Deciding whether to keep your CRT certification or progress to become a RRT can be a tough decision. The exam does not cost a lot, but you will spend a lot of time studying. So, is it worth the effort? The short answer is yes because you are able to have more flexibility when fulfilling your duties and it can make you more valuable when looking for a new job. Let’s see what other reasons there are for getting your RRT credential.

What are respiratory therapists?

If you want to know the difference between a CRT and RRT, we are going to assume you already know what a respiratory therapist is. If you want an overview of respiratory therapists, you can check out this in-depth guide we made to tell you all about this profession.  

CRT versus RRT

Certifications are a great way to show job employers you know your stuff and have the experience to support your skills. Job employers for respiratory therapy positions use certifications to validate candidates, among other factors. The two practical certifications for demonstrating your knowledge and experience with respiratory therapy are the Certified Respiratory Therapist (CRT) and Registered Respiratory Therapist (RRT) credentials. These certifications are offered by the National Board for Respiratory Care (NBRC), a nonprofit that has set the standard for respiratory care for 50+ years. The CRT is considered an entry-level certification, while the RRT highest practical certification you can take from NBRC.

What are the requirements to become a CRT or RRT?

Once you graduate from an accredited program, you can apply to become a CRT by taking and passing the Therapist Multiple-Choice (TMC) exam. This is a 140 multiple-choice exam that measures the essential knowledge, skills, and abilities needed for respiratory therapists entering the workforce. You will have about three hours to complete this test.  If you pass the TMC and score high enough, you will have the opportunity to become a RRT by taking and passing the Clinical Simulation Exam (CSE). The CSE looks at the competencies required for advanced respiratory therapists. The exam will consist of 22 problems you will have to evaluate and answer. These questions will focus on patient scenarios in a clinical setting. They are designed to simulate reality and what you would experience working in respiratory care. You are given four hours to complete this exam.

Certification Requirements for New Applicants

Certified Respiratory Therapist (CRT)Registered Respiratory Therapist (RRT)
Must be 18 years or olderMust be a CRT and received a high-cusp score on the TMC exam
Be a graduate of a 2 year+ accredited respiratory therapy program OR meet other educational requirementsBe a graduate of a 2 year+ accredited respiratory therapy program OR meet other educational requirements
Pay the $190 fee for the Therapist Multiple-Choice (TMC) examPay the $200 fee for the Clinical Simulation Exam (CSE)
Complete the exam within 3 hoursComplete the exam within 4 hours
Earn your RRT within 3 years of passing the TMC exam with a high-cusp score

What is the difference in job roles?

The expectations an employer has for a professional holding a CRT, versus a RRT, can be different. A CRT demonstrates that you have been clinically trained to provide entry-level respiratory care. This credential can be a great way to land your first job, but you may have limited responsibilities compared to a professional that holds an advanced certification. The need to have an RRT credential is also dependent on location, although more places are moving towards it. Holding a RRT shows you have advanced clinical skills and advanced decision-making abilities. As a RRT, you will also have enough training to make some judgment-calls concerning patient care and treatment. While you may not need an RRT to receive a respiratory care license, greater competition for jobs and growing responsibilities in the workplace for respiratory therapists, begin to make it a necessity for those in the workforce.Even though both credentials provide enough credibility to have eligibility for a state license, the RRT certification is required for higher-level positions in respiratory care. 

Which is more preferred for a license?

In every state, except Alaska, you are required to have a license before you can legally practice respiratory therapy. Depending on your state, you will need to have a minimum of a CRT or RRT before you can obtain your license. But more states are moving towards using the RRT as the status quo to get a license. Eventually, this can impact the number of RTs who can practice while only holding a CRT. 

What is the difference in pay?

According to, RRTs make $26.11 per hour, whereas CRTs make $22.83 per hour. That is about four dollars more per hour for RRTs. This amount does not seem that stark, and it may not be worth it to some to pursue a RRT certificate. However, that is a significant boost if you consider you only must pay for an exam and study material to get a yearly raise of a few grand. Plus, you are future-proofing your credentials by making sure you have the most advanced practical respiratory care degree.

RT Pay Comparison between RRT and CRT

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