North Carolina Respiratory Therapy — Requirements & Free Practice

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Licenses, application pathways and examination requirements

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Advanced Respiratory Care Practitioner (ARCP) Endorsement

Licensing authority: North Carolina Respiratory Care Board

Annual continuation of the ARCP endorsement

At least one of the following alternatives:

Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Competency: Demonstrate facility- and supervising-physician-approved competence for all advanced procedures and pharmacologic agents; submit initial certification copies and ongoing competency on audit.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education: Master's degree or higher in advanced respiratory-therapy clinical practice from a CoARC-accredited APRT program, including required supervised clinical training and the eight practice settings listed in qualification 1.2.
License: Active unencumbered Board RCP license with all appropriate credentials.
Life support: Attain and maintain applicable ACLS, PALS or NRP certifications.
Maintenance: Notify the Board annually of advanced practice; approved CE under .0401, annual physician competence evaluation, three-year document retention.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Rrt: Maintain the required credentials; the initial examination passing evidence is retained as a credential condition on annual continuation.
Supervision: Practice under physician delegation and approved facility protocols; no independent diagnosis, prescribing, interpretation of diagnostic tests or surgical intervention.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Pass the NBRC Advanced Practice Respiratory Therapy outcomes assessment under qualification 1.3.2. No supplied registered version identifies that examination; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Advanced Respiratory Care Practitioner endorsement

All of the following:

Competency: Demonstrate facility- and supervising-physician-approved competence for all advanced procedures and pharmacologic agents; submit initial certification copies and ongoing competency on audit.
Education: Master's degree or higher in advanced respiratory-therapy clinical practice from a CoARC-accredited APRT program, including required supervised clinical training and the eight practice settings listed in qualification 1.2.
License: Active unencumbered Board RCP license with all appropriate credentials.
Life support: Attain and maintain applicable ACLS, PALS or NRP certifications.
Maintenance: Notify the Board annually of advanced practice; approved CE under .0401, annual physician competence evaluation, three-year document retention.
Rrt: Pass the RRT examinations named in qualification 1.3.1; the Board's own CE Definitions identifies TMC and CSE as the examinations for CRT/RRT credentials, resolving those names to the frozen versions.
Supervision: Practice under physician delegation and approved facility protocols; no independent diagnosis, prescribing, interpretation of diagnostic tests or surgical intervention.
Unregistered nationwide exam aprt: Pass the NBRC Advanced Practice Respiratory Therapy outcomes assessment under qualification 1.3.2. No supplied registered version identifies that examination; it remains a condition pending nationwide registration.

ECMO (Extracorporeal Membrane Oxygenation) Endorsement

Licensing authority: North Carolina Respiratory Care Board

Annual continuation of ECMO (Extracorporeal Membrane Oxygenation) endorsement

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Scope: ECMO with or without continuous renal replacement therapy (CRRT) under the joint 2017 ruling; current PALS, NRP and ACLS as applicable in the checklist; ACLS for adults and PALS for children under the ruling.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial ECMO (Extracorporeal Membrane Oxygenation) endorsement — associate experience

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Associate respiratory-care degree with at least two years of critical/emergency-care experience and clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Scope: ECMO with or without continuous renal replacement therapy (CRRT) under the joint 2017 ruling; current PALS, NRP and ACLS as applicable in the checklist; ACLS for adults and PALS for children under the ruling.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial ECMO (Extracorporeal Membrane Oxygenation) endorsement — baccalaureate

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Baccalaureate degree in respiratory care or closely related discipline with clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Scope: ECMO with or without continuous renal replacement therapy (CRRT) under the joint 2017 ruling; current PALS, NRP and ACLS as applicable in the checklist; ACLS for adults and PALS for children under the ruling.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Pulmonary Disease Patient Educator Endorsement

