RhMSUS Certification

There are four pathways to eligibility. Each pathway contains career status, medical license possession, and musculoskeletal ultrasound scan experience/education requirements. All requirements for your selected pathway must be completed prior to submitting your application for the examination. Membership in the American College of Rheumatology (ACR) or the Association of Rheumatology Professionals (ARP) is not required.

Pathway 1 – U.S. trained rheumatologist
Pathway 2 – Non-U.S. trained rheumatologist
Pathway 3 – Rheumatology fellow in training
Pathway 4 – Physician assistant or nurse practitioner

Find your eligibility pathway

Each pathway has requirements for a minimum amount of MSUS ultrasound CME credits and MSUS scans performed.

CME Activities Criteria

1. All activities must comply with the ACCME Essential Area and Policies.
2. The activity must offer a minimum of 14 AMA PRA Category 1 Credit(s)™ and at least 40% of the total CME hours must be dedicated to mentored hands-on scanning practice sessions.
3. For hands-on scanning practice, there must be no more than five learners per faculty member.
4. Each activity must have at least one faculty member that is a rheumatologist.
5. At least 20% of the didactic portion of the course should cover diagnosis of disease pathology.
6. If commercial support is received, the sponsoring organization must attest to:
   • Complying with the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities.
   • Using ultrasound equipment from more than one commercial entity.

Credits earned outside of the required “at least 14 AMA PRA Category 1 Credit(s)™ from a single course that includes hands-on scanning practice” must be AMA PRA Category 1 Credit(s)™ specifically related to MSUS.

In case of application audit, a copy of the earned CME certificate(s) must be submitted.

For more information see RhMSUS ™ CME Activity Checklist in Appendix E of the Candidate Handbook (pg. 26).

Scan Log Criteria
Ultrasound scans can be limited or complete, diagnostic, or therapeutic. For each unique patient/subject/model, no more than one scan per day can be logged.

In case of application audit, a log with the information included on the Sample Patient/Practice Scan Log or a billing log (both without identifying information in conformity with HIPAA) must be submitted for proof of the number of scans completed.

Applications are accepted on a continual basis and candidates can select their desired testing window during the application process. Candidates are strongly encouraged to complete their applications at least 60 days prior to the desired testing date. The examination is offered twice a year in the spring and fall during a one-month window. If a candidate misses the deadline, his/her application will be credited toward the next window.

Spring 2025

• Application Deadline: March 31
• Testing Window: May 15–June 15

Fall 2025

• Application Deadline: August 31
• Testing Window: October 15–November 15

The certification registration fee includes the processing of the application, examination registration, and one testing appointment.

Exam Fees

ACR/ARP Member – $1,500
Individuals who have been elected to membership and are current on their dues.

Non-ACR/ARP Member – $1,750
Individuals who are not ACR/ARP members.

ACR Fellow in Training Member – $950
Fellows in training who have been elected to membership and are current on their dues.

Non-Member Fellow in Training – $1,025
Fellows in training who have not been elected to membership; must include a letter from their program director, chief of service, or faculty advisor to be eligible for this rate.

Additional Fees

Late Application – $50
Applications are accepted up to 30 days before the testing window opens.

Retest – $100
Candidates who fail the examination will receive information on scheduling a second testing appointment.

International Testing Site – $150
Candidates can take the examination at an international testing site for an additional fee collected at the time of scheduling.

All requirements for your selected pathway must be completed prior to submitting your application for the examination. During the application, candidates must upload a copy of their medical license and attest that they can provide documentation (e.g. copies of earned AMA PRA Category 1 Credit™, scan/billing log, etc.) that supports their compliance with the eligibility criteria for the selected pathway.

Candidates must complete an online application and a multiple-choice, computer-based examination.

Apply for RhMSUS Certification

The examination can take place at Meazure Learning internet-based testing sites located throughout the United States and also is available through live online-proctored test administration from the candidate’s own computer at a time and place of their choosing. Thirty days before the testing window opens, a Meazure Learning representative will contact you by email to schedule your examination. In-person testing center seats are filled on a first-come, first-served basis, based on test center availability.

International Testing Sites
Candidates can take the examination at an either an international testing site or through live online-proctored test administration from the candidate’s own computer at a time and place of their own choosing for an additional $150 that will be collected at the time of scheduling.

The examination consists of 100 multiple-choice questions based on the following domains.

