How to start a diagnostic imaging centre in India: licences, equipment, staffing and reporting

A diagnostic imaging centre is a regulated business built around one or two very expensive machines. The regulation is sequential: the AERB will not license a scanner that is not type-approved, will not approve a layout that is already built wrong, and will not issue a licence without an approved Radiation Safety Officer.¹ Most avoidable cost in a new centre comes from doing these steps out of order. This guide does not give equipment prices, because no reliable source publishes them.

The sequence

Step 1: business entity and registrations

Form the legal entity first, because every later approval is issued to it: the AERB licence, the PC-PNDT certificate, the equipment loan and the reporting contract will all name it. Register for GST; diagnostic services by a clinical establishment are exempt, but the centre pays GST on equipment, maintenance contracts and most services it buys. Our guide to GST and TDS on radiology reporting explains the exemption.

Whether the centre must register under the Clinical Establishments (Registration and Regulation) Act 2010 depends on the state: the central Act applies only in the states and union territories that adopted it, and several large states run their own regimes.⁴ Confirm with the state health department before signing a lease, and check fire clearance and biomedical waste authorisation locally in the same way.

Step 2: premises and shielding

The room is built for the machine, so the machine is chosen before the room is designed. For CT, the layout, wall shielding, console position and viewing window must meet AERB requirements and are submitted on e-LORA for approval before installation.¹ Build to the approved drawing; changing a wall afterwards is a fresh submission. MRI has no AERB involvement but needs radiofrequency shielding, a controlled access zone, a quench vent, a floor that can carry the magnet, and power and chilled water a CT never needs. Plan the MRI room even if the MRI comes later. Both modalities need a UPS sized for the unit and a network point in the scanner room.

Step 3: equipment

Only AERB type-approved models of CT can be licensed, and procurement of a CT unit is itself declared on e-LORA.¹ Check the approved list before signing a purchase order, particularly for refurbished units, and get the vendor to confirm in writing that the specific model is approved. Costs vary widely by make, slice count, field strength, new versus refurbished and the maintenance contract attached; obtain written quotations from at least two vendors for the unit, installation, shielding, injector, workstation and maintenance, and model the plan on those.

Step 4: AERB licence and RSO

Every institute operating a CT or X-ray unit needs a Licence for Operation from the Atomic Energy Regulatory Board under the Atomic Energy (Radiation Protection) Rules 2004, obtained through e-LORA. CT additionally requires an AERB-approved Radiation Safety Officer, and everyone who operates the unit is declared as a radiation worker and wears a TLD badge.¹² The sequence is: register the institute on e-LORA, declare the procurement, submit the layout, install and upload QA, nominate the RSO and obtain approval, declare workers, apply for the licence, then diarise the renewal. Fees and processing times are published on e-LORA and change; check the portal. The full step list, roles and common failures are in our guide to the AERB licence for a CT scanner.

Step 5: PC-PNDT registration

If the centre installs any ultrasound machine, it must be registered under the PC-PNDT Act before use: Form A to the district Appropriate Authority, a fee of ₹3,000 or ₹4,000 by category, five-year validity, every scanning doctor named on the certificate, Form F for every pregnant woman, and a monthly return by the 5th.³ Only a gynaecologist, or a radiologist, sonologist, imaging specialist or registered medical practitioner with the qualification or experience in Rule 3(3)(1)(b), may scan a pregnant woman, and that person must be on site.³ Obstetric ultrasound cannot be reported remotely in a compliant way; the detail is in our guide to the PC-PNDT Act. A CT and MRI centre with no ultrasound has no PC-PNDT obligation.

Step 6: staffing and radiologist cover

A single-CT centre needs at least two radiographers or technologists to cover a working week, one of whom may be the AERB-approved RSO, plus front desk and billing staff and a responsible medical practitioner. The hard problem is radiologist cover. Every study needs a registered radiologist's signed report, and the 5C Network estimates 20,000 to 22,000 practising radiologists for 1.4 billion people, 70 to 80 percent of them in tier-1 cities, with tier-2 and tier-3 hospitals reporting 6 to 18 month searches to fill a single post.⁵

A common pattern is a visiting radiologist by day and a managed network for nights, weekends and overflow. Raydiac's model, including how radiologists are credentialed per site and modality, is on the for hospitals and teleradiology services pages. The rate card is shared during onboarding.

Step 7: PACS and reporting

A single-scanner centre does not need an enterprise RIS-PACS: the scanner's own archive plus a small local PACS and a reporting partner's gateway, a cloud PACS with a web viewer, or a full RIS-PACS if several modalities and in-house radiologists are planned. The MoHFW EHR Standards 2016 recommend DICOM and HL7 as the interchange standards and are voluntary.⁸ What the components are and what to ask a vendor is in our guide to PACS, RIS, DICOM and HL7. Decide retention at the start: signed reports are the medical record, and images accumulate faster than a first-time owner expects.

Step 8: ABDM and the incentive scheme

Registration with the Ayushman Bharat Digital Mission is voluntary for a private centre, but the Digital Health Incentive Scheme pays for ABHA-linked records: under Corrigendum 6 of 20 November 2025, a facility earns ₹20 for every KYC-verified, ABHA-linked record above 100 transactions in a month, and the digital solution company earns ₹5, subject to a cap.⁹ The facility needs to be on the HFR, its doctors on the Healthcare Professionals Registry, and its software able to push records through ABDM. The milestones are in our guide to ABDM for diagnostic centres.

Data protection

A diagnostic centre is a data fiduciary under the Digital Personal Data Protection Act 2023 for every patient record it holds. The DPDP Rules 2025 were notified on 14 November 2025 with phased commencement; the rules on notice, security safeguards, breach reporting and erasure take effect around eighteen months later.¹⁰ Build for them now: access control, logs, encryption at rest, processing agreements with every vendor, and a named contact for data requests. Raydiac's controls are described on the security page and the obligations in our guide to the DPDP Act for hospitals and diagnostic centres.

The business plan

A diagnostic centre plan fails on cash flow more often than on demand. These are the line items the model must contain; the figures come from quotations and local knowledge, not from this guide.

Two ratios matter above all: break-even studies per day against fixed cost, and cash conversion, because volume that comes through schemes and insurers with long payment cycles needs working capital to bridge. Model reporting as a variable per-study line and an employed radiologist as a fixed line, and compare them at year-one volume.

Common mistakes

• Building the room before choosing the machine. Shielding and layout are unit-specific and approved by AERB before installation.
• Assuming a radiologist will be found. Outside metros a single post can take 6 to 18 months to fill.⁵ Arrange cover before the scanner is commissioned.
• Adding ultrasound without a qualified doctor on site. A technician-performed obstetric scan is an offence under the PC-PNDT Act, and outsourcing the report does not cure it.³
• Signing a long reporting contract before volume is known. Some providers require 12 to 24 month commitments.¹¹ Prefer monthly terms with notice until the case mix is known.
• No named owner for renewals, and no working capital. Every licence and policy expires, and receivables arrive late. Profitable-on-paper centres close for lack of cash.

Launch checklist