Licensing authority: North Carolina Respiratory Care Board

Annual continuation of Pulmonary Disease Patient Educator endorsement

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least six hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: Complete an approved pulmonary-disease patient-education course addressing needs assessment and barriers, coordinated education, care plans, health and safety, medications, equipment, habilitation/rehabilitation, communicating safety concerns and confirming understanding; document facility competence. Approved physician protocols and permitted hospital, similar-facility or DHHS-approved education settings apply.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Pulmonary Disease Patient Educator endorsement — associate experience

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least six hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Associate respiratory-care degree plus two years of supervised pulmonary-disease patient-education experience after graduation
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: Complete an approved pulmonary-disease patient-education course addressing needs assessment and barriers, coordinated education, care plans, health and safety, medications, equipment, habilitation/rehabilitation, communicating safety concerns and confirming understanding; document facility competence. Approved physician protocols and permitted hospital, similar-facility or DHHS-approved education settings apply.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Pulmonary Disease Patient Educator endorsement — baccalaureate

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least six hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Baccalaureate degree in respiratory care
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: Complete an approved pulmonary-disease patient-education course addressing needs assessment and barriers, coordinated education, care plans, health and safety, medications, equipment, habilitation/rehabilitation, communicating safety concerns and confirming understanding; document facility competence. Approved physician protocols and permitted hospital, similar-facility or DHHS-approved education settings apply.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Pulmonary Disease Patient Educator endorsement — masters

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least six hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Master's degree in respiratory therapy
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: Complete an approved pulmonary-disease patient-education course addressing needs assessment and barriers, coordinated education, care plans, health and safety, medications, equipment, habilitation/rehabilitation, communicating safety concerns and confirming understanding; document facility competence. Approved physician protocols and permitted hospital, similar-facility or DHHS-approved education settings apply.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Advanced Medication Administration Endorsement

Licensing authority: North Carolina Respiratory Care Board

Annual continuation of Advanced Medication Administration endorsement

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: At least five hours taught by an on-staff nurse educator with a master's in nursing; initial and annual assessment includes all advanced procedures and medications. Only facility-approved non-respiratory drugs/procedures under medical supervision; maintain ACLS/PALS for relevant populations.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Advanced Medication Administration endorsement — associate experience

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Associate respiratory-care degree with at least two years of critical/emergency-care experience and clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: At least five hours taught by an on-staff nurse educator with a master's in nursing; initial and annual assessment includes all advanced procedures and medications. Only facility-approved non-respiratory drugs/procedures under medical supervision; maintain ACLS/PALS for relevant populations.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Advanced Medication Administration endorsement — baccalaureate

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Baccalaureate degree in respiratory care or closely related discipline with clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: At least five hours taught by an on-staff nurse educator with a master's in nursing; initial and annual assessment includes all advanced procedures and medications. Only facility-approved non-respiratory drugs/procedures under medical supervision; maintain ACLS/PALS for relevant populations.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Conscious Sedation (Moderate Sedation) Endorsement

Licensing authority: North Carolina Respiratory Care Board

Annual continuation of Conscious Sedation (Moderate Sedation) endorsement

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: At least five hours under an anesthesiologist or certified registered nurse anesthetist; documented initial and annual conscious-sedation competence. ACLS for adults, PALS for children, both for both populations.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Conscious Sedation (Moderate Sedation) endorsement — associate experience

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Associate respiratory-care degree with at least two years of critical/emergency-care experience and clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: At least five hours under an anesthesiologist or certified registered nurse anesthetist; documented initial and annual conscious-sedation competence. ACLS for adults, PALS for children, both for both populations.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Conscious Sedation (Moderate Sedation) endorsement — baccalaureate

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Baccalaureate degree in respiratory care or closely related discipline with clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Training: At least five hours under an anesthesiologist or certified registered nurse anesthetist; documented initial and annual conscious-sedation competence. ACLS for adults, PALS for children, both for both populations.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Advanced Cardiac Stress Testing (Pharmaceutical Stress Testing) Endorsement

Licensing authority: North Carolina Respiratory Care Board

Annual continuation of Advanced Cardiac Stress Testing (Pharmaceutical Stress Testing) endorsement