• Domain I – Recognize Indications for the Use of Ultrasound in Rheumatology
• Domain II – Preparing the Patient and Environment
• Domain III – Equipment Use and Management
• Domain IV – Performing the Ultrasound Examination
• Domain V – Interpretation and Integration
• Domain VI – Procedural Guidance
• Domain VII – Documentation

The Candidate Handbook contains the following resources to help you prepare for the examination.

• Full Test Content Outline - Appendix F
• Sample Questions - Appendix G
• Recommended References - Appendix H
• Exam Preparation Tips - Appendix J

There are no official study materials for the RhMSUS™ examination but you are welcome to use the reference list found in Appendix H of the Candidate Handbook. To familiarize you with the computer-based testing system Meazure Learning also provides links to resources that will help you get acquainted with the ProctorU Online Proctoring Platform. Note: These videos are not a review of the RhMSUS™ examination content.

What to Expect
This video provides a detailed walk-through of the entire check-in process including videos that show you what to expect during the exam.

Test-Taker Resource Center
This video details how to create an account, describes system requirements, displays a full video showing the test-taking experience, lists FAQs and includes a link to test-taker support.

Examination results are mailed to the address provided on the application approximately six weeks after the testing window closes. Examination results will be released only in writing by mail. Examination results will not be released by telephone or fax. Candidates who need to update their mailing address should contact Meazure Learning (candidatesupport@meazurelearning.com).

Candidates who pass the examination will receive a personalized certificate and wallet card.

A percentage of candidate applications will be audited to ensure compliance with the eligibility criteria. Applications for audit will be selected randomly. If your application is selected for audit, you will receive instructions on how to supply satisfactory documentation that supports your compliance with the eligibility criteria before your certificate is released.

Candidates who do not pass the examination may retest in the next testing window. Candidates may not take the examination more than two times in any 12-month period. Candidates who need to retest will receive a Notice to Schedule email 45 days before the next testing window. During the scheduling process, candidates will be prompted to pay the retake fee of $100.

RhMSUS Recertification Update 2024

Current recertifications are on hold as the ACR works with Meazure Learning on creating and maintaining an operable site for recertification. Currently, we do not have a date that the site will be open to accept recertification applications but will notify those eligible for recertification as soon as it becomes available. This means if you are due or past due for recertification, your RhMSUS certification will continue.

Musculoskeletal Ultrasound Certification in Rheumatology™ - RhMSUS™ is a professional certification for physicians, physician assistants, and nurse practitioners who perform ultrasound as part of their practice in rheumatology. The RhMSUS™ credential signifies that an individual has passed the RhMSUS™ certification.

RhMSUS™ is a voluntary program and is not required for using musculoskeletal ultrasound in your practice. It is however, expected that achieving RhMSUS™ certification will become increasingly important in the future for reimbursement from Medicare and third party payors.

RhMSUS™ certification is valid for ten years. Recertification is required at ten-year intervals effective as of the date of RhMSUS™ certification. Recertification requirements are outlined in the Candidate Handbook.

RhMSUS™ has been approved as a pathway to payment for rheumatologists by Humana/HealthHelp. When a rheumatologist bills Humana for ultrasound, HealthHelp automatically sends a fax with instructions to electronically submit evidence of certification or training. Since RhMSUS™ is an approved program, designees just need to upload documentation of their certification. There have been no recent complaints regarding payment for musculoskeletal ultrasound.

If you are having issues with reimbursement for musculoskeletal ultrasound claims, please fill out the Health Plan Complaint Form and the ACR will do its part to assist you.

The RhMSUS™ program is open to ACR members and ACR non-members. There are four pathways for eligibility which are detailed in the Candidate Handbook.

• Pathway 1: U.S. trained rheumatologist – Appendix A
• Pathway 2: Non-U.S. trained rheumatologist – Appendix B
• Pathway 3: Rheumatology fellow in training – Appendix C
• Pathway 4: Physician assistant or nurse practitioner – Appendix D

Each pathway contains specific requirements for career status, medical license possession, and musculoskeletal ultrasound scan experience/education. All requirements for your selected pathway must be completed prior to submitting your application for the examination.

Sonographers, physical therapists, nurses, other health professionals (except PAs and NPs), and physicians and health professionals that do not have a minimum of 12 months experience/practice in rheumatology are not eligible to participate in the RhMSUS™ program at this time.

All requirements for your selected pathway must be completed prior to submitting your application for the examination. During the application you will be asked to upload a copy of your medical license, and attest that you can provide the documentation (e.g. copies of your earned AMA PRA Category 1 Credit™ scan/billing log, etc.) for your selected pathway if you are selected for audit.

