Diagnostic Imaging Center of Excellence

The highest achievement for medical imaging facilities

DICOE provides a comprehensive assessment of your facility, including structure, operations and outcome. With it, you'll attract and retain the best radiologists and technologists while letting your peers know you're operating at the highest professional level. But it's so much more than the face you present to the world. Your on-site survey by the DICOE team of medical imaging experts provides third-party analysis of your patient care, quality and radiation safety. The survey team's recommendations serve as a true roadmap for maintaining operational and outcome excellence.

How can I achieve DICOE?

The eligibility requirements are straightforward: ACR accreditation in all the modalities you provide for which ACR offers accreditation, adherence to the Image Gently® and Image Wisely® pledges, and NRDR registry participation (see below). Achieving DICOE also requires an on-site visit. Indeed, this is one of the strengths of the program. Please note, if your practice operates in multiple states, a separate application must be prepared for each state.

Participation in at least two NRDR registries is required.

The National Radiology Data Registry is a tool for improving the quality of patient care using comparative performance and feedback on quality measures. Participation is a requirement for DICOE facilities. As such, you'll receive a 15% reduction in registry costs. The following NRDR registries are offered by ACR:

Clinical Decision Support Registry (CDSR) CT Colonography (CTC) Registry Lung Cancer Screening Registry (LCSR) National Mammography Database (NMD) Dose Index Registry (DIR) General Radiology Improvement Database (GRID) 3D Printing Registry (3DP)

Sites offering CT modality must participate in ACR DIR registry. Sites not offering CT modality must participate in ACR GRID registry. In addition, sites must choose any of the other registries above to fulfill the two-registry participation requirement.

What are the program guidelines?

Applicable to all sites within your practice, each location must share common governance, policies, procedures, and radiologist groups and can include a combination of location types (e.g.,hospital, outpatient, freestanding). If a practice consists of more than five sites within a state, the DICOE team will survey an additional site of their choosing. This additional site survey will occur during the same in-state team visit, minimizing travel expenses and your schedule disruptions.

What areas are assessed?

DICOE follows Center of Excellence driving principles of adoption, implementation, and maintenance. In this way, an actionable framework for positive change is created, one that can guide facilities throughout the designation's three-year cycle. The DICOE team is made up of a radiologist, a medical physicist, and an ACR staff member, and will conduct the extensive on-site assessment. Covering several critical areas of your operation, the DICOE team will examine:

Governance — There is a clear delineation of roles and responsibilities
Personnel — All certifications and licensing are up to date.
Facility organization and management — Facility layout must account for patient privacy and safety.
Physical environment — Facilities should provide clean, professional, and patient-centric care.
Equipment and IT — All equipment is tested annually, maintained, and operating in optimum conditions mandated by ACR accreditation.
Radiation and general safety — All safety procedures are known to the team and followed.
Quality management — Quality measures are selected, analyzed to improve imaging quality for maintaining the best outcome.
Policies and procedures — Are patient rights clearly posted and adhered to?
Patient rights — There is a clear delineation of roles and responsibilities.
Medical records — Effective imaging report communications while maintaining privacy.

Our goal is to raise the minimum standards of value-based care to the highest possible level throughout the radiology practice; therefore, surveyors may request a Corrective Action Plan (CAP) as needed. The execution of CAP and the DICOE final report provides a valuable roadmap to maintain excellence at your facility. ACR staff stands ready to support you through the life of DICOE.

In addition, if your practice includes routine fluoroscopy and diagnostic X-ray—two imaging areas for which there are not ACR accreditations—the site survey will also include review of their safety, protocols and documentation of dose (for fluoroscopy).

Fees & Applications

Because each practice is different, the fees, while standardized, will vary. We have provided a table below and three examples to help you arrive at the cost for your facility/practice.

Diagnostic Imaging Center of Excellence (DICOE) Per State
Application Cycle	Number of Sites	Fee	Site Survey Required (Y/N)	Add Sites mid cycle**
Initial/Renewal	1 to 5	$3,000	Yes	$300/site-up to 5 sites
	6 to 10 sites	add $2,000	Yes	$300/site-up to 10 sites
	11 to 15 sites	add $1,000	Yes	$300/site-up to 15 sites
	16 or more sites	add $1,000 per five sites	Yes	$300/site-less than 4 add. sites

Example 1: Applied for 15 sites within one state

First 1-5 sites $3,000

6-10 sites $2,000

11-15 sites $1,000

Total Fee $6,000

Example 2: Initial application included three sites. During mid-cycle, they add 2 sites

First 3 sites $3,000

Add 2 sites $600

Total Fee $3,600

Example 3: Original practice is in OH State and they need to add 3 sites in PA

First 3 sites $3,000

Add 2 sites $600

Total Fee $3,600

Please note that a practice is a single hospital or group practice. DICOE applications cover up to five sites in a single state. However, you'll have noticed in the table above that the cost per five sites decreases with the size of the practice.

New sites can be added up to the halfway point of the three-year DICOE cycle, and sites in multiple states require separate applications for each state. Travel and expenses for the DICOE survey teams are additional.

Please use the table and examples to determine your costs (excluding survey team expenses) for use in your application.

The worksheets at right help you gather all the information needed to complete the DICOE application. Each facility location must have a separate Modality form completed.

Application worksheets

Facility information worksheet
Modality information worksheet
Payment information worksheet

Once you've completed your worksheets, proceed to the DICOE application.

Once submitted, changes cannot be made to the above. If you need to make any changes after submission, please call 1-800-770-0145 or email us at DICOE@acr.org.