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Florida Respiratory Therapy — Requirements & Free Practice

US-FL · License preparation

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Certified Respiratory Therapist

Florida licensure at the certified respiratory therapist level; national certification and Board-accepted equivalent credentials are applicant qualifications.

Licensing authority: Florida Board of Respiratory Care / Florida Department of Health · Application information

Restoration during the delinquent licensure cycle
No examination is required for this applicant pathway.
Application And Fees
Submit the renewal application and applicable renewal fees, and comply with fingerprint screening or retention requirements.
Continuing Education
Complete 24 hours per biennium, including two hours of Florida laws and rules and two hours of medical error prevention. At first renewal complete the required HIV/AIDS education. New licensees first licensed in the second year of a biennium have the general-credit exemption, but must complete those mandatory courses. BLS does not count; no more than five hours may focus on risk management.
Credit Options
Rule 64B32-6.004 permits approved courses, specified certification or recertification classes, Board meetings, listed specialty credentials and other prescribed activities. These credentials and courses are applicant conditions; the rule does not identify a separate required license examination.
Delinquency
Affirmatively apply for active or inactive status within the delinquent cycle and pay delinquency and status-change fees. Meet the continuing education requirements for the relevant inactive or delinquent periods. Failure to restore before that cycle ends renders the license null and requires a new initial application.
Existing License
Hold the existing CRT license.
Hardship
The Board may waive all or part of continuing education or extend the time on a documented emergency or hardship request under Rule 64B32-6.004(7).
Older Board Page
The Board web page still states: “Successful completion of the National Board of Respiratory Care re-credentialing exam”. The current Rule 64B32-6.004 prescribes the credit options quoted in this finding; the web page’s unnamed recredentialing option is retained as a condition, not as a newly identified examination.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after disciplinary action
No examination is required for this applicant pathway.
Existing License
Hold the existing CRT license.
Final Order
Satisfy all final-order terms and conditions, and satisfy the Board that respiratory care can be delivered safely. The statute sets no identified license examination for this reinstatement route; individual final-order requirements remain applicant conditions.

Official no-examination sources

Effective from 2026-09-22.

Licensure by endorsement — equivalent credential
Therapist Multiple-Choice Examination
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Equivalent Credential
Hold an equivalent credential acceptable to the Board, verified by oath and satisfactory evidence. The NBRC examinations are the identified current credential route; acceptance of an equivalent credential may excuse those examinations for this applicant.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Reactivation — inactive for no more than two consecutive biennial cycles
No examination is required for this applicant pathway.
Continuing Education
Meet section 456.036(11), document 24 hours and medical-error prevention for the inactive biennium, and document twelve hours for each inactive year as stated in Rule 64B32-6.007.
Existing License
Hold the existing CRT license.
Fees
Pay applicable renewal, reactivation and change-of-status fees.
Inactive Duration
No more than two consecutive biennial cycles on inactive status.

Official no-examination sources

Effective from 2026-09-22.

Election and renewal of inactive status
No examination is required for this applicant pathway.
Existing License
Hold the existing CRT license.
Inactive
Elect inactive status and pay applicable inactive renewal and status-change fees. An inactive license does not authorize practice.

Official no-examination sources

Effective from 2026-09-22.

Military licensure — active license held in another jurisdiction
No examination is required for this applicant pathway.
Additional Information
Supply the information required by sections 456.039(1) and 456.0391(1), if applicable, within one year of license issuance.
Background Screening
Submit required fingerprints; NPDB verification applies.
Discipline
Attest to no current disciplinary proceeding; qualify under the statutory restrictions.
Eligible Applicant
Qualify as an Armed Forces, Reserve Forces, National Guard, or qualifying Public Health Service health care practitioner, or as an active-duty service member’s spouse, under section 456.024(4)(a).
Fees
Application, licensure and unlicensed activity fees are waived.
Honorable Discharge
For military members, provide proof of honorable discharge within six months before application or an upcoming honorable discharge.
Other License
Hold an active, unencumbered license from another United States jurisdiction and have no disciplinary action in the five years before application. Section 456.024(4)(b)3.a. is an alternative to the training-and-examination provisions in 3.b. and 3.c.; the other jurisdiction’s own examinations are applicant qualifications.
Recent Practice
Actively practiced the profession during the three years before application.

Official no-examination sources

Effective from 2026-09-22.