No, completion of the ACR Musculoskeletal Ultrasound Course for Rheumatologists-Fundamentals; or Musculoskeletal Ultrasound for Rheumatologists with Interventional Cadaver Workshop – Intermediate or any other musculoskeletal ultrasound courses does not mean that you are certified in RhMSUS™. These courses are accredited for AMA PRA Category 1 Credit™ so if you complete them you are awarded AMA PRA Category 1 Credit™ and issued a CME certificate. CME credits in musculoskeletal ultrasound are needed and can be used to fulfill eligibility requirements. To receive the RhMSUS™ designation, you must complete the RhMSUS™ certification program.

If you do not meet all of the eligibility criteria you are encouraged to work toward meeting those criteria before applying for the program as all requirements for your selected eligibility pathway must be completed prior to submitting your application. Applications are accepted on a continual basis. If you miss the deadline for the current examination, your application will be credited toward the next testing window. Eligibility criteria are detailed in Appendices A–E of the Candidate Handbook.

If you do not pass the certification examination you may retest in the next testing window. You may not take the examination more than two times in any 12-month period. If you need to re-test you will receive a Notice to Schedule (NTS) email 45 days before the next testing window. During the scheduling process, you will be prompted to pay the retake fee of $100. You will not be officially scheduled for their retake exam until the retake fee has been paid at the end of the scheduling process. Eligibility lasts for 366 days, so if you should need to re-test once your eligibility expires you will need to re-apply to RhMSUS™. You can repeat the re-application and re-test cycle as many times as needed. Examination retake information is detailed in the Candidate Handbook.

There is no limit to the number of attempts that you may require to achieve passing status on the certification examination. However, you may sit for the examination no more than two times in any 12-month period. Eligibility lasts for 366 days, so if you should need to re-test once your eligibility expires you will need to re-apply to RhMSUS™. You can repeat the re-application and re-test cycle as many times as needed. Examination retake information is detailed in the Candidate Handbook.

The RhMSUS™ examination will be offered twice a year using computer-based testing and administered at both Meazure Learning throughout the United States, and through live online-proctored test administration from the candidate’s own computer at a time and place of their choosing. Examinations will take place in the spring and fall, and each testing window will be four weeks. Detailed information on scheduling an exam is in the Candidate Handbook.

International Testing Available

Candidates can take the examination at an either an international testing site or through live online-proctored test administration from the candidate’s own computer at a time and place of their own choosing for an additional $150 that will be collected at the time of scheduling.

No, the examination scoring process can take up to six (6) weeks after the close of the testing window. After scoring is completed, you will receive your results in writing by mail. Examination results will not be released by telephone or fax.

There are no official study materials for the RhMSUS™ examination but you are welcome to use the reference list found in Appendix H of the Candidate Handbook. To familiarize you with the computer-based testing system Meazure Learning also provides links to resources that will help you get acquainted with the ProctorU Online Proctoring Platform. Note: These videos are not a review of the RhMSUS™ examination content.

What to Expect
This video provides a detailed walk-through of the entire check-in process including videos that show you what to expect during the exam.

Test-Taker Resource Center
This video details how to create an account, describes system requirements, displays a full video showing the test-taking experience, lists FAQs and includes a link to test-taker support.

The examination will cover the following major topic areas. For the full examination outline can be found in Appendix F of the Candidate Handbook.

• Domain I – Recognize Indications for the Use of Ultrasound in Rheumatology
• Domain II – Preparing the Patient and Environment
• Domain III – Equipment Use and Management
• Domain IV – Performing the Ultrasound Examination
• Domain V – Interpretation and Integration
• Domain VI – Procedural Guidance
• Domain VII – Documentation

The certification registration fee is $1,500 for ACR/ARP members, $1,750 for non-members, $950 for ACR Fellow in Training members, $1,025 for non-member Fellows in Training. This fee includes the processing of the application, examination registration, and one testing appointment.

As the certification is valid for 10 years this equates to $150 a year for members and $175 a year for non-members to obtain and maintain the RhMSUS™ credential.

RhMSUS™ certification is valid for 10 years. Recertification is required at 10-year intervals effective as of the date of RhMSUS™ certification. Recertification requirements are outlined in the Candidate Handbook.

Yes, certification is voluntary and there are no current legal requirements for you to use musculoskeletal ultrasound in your practice. As payors/insurers and institutions may have their own credentialing requirements for its physician and health professionals to use musculoskeletal ultrasound, it is expected that the RhMSUS™ certification will become increasingly important.

Certification is a voluntary process through which an organization grants recognition to an individual after verifying that he/she has met minimum criteria and in some cases passed an assessment.

