Neurodiagnostic Tech Certifications Eligibility, Testing & Renewals - AAET, ABRET
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Diagnosing brain and nervous system disorders are primarily done with the help of specialized testing. While it is the doctors who interpret the results of the test, neurodiagnostic technicians (NDT) are the experts performing the tests. With the data NDTs collect, doctors have the information they need to diagnose sleep, seizure, nervous system disorders, and more.
To become an NDT, aspiring professionals can receive on-the-job training or complete an education program. These programs typically take between one to two years to complete. Graduates receive either a certificate of completion or an associate’s degree. Students who chose to pursue an education in this field should ensure their program is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), as this is a requirement for some certifications and guarantees a minimum level of quality of education.
While certification in the field is not mandatory, it is highly recommended as it provides assurance to employers that the candidate is competent in their field. The two primary certifying bodies for neurodiagnostic techs are the American Association of Electrodiagnostic Technologists (AAET) and the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET). The AAET offers only the certification of Registered Nerve Conduction Study Technologist (R.NCS.T.), while ABRET offers six different certifications in various competencies.
Neurodiagnostic techs are currently in high demand, according to the Bureau of Labor Statistics. Between 2018 and 2028, there is an anticipated 11 percent increase in jobs for clinical laboratory technologists and technicians, including NDTs. This increase is largely due to an aging population who require additional medical care. Professionals in this field earn $53,120 per year on average.
Continue reading to learn about the various certifications available in this field, eligibility requirements for the exams, and how to prepare for each exam.
Early Preparation in High School to Become a Neurodiagnostic Tech
A high school diploma or GED is the first step towards becoming a neurodiagnostic technician. Completing high school or obtaining a GED demonstrates a commitment to completing a course of education as well as indicating a minimum level of education and competency.
Students interested in pursuing this career should focus on classes such as biology, chemistry, math, and English. Since neurodiagnostic techs often interact with patients, classes such as psychology and sociology can provide valuable interpersonal skills.
Neurodiagnostic techs perform tests that help doctors diagnose brain, neurological, or sleep disorders. Performing these tests requires training or education on specialized equipment as well as excellent interpersonal skills to comfort patients. Certification in this field is optional albeit highly recommended. Below are the top two certifying agencies and the certifications they offer.
American Association of Electrodiagnostic Technologists (AAET) Registered Nerve Conduction Study Technologist (R.NCS.T.) Certification Eligibility
In order to be eligible to sit for the AAET R.NCS.T. exam, candidates must qualify under one of two pathways. The pathways are:
- Have one year of experience and proof of 100 patient encounters or have one year of experience and complete 30 AAET continuing education units (CEUs)
- Complete a neurodiagnostic technology (NDT) program accredited by CAAHEP and have proof of 100 patient encounters or complete an NDT CAAHEP-accredited program and complete 30 AAET CEUs
In addition to meeting education or experience requirements, candidates must complete an AAET Attestation Statement that verifies that the applicant is not performing invasive (i.e., needle) exams and that the interpretations are completed by the physician. If the state or regional regulations allow neurodiagnostic techs to perform invasive procedures, applicants must supply a copy of a superseding certificate that allows invasive exams and interpretation.
To take the exam, candidates must complete an application, pay the $625 application fee, and provide a copy of their certification card for Basic Life Support (BLS) for the Healthcare Provider issued by the American Heart Association.
American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET) Certification Eligibility
The ABRET has six certifications neurodiagnostic techs can earn and each has its own eligibility standards. They are:
Registered Electroencephalogram Technologist (R. EEG T.)
There are four pathways to qualify to sit for this certification.
- Graduate from an NDT CAAHEP-accredited program, complete 50 EEGs, and have current CPR or BLS certification
- Complete an ABRET-recognized certificate program, complete 100 EEGs, and have current CPR or BLS certification
- Complete an associate’s degree or have a Registered Polysomnographic Technologist (RPSGT) certification, one year of clinical EEG experience, documentation of 150 EEGs, 30 EEG Neurodiagnostic Society (ASET) credits, and current CPR or BLS certification
- Have four years of clinical EEG experience, documentation of 150 EEGs, 60 EEG Neurodiagnostic Society (ASET) credits, and current CPR or BLS certification
Registered Evoked Potential Technologist (R. EP T.)