Military spouse professional licensure — Florida duty station
Therapist Multiple-Choice Examination
Background Screening
Submit fingerprints and satisfy level 2 screening.
Disqualification
Meet section 456.024(5)(g) restrictions concerning convictions, suspended or revoked licenses, NPDB reports and prior failure of any applicable Florida examination.
Eligibility
Otherwise be entitled to full licensure under the practice act and eligible to take the examination, if applicable; Section 456.024(5) does not explicitly demand a new passing score, but requires full entitlement under the practice act; the current NBRC credential pathway is preserved and individual examination relief is an applicant condition.
Fees
The licensure application fee is waived; fingerprint processing costs remain payable.
Other License
Hold a valid professional license from another United States jurisdiction and have no disciplinary proceedings.
Spouse Status
Be married to an active-duty member assigned to a Florida duty station under official orders.
Spouse of an active duty service member licensure — equivalent training
Therapist Multiple-Choice Examination
Additional Information
Supply the information required by sections 456.039(1) and 456.0391(1), if applicable, within one year of license issuance.
Background Screening
Submit required fingerprints; NPDB verification applies.
Discipline
Attest to no current disciplinary proceeding; qualify under the statutory restrictions.
Eligible Applicant
Qualify as an Armed Forces, Reserve Forces, National Guard, or qualifying Public Health Service health care practitioner, or as an active-duty service member’s spouse, under section 456.024(4)(a).
Fees
Application, licensure and unlicensed activity fees are waived.
Honorable Discharge
For military members, provide proof of honorable discharge within six months before application or an upcoming honorable discharge.
National Qualification
The profession-specific NBRC credential requirement in section 468.355 identifies the current respiratory qualification; all other training and equivalence decisions remain applicant conditions.
Recent Practice
Actively practiced the profession during the three years before application.
Training
Where licensure in a jurisdiction is not required for the relevant military practice or spouse profession, provide training or experience substantially equivalent to Florida licensure requirements and evidence of passing the appropriate national or regional standards examination, if required in Florida.
Military health care practitioner licensure — equivalent training
Therapist Multiple-Choice Examination
Additional Information
Supply the information required by sections 456.039(1) and 456.0391(1), if applicable, within one year of license issuance.
Background Screening
Submit required fingerprints; NPDB verification applies.
Discipline
Attest to no current disciplinary proceeding; qualify under the statutory restrictions.
Eligible Applicant
Qualify as an Armed Forces, Reserve Forces, National Guard, or qualifying Public Health Service health care practitioner, or as an active-duty service member’s spouse, under section 456.024(4)(a).
Fees
Application, licensure and unlicensed activity fees are waived.
Honorable Discharge
For military members, provide proof of honorable discharge within six months before application or an upcoming honorable discharge.
National Qualification
The profession-specific NBRC credential requirement in section 468.355 identifies the current respiratory qualification; all other training and equivalence decisions remain applicant conditions.
Recent Practice
Actively practiced the profession during the three years before application.
Training
Where licensure in a jurisdiction is not required for the relevant military practice or spouse profession, provide training or experience substantially equivalent to Florida licensure requirements and evidence of passing the appropriate national or regional standards examination, if required in Florida.
MOBILE Act licensure by endorsement
Therapist Multiple-Choice Examination
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Discipline
Meet section 456.0145(2) restrictions: no pending disciplinary proceeding or investigation; no disciplinary action in the preceding five years; no disqualifying conviction, revoked or suspended license, or surrender in lieu of discipline. NPDB reports are subject to the statutory appeal and Florida-equivalent-conduct exceptions.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Financial Responsibility
Meet applicable financial responsibility requirements, if required.
National Qualification
Have passed the recognized national licensure examination or hold a national certification recognized for this profession; NBRC credential recognition is established by section 468.355.
Other License
Hold an active, unencumbered license in a profession with similar scope issued by a United States jurisdiction.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Recent Practice
Actively practiced at least two years during the four years immediately before application.
Licensure by endorsement — NBRC credential
Therapist Multiple-Choice Examination
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
National Credential
Hold the active NBRC CRT credential; verify it by oath and direct NBRC verification.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Licensure by endorsement — other jurisdiction
Therapist Multiple-Choice Examination
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Other Jurisdiction
Petition the Board with verified evidence of licensure, certification, registration, or other authority to deliver respiratory care in another jurisdiction. The Board decides acceptability and equivalence. Rule 64B32-2.001 accepts requirements equivalent to or more stringent than Florida requirements; this acceptance may excuse NBRC testing.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
New application after null and void license
Therapist Multiple-Choice Examination
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Prior Status
The former null and void license cannot be reactivated; submit a new application and meet current CRT/RRT requirements.
New application after voluntarily relinquished license
Therapist Multiple-Choice Examination
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Prior Status
The former voluntarily relinquished license cannot be reactivated; submit a new application and meet current CRT/RRT requirements.
Regaining licensure after denial of renewal
Therapist Multiple-Choice Examination
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Denied Renewal
Meet initial licensure qualifications after denial under section 456.0635(3). A person whose renewal was denied under section 24, chapter 2009-223, between July 1, 2009 and June 30, 2012 is not required to retake initial licensure examinations.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Biennial renewal
No examination is required for this applicant pathway.
Application And Fees
Submit the renewal application and applicable renewal fees, and comply with fingerprint screening or retention requirements.
Continuing Education
Complete 24 hours per biennium, including two hours of Florida laws and rules and two hours of medical error prevention. At first renewal complete the required HIV/AIDS education. New licensees first licensed in the second year of a biennium have the general-credit exemption, but must complete those mandatory courses. BLS does not count; no more than five hours may focus on risk management.
Credit Options
Rule 64B32-6.004 permits approved courses, specified certification or recertification classes, Board meetings, listed specialty credentials and other prescribed activities. These credentials and courses are applicant conditions; the rule does not identify a separate required license examination.
Existing License
Hold the existing CRT license.
Hardship
The Board may waive all or part of continuing education or extend the time on a documented emergency or hardship request under Rule 64B32-6.004(7).
Older Board Page
The Board web page still states: “Successful completion of the National Board of Respiratory Care re-credentialing exam”. The current Rule 64B32-6.004 prescribes the credit options quoted in this finding; the web page’s unnamed recredentialing option is retained as a condition, not as a newly identified examination.

Official no-examination sources

Effective from 2026-09-22.

Military active duty maintenance exemption
No examination is required for this applicant pathway.
Existing License
Hold the existing CRT license.
Military Status
Be on active duty and have been in good standing and entitled to practice this profession in Florida on entering service. Good standing is maintained without registering, paying fees or other acts during active duty and for six months after discharge, while not practicing in the private sector for profit.

Official no-examination sources

Effective from 2026-09-22.

Military spouse maintenance exemption
No examination is required for this applicant pathway.
Absence
Be absent from Florida because of the service member spouse’s Armed Forces duties; document absence and military status.
Existing License
Hold the existing CRT license.
Notification
Notify the Board within six months of returning to Florida or the spouse’s active-duty discharge. A change of status in the second half of a biennium carries the stated continuing education exemption.

Official no-examination sources

Effective from 2026-09-22.

Reactivation — retired five years or more
No examination is required for this applicant pathway.
Continuing Education
Meet the rule’s continuing education requirements for each retired biennium and take the required medical-errors course.
Existing License
Hold the existing CRT license.
Fees
Pay active-status renewal fees for all retired biennial periods and applicable reactivation fees.
Licensure Evidence
Rule 64B32-4.002 requires evidence of licensure as a CRT or RRT under its referenced statutory section. An existing RCP category holder must also satisfy this CRT/RRT evidence condition; the rule does not excuse it for a legacy category.
Retired Duration
five years or more
Review Course
For retirement of five years or more, complete the fourteen-hour Board-approved comprehensive review course within six months before reactivation; for shorter retirement this additional review course is not imposed by the rule.

Official no-examination sources

Effective from 2026-09-22.

Reactivation — retired less than five years
No examination is required for this applicant pathway.
Continuing Education
Meet the rule’s continuing education requirements for each retired biennium and take the required medical-errors course.
Existing License
Hold the existing CRT license.
Fees
Pay active-status renewal fees for all retired biennial periods and applicable reactivation fees.
Licensure Evidence
Rule 64B32-4.002 requires evidence of licensure as a CRT or RRT under its referenced statutory section. An existing RCP category holder must also satisfy this CRT/RRT evidence condition; the rule does not excuse it for a legacy category.
Retired Duration
less than five years
Review Course
For retirement of five years or more, complete the fourteen-hour Board-approved comprehensive review course within six months before reactivation; for shorter retirement this additional review course is not imposed by the rule.

Official no-examination sources

Effective from 2026-09-22.

Election of retired status
No examination is required for this applicant pathway.
Existing License
Hold the existing CRT license.
Retired
Choose retired status, pay applicable retired and status-change fees, and cease practicing under that license. Retired status is a dormant status of the existing license.

Official no-examination sources

Effective from 2026-09-22.

Registered Respiratory Therapist

Florida licensure at the registered respiratory therapist level, including advancement from a Florida CRT license.

