How to Become a Medical Assistant in Texas

Who can apply

• Texas has no state license, certification or registration for medical assistants. A medical assistant works under a physician's delegation under Occupations Code section 157.001.
• To take x-rays for a physician, you must complete Board-approved training and be on the Non-Certified Radiologic Technician (NCT) Registry, hold a Limited Medical Radiologic Technologist (LMRT) certificate, or have an approved hardship exemption.
• Texas Medical Board credentials require fingerprints for state and national criminal history checks and proof of US citizenship or lawful presence.

Step by step

1. Finish a medical assistant program or get on-the-job training from your employer. Texas does not require a set program.
2. (Optional) Pass a national certification exam (CMA-AAMA, RMA-AMT, CCMA-NHA or NCMA-NCCT). Texas does not require one.
3. If you will take x-rays, complete a Board-approved NCT training program and apply to the NCT Registry ($110, which includes the jurisprudence exam), or complete an approved limited program, pass the ARRT limited scope exam, and apply for an LMRT certificate ($130).
4. Work only on tasks your supervising physician delegates under section 157.001.

Training and exam

Training: No state-mandated medical assistant program. Under Occupations Code 157.001, a physician may delegate a medical act to a qualified and properly trained person under the physician's supervision, and the physician decides whether the person can do it safely. For x-ray work, NCTs must complete the mandatory training in Board Rule 186.26 through a Board-approved program before practice.

Exam: No state medical assistant exam; national certification is voluntary in Texas. For x-rays: the NCT Registry application includes the TMB jurisprudence exam. The LMRT certificate requires the ARRT Limited Scope of Practice in Radiography exam (a 100-question core module plus 20-25 questions per procedure module), which must be passed within one year of Board authorization.

What it costs in Texas

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 Texas

What a medical assistant can do in Texas: Texas law does not list medical assistant tasks. Under Occupations Code 157.001, a physician may delegate any medical act that a reasonable and prudent physician would find within sound medical judgment to delegate, if the act can be done safely by that person, is done in its customary manner, and does not violate another statute. The physician stays responsible for the delegated acts. Occupations Code 157.002(b) also lets a physician delegate to a qualified, properly trained person under supervision the administering (including by injection) or providing of prescription (dangerous) drugs in the physician's office, as the physician orders, for patients' immediate needs.

What a medical assistant cannot do: A medical assistant may not represent to the public that they are authorized to practice medicine (section 157.001(a)(2)). A delegated act may not violate any other statute, so x-rays need NCT registration or an LMRT certificate.

X-ray: To perform radiologic procedures under a Texas physician's supervision, an NCT must complete the mandatory training in Board Rule 186.26 and be listed on the NCT Registry, or have an approved hardship exemption, before starting. NCTs need 12 hours of continuing education every 24 months, including an HHSC-approved human trafficking prevention course; TMB's mandatory CE tracking through CE Broker begins September 1, 2026. An LMRT certificate lets you x-ray specific parts of the body after an approved limited program and the ARRT limited scope exam. If you work for a chiropractor, podiatrist or dentist, other agencies regulate x-ray work.

LMRT exam scoring and retakes: The passing score for every LMRT exam category is 75%, and every section of the core module must be passed at 75%. If you do not pass a section within 3 attempts, or within one year of the Board's approval to test, you must document 60 hours of remedial activity before another attempt is approved.

Sources

• Texas Occupations Code chapter 157 - Authority of physician to delegate certain medical acts
• TMB - Authority of Physician to Delegate Certain Medical Acts
• TMB - Non-Certified Radiologic Technician Registry Application
• TMB - NCT Registry Renewal
• TMB - Continuing Education for NCT Registry
• TMB - Limited Medical Radiologic Technologist Certificate Application
• TMB - Limited Medical Radiologic Technologist Exam
• Texas Occupations Code 157.002 - General delegation of administration and provision of dangerous drugs