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Setting: Drug administration during stress testing in an acute-care hospital by its employed RCPs; appropriate ACC/AHA cognitive competence, physician orders and medical-director-approved protocols. ACLS or PALS as applicable; the form states RRT credential or exemption.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Advanced Cardiac Stress Testing (Pharmaceutical Stress Testing) endorsement — associate experience

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Associate respiratory-care degree with at least two years of critical/emergency-care experience and clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Setting: Drug administration during stress testing in an acute-care hospital by its employed RCPs; appropriate ACC/AHA cognitive competence, physician orders and medical-director-approved protocols. ACLS or PALS as applicable; the form states RRT credential or exemption.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Advanced Cardiac Stress Testing (Pharmaceutical Stress Testing) endorsement — baccalaureate

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Baccalaureate degree in respiratory care or closely related discipline with clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Setting: Drug administration during stress testing in an acute-care hospital by its employed RCPs; appropriate ACC/AHA cognitive competence, physician orders and medical-director-approved protocols. ACLS or PALS as applicable; the form states RRT credential or exemption.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Critical Care Advanced Practice Transport Endorsement

Licensing authority: North Carolina Respiratory Care Board

Annual continuation of Critical Care Advanced Practice Transport endorsement

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Ambulance: Employed by a licensed ambulance provider; constant physician communication under OEMS protocols, medical-director-approved formulary and protocols; maintain ACLS, PALS and NRP. The advanced-transport ruling concerns specialty-team procedures; ordinary ground transport within the RCP scope is separately governed by the 2014 ruling and does not itself issue a new Board credential.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Critical Care Advanced Practice Transport endorsement — associate experience

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Ambulance: Employed by a licensed ambulance provider; constant physician communication under OEMS protocols, medical-director-approved formulary and protocols; maintain ACLS, PALS and NRP. The advanced-transport ruling concerns specialty-team procedures; ordinary ground transport within the RCP scope is separately governed by the 2014 ruling and does not itself issue a new Board credential.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Associate respiratory-care degree with at least two years of critical/emergency-care experience and clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial Critical Care Advanced Practice Transport endorsement — baccalaureate

At least one of the following alternatives:

Advanced credential: Current NBRC RRT credential; relevant rulings also permit other advanced practice credentials subject to advance Board determination. The registration form requires current RRT; the cardiac-stress form expressly allows an exemption. Holding this credential is an applicant condition, not an inferred examination leaf.
Ambulance: Employed by a licensed ambulance provider; constant physician communication under OEMS protocols, medical-director-approved formulary and protocols; maintain ACLS, PALS and NRP. The advanced-transport ruling concerns specialty-team procedures; ordinary ground transport within the RCP scope is separately governed by the 2014 ruling and does not itself issue a new Board credential.
Application: Complete one endorsement application for this activity, upload required evidence, sign the applicant affidavit and obtain the facility-designee affidavit; await Board approval and online verification before endorsed practice.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Ce specialty: Meet .0401 and maintain at least five hours directly related to the endorsed activity; notify the Board annually of continuing endorsed practice.
Competency: Facility certifies initial competence in each advanced procedure and medication; obtain documented annual medical-director competence evaluations and retain required documentation for three years.
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education experience: Baccalaureate degree in respiratory care or closely related discipline with clinical competencies
License: Active unencumbered Board RCP license.
Life support: Maintain BLS and the advanced-life-support certifications required for the patient populations treated.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Practice: Practice only in the settings permitted by the applicable Board ruling, with approved written physician/facility or ambulance-provider policies and procedures, medical supervision, approved drugs, monitoring and recognition of complications.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Respiratory Care Practitioner

Licensing authority: North Carolina Respiratory Care Board

Annual renewal of an active license without the reciprocity CE exemption

At least one of the following alternatives:

Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Credentials: Maintain current NBRC respiratory-care credentials and provide proof on renewal and request.
Life support: Supply current BLS, a BLS instructor certificate or ACLS certificate under .0302(e).
Military extension: Armed-forces members with qualifying tax-return extensions may submit military orders or IRS approval for the same renewal-fee and CE extension; credits used for that renewal cannot be reused.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Renewal: Apply annually, pay renewal fees, meet the current CE requirements, and not be in violation of Article 38.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Restoration after child support or subpoena forfeiture is cleared

No examination is required for this applicant pathway.