Licensing authority: Florida Board of Respiratory Care / Florida Department of Health · Application information

Restoration during the delinquent licensure cycle
No examination is required for this applicant pathway.
Application And Fees
Submit the renewal application and applicable renewal fees, and comply with fingerprint screening or retention requirements.
Continuing Education
Complete 24 hours per biennium, including two hours of Florida laws and rules and two hours of medical error prevention. At first renewal complete the required HIV/AIDS education. New licensees first licensed in the second year of a biennium have the general-credit exemption, but must complete those mandatory courses. BLS does not count; no more than five hours may focus on risk management.
Credit Options
Rule 64B32-6.004 permits approved courses, specified certification or recertification classes, Board meetings, listed specialty credentials and other prescribed activities. These credentials and courses are applicant conditions; the rule does not identify a separate required license examination.
Delinquency
Affirmatively apply for active or inactive status within the delinquent cycle and pay delinquency and status-change fees. Meet the continuing education requirements for the relevant inactive or delinquent periods. Failure to restore before that cycle ends renders the license null and requires a new initial application.
Existing License
Hold the existing RRT license.
Hardship
The Board may waive all or part of continuing education or extend the time on a documented emergency or hardship request under Rule 64B32-6.004(7).
Older Board Page
The Board web page still states: “Successful completion of the National Board of Respiratory Care re-credentialing exam”. The current Rule 64B32-6.004 prescribes the credit options quoted in this finding; the web page’s unnamed recredentialing option is retained as a condition, not as a newly identified examination.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after disciplinary action
No examination is required for this applicant pathway.
Existing License
Hold the existing RRT license.
Final Order
Satisfy all final-order terms and conditions, and satisfy the Board that respiratory care can be delivered safely. The statute sets no identified license examination for this reinstatement route; individual final-order requirements remain applicant conditions.

Official no-examination sources

Effective from 2026-09-22.

Licensure by endorsement — equivalent credential
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Equivalent Credential
Hold an equivalent credential acceptable to the Board, verified by oath and satisfactory evidence. The NBRC examinations are the identified current credential route; acceptance of an equivalent credential may excuse those examinations for this applicant.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Reactivation — inactive for no more than two consecutive biennial cycles
No examination is required for this applicant pathway.
Continuing Education
Meet section 456.036(11), document 24 hours and medical-error prevention for the inactive biennium, and document twelve hours for each inactive year as stated in Rule 64B32-6.007.
Existing License
Hold the existing RRT license.
Fees
Pay applicable renewal, reactivation and change-of-status fees.
Inactive Duration
No more than two consecutive biennial cycles on inactive status.

Official no-examination sources

Effective from 2026-09-22.

Election and renewal of inactive status
No examination is required for this applicant pathway.
Existing License
Hold the existing RRT license.
Inactive
Elect inactive status and pay applicable inactive renewal and status-change fees. An inactive license does not authorize practice.

Official no-examination sources

Effective from 2026-09-22.

Military licensure — active license held in another jurisdiction
No examination is required for this applicant pathway.
Additional Information
Supply the information required by sections 456.039(1) and 456.0391(1), if applicable, within one year of license issuance.
Background Screening
Submit required fingerprints; NPDB verification applies.
Discipline
Attest to no current disciplinary proceeding; qualify under the statutory restrictions.
Eligible Applicant
Qualify as an Armed Forces, Reserve Forces, National Guard, or qualifying Public Health Service health care practitioner, or as an active-duty service member’s spouse, under section 456.024(4)(a).
Fees
Application, licensure and unlicensed activity fees are waived.
Honorable Discharge
For military members, provide proof of honorable discharge within six months before application or an upcoming honorable discharge.
Other License
Hold an active, unencumbered license from another United States jurisdiction and have no disciplinary action in the five years before application. Section 456.024(4)(b)3.a. is an alternative to the training-and-examination provisions in 3.b. and 3.c.; the other jurisdiction’s own examinations are applicant qualifications.
Recent Practice
Actively practiced the profession during the three years before application.

Official no-examination sources

Effective from 2026-09-22.

