RCIS certification is the Registered Cardiovascular Invasive Specialist credential that Cardiovascular Credentialing International (CCI) awards to cath lab staff who pass a 170-question exam on diagnostic and interventional catheterization. This page lays out the whole route: what the credential means, which of the three eligibility pathways fits you, how the five exam domains are weighted, and where to practice first.
RCIS stands for Registered Cardiovascular Invasive Specialist. It certifies that you can work the invasive side of cardiology: scrubbing, monitoring and recording during heart catheterization, coronary and peripheral interventions, device implants and the emergencies that come with them. You will also see it written as cardiovascular invasive specialist or, less often, registered cardiac invasive specialist; all three mean the same CCI credential.
RCIS is a voluntary professional credential at registry level, not a state license; many employers require or prefer it. In practice that means two separate questions for your first cath lab job: what your employer asks for, and whether your state adds its own rules for invasive cardiovascular staff. Check both; the credential answers only the first.
Who holds it: technologists, nurses, respiratory therapists and paramedics who moved into the lab, plus graduates of invasive cardiovascular programs. It sits on top of your existing profession rather than replacing it.
One sitting, 3 hours, at a computer. Of the 170 questions, only 150 count toward your score; the other 20 are pretest items you cannot spot, so treat every case as live. The table pulls the figures that decide how you plan, each with the CCI page it comes from and the month it was checked.
| Item | What it is | Source |
|---|---|---|
| Questions | 170 questions | CCI, checked October 2026 |
| Scored | 150 scored questions | CCI, checked October 2026 |
| Item types | mostly single-best-answer items with four options, plus multiple-response, hot-spot and drag-and-place items | CCI, checked October 2026 |
| Time | 2 hours 50 minutes of question time | CCI, checked October 2026 |
| Delivery | computer-based, at Pearson VUE test centers | CCI, checked October 2026 |
| Pass mark | a scaled score of 650 | CCI, checked October 2026 |
| Fee | $365, including a $100 non-refundable application processing fee | CCI, checked October 2026 |
| Pass rate | a 75% first-time pass rate for 2025 | CCI, checked October 2026 |
The question time works out to 60 seconds a case. A calculation can take up to two minutes; past that, commit to your best estimate. Recall items have to go faster to bank that time. The pass mark is scaled: 650 is not a percentage of items correct, and CCI does not publish a raw cut. The full format, scoring and timing breakdown is on the RCIS exam page.
The exam follows the content outline used for exams from July 1, 2024. It has five domains, and they are far from equal: diagnostic and interventional procedures together carry 74% of the scored items.
Share of scored items by domain, content outline for exams from July 1, 2024 (CCI, checked September 2026).
| Domain | Weight | Scored items, approx. | What it covers |
|---|---|---|---|
| A Pre-Procedural Activities | 8% | about 12 | Room and equipment setup, patient and team preparation, time-out, consent and labs |
| B Diagnostic Procedures | 40% | about 60 | Right and left heart cath, waveforms and hemodynamic math, FFR, IVUS and OCT, radiation safety, drugs, vascular access |
| C Interventional Procedures | 34% | about 51 | Balloons and stents, complex PCI, closure devices, peripheral work, mechanical support, pacing, structural and valve procedures |
| D Emergency Procedures and Protocols | 13% | 19 or 20 | STEMI and shock on arrival, intraprocedural complications, code equipment |
| E Post-Procedural Activities | 5% | 7 or 8 | Hemostasis, access-site complications, patient teaching, handoff |
Two domains have their own deep guide so far: diagnostic procedures (B) with the pressure and output calculations worked step by step, and interventional procedures (C) from balloon sizing to structural cases. Guides for A, D and E are planned.
CCI admits candidates by pathway, each one a mix of education and lab experience. Pick the row that matches your background; the pathway decides what documentation the application asks for.
| Pathway | Typical candidate | What CCI asks for |
|---|---|---|
| RCIS235 | Technologist, nurse, RT or paramedic already working in a cath lab | A graduate of a health-science program (CVT, ultrasound, radiologic technology, respiratory therapy, nursing, paramedic/EMT and similar) with 1 year of full-time invasive cardiovascular work and 600 cardiac diagnostic or interventional procedures |
| RCIS4 | Student or graduate of an accredited invasive CVT program | A graduate of a programmatically accredited invasive cardiovascular technology program (students may apply before graduating) |
| RCIS5 | Graduate of a program without programmatic accreditation | A graduate of a non-accredited invasive cardiovascular program with at least 1 year of specialty training and at least 800 in-program clinical hours |
Nurses qualify through RCIS235: nursing is on the list of qualifying health-science programs, and the year of full-time invasive work plus the procedure count is what you document. Every condition, including what counts as a procedure, is on the RCIS certification requirements page.
Match your pathway
Confirm RCIS235, RCIS4 or RCIS5 and gather its proof (diploma, employer letter, procedure log) before you study; a missing letter stalls the application.