Certification: Clerk of superior court or child-support enforcement agency certifies the delinquency cleared or subpoena complied with or no longer applicable.
Reinstatement: Immediate reinstatement at no additional cost under G.S. 93B-13(d). A longer independent Board disciplinary revocation under subsection (c) still controls.

Official no-examination sources

Effective from 2026-09-22.

North Carolina General Statutes Chapter 93B
G.S. 93B-13
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0307, contiguous text part 1
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0307, contiguous text part 2

Reinstatement after revocation, summary suspension or surrender during investigation

All of the following:

Therapist Multiple-Choice Examination
At least one of the following alternatives:
- Therapist Multiple-Choice Examination
- Clinical Simulation Examination

Application: Submit the electronic Board application, identity copy, complete personal/education/work/license/NBRC history, truthful disclosures, and the applicable fees under .0201 and .0204.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Background: Provide fingerprints, signed release, identifying information and criminal-record-check fees under .0205; disclose court, professional-board, health-care organization, competency and conduct matters. Chemical-dependency applicants must demonstrate treatment or rehabilitation and at least two years of continuous recovery.
Board interview: If qualifications raise questions, the Board may interview the applicant or knowledgeable persons under .0203.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Discretion: Board considers misconduct, prior and subsequent conduct, current competence and public safety; may require additional CE, scope or supervision restrictions and probationary conditions. After approval, submit a .0201 application; incomplete applications over one year require another background-check fee.
Education: Provide sworn evidence of completing the accredited respiratory-care education required by G.S. 90-653(a)(3).
Interview: Appear in person for the Board competence-and-character interview; this is an applicant evaluation, not an identified separate licensure examination.
Life support: Provide sworn evidence of recognized basic cardiac life support under G.S. 90-653(a)(4).
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Petition: Submit a notarized truthful petition authorizing information release, unexpired identity, any legal-name-change evidence, NBRC verification satisfying .0201(5), CE completed since the disciplinary event, fingerprints, criminal-record consent, reinstatement and background fees.
References: Three original notarized references from nonfamily respiratory-care practitioners who observed clinical work, on Board forms, dated no more than three months before submission and sent directly by their authors.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Waiting period: At least one full calendar year since revocation, summary suspension or disciplinary surrender.

Initial licensure after inactivity greater than one year and less than five years

All of the following:

Therapist Multiple-Choice Examination
At least one of the following alternatives:
- Therapist Multiple-Choice Examination
- Clinical Simulation Examination

Application: Submit the electronic Board application, identity copy, complete personal/education/work/license/NBRC history, truthful disclosures, and the applicable fees under .0201 and .0204.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Background: Provide fingerprints, signed release, identifying information and criminal-record-check fees under .0205; disclose court, professional-board, health-care organization, competency and conduct matters. Chemical-dependency applicants must demonstrate treatment or rehabilitation and at least two years of continuous recovery.
Board interview: If qualifications raise questions, the Board may interview the applicant or knowledgeable persons under .0203.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education: Provide sworn evidence of completing the accredited respiratory-care education required by G.S. 90-653(a)(3).
Inactivity: Not practiced respiratory care for more than one year but less than five years; provide twelve hours satisfying .0401 for each full year of inactivity, in addition to .0201(a).
Life support: Provide sworn evidence of recognized basic cardiac life support under G.S. 90-653(a)(4).
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial licensure after inactivity greater than five years

All of the following:

Therapist Multiple-Choice Examination
At least one of the following alternatives:
- Therapist Multiple-Choice Examination
- Clinical Simulation Examination