Military spouse professional licensure — Florida duty station
Background Screening
Submit fingerprints and satisfy level 2 screening.
Disqualification
Meet section 456.024(5)(g) restrictions concerning convictions, suspended or revoked licenses, NPDB reports and prior failure of any applicable Florida examination.
Eligibility
Otherwise be entitled to full licensure under the practice act and eligible to take the examination, if applicable; Section 456.024(5) does not explicitly demand a new passing score, but requires full entitlement under the practice act; the current NBRC credential pathway is preserved and individual examination relief is an applicant condition.
Fees
The licensure application fee is waived; fingerprint processing costs remain payable.
Other License
Hold a valid professional license from another United States jurisdiction and have no disciplinary proceedings.
Spouse Status
Be married to an active-duty member assigned to a Florida duty station under official orders.
Spouse of an active duty service member licensure — equivalent training
Additional Information
Supply the information required by sections 456.039(1) and 456.0391(1), if applicable, within one year of license issuance.
Background Screening
Submit required fingerprints; NPDB verification applies.
Discipline
Attest to no current disciplinary proceeding; qualify under the statutory restrictions.
Eligible Applicant
Qualify as an Armed Forces, Reserve Forces, National Guard, or qualifying Public Health Service health care practitioner, or as an active-duty service member’s spouse, under section 456.024(4)(a).
Fees
Application, licensure and unlicensed activity fees are waived.
Honorable Discharge
For military members, provide proof of honorable discharge within six months before application or an upcoming honorable discharge.
National Qualification
The profession-specific NBRC credential requirement in section 468.355 identifies the current respiratory qualification; all other training and equivalence decisions remain applicant conditions.
Recent Practice
Actively practiced the profession during the three years before application.
Training
Where licensure in a jurisdiction is not required for the relevant military practice or spouse profession, provide training or experience substantially equivalent to Florida licensure requirements and evidence of passing the appropriate national or regional standards examination, if required in Florida.
Military health care practitioner licensure — equivalent training
Additional Information
Supply the information required by sections 456.039(1) and 456.0391(1), if applicable, within one year of license issuance.
Background Screening
Submit required fingerprints; NPDB verification applies.
Discipline
Attest to no current disciplinary proceeding; qualify under the statutory restrictions.
Eligible Applicant
Qualify as an Armed Forces, Reserve Forces, National Guard, or qualifying Public Health Service health care practitioner, or as an active-duty service member’s spouse, under section 456.024(4)(a).
Fees
Application, licensure and unlicensed activity fees are waived.
Honorable Discharge
For military members, provide proof of honorable discharge within six months before application or an upcoming honorable discharge.
National Qualification
The profession-specific NBRC credential requirement in section 468.355 identifies the current respiratory qualification; all other training and equivalence decisions remain applicant conditions.
Recent Practice
Actively practiced the profession during the three years before application.
Training
Where licensure in a jurisdiction is not required for the relevant military practice or spouse profession, provide training or experience substantially equivalent to Florida licensure requirements and evidence of passing the appropriate national or regional standards examination, if required in Florida.
MOBILE Act licensure by endorsement
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Discipline
Meet section 456.0145(2) restrictions: no pending disciplinary proceeding or investigation; no disciplinary action in the preceding five years; no disqualifying conviction, revoked or suspended license, or surrender in lieu of discipline. NPDB reports are subject to the statutory appeal and Florida-equivalent-conduct exceptions.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Financial Responsibility
Meet applicable financial responsibility requirements, if required.
National Qualification
Have passed the recognized national licensure examination or hold a national certification recognized for this profession; NBRC credential recognition is established by section 468.355.
Other License
Hold an active, unencumbered license in a profession with similar scope issued by a United States jurisdiction.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Recent Practice
Actively practiced at least two years during the four years immediately before application.
Licensure by endorsement — NBRC credential
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
National Credential
Hold the active NBRC RRT credential; verify it by oath and direct NBRC verification.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Licensure by endorsement — other jurisdiction
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Other Jurisdiction
Petition the Board with verified evidence of licensure, certification, registration, or other authority to deliver respiratory care in another jurisdiction. The Board decides acceptability and equivalence. Rule 64B32-2.001 accepts requirements equivalent to or more stringent than Florida requirements; this acceptance may excuse NBRC testing.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
New application after null and void license
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Prior Status
The former null and void license cannot be reactivated; submit a new application and meet current CRT/RRT requirements.
New application after voluntarily relinquished license
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Prior Status
The former voluntarily relinquished license cannot be reactivated; submit a new application and meet current CRT/RRT requirements.
Regaining licensure after denial of renewal
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Denied Renewal
Meet initial licensure qualifications after denial under section 456.0635(3). A person whose renewal was denied under section 24, chapter 2009-223, between July 1, 2009 and June 30, 2012 is not required to retake initial licensure examinations.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).
Biennial renewal
No examination is required for this applicant pathway.
Application And Fees
Submit the renewal application and applicable renewal fees, and comply with fingerprint screening or retention requirements.
Continuing Education
Complete 24 hours per biennium, including two hours of Florida laws and rules and two hours of medical error prevention. At first renewal complete the required HIV/AIDS education. New licensees first licensed in the second year of a biennium have the general-credit exemption, but must complete those mandatory courses. BLS does not count; no more than five hours may focus on risk management.
Credit Options
Rule 64B32-6.004 permits approved courses, specified certification or recertification classes, Board meetings, listed specialty credentials and other prescribed activities. These credentials and courses are applicant conditions; the rule does not identify a separate required license examination.
Existing License
Hold the existing RRT license.
Hardship
The Board may waive all or part of continuing education or extend the time on a documented emergency or hardship request under Rule 64B32-6.004(7).
Older Board Page
The Board web page still states: “Successful completion of the National Board of Respiratory Care re-credentialing exam”. The current Rule 64B32-6.004 prescribes the credit options quoted in this finding; the web page’s unnamed recredentialing option is retained as a condition, not as a newly identified examination.

Official no-examination sources

Effective from 2026-09-22.

Military active duty maintenance exemption
No examination is required for this applicant pathway.
Existing License
Hold the existing RRT license.
Military Status
Be on active duty and have been in good standing and entitled to practice this profession in Florida on entering service. Good standing is maintained without registering, paying fees or other acts during active duty and for six months after discharge, while not practicing in the private sector for profit.

Official no-examination sources

Effective from 2026-09-22.

Military spouse maintenance exemption
No examination is required for this applicant pathway.
Absence
Be absent from Florida because of the service member spouse’s Armed Forces duties; document absence and military status.
Existing License
Hold the existing RRT license.
Notification
Notify the Board within six months of returning to Florida or the spouse’s active-duty discharge. A change of status in the second half of a biennium carries the stated continuing education exemption.

Official no-examination sources

Effective from 2026-09-22.

Reactivation — retired five years or more
No examination is required for this applicant pathway.
Continuing Education
Meet the rule’s continuing education requirements for each retired biennium and take the required medical-errors course.
Existing License
Hold the existing RRT license.
Fees
Pay active-status renewal fees for all retired biennial periods and applicable reactivation fees.
Licensure Evidence
Rule 64B32-4.002 requires evidence of licensure as a CRT or RRT under its referenced statutory section. An existing RCP category holder must also satisfy this CRT/RRT evidence condition; the rule does not excuse it for a legacy category.
Retired Duration
five years or more
Review Course
For retirement of five years or more, complete the fourteen-hour Board-approved comprehensive review course within six months before reactivation; for shorter retirement this additional review course is not imposed by the rule.

Official no-examination sources

Effective from 2026-09-22.

Reactivation — retired less than five years
No examination is required for this applicant pathway.
Continuing Education
Meet the rule’s continuing education requirements for each retired biennium and take the required medical-errors course.
Existing License
Hold the existing RRT license.
Fees
Pay active-status renewal fees for all retired biennial periods and applicable reactivation fees.
Licensure Evidence
Rule 64B32-4.002 requires evidence of licensure as a CRT or RRT under its referenced statutory section. An existing RCP category holder must also satisfy this CRT/RRT evidence condition; the rule does not excuse it for a legacy category.
Retired Duration
less than five years
Review Course
For retirement of five years or more, complete the fourteen-hour Board-approved comprehensive review course within six months before reactivation; for shorter retirement this additional review course is not imposed by the rule.

Official no-examination sources

Effective from 2026-09-22.

Election of retired status
No examination is required for this applicant pathway.
Existing License
Hold the existing RRT license.
Retired
Choose retired status, pay applicable retired and status-change fees, and cease practicing under that license. Retired status is a dormant status of the existing license.

Official no-examination sources

Effective from 2026-09-22.

Advancement from Florida CRT to RRT
Application
Submit Form DH-MQA 1145 and required fees. Submit official NBRC credential verification and verification of all present and previous health care licenses; disclose and document health, criminal, and disciplinary history.
Background Screening
Submit electronic fingerprints and satisfy section 456.0135 and statutory disqualification requirements.
Continuing Education
Changing from CRT to RRT does not exempt the applicant from continuing education requirements.
Credential Evidence
The Board requires active NBRC CRT or RRT status, or accepts an equivalent credential under section 468.358 and Rule 64B32-2.001. A credential earned under an earlier examination process remains an applicant qualification. The current examination references do not assert that every credential holder must retest.
Exam Reference Reading
Florida states its requirement as the NBRC credential and verification of passing the NBRC exam. For the current registered examination pathway, CRT verification is carried by the supplied TMC version; RRT verification is carried by the supplied TMC and CSE versions. Equivalent credentials and historical credential evidence are applicant-specific exceptions.
Existing License
Hold a current Florida CRT license and obtain NBRC RRT status. Submit a new application and fees; an RRT title cannot be used in Florida until licensed at that level.
Practice Lapse
If respiratory care has not been practiced for two years or more, complete a Board-approved fourteen-hour comprehensive review course within the two years immediately before application, or be recredentialed at the level sought. The rule specifies patient assessment (3 hours), hemodynamics (2), pulmonary function (1), arterial blood gases (1), respiratory equipment (2), airway care (1), mechanical ventilation (2), emergency care/special procedures (1), and general respiratory care including medication (1).

