resource List of NMAA Texts and Guidelines.


Please click here to download an NMAA Application in Adobe Acrobat PDF format.

Applicants with a Disability

The NMTCB will make every reasonable effort to accommodate applicants for the Certification Examination who have a disability as that term is defined by the Americans with Disabilities Act (ADA).

An applicant who wishes to request modifications in the environment because of a disability must notify the NMTCB in writing at the time of application and provide appropriate documentation about the disability and the needed modification. Applications received without appropriate documentation will be processed without testing accommodations.

To ensure that the appropriate accommodations are provided for your disability, you must provide current documentation of your condition as defined by the Americans with Disabilities Act (ADA). Applicants must show documentation containing a recommendation of reasonable accommodation(s) that has been obtained from an appropriate licensed medical professional or qualified diagnostician within the past 5 years. Applications received without appropriate documentation will be processed without testing accommodations.

The supporting documentation must be submitted in sufficient time to make proper arrangements to take the examination under conditions which will accurately reflect the applicant's achievement level. Requests for modifications will be considered on a case-by-case basis.

Requests for testing accommodations will be reviewed and decision will be made to approve or deny the request within 20 business days. If NMTCB denies a request for accommodations, applicants will be given the reason(s) for denial in writing and will be provided an opportunity to appeal or to discuss alternative accommodations.

Renewal Requirements

  • Certification must be renewed annually AND the NMAA Certificant must consistently maintain NMTCB (CNMT) certification and/or ARRT(N) and/or CAMRT nuclear medicine credentials either as "Active", "in compliance" or "in good standing".
  • NMAA Certification is valid for up to 10 years after initial certification. After 10 years, recertification will be required. Certificants may recertify anytime between 8 and 10 years without penalty. The NMAA certificant will be able to recertify for an additional 10 years by successfully passing a 100-item exam. The NMAA recertification application fee is $250.
  • Biennial Continuing Education Requirements:

    1. 24 standard continuing education hours as defined in the NMTCB CE Policy; PLUS
    2. 24 Category A+ and/or American Medical Association (AMA) approved CME continuing education hours.


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