The two pathways for eligibility to this exam are:
- Complete a CAAHEP-accredited NDT program and have current CPR or BLS certification
- Haven an associate’s degree or ABRET EEG certification (R. EEG T.) and have two years of clinical neurodiagnostic experience, documentation of 25 clinical EP studies, 30 hours of EP/ neurophysiologic intraoperative monitoring (NIOM) continuing education, and current CPR or BLS certification
Certification in Neurophysiologic Intraoperative Monitoring (CNIM)
The four pathways to eligibility for this certification are:
- Complete a CAAHEP accredited program, have documentation of 100 NIOM cases, and have current CPR or BLS certification
- Have an R. EEG T. or R. EP T. certification, documentation of 150 NIOM cases, and current CPR or BLS certification
- Complete a bachelor’s degree and have documentation of 150 NIOM cases, 30 hours of intraoperative monitoring (IOM) education, and current CPR or BLS certification
- Complete an ABRET-recognized certificate program and have documentation of 150 NIOM cases and current CPR or BLS certification
Certified Long Term Monitoring Technologists (CLTM)
To be eligible for this certification candidates must meet all of the following requirements:
- One year of experience as an R. EEG T.
- One year of long-term monitoring (LTM) experience after the EEG certification was earned
- Documentation of 50 LTM cases
- Current CPR or BLS certification
Certification Examination for Autonomic Professionals (CAP)
Candidates must qualify under one of two pathways to be eligible for this certification. They are:
- Have an associate’s degree, one year of clinical autonomic testing experience, documentation of 20 autonomic cases, a list of education-related to autonomics completed in the past three years, and current CPR or BLS certification
- Have two years of clinical autonomic testing experience, documentation of 40 autonomic cases, a list of education-related to autonomics completed in the past three years, and current CPR or BLS certification
Certificate for Magnetoencephalography (CMEG)
Eligibility requirements for this certification are:
- Have an R. EEG T. or R. EP T. certification
- Complete six months of supervised work experience in the field
- Have documentation of 25 evoked or 50 spontaneous cases encompassing three or more modalities
- Complete the MEG certificate program
- Have current CPR or BLS certification
AAET Registered Nerve Conduction Study Technologist (R.NCS.T.) Certification Exam & Renewal
Candidates for the R. NCS. T. exam must first submit an online application. In addition to completing the application, candidates must supply documentation of their eligibility to take the exam including a patient encounter documentation form, educational program certificates, and current basic life support certification. The cost to apply for the exam is $650.
This exam is offered three times a year and candidates must apply by the deadline before the desired testing window. Approximately 11 weeks prior to the exam, candidates who have been approved to take the exam will receive an authorization to schedule. Candidates then select the date, time, and location of their exam through the online portal. While candidates may reschedule their exam up to five days before their scheduled test time, transferring to a new testing window may only be done once and costs $206.
Candidates will have four hours to complete the 250 multiple-choice question exam. Topics covered in the exam include:
- Physiology and anatomy
- Basic electronics, instrumentation, and stimulation
- Nerve conduction velocity concepts and Wallerian degeneration
- Late responses and blink reflex
- Neuromuscular junction transmission & repetitive nerve stimulation
- Peripheral nerves, case studies & electrode placement/practical application
- Technical considerations, anomalies, and safety
Sample questions are available in the examination handbook. Reference materials candidates should review in preparation for the exam include:
- “Conduction Studies From A-Z” by Crout, Barbara O. & Flicek, Charles W. Nerve
- “Clinical Neurophysiology (Contemporary Neurology Series). 2nd Edition” by Daube, Jasper R., MD.
- “Manual of Nerve Conduction Study and Surface Anatomy for Needle Electromyography. 4th Edition” by DeLisa, Joel A. & Lee, Hang J.
- “Dorland’s Pocket Medical Dictionary. 32nd Edition” by Dorland Elsevier Health Science Division
- “Electrodiagnostic Medicine. 2nd Edition” by Dumitru, Daniel; Amato, Anthony; Zwarts, Machiel.
- “Electrodiagnosis in Diseases of Nerve and Muscle: Principles and Practice. 3rd Edition” by Kimura, J.
- “Laboratory Reference for Clinical Neurophysiology” by Liveson, Jay A; Ma, Dong M..