Therapist Multiple-Choice Examination

Provider
The National Board for Respiratory Care (NBRC); administered Monday through Saturday at more than 300 assessment centers through the NBRC testing agency PSI
Format
Computer-based multiple-choice examination; each scored item is linked to a content area and cognitive level (recall, application, analysis); the TMC ends December 31, 2026 and the Respiratory Therapy Examination is used from January 1, 2027
Exam questions
160 multiple-choice items: 140 scored and 20 pretest
Time limit
3 hours
Passing score
Raw score (each item worth one point) compared with two cut scores: the low cut score earns the CRT credential; the high cut score earns the CRT credential and eligibility for the Clinical Simulation Examination for candidates eligible to earn the RRT
Exam fee
$190 new applicants; $150 repeat applicants
Examination outline
  • I. PATIENT DATA (50 of 140 scored items; Recall 15, Application 27, Analysis 8) (35.71%)
    • I.A. Evaluate Data in the Patient Record (10 of 50 section items; Recall 4, Application 6, Analysis 0) — 1. Patient history, for example, history of present illness (HPI), orders, medication reconciliation, progress notes, DNR status / advance directives, social, family, and medical history; 2. Physical examination relative to the cardiopulmonary system; 3. Lines, drains, and airways, for example, chest tube, vascular lines, artificial airway; 4. Laboratory results, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 5. Blood gas analysis and / or hemoximetry (CO-oximetry) results; 6. Pulmonary function testing results, for example spirometry, lung volumes, DLCO; 7. 6-minute walk test results; 8. Imaging study results, for example, chest radiograph, CT scan, ultrasonography and / or echocardiography, PET scan, ventilation / perfusion scan; 9. Maternal and perinatal / neonatal history, for example, APGAR scores, gestational age, L / S ratio; 10. Sleep study results, for example, apnea-hypopnea index (AHI); 11. Trends in monitoring results: a. fluid balance; b. vital signs; c. intracranial pressure; d. ventilator liberation parameters; e. pulmonary mechanics; f. noninvasive, for example, pulse oximetry, capnography, transcutaneous; g. cardiac evaluation / monitoring results, for example, ECG, hemodynamic parameters; 12. Determination of a patient's pathophysiological state
    • I.B. Perform Clinical Assessment (10 of 50 section items; Recall 3, Application 6, Analysis 1) — 1. Interviewing a patient to assess a. level of consciousness and orientation, emotional state, and ability to cooperate; b. level of pain; c. shortness of breath, sputum production, and exercise tolerance; d. smoking history; e. environmental exposures; f. activities of daily living; g. learning needs, for example, literacy, preferred learning style, social / cultural; 2. Performing inspection to assess a. general appearance; b. characteristics of the airway, for example, patency, Mallampati classification, tracheal shift; c. cough, sputum amount and character; d. status of a neonate, for example, APGAR score, gestational age; e. skin integrity, for example, pressure ulcers, stoma site; 3. Palpating to assess a. pulse, rhythm, intensity; b. accessory muscle activity; c. asymmetrical chest movements, tactile fremitus, crepitus, tenderness, tactile rhonchi, and / or tracheal deviation; 4. Performing diagnostic chest percussion; 5. Auscultating to assess a. breath sounds; b. heart sounds and rhythm; c. blood pressure; 6. Reviewing a chest radiograph to assess a. quality of imaging, for example, patient positioning, penetration, lung inflation; b. presence and position of airways, lines, and drains; c. presence of foreign bodies; d. heart size and position; e. presence of, or change in, (i) cardiopulmonary abnormalities, for example, pneumothorax, consolidation, pleural effusion, pulmonary edema, pulmonary artery size; (ii) diaphragm, mediastinum, and / or trachea
    • I.C. Perform Procedures to Gather Clinical Information (12 of 50 section items; Recall 4, Application 7, Analysis 1) — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas sample collection; 6. Blood gas analysis and / or hemoximetry (CO-oximetry); 7. Oxygen titration with exercise; 8. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 9. Hemodynamic monitoring; 10. Pulmonary compliance and airways resistance; 11. Plateau pressure; 12. Auto-PEEP determination; 13. Spontaneous breathing trial (SBT); 14. Apnea monitoring; 15. Apnea test (brain death determination); 16. Overnight pulse oximetry; 17. CPAP / NPPV titration during sleep; 18. Cuff management, for example, tracheal, laryngeal; 19. Sputum induction; 20. Cardiopulmonary stress testing; 21. 6-minute walk test; 22. Spirometry outside or inside a pulmonary function laboratory; 23. DLCO inside a pulmonary function laboratory; 24. Lung volumes inside a pulmonary function laboratory; 25. Tests of respiratory muscle strength - MIP and MEP; 26. Therapeutic bronchoscopy
    • I.D. Evaluate Procedure Results (10 of 50 section items; Recall 2, Application 4, Analysis 4) — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas analysis and / or hemoximetry (CO-oximetry); 6. Oxygen titration with exercise; 7. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 8. Hemodynamic monitoring; 9. Pulmonary compliance and airways resistance; 10. Plateau pressure; 11. Auto-PEEP; 12. Spontaneous breathing trial (SBT); 13. Apnea monitoring; 14. Apnea test (brain death determination); 15. Overnight pulse oximetry; 16. CPAP / NPPV titration during sleep; 17. Cuff status, for example, laryngeal, tracheal; 18. Cardiopulmonary stress testing; 19. 6-minute walk test; 20. Spirometry outside or inside a pulmonary function laboratory; 21. DLCO inside a pulmonary function laboratory; 22. Lung volumes inside a pulmonary function laboratory; 23. Tests of respiratory muscle strength - MIP and MEP
    • I.E. Recommend Diagnostic Procedures (8 of 50 section items; Recall 2, Application 4, Analysis 2) — 1. Testing for tuberculosis; 2. Laboratory tests, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 3. Imaging studies; 4. Bronchoscopy a. diagnostic; b. therapeutic; 5. Bronchoalveolar lavage (BAL); 6. Pulmonary function testing; 7. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 8. Blood gas and/or hemoximetry (CO-oximetry); 9. ECG; 10. Exhaled gas analysis, for example, CO2, CO, FENO; 11. Hemodynamic monitoring; 12. Sleep studies; 13. Thoracentesis
  • II. TROUBLESHOOTING AND QUALITY CONTROL OF DEVICES, AND INFECTION CONTROL (20 of 140 scored items; Recall 8, Application 9, Analysis 3) (14.29%)
