So, you want to be a respiratory therapist? That’s great! As an RT, you will have the opportunity to work with patients of all ages and help them breathe easier.

Before you can start your career, though, you must first obtain your license and credentials. Then you’ll need to keep them active throughout your career.

In this article, we will discuss the requirements for earning credentials, obtaining a state license, and meeting the necessary requirements to keep them up-to-date.

Respiratory Therapist Credentials

Credentials are essentially proof that you have completed the educational and/or clinical requirements necessary to work as a respiratory therapist.

In order to sit for the credentialing exams, you must first graduate from an accredited respiratory therapy program.

Once you have graduated, you will then need to pass two exams:

  1. Therapist Multiple-Choice Exam (TMC)
  2. Clinical Simulation Exam (CSE)

After passing both exams, you will earn the Registered Respiratory Therapist (RRT) credential. This makes you eligible to apply for a license in the state in which you wish to practice respiratory care.

respiratory therapist credential

Respiratory Therapist License

A license is required in order to practice respiratory care in all states.

To obtain a license, you must first graduate from an accredited respiratory therapy program, pass the board exams, and earn credentials.

Once you have done so, you will need to submit an application to your state’s licensing board, along with the required fee.

After your application has been reviewed and approved, you will receive your license and be able to practice respiratory care in your state.

respiratory therapist state license map

How to Maintain Your Credentials

In order to maintain your credentials as a respiratory therapist, you will need to participate in the Credential Maintenance Program (CMP).

The CMP is a program offered by the National Board for Respiratory Care (NBRC) that requires respiratory therapists to recertify their credentials every five years. There are three ways to do so:

  1. Complete Assessments or Submit CEUs
  2. Pass the Previous Board Exam for Your Highest Credential
  3. Pass a New NBRC Credentialing Exam

If you received your credentials on or after July 1, 2002, you will be required to participate in the CMP to maintain your NBRC credentials.

If your credentials were awarded prior to July 1, 2002, you are not required to participate in the CMP.

Complete Assessments or Submit CEUs

One way to maintain your credentials is to complete quarterly assessments offered by the NBRC. Each assessment is designed to test your knowledge of the latest respiratory care information and guidelines.

Alternatively, you can submit continuing education units (CEUs) to the NBRC to maintain your credentials. CEUs can be earned by attending workshops, conferences, and other educational events related to respiratory care.

If your assessment score is high enough, you will not be required to submit CEUs to the NBRC. However, if your assessment scores are low, you may be required to submit up to 30 CEUs.

Pass the Previous Board Exam for Your Highest Credential

Another way to maintain your credentials is to pass the previous board exam that rewarded your highest credential.

To use this option, you must retake the exam during the last year of the five-year credential period. If you successfully pass the exam, a new five-year period will begin on that date.

If you hold multiple NBRC credentials and elect to use this option to maintain your credentials, you must pass the exam for the highest level credential that you hold.

For example, if you previously obtained the RRT-ACCS credential, you must retake and pass the ACCS exam since it is your highest level credential.

Pass a New NBRC Credentialing Exam

The final way to maintain your credentials is to pass a new NBRC credentialing exam.

Passing an NBRC exam that you did not previously take automatically extends the credentialing period of all credentials you hold for an additional five years.

This means that all of your NBRC credentials will have the same expiration date; therefore, you will be able to maintain all your credentials at once.

How to Document CEUs

If you decide to submit CEUs to the NBRC in order to maintain your credentials, you will need to document them properly. This involves participating in approved educational activities, which may include:

  • Lecture
  • Panel
  • Workshop
  • Seminar
  • Symposium
  • Online education

You must submit your CEUs to the NBRC website and pay the required fees prior to the expiration date of your credentials. Your credentials will expire if you do not meet the deadline.

What Happens if Your Credential Expires?

If your credential expires, you will no longer be able to practice respiratory care in the United States. However, there is a path for reinstation.

If you are within a six-month time period of expiration, you can still submit your CEUs online and pay a $250 fee for reinstatement. The CEUs must have been earned during the most recent five-year term for this option to work.

If you are more than six months past the expiration date, you will need to retake and pass the NBRC exams for all previously held credentials.

How to Maintain Your License

In order to keep your respiratory therapist license active, you must meet the requirements of your state’s licensing board.

This may vary from state to state, but it generally involves completing continuing education units (CEUs) and renewing your license on an annual, biannual, or biennial basis.

You may be able to complete your CEUs online, but some states require that you attend in-person workshops and conferences.

You will also be required to pay a renewal fee, which can range $20 to $300, depending on your state. Be sure to check with your state’s licensing board for specific requirements.

Final Thoughts

To recap, you will need to maintain your credentials with the NBRC and your license with your state’s licensing board in order to practice respiratory care in the United States.

You can maintain your credentials by passing an NBRC exam, submitting CEUs, or passing the previous board exam for your highest credential.

To renew your license, you will need to complete CEUs and pay a renewal fee to your state’s licensing board. By following these steps, you can ensure that you are able to continue practicing respiratory care in the United States.

Be sure to read our guide that discusses a respiratory therapist’s salary for each state. Thanks for reading!


The following are the sources that were used while doing research for this article:

Medical Disclaimer: The information provided by Respiratory Therapy Zone is for educational and informational purposes only. It should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition.