Frequently Asked Questions about RhMSUS

What is the RhMSUS Program?

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.

Do I need to participate in the RhMSUS Program?

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.

How long is the RhMSUS designation valid?

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 (pg. 11).

Is RhMSUS accepted by payors/insurers or institutions for MSUS credentialing?

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.

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

Who is eligible to participate in the RhMSUS program?

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. (pg. 12)
  • Pathway 2: Non-U.S. trained rheumatologist – Appendix B. (pg.15)
  • Pathway 3: Rheumatology fellow-in-training – Appendix C. (pg. 17)
  • Pathway 4: Physician assistant or nurse practitioner – Appendix D. (pg. 19)

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.

Who is not eligible to participate in the RhMSUS program?

Sonographers, physical therapists, nurses, and 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 as this time.

I have attended ACR Musculoskeletal Ultrasound Courses in the past. Am I considered “certified” in musculoskeletal ultrasound in rheumatology if I took the ACR course?

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.

What if I do not meet all of the eligibility criteria?

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 (pg. 12 - 20).

What if I do not pass the RhMSUS Examination?

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 (pg. 10).

How many times can I sit for the RhMSUS Examination?

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 (pg. 10).

When and where can I sit for the RhMSUS Examination?

The RhMSUS examination will be offered twice a year using computer-based testing and administered at Castle Testing sites throughout the United States. 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 (pg. 4). Visit RhMSUS Process to view the current application deadlines and testing windows.

International Testing Sites Available

Candidates can take the examination at an international testing site for an additional $150 that will be collected at the time of scheduling.

Is the RhMSUS Examination scored immediately?

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.

Where can I find study materials for the RhMSUS Examination?

There is 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 (pg. 33). To familiarize you with the computer-based testing system Castle also provides and online demonstration and tutorial that is accessible anytime and anywhere with internet access. Please note that this demo is not a review of the RhMSUS examination content.

What topics will be covered in the RhMSUS Examination?

The examination will cover the following major topic areas. For the full examination outline can be found in Appendix F of the Candidate Handbook (pg. 22).

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

How much will it cost to participate in the RhMSUS Examination Program?

The certification registration fee is $1,500 for ACR/ARHP members and $1,750 for non-members and $950 for ACR Fellow-in-Training members and $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.

How do I maintain my 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 (pg. 11).

Can I still use ultrasound in my rheumatology practice if I am not certified?

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.

What is the difference between certification and accreditation?

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.

What is the ACR and AIUM Collaborative Pathway?

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 RhMSUS@rheumatology.org or 404-633-3777 ext. 108.

Why did the ACR introduce RhMSUS?

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 percent 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.

How is RhMSUS separate from the ABIM certification process?

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.