Apply to CCI and pay
The application costs $365, including a $100 non-refundable application processing fee (CCI, checked October 2026). Processing time varies, so leave slack between applying and the date you want to test.
Book inside the window
Approval brings a 90-day testing window that opens with the Authorization to Test; one 90-day extension can be requested. Testing runs year-round at 230+ Pearson Professional Centers in the US and 3,000+ Pearson VUE authorized centers abroad (CCI, checked October 2026). Book a date six to eight weeks ahead so the last two weeks are timed practice.
Sit the exam
Plan for 2 hours 50 minutes of question time plus 10 minutes for the tutorial and the post-exam survey. You leave with a preliminary score report at the test center, with pass/fail and percent correct per content area. If you do not pass, a retake means a new application and full fees; you can reapply one day after testing, but the next attempt must be at least 45 days later.
Keep it current
Renewal is a fee-only first renewal ($165, no CEUs) about 9-12 months after passing, then every 3 years: $165, the Code of Ethics and 36 CEUs, at least 30 of them cardiovascular (CCI, checked October 2026). The requirements page has the details.
Dates and fees above are as CCI listed them when checked; confirm them on the RCIS page at CCI before you pay.
Interventional procedures are 34% of the exam, about 51 scored items. These four cases come from that domain: two on calcium-modification tools, one on getting a device implant ready, and one on reading the pressure at the tip of a transseptal needle. Each option has its own note, so a wrong pick tells you why. No timer here; the full practice test runs at 60 seconds a case.
Orbital atherectomy is planned for a heavily calcified mid-RCA lesion after the ViperWire has crossed. At which speed should the crown be run for the initial passes?
Pick an answer. The verdict, the explanation and a note on every option appear here.
Twelve more cases on this domain sit in the interventional guide, and the worked RCIS exam questions show the reasoning for every option on the other domains.
Run the full case log on your phone
The app carries the larger RCIS question bank with the same explanations, sorted by the five exam domains.
If your question is which certification a cath lab tech gets, the credential built for that role is RCIS. The neighbors below share vocabulary but test a different lab or start from a different profession.
| Credential | Awarded by | Built for | Pick it when |
|---|---|---|---|
| RCIS | CCI | Cath lab: diagnostic and interventional catheterization | You scrub, monitor or circulate in coronary, peripheral or structural cases |
| RCES | CCI | Electrophysiology lab: EP studies and ablation | Your cases are mapping and ablation rather than cath and PCI |
| RCS | CCI | Cardiac sonography (echo) | You scan rather than work at the table |
| ARRT CI | ARRT | Cardiac-interventional credential for radiologic technologists | You already hold an ARRT radiography credential; many cath lab job posts accept either RCIS or ARRT CI |
Cardiac nursing certifications such as CV-BC or CMC belong to a separate family run by nursing certification bodies. A cath lab nurse can hold one of those and RCIS at the same time; RCIS is the one written around the procedure room.
Cheap question banks recycle old keys, and the quickest check is the domain split: material written before July 2024 prints a different one, so its study plan points at the wrong targets. The RCIS study guide shows how to spot an old book and names the four reference texts CCI points to. Stale answer keys, each with its correction, sit in a table on the worked questions page.
Key takeaways
RCIS, Registered Cardiovascular Invasive Specialist, is CCI's credential for staff who work in the cardiac cath lab. You earn it through one of three eligibility pathways and a 170-question exam across five domains. RCIS is a voluntary professional credential at registry level, not a state license; many employers require or prefer it.
It depends on the pathway. On RCIS235 you need a year of full-time invasive work and the procedure count before you can apply; on RCIS4 you can apply as a student of an accredited program. After approval you have a 90-day window to test, so plan your study to end inside it, with the last two weeks on timed runs.
CCI reports a 75% first-time pass rate for 2025 (CCI, checked October 2026), so roughly one first-time candidate in four does not pass. Most of the difficulty sits in domain B: waveform reading and calculations under a clock of about 60 seconds a case. For a dry run in the real item style there is CCI's online self-assessment exam ($55), which reports percent correct by area but does not let you review items (CCI, checked September 2026).
Not necessarily. RCIS is a credential, not a profession: holders include cardiovascular and radiologic technologists, respiratory therapists, paramedics and registered nurses. A nurse who earns it is still licensed as a nurse; the RCIS adds the cath lab credential.
RCIS is the credential written for the cath lab role. Radiologic technologists sometimes take ARRT's cardiac-interventional credential instead, and electrophysiology lab staff take RCES. The comparison table lines them up.
Apply online with CCI under your pathway, upload the documents it asks for and pay $365, including a $100 non-refundable application processing fee (CCI, checked October 2026). Once approved you receive an Authorization to Test and book a Pearson VUE seat. The steps are on the requirements page.
Match it to your lab. RCIS covers catheterization and intervention; RCES covers electrophysiology studies and ablation. Both come from CCI; if you rotate between labs, ask your employer which one your role needs first.
Work the free case run here, then carry the full RCIS bank with you: the app sorts questions by the same five domains and keeps the explanation for every option.