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Is it required by law to have a prescription to get an MRI scan in the United States? If state specific, I'm interested in California and Massachusetts.


I'm reading conflicting, unsupported information:

https://www.nerdwallet.com/community/t/need-see-doctor-get-mri-scans/23315:

You need to see a doctor for a prescription to get an MRI scan of any type.

https://ask.metafilter.com/96943/Is-it-possible-to-get-an-MRI-and-have-it-read-without-a-referral:

Yes, it's possible. It's very expensive, and a lot of radiologists won't even consider trying to interpret such a study without a referring doctor's request, because of the malpractice liability. (You cannot have the test performed without paying for its interpretation, as far as I am aware.)

https://www.quora.com/Can-I-get-an-MRI-or-a-CAT-scan-without-a-referral-if-I-just-want-to-see-what-my-brain-looks-like-What-can-it-tell-me-about-myself:

In general, you must have a prescription for an imaging procedure.

https://travel.stackexchange.com/questions/132726/are-medical-prescriptions-for-medical-imaging-or-physiotherapy-sessions-written#comment329220_132726:

it is not illegal to give an MRI without a referral, and in the US you could probably find someone who would do it as long as you could afford the very high costs.

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    Insurance companies and HMOs and many hospitals will not do an MRI without a doctor's orders as a matter of cost control and because isn't as simple as saying "give me an MRI"; the doctor's orders have to specify precisely what parts of the body are to be scanned without is beyond the capacity of most lay people to do in a comprehensible way. But, it would be unlikely for anyone to be accused of violating the law for doing an MRI without a doctor's orders (indeed some MRIs are done for research rather than for medical treatment). – ohwilleke Feb 24 at 21:08
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    user6726's answer gives a supported example where a doctor order is legally required. Beyond the legal standpoint, some patients have a pretty precise idea of what they want to check in an MRI, and MRIs typically scan a pretty broad area (e.g., an elbow), which allow the radiologist to check all the soft tissues in that area. Even if the ordering physician is very precise in their order (e.g., suspicion of ECRB tendon tear), the radiologist will still check other soft tissues when looking at the MRI. Read a few MRI reports and you'll see. – Franck Dernoncourt Feb 24 at 21:12
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The term "prescription" generally applies to drugs and is covered by pharmacy law and typically has formal requirements regarding the paper or method of transcription, so in a literal sense a prescription is not required. The law in California as it deals with prescriptions (Controlled Substances Act, or general pharmacy regulation) does not imply a requirement for a "prescription". If we switch to "doctors orders", then perhaps there is a requirement. This comes up in this letter (mirror) from the Louisiana State Board of Medical Examiners, who take the position that self-referral for MRI is the practice of medicine, which is illegal without a medical license. A radiologists who performs the procedure would exceed the scope of their license. However, there is no specific statute that says "You must have a doctors orders to perform an MRI", instead that follows from more general laws. They do point out that MRIs often entail injections which cannot be administered except under a doctor's orders. MRI technology is regulated under Louisiana law (start here).

X-ray technicians are similarly regulated in California, but that article does not apply to MRI. You must be licensed to perform an x-ray, acting within the scope of that license, and under the supervision of an appropriate licentiate of the healing arts. Bills have been introduced to widen state control, to include MRI technology, but this has not yet happened. When a contrast agent is involved, you have to have a doctor's orders.

In short, it depends primarily on the extent to which MRI is regulated, but also whether an injection is required. There are orthogonal liability issues and regulatory interactions with Medicare.

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    I strongly suspect that the position of the Louisiana State Board of Medical Examiners that self-referral is the practice of medicine is a minority view. In most states the practice of medicine applies only to medical procedures done on someone else, not procedures done on yourself. It might be the practice of medicine to give someone else stitches, for example, but not to treat yourself in that manner, in most states. Arguably there are even constitutional bodily autonomy issues involved in considering self-treatment to be the practice of medicine. – ohwilleke Feb 24 at 21:11
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    I read the OP as asking whether I need a doctor's orders for him to MRI me; and the Louisiana opinion as being about me referring myself to a radiologist. The point being that a radiologist cannot do an MRI without a doctor's orders. Now, I do not claim that any other state has that interpretation, or that they deny such an interpretation. The prerequisite is that the state has to regulate administration of MRIs. So my hands are off of the question of a radiologist MRIing himself (the liability point in the OP would be moot). – user6726 Feb 24 at 21:23

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