Accreditation is a voluntary process through which an organization grants recognition to an organization, system, or program after verifying it has met minimum criteria which may include (but are not limited to) demonstration of compliance to established performance standards through submitted application and an onsite review process.

The ACR’s RhMSUS™ certification allows you (the individual physician, physician assistant, or nurse practitioner) to demonstrate your competency in musculoskeletal ultrasound in their practice in rheumatology.

The American Institute of Ultrasound in Medicine (AIUM) musculoskeletal ultrasound accreditation allows practices to demonstrate that they meet or exceed recognized standards in the performance and interpretation of diagnostic musculoskeletal ultrasound examinations.

The AIUM recognizes the RhMSUS™ certification as meeting the educational requirements necessary for accreditation as outlined in the AIUM’s Training Guidelines for Physicians and Chiropractors Who Evaluate and Interpret Diagnostic Musculoskeletal Ultrasound Examinations.

For those seeking both RhMSUS™ certification and AIUM accreditation, the ACR and AIUM offer a reimbursement of 20% off of the initial application fees. For more information, please contact us at education@rheumatology.org.

For you (the individual rheumatologist and PA or NP) working in rheumatology to have a way to demonstrate to patient, peers, payors, and the public that you are competent in using musculoskeletal ultrasound in your practice of rheumatology.

Based on feedback from the 2010 membership survey titled “ACR Musculoskeletal Ultrasound Certification Feasibility Study,” over 80% of the respondents said the ACR should offer MSUS certification for individual rheumatology healthcare providers. And 84% said they would elect to become certified if there was a program available in the U.S. The most influential reasons cited to become certified were:

• To enhance the effectiveness of treatment or diagnosis
• To learn completely new skills or knowledge
• To increase competence in current job
• To maintain or improve current skills or knowledge
• To keep up-to-date professionally
• Proof of competency to show payors/ insurers
• Expand services provides by the practice/institution

RhMSUS™ is the only musculoskeletal ultrasound certification program in the United States developed specifically for rheumatology practice.

RhMSUS™ was developed by the American College of Rheumatology for physicians, physician assistants, and nurse practitioners to demonstrate competency in musculoskeletal ultrasound in their practice of rheumatology. It only certifies that an individual is competent in their use of musculoskeletal ultrasound in rheumatology not their competence in rheumatology.

Physicians receive certification in the subspecialty of rheumatology through the American Board of Internal Medicine (in the United States, there are other boards outside the U.S.). Physicians who want to certify in and maintain their certification in rheumatology must still do so through the ABIM.

Volunteers

Chair: Housam Sarakbi, MD, Detroit, MI (2027)
Member-at-Large: Liudmilla Kastsianok, MD, Denver, CO (2027)
Member-at-Large: Christina Schutt, MD, Rochester, NY (2027)
Member-at-Large: Tamika Webb-Detiege, MD, New Orleans, LA (2027)
Public Member: Amy Baron, Cincinnati, OH (2026)

Committee Description and Charge
The ACR Musculoskeletal Certification Program Oversight Committee shall have responsibility for the organization and implementation of the ACR Musculoskeletal Certification Program. The Committee shall:

• Develop, implement, and monitor program eligibility requirements
• Develop and implement certification policies and procedures
• Review and approve all examination items
• Develop and implement standards for recertification
• Review domains and tasks annually to ensure relevance/accuracy
• Review testing data and make recommendations for research studies

The Committee shall also select and appoint members of the Examination-Item Development Group, Examination Assembly and Review Group, Examination-Criterion Group, Job Analysis Group, and other groups and sub-committees as the Committee deems necessary or appropriate to carry out its objectives. All such appointments shall be subject to the approval of the Board of Directors or Executive Committee and Executive Vice President.

Committee Member Time Commitments

• Participate in webinars, conference calls, and emails as needed
• 30–50 hours on outside work
• The committee does a fair amount of time-sensitive work via email, requiring that members be extremely responsive and able to work under short timeframes

Committee Eligibility Criteria Including Special Positions
The ACR Musculoskeletal Certification Program Oversight Committee will consist of five (5) members plus the Director, Certification, who will serve ex officio as a nonvoting member.

Initial appointments of Oversight Committee members are made by the ACR Board of Directors, as follows: One member will be appointed as Chair of the Oversight Committee; one member will be appointed as Chair of the Examination Group(s); two members will be appointed as at-large appointees, and the fifth member will be appointed as a representative of the public.

The term of office for Oversight Committee members will be four (4) years and staggered, with the opportunity to be re-appointed for one additional term.

