How to Become a Medical Assistant in New Hampshire

Who can apply

• New Hampshire does not license medical assistants. There is no state application to work as one.
• To take x-rays you need a New Hampshire limited x-ray machine operator license. Since July 31, 2018, no one may perform medical imaging on people without a license under RSA 328-J (RSA 328-J:10).
• Limited x-ray machine operator applicants must be at least 18 and have a high school diploma or an approved equivalency (RSA 328-J:11).

Step by step

1. Finish a medical assisting program or on-the-job training.
2. Optionally earn a national certification (CMA-AAMA, RMA-AMT, CCMA-NHA or NCMA-NCCT). New Hampshire does not require one.
3. If your job includes x-rays, complete a limited x-ray machine operation course approved by the OPLC executive director, pass an approved exam such as the ARRT limited x-ray machine operator exam, and apply to OPLC for a limited x-ray machine operator license ($170 for two years).
4. Work under the physician practice that employs you. When a licensed nurse delegates a task to you, the nurse must follow the Board of Nursing delegation rules.

Training and exam

Training: No state-mandated medical assistant program. For x-rays, RSA 328-J:11 requires a limited x-ray machine operation course approved by the OPLC executive director. When a licensed nurse delegates a task, the nurse must teach it, watch you do it, and find you competent before delegating (Nur 404.06).

Exam: New Hampshire has no state medical assistant exam; national certification is voluntary. For a limited x-ray machine operator license, the board may use the ARRT limited x-ray machine operator exam (bone density, chest, extremities, podiatric, skull/sinus), the ACRRT spine exam, the American Society of Podiatric Medical Assistants podiatric exam, or the ISCD bone densitometry exam (RSA 328-J:11).

What it costs in New Hampshire

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

Keeping your credential

Renewal: X-ray limited x-ray machine operator license only: renew every 2 years with OPLC, pay the licensing fee ($170 under Plc 1002.26 (effective July 1, 2025); OPLC's fee page lists $155), and complete 24 hours of continuing education or other professional activities in each 2-year renewal cycle (Plc 1308.02).

Good to know in New Hampshire

Tasks delegated by a nurse: Under RSA 326-B:28 and Board of Nursing rule Nur 404, an RN or LPN may delegate tasks to unlicensed assistive personnel such as medical assistants only if the person is competent for the specific task. The nurse must make sure the task needs no nursing assessment, teach it, observe it, document the delegation and keep supervising. For medication, the nurse must specify the drug, dose, route and time. A nurse cannot be forced to delegate if they believe it is unsafe (RSA 326-B:29). The Board of Nursing proposed readopting Nur 400 (including these delegation rules, with technical edits) in March 2026.

What a limited x-ray operator cannot do: A limited x-ray machine operator works only within the body areas on their permit, under the direct supervision of a licensed practitioner or licensed radiographer, and may not perform CT, fluoroscopy, MRI, mammography, radiation therapy, sonography, mobile imaging or contrast studies (RSA 328-J:12).

X-ray orders: A licensee under RSA 328-J may image people only by prescription of someone authorized by the state to order imaging and under a licensed practitioner's supervision (RSA 328-J:12). To renew, a limited x-ray machine operator must complete 24 hours of continuing education or other professional activities in each 2-year cycle (Plc 1308.02(b)).

Medications a nurse may delegate: Under Nur 404.07, a nurse may delegate medication given by topical, oral, nasal, eye, ear, vaginal, rectal or enteral-tube routes, and insulin or epinephrine injections from a labeled pre-set or pre-drawn device. A nurse may not delegate other injected (parenteral) medications, medication through a nasogastric tube, the first dose of a new medication or a dose change.

Sources

• RSA 328-J:10 - License required
• RSA 328-J:11 - Licensure; limited x-ray machine operator
• RSA 328-J:12 - Scope of practice; limitations
• N.H. Admin. Code Plc 1002.26 - MIRT application processing and licensing fees (Cornell LII)
• RSA 326-B:28 - Delegation of nursing activities and tasks
• RSA 326-B:29 - Delegation; nurse may refuse unsafe delegation
• N.H. Admin. Code Nur 404.06 - Delegation of nursing tasks (Cornell LII)
• NH Rulemaking Notice 2026-68 - Nur 400 readoption (March 2026)
• N.H. Admin. Rules Plc 1000 - Fees (Plc 1002.26, eff. 7-1-25)
• NH OPLC - Advisory Board of Medical Imaging and Radiation Therapy License Fees
• N.H. Admin. Rules Plc 1300 - Medical imaging and radiation therapy (Plc 1308.02)