Application: Submit the electronic Board application, identity copy, complete personal/education/work/license/NBRC history, truthful disclosures, and the applicable fees under .0201 and .0204.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Background: Provide fingerprints, signed release, identifying information and criminal-record-check fees under .0205; disclose court, professional-board, health-care organization, competency and conduct matters. Chemical-dependency applicants must demonstrate treatment or rehabilitation and at least two years of continuous recovery.
Board interview: If qualifications raise questions, the Board may interview the applicant or knowledgeable persons under .0203.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Education: Provide sworn evidence of completing the accredited respiratory-care education required by G.S. 90-653(a)(3).
Exact five year boundary: The rule separately says less than five years and greater than five years. It assigns no additional branch to exactly five years; the general .0201(a) requirements remain applicable.
Inactivity: Not practiced respiratory care for more than five years; in addition to .0201(a), provide either sixty hours meeting .0401 and a successful NBRC entry-level examination taken as an assessment before issuance, or a Board-approved respiratory-care refresher. The refresher substitutes for .0201(b)(2)(A), not the paragraph (a) evidence.
Life support: Provide sworn evidence of recognized basic cardiac life support under G.S. 90-653(a)(4).
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Initial licensure by examination

Therapist Multiple-Choice Examination

Application: Submit the electronic Board application, identity copy, complete personal/education/work/license/NBRC history, truthful disclosures, and the applicable fees under .0201 and .0204.
Background: Provide fingerprints, signed release, identifying information and criminal-record-check fees under .0205; disclose court, professional-board, health-care organization, competency and conduct matters. Chemical-dependency applicants must demonstrate treatment or rehabilitation and at least two years of continuous recovery.
Board interview: If qualifications raise questions, the Board may interview the applicant or knowledgeable persons under .0203.
Education: Provide sworn evidence of completing the accredited respiratory-care education required by G.S. 90-653(a)(3).
Life support: Provide sworn evidence of recognized basic cardiac life support under G.S. 90-653(a)(4).

Late renewal of a lapsed license within twenty four months

At least one of the following alternatives:

Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Credentials: Maintain current NBRC respiratory-care credentials and provide proof on renewal and request.
Lapse: License automatically lapses if not renewed; no practice while lapsed. Pay the late fee as well as renewal fees. Statute permits late renewal up to five years but leaves its provision to the Board; .0302(f) restricts renewability to twenty-four months.
Life support: Supply current BLS, a BLS instructor certificate or ACLS certificate under .0302(e).
Military extension: Armed-forces members with qualifying tax-return extensions may submit military orders or IRS approval for the same renewal-fee and CE extension; credits used for that renewal cannot be reused.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Renewal: Apply annually, pay renewal fees, meet the current CE requirements, and not be in violation of Article 38.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

Military spouse endorsement

No examination is required for this applicant pathway.

Competency: Demonstrate competency by Board-determined methods, such as CE or practice at least two of the preceding five years; relevant full/part-time paid or volunteer experience counts.
Conduct: No disqualifying act, good standing, no disciplinary action and no pending complaint.
Fees: No initial application fee under G.S. 93B-15.1(k); ordinary renewal fees and actual third-party background-check costs remain possible.
Implementing application demand: Board .0201(c) or (d) directs an application under .0201. The paragraph (a)(5) application checklist states: "evidence from the National Board for Respiratory Care (NBRC) that the applicant passed the entry-level examination administered by it; and". This lower-ranked demand is disclosed as a condition rather than overriding the statutory pathway.
Marriage: Provide evidence of marriage to an active military member under .0201(d).
Outside license: Current substantially equivalent or higher outside-jurisdiction occupational license, certification or registration.
Statutory priority: G.S. 93B-15.1(b) requires issuance notwithstanding other law on its listed conditions; no currently offered profession examination is identified in that defining statutory pathway.
Timing: Board must issue or give a reasoned deficiency notice within fifteen days, subject to pending-complaint disposition provisions.

Official no-examination sources

Effective from 2026-09-22.

North Carolina General Statutes Chapter 93B
G.S. 93B-15.1
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0201, contiguous text part 1
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0201, contiguous text part 2
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0201, contiguous text part 3

Military training and experience

No examination is required for this applicant pathway.