The following expectations pertain to the nomination and appointment of all members of the Oversight Committee:

• All members of the Oversight Committee must strongly support the vision of the certification program and be committed to ensuring its successful implementation.
• Membership on the Oversight Committee is volunteer based.
• All appropriate stakeholders should be involved – candidates, certificants, patients, and the public, with due consideration to gender and all other facets of diversity, to the fullest extent possible.
• All members must sign a confidentiality agreement committing to strict confidence and not to use or disclose any confidential information.
• Five or more years as an educator or direct supervisor (does not apply to public member).

The following expectations pertain to the nomination and appointment of the public member of the Oversight Committee:

• The public member represents the direct and indirect users of certificants’ skills and/or services. Because this may be defined broadly, a rotating system for representation of various publics may be implemented over time.
• The public member may be a professional, but should not have similar credentials to certificants.
• The public member may be or have been a potential consumer of the certificants’ skills or services.
• The public member should also have experience with public advocacy.

Committee Member Conflict of Interest Policies
Members of the Oversight Committee have fiduciary responsibility for the certification of qualified individuals who meet its standards related to the performance of musculoskeletal ultrasound in their practice of rheumatology. The primary obligations are to stakeholders (e.g., patients, employers). In order for Oversight Committee members to ensure their decisions uphold these obligations, all Oversight Committee members will abide by the following requirements concerning conflict of Interest:

• Members whose primary employment is in commercial entities or health care insurance companies are not eligible to serve on the Oversight Committee.
• Members of the Oversight Committee must be free of conflict of interest relevant to the subject matter throughout the length of their term and for 12 months following the end of their term.
• Members of the Oversight Committee cannot serve as course directors or planning committee members for any CME granting musculoskeletal ultrasound instructional courses including ACR courses throughout the length of their term and for 12 months following the end of their term.*
• Members of any entity that provides training that fulfills RhMSUS Program eligibility criteria cannot serve on the Oversight Committee.
• Members cannot serve as members of the ACR Committee on Education or the ACR Musculoskeletal Ultrasound Planning Committee throughout the length of their term and for 12 months following the end of their term.

*The Chair of the Examination Group(s) cannot serve as faculty for any musculoskeletal ultrasound instructional course including CME and non-CME courses and ACR courses throughout the length of their term and for 12 months following the end of their term.

The Examination Group(s) will carry out the review and approval of all examination items on behalf of the Oversight Committee. Except for the Chair of the Examination Groups, members of the Oversight Committee shall not review the examination in its entirety or any individual questions unless their opinion regarding an individual question is specifically requested by the psychometric consultant, other committee leaders within RhMSUS, the ACR staff member for RhMSUS or the ACR board.

Volunteers

Coming soon

Roles

• Review candidates' appeals when candidates are not satisfied with the original decision of the certification
• Make recommendations related to certification policies and procedures to oversight committee as needed

Desired Expertise

• Comprehensive understanding of the ACR's certification policies and procedures

Time Commitments

• Webinars, conference calls, and emails as needed
• Members are "on call" for issues that arise requiring that members be extremely responsive and able to work under short time frames

Volunteers

Appointed by Oversight Committee

Roles

• Write, review, and validate multiple-choice test items

Desired Expertise

• Must have good understanding of the knowledge and skills required of the minimally competent professional and five+ years as an educator or direct supervisor
• Skill in question writing is preferred

Time Commitments

• Submission to item writing bank
• Webinars, conference calls, and emails as needed

Volunteers

Appointed by Oversight Committee

Roles

• Assemble examination forms according to the examination blueprint, following psychometric and editorial review of the multiple-choice test items

Desired Expertise

• Must have good understanding of the knowledge and skills required of the minimally competent professional and five+ years as an educator or direct supervisor
• Skill in question writing is preferred

Time Commitments

• Webinars, conference calls, and emails as needed

Volunteers

Appointed by Oversight Committee

Roles

• Evaluate each test item according to its relevance and difficulty for the minimally-competent professional

Desired Expertise

• Must have good understanding of the knowledge and skills required of the minimally competent professional and five+ years as an educator or direct supervisor

Time Commitments

• Webinars, conference calls, and emails as needed

Volunteers

Appointed by Oversight Committee

Roles

• Evaluate each test prompt according to its relevance and difficulty for the minimally competent professional. Update as needed.

Desired Expertise

• Must have good understanding of the knowledge and skills required of the minimally competent professional and five+ years as an educator or direct supervisor

Time Commitments

• Webinars, conference calls, and emails as needed