Key Takeaways

  • The NBRC Therapist Multiple-Choice (TMC) exam has 160 questions (140 scored + 20 pretest) with a 3-hour time limit
  • The TMC exam fee is $190, administered at PSI testing centers or via remote proctoring
  • A score of 86/140 or higher on scored items earns the CRT (Certified Respiratory Therapist) credential
  • A score of 92/140 or higher makes you eligible to take the Clinical Simulation Exam (CSE) for RRT
  • The CSE has 22 problems (20 scored + 2 pretest) with a 4-hour time limit
  • The overall pass rate is approximately 61%, with first-time pass rates of 65-70%
  • All TMC questions are multiple-choice with 4 answer options
  • Candidates must graduate from a CoARC-accredited respiratory therapy program (minimum Associate degree)
Last updated: February 2026

NBRC TMC Exam Overview

The National Board for Respiratory Care (NBRC) administers the Therapist Multiple-Choice (TMC) examination, which is the primary certification exam for respiratory therapists in the United States. The TMC exam serves a dual purpose: it determines eligibility for both the Certified Respiratory Therapist (CRT) credential and the Registered Respiratory Therapist (RRT) credential.

Exam Details at a Glance

DetailInformation
Exam NameTherapist Multiple-Choice (TMC) Examination
Administering BodyNational Board for Respiratory Care (NBRC)
Number of Questions160 total (140 scored + 20 pretest)
Time Limit3 hours (180 minutes)
Exam Fee$190 per attempt
Question FormatMultiple-choice with 4 options
CRT Cut Score86 out of 140 scored items
RRT Eligible Cut Score92 out of 140 scored items
Testing VendorPSI (Psychological Services Inc.)
Testing OptionsPSI test centers or remote proctoring
Overall Pass Rate~61%
First-Time Pass Rate~65-70%
ResultsAvailable within 2-3 business days

Understanding the Scoring System

The TMC exam contains 160 total questions, but only 140 are scored. The remaining 20 are pretest items that NBRC is evaluating for future exams. You will not know which questions are pretest items, so treat every question as if it counts.

  • CRT Credential: Score 86 or higher on the 140 scored items
  • RRT Eligibility: Score 92 or higher on the 140 scored items, then pass the CSE
  • If you score between 86 and 91, you earn the CRT but are not eligible for the CSE

Clinical Simulation Exam (CSE)

Candidates who achieve an RRT-eligible score on the TMC must then pass the Clinical Simulation Exam (CSE):

CSE DetailInformation
FormatClinical simulation problems
Number of Problems22 total (20 scored + 2 pretest)
Time Limit4 hours (240 minutes)
ContentPatient management scenarios requiring clinical decisions
ScoringEach problem has branching decision paths

The CSE presents you with patient scenarios where you must make clinical decisions. Unlike multiple-choice questions, the CSE requires you to gather information, evaluate data, and select appropriate interventions in a simulated clinical environment.

Remote Proctoring Option

PSI offers remote proctoring as an alternative to testing at a physical test center:

  • Take the exam from your home or a quiet, private location
  • Requires a computer with webcam, microphone, and stable internet
  • Same exam content and timing as in-person testing
  • Government-issued photo ID required
  • Your testing space must be free of notes, reference materials, and other people
Test Your Knowledge

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Test Your KnowledgeFill in the Blank

The TMC exam has a total of 160 questions, but only _____ are scored toward your credential.

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