RRT - Registered Respiratory Therapist

Respiratory therapists are trained to help patients with lung disorders or diseases caused by various issues. Registered Respiratory Therapist (RRT) certification is one of two principal credentials for respiratory therapists. Certified Respiratory Therapist (CRT) certification is the first-level credential offered by the National Board for Respiratory Care (NBRC), and RRT certification is the second. CRT certification and/or RRT certification are used as the basis for licensure in the 49 states that regulate the practice of respiratory therapy.

Registered respiratory therapist certification is intended for respiratory care professionals who want to set themselves apart as having the essential knowledge and skills required of advanced respiratory therapists. All states but Alaska require respiratory therapists to be licensed to practice professionally. Licensure requires completing a state-approved education program, submitting an application and fee, and passing a state-administered exam. Some states that recognize CRT and/or RRT certification don’t administer an exam. Among RTs, RRT certification is recognized nationally as the standard of excellence.

RRT certification includes two examinations. The Therapist Multiple-Choice (TMC) exam evaluates an RT’s abilities as they enter into practice and determines their eligibility to take the Clinical Simulation Examination (CSE) to complete full certification requirements.

• Completion Time: Candidates have 3 hours to finish the TMC and 4 hours to finish the CSE.

• Cost: The TMC exam costs $190 for new applicants and $150 for repeat applicants. The CSE costs $200 for new and repeat applicants. Total cost to earn RRT certification is $350 to $390. Candidates who only pass the TMC exam earn CRT certification.

Applicants may apply online or submit a paper application. If applying and paying by credit card online, the application is processed immediately. If mailing the application and fee, the application will be processed within approximately 5 to 7 business days.

Applicants receive an email confirmation notice of eligibility containing a website and toll-free phone number they must use to schedule their exam appointment. If an applicant's eligibility can't be confirmed, they receive an email requesting additional information to complete their application.

Earning RRT certification requires passing two tests, starting with the TMC. This exam has two cut scores. Achieving the low cut score results in earning CRT certification but not qualifying to take the CSE, which is the second test required to earn RRT certification.

Eligibility to take the TMC includes being aged 18 or older and having an associate degree or higher from a respiratory therapy education program accredited by the Commission on Accreditation for Respiratory Care (CoARC) or they can:

• Be a CRT for four-plus years and have at least 62 semester hours from a regionally accredited college or university with college credits including anatomy and physiology, microbiology, chemistry and math.

• Be a CRT for two-plus years with an associate degree or higher from an accredited entry-level respiratory care education program.

• Be a CRT for two-plus years with a bachelor’s degree in something besides respiratory care with at least 62 semester hours from a regionally accredited college or university with credits including anatomy and physiology, microbiology, chemistry, and math.

Canadian candidates who hold the Canadian Society of Respiratory Therapists RRT credential don’t need to fulfill the aforementioned education requirements. The TMC exam includes 160 multiple choice questions with 140 of them scored.

Achieving the high cut score on the TMC results in CRT certification and qualifies candidates to take the CSE and continue their path to RRT certification. CSE candidates must have at least an associate degree from an advanced level respiratory education program accredited by the CoARC, or they can:

• Be a CRT for four-plus years and have at least 62 semester hours from a regionally accredited college or university with college credits including anatomy and physiology, microbiology, chemistry, and math.

• Be a CRT for two-plus years with an associate degree or higher from an accredited entry-level respiratory care education program.

• Be a CRT for two-plus years with a bachelor’s degree in something besides respiratory care with at least 62 semester hours from a regionally accredited college or university with credits including anatomy and physiology, microbiology, chemistry, and math.

Canadian candidates who hold the Canadian Society of Respiratory Therapists RRT credential don’t need to fulfill the aforementioned education requirements. The CSE consists of 22 problems with 20 of them scored. Each problem simulates reality with a clinical setting and patient situation relevant to the practice of respiratory care.

Once an RRT certification candidate meets the exam admission requirements, they can apply and pay for the exam by credit card online and their application processes immediately. Alternately, they can mail their application and fee, and it’s processed in about 5 to 7 business days. Once approved to take either exam, respiratory professionals can schedule both exams online or they can call a toll-free number to schedule an exam appointment.

Registered Respiratory Therapist certification is valid for 5 years, from the end of the month in which the credential was issued. RRTs credentialed on or after July 1, 2002, must participate in the Credential Maintenance Program to maintain their NBRC credentials. Through this program, RRTs have three options to maintain and recertify their credentials every 5 years, which includes:

1. Completing quarterly assessments and CE credits. The number of CE credits required is based on the outcome of the assessments with three levels possible, including two that can reduce or eliminate the amount of CE credits required.

2. Retaking and passing the exam for the highest-level credential the RRT holds that’s subject to the Credential Maintenance Program. The exam must be taken during the last year of the 5-year credential period and the new 5-year period will begin on the date of passing the new exam.

3. Passing an NBRC credentialing exam not previously completed. This option automatically extends credentialing periods for all NBRC credentials for another five years so they all have the same expiration date and allows for simultaneous maintenance of all credentials going forward.

Option 1 requires RRT certification holders to pay $125 every five years, which is split into annual payments of $25 during each of the five years in the credentialing term. Option 2 and 3 require the RRT to pay for the exam they’re taking but not the $125 credential maintenance fee.

Earning continuing education (CE) credits is one option RRT certification holders have to maintain their credentials. The number of CE credits required is based on assessments taken quarterly. However, CE credits aren’t required if they choose one of the other two recertifying options, which both require taking an exam.

NBRC provides free practice exams for the TMC and CSE. It also sells official NBRC Self-Assessment Exams. The TMC SAE costs $50 and the CSE SAE costs $70. All online SAEs can only be taken once per purchase and are non-refundable.

RRTs who want to enter specialty fields have several avenues of certification they can pursue that make logical next steps in their careers.

• RRT-ACCS: After being an RRT for a year, respiratory therapists can apply for the Adult Critical Care Specialty (ACCS) exam, which measures the knowledge and skills of RTs in the adult critical care specialty. Earning the RRT-ACCS can open new career paths in intensive care areas.

• RRT-NPS: After earning the RRT, respiratory therapists can apply for the Neonatal/Pediatric Respiratory Care Specialty (NPS) exam, which measures their knowledge and skills in the neonatal/pediatric respiratory care specialty. Earning the RRT-NPS can open new career paths in children’s hospitals and general hospitals with neonatal-pediatric wards.

• RRT-SDS: Respiratory therapists who’ve earned the RRT can apply for the Sleep Disorders Specialty (SDS) exam, which measures their knowledge and skills in sleep disorders testing and therapeutic intervention. Earning the RRT-SDS can open new career paths in hospitals, sleep centers, and private practice.