Getting Started

AIM with DICOE - Reach for the Pinnacle of Medical Imaging

Diagnostic Imaging Center of Excellence commonly known as DICOE is a one of a kind program in diagnostic medical imaging. It is made for facilities who aim to go beyond the Gold standard of ACR accreditation. Our goal is to raise the minimum standard and achieve high standards towards value-based care.

A healthcare network, hospital, outpatient, or freestanding imaging center regardless of their size or locations are encouraged to apply for a DICOE designation. The entity can offer a single or multiple modality service. The DICOE team is available to help all sites.

The DICOE follows key driving principles of Center of Excellence (COE). The key driving principles are to adopt, implement and maintain:

• Adoption - DICOE provides a framework for a positive change in practice to benefit facilities, medical providers, and patients.
• Implementation - DICOE provides a blueprint for implementation to achieve the coveted DICOE designation.
• Maintenance - DICOE designation provides and supports facilities to track to maintain the comprehensive standard of care. 
   

01 Benefits

• Comprehensive assessment of the medical imaging facility, including structure and outcomes
• Participation in ACR registries at no cost
• Ongoing process for self-assessment
• Recognition that distinguishes your facility to providers, payers, patients and administrators
• Three-year status
• Customizable materials for local public relations and marketing

Download DICOE brochure »

Video Testimonials
Chair, ACR Quality & Safety Commission		Mount Desert Island Hospital		Hacksensack University Medical Center

02 Determine Eligibility & Program Guidelines – Please note future updates below

Diagnostic Imaging Center of Excellence Program Requirements » Revised 10/1/2020

A facility is eligible to receive the ACR Diagnostic Imaging Center of Excellence designation if it meets the following basic criteria:

• ACR accreditation in all modalities provided for which ACR offers accreditation
• Participates in Dose Index Registry^® and General Radiology Improvement Database
• Has pledged to Image Gently^® and Image Wisely^®
• Site survey assessing multiple areas of quality, safety, procedures and personnel by an ACR survey team that includes a radiologist, medical physicist and technologist working with your team members

Areas of Assessment

• Governance
• Personnel
• Facility organization and management
• Physical environment
• Equipment and IT infrastructure
• Radiation and general safety
• Quality management
• Policies and procedures
• Patient rights
• Medical records

The Diagnostic Imaging Center of excellence (DICOE) program adheres to the following program guidelines:

A healthcare network or a practice may include combination of locations (hospital, outpatient or free standing imaging centers). The DICOE designation is applicable to all locations within your practice included at the time of your application. These locations must be a part of one practice, which share common governance, policy, procedure, and radiologists group.

• If a practice or a group practice consists of more than five sites within a state, the DICOE survey team holds a right to survey an additional site of their choice. The DICOE site survey is planned within the same trip to minimize travel expenses.
• A separate application needs to be prepared for each state.
• A DICOE designated location can add additional sites (up to five) through the mid cycle of DICOE designation period. There will be an additional processing fee for each added site during the period.
• The DICOE team will request sites (or practice) to submit the Corrective Action Plan (CAP) within 90 days from the survey date. 
   

Please note the following updates to Eligibility and Program Guidelines effective on January 1, 2021:

Beginning January 1, 2021 program requirements for DICOE are changing to allow facilities to be eligible based on participation in many more National Radiology Data Registry (NRDR^®) for imaging services they offer. Facilities currently must participate in Dose Index Registry^® and General Radiology Improvement Database.

There are three current eligibility requirements which will remain in effect — with a change to the requirement for NRDR participation taking effect on Jan. 1, 2021:

1. ACR accreditation in all modalities provided for which ACR offers accreditation
2. Has pledged to Image Gently^® and Image Wisely^®
3. Agreement to an onsite survey by DICOE team
4. Effective Jan. 1, 2021: Participate in at least two NRDR registries based on facility’s offered services:
• Sites with CT service must participate in the ACR Dose Index Registry (DIR^®) and a second NRDR registry (see options below).
• Sites without CT service must participate in General Radiology Improvement Database (GRID^®) and a second registry (see options below).