- “Essentials of Clinical Neurophysiology. Volume 1. 3rd
- Edition” by Misulis, Karl E. & Head, Thomas Channing.
- “Electromyography: Nerve Conduction Studies. 2nd edition” by Oh, Shin J. Clinical.
- “Electromyography and Neuromuscular Disorders. 2nd Edition“ by Preston, David & Shapiro, Barbara
- “EMG Secrets: Questions and Answers Reveal the Art and Science of
- Electromyography” by Tan, Faye Chiou, MD.
This list of reference materials is not exhaustive and students should review all resources they have access to in preparation for this exam.
R.NCS.T. Certification Renewal
R. NCS. T. certifications are valid for five years. To renew, certificate holders must complete 30 continuing education units or retake the exam. If completing continuing education, certificate holders must complete five mandatory AAET course hours. The remainder of the hours may be from the AAET or outside sources. Documentation of outside education must be provided when submitting the renewal application. Applications to renew cost $75 and must be completed online.
ABRET Certification Exams & Renewals
Preparation for each of the six certification exams offered by ABRET varies. Here is an overview of each exam:
Registered Electroencephalogram Technologist (R. EEG T.) Certification Exam
Candidates for the R. EEG T. exam must submit a completed online application along with their eligibility documentation and a $700 exam fee. Once the application is approved, candidates will receive a scheduling authorization allowing them to select the date, time, and testing center for the exam. This exam takes four hours and is all multiple choice. Topic covered include:
- Pre-study patient preparation
- Performing the study
- Ensure integrity of data
- Recording strategies
- Waveform identification
A lengthy list of references to review is available in the R. EEG T. exam handbook including:
- “Atlas of Pediatric and Adult Electroencephalography” by Blume WT, Holloway GM, Kaibara M, Young GB.
- “Atlas of EEG and Seizure Semiology” by Abou-Khalil B, Misulis KE.
- “Handbook of EEG Interpretation. 2nd Edition.” by Tatum WO.
Candidates should review all available resources in preparation for this exam including online reference materials published by the American Society of Electroneurodiagnostic (ASET).
R. EEG T. Certification Renewals
The R. EEG T. certification is valid for five years. To renew applicants must complete an online application, pay a $100 fee, and complete 30 hours of continuing education. In lieu of completing continuing education hours, applicants may elect to retake the exam.
Registered Evoked Potential Technologist (R. EP T.) Certification Exam
To sit for the R. EP T. exam, candidates must complete an online application, supply documentation of eligibility, and pay a $400 application fee. Once the application is approved, candidates will receive an email with authorization to schedule their exam. This exam consists of multiple-choice questions and candidates will have four hours to complete the exam. Topics covered in the exam include:
- Pre-study procedures
- Performing the evoked potential study
- Post-study procedures
- Ethics and professional issues
The online R. EP. T exam handbook contains a list of reference materials to be reviewed in preparation for this exam including:
- “Primer of Intraoperative Neurophysiologic Monitoring” by Butterworth-Heinemann
- “Spehlmann’s Evoked Potential Primer” by Butterworth Heinemann
- “Evoked Potentials in Clinical Medicine“ by Chiappa K.
Candidates should also review online resources provided by ASET.
R. EP T. Certification Renewals
The R. EP T. certification is valid for five years. Renewals are completed through an online application and must be accompanied by a $100 renewal fee and documentation of 30 hours of continuing education. Certificate holders may opt to retake the exam instead of completing continuing education.
Neurophysiologic Intraoperative Monitoring (CNIM) Certification Exam
In order to sit for the CNIM exam, candidates must complete an online application, provide proof of eligibility to test, and pay a $700 exam fee. When a candidate’s application to test is approved they will receive an authorization to schedule their exam. This exam must be complete in four hours and is completely multiple choice. Topics covered in the exam include:
- Preparation and application of fundamental concepts including neuroanatomy, documentation, diagnostic procedures, patient safety, and digital instrumentation
- Intraoperative phase including communication in the operating room, effects of anesthesia, surgical procedures, use of various diagnostic methods, and troubleshooting
- Post-operative phase including infection control, data management, and patient privacy.
Reference to materials to review for this exam includes:
- “Handbook of EEG Interpretation. 2nd Edition.” by Tatum WO.
- “A Practical Approach to Neurophysiologic Intraoperative Monitoring. 2nd Edition” by Husain AM
- “Intraoperative Neurophysiologic Monitoring” by Moller, AR.
