Key Takeaways
- The CRT credential is earned by scoring 86+ on the TMC exam alone
- The RRT credential requires scoring 92+ on the TMC AND passing the CSE
- NBRC credentials are valid for 5 years (earned after July 1, 2002) and must be renewed
- A major 2027 change will replace the TMC+CSE with a single RTE (Respiratory Therapist Examination)
- The new RTE will have 160 scored multiple-choice questions with a 4-hour time limit
- Prerequisites include graduating from a CoARC-accredited RT program (minimum Associate degree)
- The median respiratory therapist salary is approximately $80,450 with 12-13% job growth projected
- Approximately 135,800 licensed respiratory therapists practice in the United States
Credential Pathway: CRT to RRT
Understanding the certification pathway is essential for planning your respiratory therapy career. The NBRC offers two credentials through a tiered examination process, though a significant change is coming in 2027.
Current Credential Structure (Through 2026)
The NBRC currently uses a two-tier examination system:
Tier 1: Certified Respiratory Therapist (CRT)
- Earned by scoring 86 or higher on the 140 scored TMC items
- Entry-level credential recognized in most states
- Does not require the CSE
- Sufficient for licensure in some states
Tier 2: Registered Respiratory Therapist (RRT)
- Requires scoring 92 or higher on the TMC (demonstrating advanced knowledge)
- Must then pass the Clinical Simulation Exam (CSE)
- Advanced-level credential preferred by most employers
- Required for many supervisory and specialized positions
Prerequisites for Exam Eligibility
| Requirement | Details |
|---|---|
| Education | Graduate of a CoARC-accredited respiratory therapy program |
| Minimum Degree | Associate degree (many employers prefer or require Bachelor's) |
| Program Types | Associate (2 years) or Bachelor's (4 years) RT programs |
| Accreditation | Program must be accredited by the Commission on Accreditation for Respiratory Care (CoARC) |
| Application | Submit through NBRC's online portal |
Credential Validity and Renewal
- Credentials earned after July 1, 2002 are valid for 5 years
- Renewal requires earning continuing competency credits during the 5-year period
- Failure to renew results in credential expiration
- Expired credentials may require re-examination
Re-Examination Policy
| Attempt | Waiting Period |
|---|---|
| 1st attempt | N/A |
| 2nd attempt | No mandatory waiting period |
| 3rd attempt | No mandatory waiting period |
| 4th+ attempt | 120-day (4-month) waiting period required |
The 2027 Transition: New RTE Exam
Starting in 2027, the NBRC will implement a major change to the credentialing system:
- The current TMC + CSE pathway will be replaced by a single exam: the Respiratory Therapist Examination (RTE)
- The RTE will have 160 scored multiple-choice questions with a 4-hour time limit
- This change aims to simplify the credentialing process
- The separate CRT and RRT distinction may be affected — check NBRC.org for the latest updates
Career Outlook
| Metric | Value |
|---|---|
| Median Annual Salary | $80,450 |
| Job Growth (Projected) | 12-13% (much faster than average) |
| Licensed RTs in the U.S. | ~135,800 |
| Work Settings | Hospitals, home care, sleep labs, rehab facilities, physician offices |
Specialization Credentials
After earning your RRT, you can pursue specialty credentials:
| Specialty | Abbreviation | Focus Area |
|---|---|---|
| Adult Critical Care | ACCS | ICU ventilator management, hemodynamic monitoring |
| Neonatal/Pediatric | NPS | NICU, pediatric respiratory care |
| Sleep Disorders | SDS | Polysomnography, CPAP/BiPAP titration |
| Pulmonary Function | PFT | Spirometry, lung volume testing, DLCO |
A respiratory therapy graduate scores 89 out of 140 on the TMC exam. What credential do they earn?
How long is an NBRC credential valid before it must be renewed?
Which of the following are NBRC specialty credentials available after earning the RRT? (Select all that apply)
Select all that apply
What major change to NBRC credentialing is planned for 2027?