Conduct: No act constituting refusal, suspension or revocation grounds and no pending complaint.
Experience: Active practice at least two of the preceding five years; all relevant military experience is credited.
Fees: No initial application fee under G.S. 93B-15.1(k); ordinary renewal fees and actual third-party background-check costs remain possible.
Implementing application demand: Board .0201(c) or (d) directs an application under .0201. The paragraph (a)(5) application checklist states: "evidence from the National Board for Respiratory Care (NBRC) that the applicant passed the entry-level examination administered by it; and". This lower-ranked demand is disclosed as a condition rather than overriding the statutory pathway.
Statutory priority: G.S. 93B-15.1(a) requires issuance notwithstanding other law on its listed conditions; no currently offered profession examination is identified in that defining statutory pathway.
Timing: Board must issue or give a reasoned deficiency notice within fifteen days, subject to pending-complaint disposition provisions.
Training: Awarded a military occupational specialty with substantially equivalent training, testing or equivalent training and experience, and performance in the specialty.

Official no-examination sources

Effective from 2026-09-22.

North Carolina General Statutes Chapter 93B
G.S. 93B-15.1
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0201, contiguous text part 1
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0201, contiguous text part 2
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0201, contiguous text part 3

Conversion from inactive to active status

At least one of the following alternatives:

Application: Submit renewal application, renewal fee and late fee.
Audit: Retain CE evidence for at least three years and submit it within thirty calendar days of an audit notice under .0402.
Ce: Provide evidence of at least twelve hours satisfying .0401 for each full year of inactivity.
Ce extensions: Documented qualifying military service or serious or disabling illness may support a Board-approved CE extension under .0402(b).
Continuing education options: 21 NCAC 61 .0401 permits twelve CE credits, at least six traditional and at most six nontraditional, or one of the paragraph (b) substitute activities. The exam alternatives are optional means of satisfying CE; applicants may instead use approved CE courses, a Board-approved refresher, a three-semester-hour qualifying degree course, presentation of respiratory-care research, or a published respiratory-care book or peer-reviewed article.
Existing status: Hold an inactive license within its sixty-month maximum.
Other profession examination: The BRPT Registry Examination for Polysomnographic Technologist (RPSGT) is also an accepted CE substitute; it is an examination of another profession and remains an applicant condition.
Partial ce credit: ACLS, PALS or NRP completion or renewal may earn five traditional hours total per cycle; clinical precepting up to three traditional hours; NBRC credential-maintenance quarterly assessments up to six nontraditional hours for any credential held.
Tmc score for ce: Use of the TMC examination for CE requires its high cut score; this is distinct from the entry-level licensure passing requirement.
Unregistered nationwide exam accs: Adult Critical Care Specialty Examination (ACCS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam ae c: Asthma Educators Certification Examination (AE-C) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam aprt: Advanced Practice Respiratory Therapist Outcome Assessment Examination is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam nps: Neonatal/Pediatric Respiratory Care Specialty Examination (NPS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam pft: Pulmonary Function Technology Examination (PFT), replacing the separate CPFT and RPFT programs merged in June 2015 is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.
Unregistered nationwide exam sds: Sleep Disorders Specialty Examination (SDS) is accepted by 21 NCAC 61 .0401(b)(1) but has no exam version in the supplied nationwide context; it remains a condition pending nationwide registration.

New licensure after a lapse exceeding twenty four months

Therapist Multiple-Choice Examination

Application: Submit the electronic Board application, identity copy, complete personal/education/work/license/NBRC history, truthful disclosures, and the applicable fees under .0201 and .0204.
Background: Provide fingerprints, signed release, identifying information and criminal-record-check fees under .0205; disclose court, professional-board, health-care organization, competency and conduct matters. Chemical-dependency applicants must demonstrate treatment or rehabilitation and at least two years of continuous recovery.
Board interview: If qualifications raise questions, the Board may interview the applicant or knowledgeable persons under .0203.
Education: Provide sworn evidence of completing the accredited respiratory-care education required by G.S. 90-653(a)(3).
Lapse: A license lapsed more than twenty-four months is not renewable under .0302(f); apply for a new license and meet all then-existing requirements. If inactivity exceeds one year, the additional .0201(b) conditions apply as documented in the corresponding initial-inactivity routes.
Life support: Provide sworn evidence of recognized basic cardiac life support under G.S. 90-653(a)(4).