A lengthy list of reference materials available in the online CNIM exam handbook. Candidates should not limit themselves to the reference materials listed in the handbook and should review all printed and online resources they have at their disposal.
CNIM Certification Renewals
Recertification for CNIM certificate holders is required every five years. It costs $100 to renew this certification. In order to renew, applicants must either complete 50 hours of continuing education or retake the exam. Applications are completed online.
Certified Long Term Monitoring Technologists (CLTM) Certification Exam
The CLTM exam is a four-hour multiple-choice computer-based exam. To apply for this exam candidates must submit an online application, documentation of their eligibility to test, and pay a $500 application fee. Candidates whose applications are approved will receive authorization to schedule the exam and have the opportunity to choose the date, time, and testing location for their exam. Topics covered in this exam include:
- Pre-study procedures including seizure classification, medical terminology, infection control, age-specific criteria, and electrical safety techniques
- Performing the study including neuroanatomy, epilepsy monitoring, functional mapping, waveform identification, and effects of drugs on patients
- Post-study procedures including patient privacy, data storage, and localization techniques
Candidates should carefully review the online CLTM exam handbook to familiarize themselves with testing procedures and question format. The handbook also has a list of reference materials to review which include:
- “Long Term Monitoring in Epilepsy” by Gotman J, Ives JR, Gloor P
- “Atlas of Ambulatory EEG” by Chang BS, Schachter SG, Schomer DL
- “Textbook of Epilepsy Surgery” by Luders OH
CLTM Certification Renewals
CLTM certification must be renewed every five years. To renew, applicants must submit an online application, pay a $100 renewal fee, and complete 50 hours of continuing education. Applicants may elect to retake the exam instead of completing continuing education hours.
Certificate for Autonomic Professionals (CAP) Certification Exam
To take the CAP exam, candidates must provide proof of their eligibility, complete an online application, and pay a $400 exam fee. Upon approval of the application, candidates will receive an authorization to schedule their exam. They will be able to choose the testing center, date, and time of their exam. This exam covers the following topics:
- Assessment of the patient
- Setting up the equipment
- Running sudomotor, adrenergic, and cardiovagal tests
- Testing factors
Reference materials candidates should review include:
- “Clinical Autonomic Disorders 3rd Edition” by Phillip A Low & Eduardo E. Benarroch
- “Autonomic Neurology” by Eduardo E.Benarroch
- “Primer on the Autonomic Nervous System, 3rd Edition” by David Robertson, Italo Biaggioni, Geoffrey Burnstock, Phillip A. Low, Julian F.R. Paton
The online exam handbook lists other reference materials, however, candidates should review all resources they have access too including online content published by ASET.
CAP Certification Renewals
The CAP certification is valid for five years. To renew, applicants must complete 15 hours of continuing education in addition to submitting an online application and paying a $100 renewal fee.
Certificate for Magnetoencephalography (CMEG) Certification Exam
Preparation for the CMEG exam begins by completing the MEG Technologist Certificate Program. To begin the program candidates must pay a $700 application fee, complete an online application, and submit documentation of eligibility. Once approved, candidates receive access to the online self-directed program. The program consists of videos, reading, and quizzes. The final step in the program is the CMEG exam. The final exam topics include:
- Pre-Study Preparation
- MEG Instrumentation
- Performing the Study
- Post-Study Procedures
The final exam is proctored and takes place at a university or college near the candidate. The candidate is responsible to pay for the proctor fee, which can vary but is typically $50. The primary materials candidates should study for this exam include:
- Guideline Documents from the American Clinical Magnetoencephalography Society
- “What you need to know to become a MEG technologist” by Mason K. M., Ebersole S. M., Fujiwara H., Lowe, J. P., Bowyer, S. M.
- Clinical Magnetoencephalography and Magnetic Source Imaging” by Papanicolaou, A. C.
(CMEG) Certification Renewals
CMEG certificates must be renewed every five years. Applicants for renewal must complete 15 hours of continuing education, pay a $100 renewal fee, and submit an online application.
State Licensure for Neurodiagnostic Techs
Currently, there are no state licensing requirements for neurodiagnostic technicians. However, state legislations are constantly changing so aspiring professionals in this field should carefully research their state requirements to ensure licensing is not required.