    • II.A. Assemble / Troubleshoot Devices (15 of 20 section items; Recall 4, Application 8, Analysis 3) — 1. Medical gas delivery interfaces, for example, mask, cannula, heated high-flow nasal cannula; 2. Long-term oxygen therapy; 3. Medical gas delivery, metering, and /or clinical analyzing devices, for example, concentrator, liquid system, flowmeter, regulator, gas cylinder, blender, air compressor, gas analyzers; 4. CPAP / NPPV with patient interfaces; 5. Humidifiers; 6. Nebulizers; 7. Metered-dose inhalers, spacers, and valved holding chambers; 8. Dry-powder inhalers (DPI); 9. Resuscitation equipment, for example, self-inflating resuscitator, flow-inflating resuscitator, AED; 10. Mechanical ventilators; 11. Intubation equipment; 12. Artificial airways; 13. Suctioning equipment, for example, regulator, canister, tubing, catheter; 14. Blood analyzers, for example, hemoximetry (CO-oximetry), point-of-care, blood gas; 15. Patient breathing circuits; 16. Hyperinflation devices; 17. Secretion clearance devices; 18. Heliox delivery device; 19. Portable spirometer; 20. Testing equipment in a pulmonary function laboratory; 21. Pleural drainage; 22. Noninvasive monitoring, for example, pulse oximeter, capnometer, transcutaneous; 23. Bronchoscopes and light sources; 24. Hemodynamic monitoring a. pressure transducers; b. catheters, for example, arterial, pulmonary artery
    • II.B. Ensure Infection Prevention (2 of 20 section items; Recall 2, Application 0, Analysis 0) — 1. Adhering to infection prevention policies and procedures, for example, Standard Precautions, donning/doffing, isolation; 2. Adhering to disinfection policies and procedures; 3. Proper handling of biohazardous materials
    • II.C. Perform Quality Control Procedures (3 of 20 section items; Recall 2, Application 1, Analysis 0) — 1. Blood analyzers; 2. Gas analyzers; 3. Pulmonary function equipment for testing a. spirometry results; b. lung volumes; c. diffusing capacity (DLCO); 4. Mechanical ventilators; 5. Noninvasive monitors
  • III. INITIATION AND MODIFICATION OF INTERVENTIONS (70 of 140 scored items; Recall 10, Application 30, Analysis 30) (50%)
    • III.A. Maintain a Patent Airway Including the Care of Artificial Airways (10 of 70 section items; Recall 3, Application 4, Analysis 3) — 1. Proper positioning of a patient; 2. Recognition of a difficult airway; 3. Establishing and managing a patient's airway a. nasopharyngeal airway; b. oropharyngeal airway; c. esophagealtracheal tubes / supraglottic airways; d. endotracheal tube; e. tracheostomy tube; f. laryngectomy tube; g. speaking valves; h. devices that assist with intubation, for example, endotracheal tube exchanger, video laryngoscopy; 4. Performing tracheostomy care; 5. Exchanging artificial airways; 6. Maintaining adequate humidification; 7. Initiating protocols to prevent ventilator-associated infections; 8. Performing extubation
    • III.B. Perform Airway Clearance and Lung Expansion Techniques (5 of 70 section items; Recall 2, Application 2, Analysis 1) — 1. Postural drainage, percussion, or vibration; 2. Suctioning, for example, nasotracheal, oropharyngeal; 3. Mechanical devices, for example, high-frequency chest wall oscillation, vibratory PEP, intrapulmonary percussive ventilation, insufflation / exsufflation; 4. Assisted cough, for example, huff, abdominal thrust; 5. Hyperinflation therapy; 6. Inspiratory muscle training
    • III.C. Support Oxygenation and Ventilation (15 of 70 section items; Recall 1, Application 5, Analysis 9) — 1. Initiating and adjusting oxygen therapy; 2. Minimizing hypoxemia, for example, patient positioning, secretion removal; 3. Initiating and adjusting mask or nasal CPAP; 4. Initiating and adjusting mechanical ventilation settings a. continuous mechanical ventilation; b. noninvasive ventilation; c. high-frequency ventilation; d. alarms; 5. Recognizing and correcting patient-ventilator dyssynchrony; 6. Utilizing ventilator graphics; 7. Performing lung recruitment maneuvers; 8. Liberating a patient from mechanical ventilation
    • III.D. Administer Medications and Specialty Gases (4 of 70 section items; Recall 1, Application 3, Analysis 0) — 1. Aerosolized preparations a. antimicrobials; b. pulmonary vasodilators; c. bronchodilators; d. mucolytics / proteolytics; e. steroids; 2. Endotracheal instillation; 3. Specialty gases, for example, heliox, inhaled NO
    • III.E. Ensure Modifications are Made to the Respiratory Care Plan (18 of 70 section items; Recall 1, Application 7, Analysis 10) — 1. Treatment termination, for example, life-threatening adverse event; 2. Recommendations a. starting treatment based on patient response; b. treatment of pneumothorax; c. adjustment of fluid balance; d. adjustment of electrolyte therapy; e. insertion or change of artificial airway; f. liberating from mechanical ventilation; g. extubation; h. discontinuing treatment based on patient response; i. consultation from a physician specialist; 3. Recommendations for changes a. patient position; b. oxygen therapy; c. humidification; d. airway clearance; e. hyperinflation; f. mechanical ventilation; 4. Recommendations for pharmacologic interventions a. bronchodilators; b. anti-inflammatory drugs; c. mucolytics and proteolytics; d. aerosolized antibiotics; e. inhaled pulmonary vasodilators; f. cardiovascular; g. antimicrobials; h. sedatives and hypnotics; i. analgesics; j. narcotic antagonists; k. benzodiazepine antagonists; l. neuromuscular blocking agents; m. diuretics; n. surfactants; o. changes to drug, dosage, administration frequency, mode, or concentration
    • III.F. Utilize Evidence-Based Practice (6 of 70 section items; Recall 0, Application 2, Analysis 4) — 1. Classification of disease severity; 2. Recommendations for changes in a therapeutic plan when indicated; 3. Application of guidelines, for example, ARDSNet, NAEPP, GOLD
    • III.G. Provide Respiratory Care in High-Risk Situations (5 of 70 section items; Recall 0, Application 2, Analysis 3) — 1. Emergency a. cardiopulmonary emergencies, excluding CPR; b. disaster management; c. medical emergency team (MET) / rapid response team; 2. Interprofessional communication; 3. Patient transport a. land / air between hospitals; b. within a hospital
    • III.H. Assist a Physician / Provider in Performing Procedures (4 of 70 section items; Recall 1, Application 3, Analysis 0) — 1. Intubation; 2. Bronchoscopy; 3. Specialized bronchoscopy, for example, endobronchial ultrasound (EBUS), navigational bronchoscopy (ENB); 4. Thoracentesis; 5. Tracheotomy; 6. Chest tube insertion; 7. Insertion of arterial or venous catheters; 8. Moderate (conscious) sedation; 9. Cardioversion; 10. Withdrawal of life support
    • III.I. Conduct Patient and Family Education (3 of 70 section items; Recall 1, Application 2, Analysis 0) — 1. Safety and infection control; 2. Home care and related equipment; 3. Lifestyle changes, for example, smoking cessation, exercise; 4. Pulmonary rehabilitation; 5. Disease / condition management, for example, asthma, COPD, CF, tracheostomy care, ventilator dependent
Examination sources

