RTBS Passing Score 2026: Exactly What You Need to Pass

What "75" Actually Means on the RTBS Exam

If you are preparing for the Registered Technologist - Breast Sonography credential, the first number you will hear is 75. Candidates routinely assume that means they need to answer 75% of the questions correctly. That assumption is wrong, and it quietly distorts how people prepare.

The ARRT postprimary Breast Sonography (BS) examination reports results on a scaled-score system running from 1 to 99. A scaled score of 75 is the passing standard. It is a reporting convention, not a percent-correct figure. The number of questions you must answer correctly to reach a scaled 75 depends on the specific exam form you receive and the passing standard that has been set for it.

This matters for expectations. If you read "75" as a percentage, you might feel comfortable scoring in the mid-70s on practice tests and assume you are on track. Practice-test percentages and scaled scores are different measurements, so the safer strategy is to build real mastery of the content rather than to chase a threshold. For a broader look at how demanding the test is, see our complete RTBS difficulty guide.

How Scaled Scoring Works for Breast Sonography

Scaled scoring exists because different versions (forms) of an exam are never perfectly identical in difficulty. One form might contain a slightly harder mix of questions than another. If the pass mark were a fixed raw count, candidates who drew the harder form would be penalized unfairly.

To prevent that, your raw score (the number of scored questions you answered correctly) is converted onto the 1-99 scale. The conversion is calibrated so that a scaled score of 75 represents the same level of competence regardless of which form you took. That is why the score report speaks in scaled terms and why the equivalent raw score can shift slightly from one form to the next.

What this means in practice

• Your raw count is not the headline number. The scaled result is what determines pass or fail.
• Unscored items do not affect you. Forty of the 225 questions are pilot items that are not counted toward your result.
• You cannot identify which items are pilots. Treat every question as if it counts.
• Percent-correct on practice tests is only a rough proxy. Use it to track trends, not to predict your exact outcome.

ARRT publishes its general explanation of how results are calculated on its exam-scoring page, and it is worth reading once so the score report does not surprise you.

Standard Setting and the Form-Specific Raw Score

The passing standard is not arbitrary. ARRT uses a formal standard-setting process in which subject-matter experts judge how a minimally competent breast sonographer would perform on the content. The results are documented in a Standard Setting Report for Breast Sonography, effective September 2026, alongside the updated content specifications that take effect September 1, 2026.

Two details from that framework are important for candidates:

• The report provides a form-specific raw-score equivalent for the passing standard. It is tied to a particular exam form, not a universal cutoff that applies to every candidate.
• It also provides a projected pass rate. That is a forecast based on the standard-setting work, not an observed result from a 2026 testing cohort.

Because the blueprint and the passing standard were revised for September 2026, older advice about "how many questions you can miss" is unreliable. Candidates testing under the current specifications should rely on the current ARRT documents rather than forum posts written for earlier versions. For the full picture of how this credential fits together, our RTBS certification overview is a good companion read.

Exam Structure: 225 Questions, 185 Scored

Understanding the format helps you interpret the passing score correctly. The Breast Sonography examination is a computer-based test delivered at Pearson VUE testing centers.

Most items are one-best-answer multiple-choice, but the handbook also permits other formats, including multiple-response, sorting, and image or video items. Because this is a sonography credential, expect image-based questions in which you must recognize an anatomic or technical feature and then choose the correct response. Do not confuse the 225 minutes of testing with the 245-minute appointment; the extra time covers check-in and administrative steps rather than additional exam time.

Pacing matters here. With 225 questions and 225 minutes, you have roughly one minute per item on average, but image and video questions will take longer than straightforward recall questions. Build practice habits that mimic this rhythm. Our practice test platform is designed to help you rehearse with realistic question styles and timing.

Where the Scored Questions Come From

Your scaled score is built from performance across three official major categories. The content specifications give scored-question allocations as counts, and those counts are the figures to trust.

Those three allocations total the 185 scored questions. Image Production is by far the largest block, which makes it the single most influential area for your result. Older materials that list different counts (such as 18/102/65) reflect a previous version and should not be used for planning.

For a deeper walkthrough of each category, see our complete guide to all 3 RTBS content areas.

Reading the Pass-Rate Data Carefully

The most recent observed data point comes from the ARRT Annual Exam Report for 2025: a first-time pass rate of 78.1% among 146 candidates. That is a useful reference, but it needs context to be interpreted honestly.

• It is a first-time figure. It reflects candidates on their first attempt, not retakers.
• The cohort is small. A pool of 146 candidates means the figure can move noticeably from year to year.
• It predates the current blueprint. The September 2026 content specifications and the revised passing standard did not apply to that cohort, so it is not a clean prediction for current candidates.

Attempt Limits, Fees and Retake Mechanics

Because the passing score is firm, it helps to know exactly what happens if you do not reach it on the first try.

• Attempts: Three examination attempts are permitted within three years before requalification is required. This is a three-year window, not three attempts per year.
• Initial application and exam fee: $225 USD, or $450 if you are using an ARDMS supporting credential.
• Reapplication fee: $200 for each reapplication after an unsuccessful attempt.

The fee difference for ARDMS-supporting-credential applicants is easy to overlook, so confirm which route applies to you before you budget. Our RTBS certification cost breakdown walks through the full pricing picture, including maintenance costs after you pass.

Eligibility reminders that affect your timeline

You must hold a qualifying supporting credential: current Radiography plus Mammography, or Sonography, or Vascular Sonography. The Sonography and Vascular Sonography routes may be earned through ARRT or ARDMS. You also need ARRT ethics compliance, 16 structured-education hours within the 24 months before application (with at least one credit in each major category), and documented clinical experience. That experience means independently performing 200 nonsimulated breast examinations and participating in at least 20 approved elective procedures within the qualifying 24-month window. Bilateral examinations count as two, no more than nine procedures may be logged per day, scanning must be physically onsite, and each mandatory examination must be presented to the radiologist for final interpretation. Full details are in our RTBS requirements guide.

Aiming Above the Line: A Domain-Weighted Plan

Since the scaled-score threshold cannot be translated into a safe "number I can miss," the sensible target is comfortable mastery. Weighting your time by scored-question counts keeps your effort aligned with what the exam actually rewards. This is the one place where we will talk about scheduling, and it is tied directly to the blueprint.

Image Production comes first because it dominates the scored items and because its subcategories reinforce one another. Procedures follows once you can read and judge images confidently. For a fuller roadmap, see our RTBS study guide.

After You Pass: Registration and Maintenance

Once you earn the credential, maintaining it is straightforward but mandatory. Annual ARRT registration renewal costs $65, regardless of how many ARRT credentials you hold. Ordinarily, 24 approved continuing education credits are required per two-year biennium. Because credentials earned on or after January 1, 2011 fall under the Continuing Qualifications Requirements (CQR), you will also complete a CQR cycle every ten years.

Breast sonographers are typically employed in breast imaging centers, hospital radiology departments and women's health facilities, where the credential signals specialized competence beyond a general imaging background. If you are weighing the payoff, our ROI analysis and salary guide cover the career side in more depth.

Frequently Asked Questions

The passing score is simple to state and easy to misread. Remember that 75 is a scaled score, that Image Production holds the most scored questions, and that the current standard reflects the September 2026 specifications. When you are ready to test your readiness against realistic questions, head back to the main practice test site and start drilling the domains that carry the most weight.