The Two-Layer System: ARDMS vs. State Licensing

Most sonographers only have to worry about one CE requirement: ARDMS (or CCI) credential renewal, which requires 30 CME credits every 3 years. That's the federal standard, and in states without separate licensure, it's the only ongoing requirement.

However, several states have passed legislation requiring sonographers to hold a state-issued license in addition to their ARDMS/CCI credentials. These states have their own CE requirements, renewal cycles, and fees — independent of and in addition to ARDMS maintenance.

States with dedicated sonographer or diagnostic imaging state licensure (as of 2026):

State	Licensing Board	CE Requirement	Renewal Cycle
Oregon	Oregon Medical Imaging Licensing Program (OMILP)	24 CE hours per 2 years	Every 2 years
New Mexico	NM Medical Imaging and Radiation Therapy Program	24 CE hours per 2 years	Every 2 years
North Dakota	ND Medical Imaging and Radiation Therapy Board	24 CE hours per 2 years	Every 2 years
New Hampshire	NH Medical Imaging and Radiation Therapy Licensing Program	24 CE hours per 2 years	Every 2 years
Arkansas	Arkansas Department of Health	12 CE hours per year	Annual
Louisiana	Louisiana State Radiologic Technology Board	24 CE hours per 2 years	Every 2 years
West Virginia	WV Medical Imaging and Radiation Therapy Program	24 CE hours per 2 years	Every 2 years
Hawaii	Hawaii Medical Imaging and Radiation Therapy Licensure Program	24 CE hours per 2 years	Every 2 years
Tennessee	TN Department of Health	12 CE hours per year	Annual
Kentucky	KY Radiologic Technologist Licensing Program	24 CE hours per 2 years	Every 2 years
Minnesota	MN Department of Health Radiologic Technology Program	24 CE hours per 2 years	Every 2 years

Note: State licensing law is subject to change. Verify current requirements with the relevant state board before relying on this table. Several additional states have licensing bills in progress as of 2026.

States With No Separate Sonographer License

The majority of US states do not separately license sonographers. In these states, maintaining your ARDMS or CCI credential satisfies all professional requirements. These include:

California, Texas, Florida, New York, Pennsylvania, Illinois, Ohio, Michigan, Georgia, Arizona, Virginia, Washington, Massachusetts, Colorado, and most others

If you work exclusively in an unlicensed state, your ARDMS/CCI renewal cycle is your only CE obligation.

Oregon: The Most Comprehensive State System

Oregon's OMILP is the most developed state program for diagnostic medical imaging licensure. Key features:

License categories:

Diagnostic Medical Sonographer
Cardiovascular Invasive Specialist
Radiologic Technologist (separate category)

CE requirements for Oregon sonographers:

24 hours per 2-year renewal period
At least 12 hours must be in the sonographer's primary specialty area
Ethics CE (typically 1–2 hours) required each cycle

Oregon CE sources accepted:

ARDMS-approved CME credits count toward Oregon requirements
SDMS, AIUM, SVU, ASE conference credits accepted
Online modules from accredited providers accepted
Employer in-service: generally NOT accepted unless formally accredited

Fee: Approximately $100–$120 per 2-year renewal

Important: Oregon requires a state license in addition to ARDMS credentialing. If you move to Oregon with only ARDMS credentials, you must apply for the Oregon state license before practicing — you cannot legally practice while your application is pending.

Arkansas: Annual Renewal State

Arkansas is notable for requiring annual CE renewal (rather than biennial), and the CE requirement is 12 hours per year rather than 24 per 2 years.

Arkansas state CE details:

12 category A or B CE hours per year
Online ARDMS-approved CE accepted
License fee: approximately $50–$75/year
Renewal deadline: December 31 annually

The annual cycle means you cannot "bank" credits from a conference into a 2-year window — you need 12 qualifying credits within each calendar year.

Tennessee: Annual Renewal

Tennessee requires annual renewal with 12 CE hours per year. Tennessee follows ARDMS CE credit standards for most accepted sources.