Clinical Simulation Examination

Provider
The National Board for Respiratory Care (NBRC); administered Monday through Saturday at more than 300 assessment centers through the NBRC testing agency PSI
Format
Computer-based clinical simulation examination of patient-management problems with information-gathering and decision-making sections; each section of each problem is classified to a minor content heading of the Detailed Content Outline. Admission requires the CRT and a TMC pass at the high cut score; with the implementation of the Respiratory Therapy Examination the CSE is available only to those who passed the TMC at the high cut score by December 31, 2026, and it ends December 31, 2027
Exam questions
22 problems: 20 scored and 2 pretest
Time limit
4 hours
Passing score
Points associated with the candidate’s set of responses are summed across the whole examination into one score compared with a cut score linked to examination committee decisions on whether each positively-scored option is required as a demonstration of minimal competence
Exam fee
$200 for both new and repeat applicants
Examination outline
  • I. PATIENT DATA
    • I.A. Evaluate Data in the Patient Record — 1. Patient history, for example, history of present illness (HPI), orders, medication reconciliation, progress notes, DNR status / advance directives, social, family, and medical history; 2. Physical examination relative to the cardiopulmonary system; 3. Lines, drains, and airways, for example, chest tube, vascular lines, artificial airway; 4. Laboratory results, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 5. Blood gas analysis and / or hemoximetry (CO-oximetry) results; 6. Pulmonary function testing results, for example spirometry, lung volumes, DLCO; 7. 6-minute walk test results; 8. Imaging study results, for example, chest radiograph, CT scan, ultrasonography and / or echocardiography, PET scan, ventilation / perfusion scan; 9. Maternal and perinatal / neonatal history, for example, Apgar scores, gestational age, L / S ratio; 10. Sleep study results, for example, apnea-hypopnea index (AHI); 11. Trends in monitoring results: a. fluid balance; b. vital signs; c. intracranial pressure; d. ventilator liberation parameters; e. pulmonary mechanics; f. noninvasive, for example, pulse oximetry, capnography, transcutaneous; g. cardiac evaluation / monitoring results, for example, ECG, hemodynamic parameters; 12. Determination of a patient's pathophysiological state
    • I.B. Perform Clinical Assessment — 1. Interviewing a patient to assess a. level of consciousness and orientation, emotional state, and ability to cooperate; b. level of pain; c. shortness of breath, sputum production, and exercise tolerance; d. smoking history; e. environmental exposures; f. activities of daily living; g. learning needs, for example, literacy, preferred learning style, social / cultural; 2. Performing inspection to assess a. general appearance; b. characteristics of the airway, for example, patency, Mallampati classification, tracheal shift; c. cough, sputum amount and character; d. status of a neonate, for example, Apgar score, gestational age; e. skin integrity, for example, pressure ulcers, stoma site; 3. Palpating to assess a. pulse, rhythm, intensity; b. accessory muscle activity; c. asymmetrical chest movements, tactile fremitus, crepitus, tenderness, tactile rhonchi, and / or tracheal deviation; 4. Performing diagnostic chest percussion; 5. Auscultating to assess a. breath sounds; b. heart sounds and rhythm; c. blood pressure; 6. Reviewing a chest radiograph to assess a. quality of imaging, for example, patient positioning, penetration, lung inflation; b. presence and position of airways, lines, and drains; c. presence of foreign bodies; d. heart size and position; e. presence of, or change in, (i) cardiopulmonary abnormalities, for example, pneumothorax, consolidation, pleural effusion, pulmonary edema, pulmonary artery size; (ii) diaphragm, mediastinum, and / or trachea
    • I.C. Perform Procedures to Gather Clinical Information — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas sample collection; 6. Blood gas analysis and / or hemoximetry (CO-oximetry); 7. Oxygen titration with exercise; 8. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 9. Hemodynamic monitoring; 10. Pulmonary compliance and airways resistance; 11. Plateau pressure; 12. Auto-PEEP determination; 13. Spontaneous breathing trial (SBT); 14. Apnea monitoring; 15. Apnea test (brain death determination); 16. Overnight pulse oximetry; 17. CPAP / NPPV titration during sleep; 18. Cuff management, for example, tracheal, laryngeal; 19. Sputum induction; 20. Cardiopulmonary exercise testing; 21. 6-minute walk test; 22. Spirometry outside or inside a pulmonary function laboratory; 23. DLCO inside a pulmonary function laboratory; 24. Lung volumes inside a pulmonary function laboratory; 25. Tests of respiratory muscle strength - MIP and MEP; 26. Therapeutic bronchoscopy
    • I.D. Evaluate Procedure Results — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas analysis and / or hemoximetry (CO-oximetry); 6. Oxygen titration with exercise; 7. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 8. Hemodynamic monitoring; 9. Pulmonary compliance and airways resistance; 10. Plateau pressure; 11. Auto-PEEP; 12. Spontaneous breathing trial (SBT); 13. Apnea monitoring; 14. Apnea test (brain death determination); 15. Overnight pulse oximetry; 16. CPAP / NPPV titration during sleep; 17. Cuff status, for example, laryngeal, tracheal; 18. Cardiopulmonary exercise testing; 19. 6-minute walk test; 20. Spirometry outside or inside a pulmonary function laboratory; 21. DLCO inside a pulmonary function laboratory; 22. Lung volumes inside a pulmonary function laboratory; 23. Tests of respiratory muscle strength - MIP and MEP
    • I.E. Recommend Diagnostic Procedures — 1. Testing for tuberculosis; 2. Laboratory tests, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 3. Imaging studies; 4. Bronchoscopy a. diagnostic; b. therapeutic; 5. Bronchoalveolar lavage (BAL); 6. Pulmonary function testing; 7. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 8. Blood gas and/or hemoximetry (CO-oximetry); 9. ECG; 10. Exhaled gas analysis, for example, CO2, CO, FENO; 11. Hemodynamic monitoring; 12. Sleep studies; 13. Thoracentesis