The ACR currently offers the following NRDR registries:

• Clinical Decision Support (CDS) registry. The ACR CDS registry provides facilities with access to their image-ordering clinical decision support data that correspond to imaging CMS Priority Clinical Areas, and several other imaging areas.
• CT Colonography (CTC) registry. The ACR CTC registry helps participants promote quality of care for patients undergoing CT Colonography.
• Lung Cancer Screening (LCSR) registry. The ACR LCSR registry helps clinicians monitor and demonstrate the quality of CT lung cancer screenings in their practice through periodic feedback reports that include peer and registry benchmarks.
• National Mammography Database (NMD) registry. The ACR NMD registry is a quality improvement tool that uses data already collected under MQSA federal mandate to create reports that benchmark facility and physician performance and exceed the FDA’s audit data collection requirements
• DIR registry. Since 2011, the ACR DIR has helped clinicians and facilities improve the quality of patient care by collecting CT dose indices through automated data transmission and leveraging that data to provide feedback to participants and establish national benchmarks.
• GRID registry. The ACR GRID registry is a robust dataset of process measures (e.g. turnaround times, wait times) and outcomes (e.g. adverse incidents) that helps participants pinpoint problems.

Please access https://nrdrsupport.acr.org/support/home for further information.

With more NRDR registries from which to choose for DICOE eligibility, sites can select those that best suit their business model. Per our current and future changes, DICOE sites can opt to participate in DIR and GRID registry.

In addition, please note the highlights of the DICOE Program Requirement updates below. These updates will be effective starting January 1, 2021.

Although ACR does not offer an accreditation program, the DICOE site survey will include review of routine diagnostic imaging (X-ray) and fluoroscopy. The survey will focus on the following areas:

• Equipment safety
• Radiation safety
• Use of protocol
• Documenting fluoroscopy dose

In addition, each facility must assign a radiologist to provide consultation to referring providers during their working hours.

03 Payment Policy and Fees

Effective immediately all applications will be assessed in accordance with the new DICOE payment policy.

DICOE Payment Policy Revised January 1, 2019

1. DICOE defines a Practice as a single hospital/group practice. As long as these locations are within one state, one application is sufficient. A single DICOE application includes a maximum of five locations within the state. Please calculate and submit the total application fee along with a copy of your application.
2. Multi-state Radiology practices must complete a separate application for each state.
3. DICOE surveyors are required to survey at least one location.
4. Applicants agree to an on-site survey by a team that includes a radiologist, a medical physicist and ACR Staff.
5. Applicants agree to pay for the surveyor’s travel and expenses

DICOE Fee Table

A DICOE Designation period is for three years. Please complete a separate application and fees for each state within USA.

Diagnostic Imaging Center of Excellence (DICOE) PER STATE
Application Cycle	Number of Locations	Fee	Site Survey required (Y/N)	Add Locations mid cycle**
Initial/ Renewal	1 to 5	$3,000	Yes	$300/location- up to 5 locations
	6 to 10 sites	add $2000	Yes	$300/location- up to 10 locations
	11 to 15 sites	add $1000	Yes	$300/location- up to 15 locations
	16 or more sites	add $1000 per five sites	Yes	$300 /location less than 4 additional locations
Diagnostic Imaging Center of Excellence (DICOE) International
Initial/ Renewal	1 to 5	$3,750	Yes	Will review the application on a case by case basis

** Mid cycle is defined as 1.5 years from the date of DICOE designation.

Example 1:

Practice #1 – Applied for 15 locations within one state.

First 1-5 locations	$3000
6-10 locations	$2000
11-15 locations	$1000
Total Fee	$6000

Example 2:

Practice #2 – Initial application included three locations. During mid- cycle, they add 2 locations.

First 3 locations	$3000
Add 2 locations	$600
Total fee	$3600

Example 3:

Practice #3 – Original practice is in OH State and they need to add 3 locations in PA.

First application for OH	$3000
Add 3 locations for PA	$2000
Total fee	$5000

04 Apply

Please click on the button below to complete an electronic Diagnostic Imaging Center of Excellence (DICOE) application form. Application is considered ‘complete’ only when the facility, modality and payment sheets are accurately filled.

DICOE Application

Please follow the instructions for application and payment submission. If you have any questions please contact DICOE@acr.org or call 1-800-770-0145 extension 4542.