How to Become a Medical Assistant in Iowa

Who can apply

• Iowa has no state license or registration for medical assistants. No Iowa statute or Board of Medicine rule lists general medical assistant duties; tasks depend on what the physician delegates.
• To take x-rays you need an Iowa HHS permit. For a medical assistant this is usually a Limited Radiologic Technologist permit (chest, spine, extremities, shoulder or pediatrics; no CT or fluoroscopy).
• At a medical spa, the Board of Medicine says a medical director may delegate medical aesthetic services only to non-physician persons who are appropriately licensed or certified in Iowa, with written proof of their education and training.

Step by step

1. Finish a medical assistant program or get on-the-job training from your employer. Iowa does not require a set program.
2. (Optional) Pass a national certification exam (CMA-AAMA, RMA-AMT, CCMA-NHA or NCMA-NCCT). Iowa does not require one.
3. If you will take x-rays, complete an Iowa HHS recognized limited radiography course (Core plus Chest, Extremities and/or Spine) and arrange your own clinical training.
4. Pass the ARRT limited scope exam with at least 70 percent on the core section and each category (or another exam HHS accepts), then apply for your permit through the AMANDA portal.
5. Work only on tasks your physician delegates and, for x-rays, only in the categories on your permit.

Training and exam

Training: No state-mandated medical assistant program. For a Limited Radiologic Technologist permit you must complete an Iowa HHS recognized training program; HHS offers online courses at $200 per category (Core is required), and you arrange your own clinical site.

Exam: No state medical assistant exam, and Iowa does not require national certification. For x-ray, Iowa HHS requires at least 70 percent on the ARRT limited scope of practice in radiography exam core section and on each category, or another HHS-approved exam. Since January 1, 2022, you pay ARRT exam fees directly to ARRT.

What it costs in Iowa

Fixed amounts are set by the state. Items marked “your quote” are priced by private sellers, so enter what you’re quoted.

Good to know in Iowa

What a medical assistant can do in Iowa: Iowa has no medical-assistant-specific law. You may do tasks your physician delegates and supervises. Taking x-rays needs an Iowa HHS permit.

What a medical assistant cannot do: Without an HHS permit you may not take x-rays. At medical spas, the Board of Medicine treats medical aesthetic services as the practice of medicine and says they may not be delegated to non-physician persons who are not appropriately licensed or certified in Iowa. Delegated staff need direct, on-site physician supervision at least four hours a week, and the medical director must review at least 10 percent of charts.

X-ray: A Limited Radiologic Technologist does radiography of the chest, spine, extremities, shoulder or pediatrics, not CT or fluoroscopy. Shoulder and pediatrics use competency forms. To keep the permit, report 12.0 hours of continuing education each two-year cycle; if you miss them, the permit expires and you may not take x-rays. Iowa also has narrower X-Ray Equipment Operator permits for podiatric radiography and bone densitometry.

Failing the x-ray exam: After three failed attempts on the ARRT limited scope exam you must repeat the formal education or finish a department-approved review program. You must file a new application with HHS each time you take the exam (641 IAC 42.9(2)e).

Sources

• Iowa HHS - Limited Radiologic Technologist
• Iowa HHS - Permits to Operate
• Iowa Board of Medicine - Medical Monitor Newsletter, December 2025 (medical spa delegation, 481 IAC 655.6)
• Iowa Admin. Code r. 641-42.9
• Iowa HHS Chapter 42 Permit Regulatory Guide
• Iowa Admin. Code r. 641-42.9 - Limited radiologic technologist permit (Cornell LII)