NBRC exam: the TMC and the RT Examination that replaces it

From January 4, 2027, it’s the RT Examination. Its low cut earns the CRT credential and its high cut the RRT. Through December 31, 2026, it’s the TMC, where the low cut earns the CRT and the high cut earns the CRT and makes you eligible for the CSE, which you pass to become an RRT. NBRC doesn’t publish the cut score numbers. All 49 states that regulate respiratory care base their license on the CRT or RRT credential, but the license itself comes from your state, not from NBRC.

It’s longer: 185 multiple-choice questions, 160 scored and 25 pretest, in four hours, against the TMC’s 160 questions, 140 scored, in three hours. It tests depth of clinical judgment as well as breadth of knowledge, and its high cut earns the RRT, so there’s no separate simulation exam. NBRC accepts RT applications in the Practitioner Portal from October 1, 2026, and TMC applications only through December 17, 2026.

For the RT Examination, you must be 18 or older and hold at least an associate degree from an entry-into-practice respiratory therapy program accredited or supported by the Commission on Accreditation for Respiratory Care (CoARC). That’s the only route. The TMC takes the same graduates, plus CRTs who meet NBRC’s CRT-to-Registry routes of years and college credits, and holders of the Canadian Society of Respiratory Therapists (CSRT) RRT. The CRT-to-Registry routes end on December 31, 2026. Respiratory therapy education from outside the United States doesn’t qualify for the TMC.

Three times without waiting, on the TMC, CSE and RT Examination alike. After that, NBRC requires at least 120 days between attempts. Each retake needs a fresh application and the repeat fee, and you can reapply online two business days after your exam. Attempts on the TMC or CSE don’t count toward the RT Examination. A CRT who scores below the low cut on a retake keeps the CRT credential.

No. NBRC offered live remote proctoring from April 2020 and ended it on December 31, 2024, citing technical problems and rule violations. From January 1, 2025, NBRC exams are taken at a PSI testing site. NBRC’s free practice exams and paid SAEs are online, but they’re study tools, not the credentialing exam.

Yes. NBRC follows the Americans with Disabilities Act (ADA) and can arrange special testing conditions. You fill in the Request for Special Examination Accommodations form and the Documentation of Disability-Related Needs form from the Candidate Handbook and send them to NBRC. If you haven’t had accommodations on an NBRC exam before, NBRC must receive the request before you apply and pay; if it arrives after you’ve paid and booked, the accommodations won’t be in place for that appointment.

Not on the TMC or the RT Examination. American Association for Respiratory Care (AARC) members get a one-time $40 discount the first time they apply for the CSE or for the pulmonary function (PFT) exam or the neonatal/pediatric (NPS), sleep disorders (SDS), adult critical care (ACCS) or asthma educator (AE-C) specialty exams. You register for it on the AARC site first and then start your NBRC application from the link AARC emails you; it can’t be added afterward. Employers and schools can also buy prepaid exam vouchers from NBRC for their candidates.

Eight: the Certified Respiratory Therapist (CRT) and Registered Respiratory Therapist (RRT), the Certified and Registered Pulmonary Function Technologist (CPFT and RPFT), and four specialties. Those are Adult Critical Care (RRT-ACCS), Neonatal/Pediatric (RRT-NPS), Sleep Disorders (CRT-SDS and RRT-SDS) and Asthma Educator (AE-C). All of them are kept through NBRC’s Credential Maintenance Program. NBRC is a voluntary credentialing board in Overland Park, Kansas, sponsored by the AARC, the American College of Chest Physicians, the American Society of Anesthesiologists and the American Thoracic Society.