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Breast Imaging Centers of Excellence (BICOE) (Revised 12-12-19)

Revision History

The American College of Radiology recognizes breast imaging centers that achieve excellence by seeking and earning accreditation in all of the ACR’s voluntary breast imaging accreditation programs and modules in addition to the mandatory Mammography Accreditation Program by providing them a certificate that identifies them as a Breast Imaging Center of Excellence (BICOE). The ACR will award the designation and one certificate at no additional fee to a center to acknowledge their dedication to improving women’s health by participating in these rigorous quality assurance programs. All BICOE facilities will be identified by the symbol shown above on the ACR’s Accredited Facility Search page.

Benefits of BICOE designation include:

  • Comprehensive assessment of the medical imaging facility, including structure and outcomes

  • Participation in the ACR National Mammography Database registry at no cost for the first year

  • 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

In order to receive the ACR’s BICOE designation, a center must be fully accredited in:

  • Mammography by the ACR (or an FDA-approved state accrediting body)

  • Stereotactic Breast Biopsy by the ACR

  • Breast Ultrasound by the ACR (including the Ultrasound-Guided Breast Biopsy module), and

  • Effective January 1, 2016, Breast MRI by the ACR. (Centers may also satisfy this requirement if they refer their patients to another facility for breast MRI and breast MR-guided biopsy outside their center. This facility must be accredited by the ACR in Breast MRI and may be within their facility system or in a referral relationship with the Center of Excellence.)

The ACR is the leader in quality programs for breast imaging. As such, it is developing new initiatives to stay current with the science and technology that drive radiology practice as well as the clinical needs of the profession. In the future, centers may need to meet more rigorous requirements, such as performing expanded audits or achieving accreditation in Breast MRI, to maintain their BICOE designations.


The ACR will send a BICOE certificate to each center which fulfills the above requirements. A center’s BICOE designation will remain in effect as long as all of its breast imaging facilities (whether they are at the center’s home location or at a different location) remain accredited in all required breast imaging services provided. If the center neglects to renew any of its accreditations or fails during renewal, the ACR will notify the center that it no longer has the BICOE designation and that the ACR BICOE certificate must be removed from public display.

In most cases, centers will not need to complete any forms to receive a certificate. The ACR will consult its database and automatically provide an eligible center a BICOE certificate if a center is at a single physical location and its

  • Mammography facility is accredited by the ACR, and

  • Mammography, stereotactic breast biopsy and breast ultrasound facilities are accredited under exactly the same name

Some centers will need to specifically request a BICOE designation. The ACR has no way of identifying a breast imaging center’s affiliated facilities if they have different names or are located at different physical locations. These eligible centers must complete a BICOE Request Form in order to receive a certificate. The request form must be signed by the owner/officer and lead interpreting physician of each affiliated facility. Furthermore, centers must notify the ACR if imaging locations are no longer affiliated with the center.

Because the ACR cannot maintain records of facilities accredited by state mammography accrediting bodies in its database, eligible centers accredited in mammography by states will also need to complete a BICOE Request Form and provide the ACR a copy of their current Mammography Quality Standards Act (MQSA) certificate.


How to Obtain Breast Imaging Center of Excellence Certificates

If the Center’s…

ACR Automatically 

Sends Certificate

Center Must 

Request Certificate

  • Mammography facility is accredited by ACR, and

  • Mammography, stereotactic breast biopsy, breast ultrasound and breast MRI facilities have exactly the same name, and

  • Mammography, stereotactic breast biopsy, breast ultrasound and breast MRI facilities are at the same physical location

Mammography, stereotactic breast biopsy, breast ultrasound and breast MRI facilities are accredited under different names (see your ACR accreditation certificates)

Mammography, stereotactic breast biopsy, breast ultrasound and breast MRI facilities are at different physical locations

Mammography facility is accredited by state (and not ACR)

The ACR will send one BICOE certificate to the lead interpreting physician for the center’s mammography facility. Centers may obtain additional certificates for affiliated facilities or replacement certificates for a small fee.

National Mammography Database 

Facilities achieving and maintaining the BICOE designation are eligible to participate in the ACR National Mammography Database (NMD) free of charge the first year. Participation in NMD allows facilities to:

  • Benchmark practice performance

  • Compare processes and outcomes to similar practices nationwide

  • Meet and exceed the FDA’s audit data collection requirements

  • Target specific areas for attention and implement successful quality improvement programs

  • Meet criteria for practice quality improvement (PQI) to fulfill ABR Maintenance of Certification Program requirements

  • Receive reports every six months

  • Participate in free webinars to

    • Discuss how to interpret the data

    • Share ideas with other NMD participants on how to use the data for practice improvement

  • Choose what data points are included with their participation. Many data points uploaded to NMD are optional.

To register with the National Mammography Database:

Additional Information 

Visit the ACR’s accreditation website for request forms and further information on the Breast Imaging Centers of Excellence as well as information on all of the ACR’s accreditation programs.

To contact the ACR Breast Imaging Accreditation office by phone, dial (800) 227-6440.

For more information on the National Mammography Database, email or call 1-800-227-5463, extension 3535.

Revision History for this Article



Description of Revision(s)



Article created; FAQs incorporated; No criteria changes

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