Daily Practice

APEx Process Overview


The APEx - Accreditation Program for Excellence® or APEx® was created to support quality improvement in radiation therapy practices. The program establishes standards of performance derived from white papers and consensus practice guidance for radiation oncology. Facilities that obtain practice accreditation will have the systems, personnel, and policies and procedures that are needed to meet the APEx Standards for high-quality patient care.

The APEx program provides an objective review by professional peers of essential functions and processes of radiation oncology practices (ROPs). It offers transparent, measurable, evidence- and consensus-based standards that emphasize a professional commitment to safety and quality. Radiation oncology practices accredited by ASTRO will:

  • Undergo an objective, external review of radiation oncology practices, policies and processes;
  • Demonstrate respect for protecting the rights of patients and being responsive to patient needs and concerns; and
  • Adopt procedures to encourage safety and quality of care.


APEx consists of a series of standards and evidence indicators relating to the performance of radiation oncology practice. ASTRO evaluates the clinical processes of radiation oncology practices, focusing on quality and safety of radiation oncology services.

Applicants must also meet applicable state and federal licensure and certification requirements, including those of the Nuclear Regulatory Commission, as well as requirements of professional practice organizations. The ASTRO standards identify systematic quality and safety approaches that build on the regulatory framework to add value for practitioners and health care purchasers.

ASTRO reviews all treatment modalities and equipment in operation at the time of the accreditation application and facility visit. Practices may not imply or state that equipment or facilities not reviewed by ASTRO are accredited.

Facility Visit Preparation
Facility Visit