  • II. TROUBLESHOOTING AND QUALITY CONTROL OF EQUIPMENT, AND INFECTION CONTROL
    • II.A. Assemble /Troubleshoot Devices — 1. Medical gas delivery interfaces, for example, mask, cannula, heated high-flow nasal cannula; 2. Long-term oxygen therapy; 3. Medical gas delivery, metering, and /or clinical analyzing devices, for example, concentrator, liquid system, flowmeter, regulator, gas cylinder, blender, air compressor, gas analyzers; 4. CPAP / NPPV with patient interfaces; 5. Humidifiers; 6. Nebulizers; 7. Metered-dose inhalers, spacers, and valved holding chambers; 8. Dry-powder inhalers (DPI); 9. Resuscitation equipment, for example, self-inflating resuscitator, flow-inflating resuscitator, AED; 10. Mechanical ventilators; 11. Intubation equipment; 12. Artificial airways; 13. Suctioning equipment, for example, regulator, canister, tubing, catheter; 14. Blood analyzers, for example, hemoximetry (CO-oximetry), point-of-care, blood gas; 15. Patient breathing circuits; 16. Hyperinflation devices; 17. Secretion clearance devices; 18. Heliox delivery device; 19. Portable spirometer; 20. Testing equipment in a pulmonary function laboratory; 21. Pleural drainage; 22. Noninvasive monitoring, for example, pulse oximeter, capnometer, transcutaneous; 23. Bronchoscopes and light sources; 24. Hemodynamic monitoring a. pressure transducers; b. catheters, for example, arterial, pulmonary artery
    • II.B. Ensure Infection Prevention — 1. Adhering to infection prevention policies and procedures, for example, Standard Precautions, donning/doffing, isolation; 2. Adhering to disinfection policies and procedures; 3. Proper handling of biohazardous materials
    • II.C. Perform Quality Control Procedures — 1. Blood analyzers; 2. Gas analyzers; 3. Pulmonary function equipment for testing a. spirometry results; b. lung volumes; c. diffusing capacity (DLCO); 4. Mechanical ventilators; 5. Noninvasive monitors
  • III. INITIATION AND MODIFICATION OF INTERVENTIONS
    • III.A. Maintain a Patent Airway Including the Care of Artificial Airways — 1. Proper positioning of a patient; 2. Recognition of a difficult airway; 3. Establishing and managing a patient's airway a. nasopharyngeal airway; b. oropharyngeal airway; c. esophagealtracheal tubes / supraglottic airways; d. endotracheal tube; e. tracheostomy tube; f. laryngectomy tube; g. speaking valves; h. devices that assist with intubation, for example, endotracheal tube exchanger, video laryngoscopy; 4. Performing tracheostomy care; 5. Exchanging artificial airways; 6. Maintaining adequate humidification; 7. Initiating protocols to prevent ventilator-associated infections; 8. Performing extubation
    • III.B. Perform Airway Clearance and Lung Expansion Techniques — 1. Postural drainage, percussion, or vibration; 2. Suctioning, for example, nasotracheal, oropharyngeal; 3. Mechanical devices, for example, high-frequency chest wall oscillation, vibratory PEP, intrapulmonary percussive ventilation, insufflation / exsufflation device; 4. Assisted cough, for example, huff, abdominal thrust; 5. Hyperinflation therapy; 6. Inspiratory muscle training
    • III.C. Support Oxygenation and Ventilation — 1. Initiating and adjusting oxygen therapy; 2. Minimizing hypoxemia, for example, patient positioning, secretion removal; 3. Initiating and adjusting mask or nasal CPAP; 4. Initiating and adjusting mechanical ventilation settings a. continuous mechanical ventilation; b. noninvasive ventilation; c. high-frequency ventilation; d. alarms; 5. Recognizing and correcting patient-ventilator dyssynchrony; 6. Utilizing ventilator graphics; 7. Performing lung recruitment maneuvers; 8. Liberating a patient from mechanical ventilation
    • III.D. Administer Medications and Specialty Gases — 1. Aerosolized preparations a. antimicrobials; b. pulmonary vasodilators; c. bronchodilators; d. mucolytics / proteolytics; e. steroids; 2. Endotracheal instillation; 3. Specialty gases, for example, heliox, inhaled NO
    • III.E. Ensure Modifications are Made to the Respiratory Care Plan — 1. Treatment termination, for example, life-threatening adverse event; 2. Recommendations a. starting treatment based on patient response; b. treatment of pneumothorax; c. adjustment of fluid balance; d. adjustment of electrolyte therapy; e. insertion or change of artificial airway; f. liberating from mechanical ventilation; g. extubation; h. discontinuing treatment based on patient response; i. consultation from a physician specialist; 3. Recommendations for changes a. patient position; b. oxygen therapy; c. humidification; d. airway clearance; e. hyperinflation; f. mechanical ventilation; 4. Recommendations for pharmacologic interventions a. bronchodilators; b. anti-inflammatory drugs; c. mucolytics and proteolytics; d. aerosolized antibiotics; e. inhaled pulmonary vasodilators; f. cardiovascular; g. antimicrobials; h. sedatives and hypnotics; i. analgesics; j. narcotic antagonists; k. benzodiazepine antagonists; l. neuromuscular blocking agents; m. diuretics; n. surfactants; o. changes to drug, dosage, administration frequency, mode, or concentration
    • III.F. Utilize Evidence-Based Practice — 1. Classification of disease severity; 2. Recommendations for changes in a therapeutic plan when indicated; 3. Application of guidelines, for example, ARDSNet, NAEPP, GOLD
    • III.G. Provide Respiratory Care Techniques in High-Risk Situations — 1. Emergency a. cardiopulmonary emergencies excluding CPR; b. disaster management; c. medical emergency team (MET) / rapid response team; 2. Interprofessional communication; 3. Patient transport a. land / air between hospitals; b. within a hospital
    • III.H. Assist a Physician / Provider in Performing Procedures — 1. Intubation; 2. Bronchoscopy; 3. Specialized bronchoscopy, for example, EBUS, navigational bronchoscopy (ENB); 4. Thoracentesis; 5. Tracheotomy; 6. Chest tube insertion; 7. Insertion of arterial or venous catheters; 8. Moderate (conscious) sedation; 9. Cardioversion; 10. Withdrawal of life support
    • III.I. Conduct Patient and Family Education — 1. Safety and infection control; 2. Home care and related equipment; 3. Lifestyle changes, for example, smoking cessation, exercise; 4. Pulmonary rehabilitation; 5. Disease / condition management, for example, asthma, COPD, CF, tracheostomy care, ventilator dependent
Examination sources