Respiratory therapists work where breathing is on the line: the ICU, the emergency department, the delivery room, and patients’ homes. If that’s the career you are building, the NBRC Respiratory Therapy (RT) Examination is the step that turns your education into a recognized credential.

Starting January 4, 2027, this single exam can earn you either the Certified Respiratory Therapist (CRT) or the Registered Respiratory Therapist (RRT) credential, depending on your score. In this guide, we’ll cover who should take it, how to qualify, how long to study, what the job market looks like, and where your credential can take you next.

Who Is the NBRC RT Exam For?

The RT Examination is the entry-level credentialing exam for respiratory therapists in the United States. It’s the right exam for you if you are:

  • A graduating or recent respiratory therapy student from a program accredited by the Commission on Accreditation for Respiratory Care (CoARC) who plans to test in 2027 or later.
  • A new graduate who wants the RRT right away. Under the new model, you can earn the RRT in one exam instead of taking the TMC and then the CSE.
  • A current CRT with a CoARC-accredited associate degree who has not yet earned the RRT and did not pass the TMC at the high cut score before the end of 2026.

Many states require the CRT or RRT for licensure, and many hospitals prefer or require the RRT for critical care roles. Check with your state licensing board, because credentialing and licensure are separate.

Who Might Take a Different Route?

If you test before December 31, 2026, you’ll take the TMC, which ends that day. If you pass the TMC at the high cut score by then, you can take the CSE through December 31, 2027, or switch to the RT Examination and pass at the high cut score.

What Are the NBRC RT Eligibility Requirements?

According to the NBRC Candidate Handbook (September 2026), you must:

  • Be at least 18 years old, and
  • Be a graduate of, and hold at least an associate degree from, an entry-into-practice respiratory therapy program supported or accredited by CoARC.

The NBRC RT Examination page also lists holding the Canadian Society of Respiratory Therapists (CSRT) RRT credential as a qualifying pathway. If you’re applying through that route, confirm the details with the NBRC before you register.

What Happens to the CRT-to-Registry Policy?

The NBRC is ending its CRT-to-Registry admission policy on December 31, 2026. That policy allowed some CRTs without an accredited associate degree to qualify for RRT testing. After that date, CRTs who want the RRT must meet the standard requirement of an associate degree from a CoARC-accredited program. If this applies to you, consider testing under the current policy in 2026 or contacting the NBRC. You can find a list of accredited programs on the CoARC website if you’re considering finishing a degree.

How Do You Apply?

  1. Complete your program and confirm your degree has been conferred.
  2. Create an account and apply through the NBRC website.
  3. Pay the $360 exam fee ($300 for repeat attempts).
  4. Once approved, schedule with PSI at one of nearly 300 assessment centers.

Retake rules are generous: you may take the exam three times without waiting, then must wait at least 120 days between attempts.

How Long Should You Study for the NBRC RT Exam?

Most new graduates do well with 8 to 12 weeks of focused study, while candidates who have been out of school for a while or work full time often benefit from three to six months. Because one score decides CRT or RRT, plan to study to the RRT standard.

Sample 12-Week Plan

  • Week 1: Read the RT Detailed Content Outline, take a mixed baseline quiz, and map misses to outline sections.
  • Weeks 2–3: Patient Data. ABG interpretation, chest radiographs, pulmonary function testing, and hemodynamics.
  • Weeks 4–5: Management of Devices and Patient Safety. Oxygen delivery, ventilator alarms, chest drainage, and infection control.
  • Weeks 6–8: Initiation and Modification of Interventions. Mechanical ventilation, NPPV, airway management, medications, and resuscitation.
  • Weeks 9–10: Depth of Clinical Judgment. Adult chronic lung disease, ARDS, cardiovascular and neuromuscular cases, then neonatal resuscitation and pediatric asthma and bronchiolitis.
  • Week 11: Timed mixed practice or a full-length mock exam to build four-hour stamina.
  • Week 12: Review missed questions, revisit weak sections, and taper.

Beginner vs. Experienced Candidates

New graduates usually have fresh content knowledge but less bedside decision-making experience, so extra time on clinical judgment pays off.

Working CRTs often reason well at the bedside but may need to refresh pulmonary function testing, neonatal topics, or calculations they don’t use daily.

What Careers Can You Pursue With a CRT or RRT?

Respiratory therapists work in:

  • Adult, neonatal, and pediatric intensive care units
  • Emergency departments and rapid response teams
  • Pulmonary function and sleep laboratories
  • Pulmonary rehabilitation and outpatient clinics
  • Home care, long-term care, and ground or air transport

With experience, many therapists move into roles such as clinical educator, department supervisor or manager, ECMO specialist, or program faculty.

How Much Do Respiratory Therapists Earn?

The U.S. Bureau of Labor Statistics (BLS) reports a median annual wage of $82,280 for respiratory therapists as of May 2025. The lowest 10 percent earned less than $63,660, and the highest 10 percent earned more than $118,050. Median pay was $82,730 in hospitals, $79,270 in nursing care facilities, and $77,890 in physician offices.

BLS projects employment to grow 9 percent from 2025 to 2035, much faster than the average for all occupations, with about 8,600 openings each year. Pay varies by region, shift, and specialty, and many employers offer higher pay for the RRT or specialty credentials.

How Do You Maintain Your CRT or RRT?

NBRC awards credentials for five-year terms through the Credential Maintenance Program. The most common option combines quarterly online assessments with continuing education (CE). If your assessment performance is high enough, you may not need to document CE.

Otherwise, you’ll document 15 or 30 CE credits related to your credential. You can also renew by retaking and passing the exam or by passing an NBRC credentialing exam you haven’t completed before. See the Candidate Handbook for details.

Which Credentials Stack Well With CRT or RRT?

Once you hold the CRT or RRT, NBRC specialty credentials let you show expertise in the work you do most:

  • Adult Critical Care Specialist (ACCS): A strong fit for ICU therapists managing complex ventilation, hemodynamics, and ARDS. It builds on the RRT.
  • Neonatal/Pediatric Specialist (NPS): For therapists in NICUs, PICUs, delivery rooms, and pediatric transport.
  • Sleep Disorders Specialist (SDS): For therapists in sleep labs or home CPAP programs.
  • Certified or Registered Pulmonary Function Technologist (CPFT or RPFT): For therapists moving into pulmonary diagnostics.
  • Asthma Educator Specialist (AE-C): For therapists in outpatient, school, or disease-management programs.

Pick the credential that matches your current role or the job you want next, and check its eligibility rules on the NBRC website before you apply.

Start Preparing for the NBRC RT Exam With Pocket Prep

Whether you are months from graduation or already working as a CRT, Pocket Prep’s 985 NBRC RT practice questions fit into your schedule, and each one includes a detailed explanation. Use Quick 10 on busy days, Timed Quiz and mock exams to build stamina, and study reminders to keep your streak going. You have already done the hard work in school; now it’s time to turn it into your credential.