CRT/RRT 2026 Snapshot (NBRC)
If you are preparing for the respiratory therapist credentialing pathway in 2026, start with the current NBRC structure:
| Item | Current NBRC-Published Detail |
|---|---|
| Credentialing pathway (current) | TMC for CRT + RRT eligibility decision, then CSE for RRT completion in eligible cases |
| TMC structure | 160 total items (140 scored + 20 pretest) |
| TMC time limit | 3 hours |
| CSE structure | 22 problems (20 scored + 2 pretest) |
| CSE time limit | 4 hours |
| TMC fee | $190 new applicant / $150 repeat applicant |
| CSE fee | $200 |
| TMC scoring model | Low cut score and high cut score decision model |
| TMC outline timeline | Current TMC detailed content outline effective through December 31, 2026 |
What the TMC Actually Tests
NBRC's current TMC detailed content outline distributes scored items as follows:
| Domain | Scored Items | Approximate Weight |
|---|---|---|
| Patient Data Evaluation and Recommendations | 50 | 35.7% |
| Troubleshooting, Quality Control, and Infection Control | 20 | 14.3% |
| Initiation and Modification of Interventions | 70 | 50.0% |
| Total | 140 | 100% |
Practical implication
Your biggest score driver is Interventions (70 items), followed by Patient Data Evaluation (50 items).
If your study time is limited, allocate in this order:
- Interventions
- Patient Data Evaluation
- Troubleshooting / QC / Infection Control
CRT vs RRT Pathway (Current Model)
NBRC explains the current TMC decision model this way:
- Low cut score: candidate earns CRT
- High cut score: candidate earns CRT and becomes eligible for CSE in the current pathway
That means your TMC performance determines whether you stop at CRT or continue to the CSE step for the RRT track.
2026-2027 Transition You Need to Know
NBRC has posted a transition to a single RT Examination model beginning in January 2027.
Important posted timeline notes:
- Current TMC detailed content outline remains effective through December 31, 2026
- NBRC states CSE remains available through December 31, 2027 for candidates who achieved the TMC high-cut eligibility condition by December 31, 2026
If your testing plan is close to the 2026-2027 boundary, verify the active exam model before scheduling.
Fees and Retake Policy (Current NBRC Rules)
Fees
- TMC: $190 new / $150 repeat
- CSE: $200
Retake timing
NBRC FAQ guidance states:
- No waiting period for first, second, and third attempts
- 120-day wait after the third unsuccessful attempt
Because of this rule, rushed attempts can slow your credential timeline.
8-Week Study Plan for 2026 TMC Prep
Weeks 1-2: Foundation + Baseline
- Take a timed baseline TMC-style set.
- Build an error log by domain.
- Refresh ABGs, oxygenation/ventilation interpretation, and core intervention logic.
Weeks 3-4: Interventions Block (Highest Weight)
- Drill oxygen therapy, ventilation adjustment logic, airway management, and reassessment decisions.
- Focus on scenario questions, not memorization only.
- Add timed mixed sets every third session.
Weeks 5-6: Patient Data Interpretation
- Work daily on ABG trends, imaging/lab integration, and prioritization.
- Practice chart-to-action questions where multiple findings must be synthesized.
- Tighten safety escalation logic for unstable patients.
Week 7: Troubleshooting + Infection Control
- Drill ventilator alarms, device checks, QC workflows, and infection-control decisions.
- Create short checklists for common equipment failure patterns.
Week 8: Final Readiness
- Run 2 full timed simulations.
- Review only recurring misses and high-impact weak areas.
- Lock in test-day logistics and pacing strategy.
High-Return Daily Workflow
- 45-60 minutes: timed questions
- 30 minutes: rationale review + error log update
- 15 minutes: flashcard recall on weak concepts
Consistency beats occasional marathon sessions.
Free RT Resources on This Site
- Study guide: RT Study Guide
- Practice questions: RT Practice Questions
- Flashcards: RT Flashcards
Use all three together: guide for depth, practice sets for decision-making, flashcards for retention speed.