New Mexico: ARDMS Sync

New Mexico's CE requirements are closely aligned with ARDMS — if you maintain current ARDMS credentials and log the same CME credits with the state board, you're covered. New Mexico sonographers are licensed through the NM Medical Imaging and Radiation Therapy Program.

Double-Dipping: Can ARDMS CME Satisfy State Requirements?

In most states with licensure, yes — the same CE credits satisfy both ARDMS renewal and state licensing requirements, provided they come from ARDMS-approved sources. You don't need to take separate courses for each.

Exception: Some states require state-specific topics:

Oregon requires ethics CE in each cycle (not universally required by ARDMS)
Some states require CE related to state law or professional conduct in the licensed state

Always check the state board's website for "approved CE providers" to ensure your credits will count.

What Happens If You Let a State License Lapse

This is important. Practicing as a sonographer without a current state license in a state that requires one is illegal, even if your ARDMS credentials are current.

Consequences vary by state:

Consequence	Severity
Civil penalty / fine	Typically $250–$2,500 per violation
License suspension upon reinstatement attempt	Some states require additional CE before reinstating
Employer liability	The facility employing an unlicensed sonographer also has exposure
Credentialing committee issues	If a hospital's medical staff credentialing committee discovers lapsed licensure, clinical privileges may be suspended

Reinstatement process (typical):

Pay reinstatement fee (often higher than renewal fee)
Complete required CE for missed periods
Submit reinstatement application and affirmation of current competency

The most common scenario for lapsed licensure: a sonographer moves from an unlicensed state (e.g., California) to a licensed state (e.g., Oregon) and doesn't realize a separate state license is required. The ARDMS credential is still valid, but they're practicing without a state license.

Multi-State Practice: What Happens When You Work in Multiple States

Travel sonographers who work assignments in multiple states face the most complex licensure situation. If you take an assignment in Oregon, New Hampshire, or another licensed state, you need a state license for each.

Practical approach for travelers:

Before accepting an assignment, Google "[state name] sonographer licensing" and check the state's allied health board website.
If the state requires licensure, apply immediately — processing can take 4–8 weeks in some states.
Factor in the license cost ($50–$120 per state) when evaluating contract profitability.
Maintain a digital folder of all state licenses with renewal dates clearly marked.

Some travel agencies include state licensing assistance as part of their placement support. Ask before signing a contract.

CE Sources That Satisfy Both ARDMS and State Requirements

The following sources are broadly accepted by ARDMS and most state boards:

Source	Credit Range	Cost
SDMS Conference	20–25 per conference	$575–$850 (member)
AIUM Annual Convention	15–22 per convention	$600–$750 (member)
SVU Annual Conference	12–18 per conference	$500–$700 (member)
SonoWorld online modules	0.5–2 per module	$15–$30/module
Ultrasound CE online	1–3 per module	$20–$35/module
AIUM/SDMS online journals (CME articles)	0.5–1 per article	Free with membership
Vendor webinars (GE, Philips, Siemens)	0.5–1.5 per webinar	Free
Regional society meetings	6–8 per meeting	$75–$150

A single SDMS or AIUM conference covers the ARDMS 3-year requirement and the state's 2-year requirement in one event, assuming the credit documentation is submitted to both bodies.

Tracking State CE Separately From ARDMS

Unlike ARDMS (which has a centralized tracker at myARDMS.org), state CE tracking is done through the individual state board portal. Most state boards now have online portals where you upload certificates and log credits.

Recommended practice:

When you complete a CE activity, immediately upload the certificate to both your ARDMS tracker and your state board portal (if applicable)
Set a recurring calendar reminder 60 days before each renewal deadline
Keep a master spreadsheet or simple notes file listing: CE activity name, date completed, credit hours, provider, submitted to (ARDMS / state)

Losing a CME certificate and having to contact the provider for a duplicate is avoidable friction. Store everything in a cloud folder organized by year.

Sonographer Continuing Education Requirements by State: What You Need to Keep Your License