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September 6, 2022 — The American College of Radiology (ACR) Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) Accreditation Committees have announced that a radiologist (MD/DO) will now provide direct or general supervision of intravenous contrast material administration and ensure compliance with guidance provided in the ACR Manual on Contrast Media.
Also, in line with the ACR-SPR Practice Parameter for the Use of IV Contrast Media, and recognizing a range of responsible providers trained in and capable of managing an acute hypersensitivity reaction under general supervision of a radiologist, the following providers may provide direct supervision of intravenous contrast administration:
- Non-radiologist physicians (MD/DO).
- Advanced practice providers (nurse practitioner, physician assistant).
- Registered nurses following a symptom- and sign-driven treatment algorithm.
The provider of direct supervision must be immediately available to furnish assistance and direction throughout the performance of the procedure. This does not mean that the supervising provider or radiologist must be present in the room where and when the procedure is performed.
However, there should be at least one person who can recognize adverse events related to contrast media administration in attendance (in the room or in an adjacent control room) to observe the patient during and immediately after the injection and summon medical assistance as needed.
All local and state regulations regarding supervision of contrast media administration must be followed.
For more information, consult the ACR Manual on Contrast Media and the ACR-SPR Practice Parameter for the Use of IV Contrast Media.
October 23, 2025 