Licensure by reciprocity

Therapist Multiple-Choice Examination

Application: Submit the electronic Board application, identity copy, complete personal/education/work/license/NBRC history, truthful disclosures, and the applicable fees under .0201 and .0204.
Background: Provide fingerprints, signed release, identifying information and criminal-record-check fees under .0205; disclose court, professional-board, health-care organization, competency and conduct matters. Chemical-dependency applicants must demonstrate treatment or rehabilitation and at least two years of continuous recovery.
Board discretion: G.S. 90-655 permits the Board to grant reciprocity; .0306 exercises that discretion and requires an application under .0201, including NBRC entry-level passing evidence.
Board interview: If qualifications raise questions, the Board may interview the applicant or knowledgeable persons under .0203.
Ce exemption: Exempt from .0401 while maintaining an active license in the home jurisdiction of record.
Education: Provide sworn evidence of completing the accredited respiratory-care education required by G.S. 90-653(a)(3).
Existing license: Hold a valid respiratory-care license, certificate or registration in an acceptable jurisdiction that the Board finds substantially equivalent; the implementing rule requires that license to have been active for at least one year.
Life support: Provide sworn evidence of recognized basic cardiac life support under G.S. 90-653(a)(4).

Annual renewal while maintaining the home jurisdiction license

No examination is required for this applicant pathway.

Ce exemption: 21 NCAC 61 .0401(d) and .0306 exempt the reciprocal license from .0401 while the home-jurisdiction license remains active. The renewal evidence of current NBRC credentials is a credential-maintenance condition, not a newly identified examination.
Credentials: Maintain current NBRC respiratory-care credentials and provide proof on renewal and request.
Life support: Supply current BLS, a BLS instructor certificate or ACLS certificate under .0302(e).
Military extension: Armed-forces members with qualifying tax-return extensions may submit military orders or IRS approval for the same renewal-fee and CE extension; credits used for that renewal cannot be reused.
Renewal: Apply annually, pay renewal fees, meet the current CE requirements, and not be in violation of Article 38.

Official no-examination sources

Effective from 2026-09-22.

North Carolina Respiratory Care Practice Act, Chapter 90 Article 38
G.S. 90-658
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0302, contiguous text part 1
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0306, contiguous text part 1
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0401, contiguous text part 1
21 NCAC Chapter 61, Respiratory Care Board
21 NCAC 61 .0401, contiguous text part 2

Respiratory Care Practitioner — Provisional License

Licensing authority: North Carolina Respiratory Care Board

Provisional licensure while applying to take the certification examination

Therapist Multiple-Choice Examination

Duration: Maximum twelve months; .0103(15) states that this license is nonrenewable.
Education: Complete the education in G.S. 90-653(a)(3). The .0303 reference to 90-563(a)(3) is read with its express reference to 90-656 and the controlling statute.
Exam application: Apply to take the NBRC entry-level certification examination and apply to the Board; passing is not a precondition to issuing this provisional license.
Fees: Submit the applicable provisional application and endorsement fees.
Supervision: A licensed RCP must be in the same facility and readily available for supervision and consultation whenever the provisional licensee practices.

Respiratory Care Practitioner — Temporary License

Licensing authority: North Carolina Respiratory Care Board

Temporary licensure while awaiting official documents

Therapist Multiple-Choice Examination

Application: Submit the electronic Board application, identity copy, complete personal/education/work/license/NBRC history, truthful disclosures, and the applicable fees under .0201 and .0204.
Background: Provide fingerprints, signed release, identifying information and criminal-record-check fees under .0205; disclose court, professional-board, health-care organization, competency and conduct matters. Chemical-dependency applicants must demonstrate treatment or rehabilitation and at least two years of continuous recovery.
Board interview: If qualifications raise questions, the Board may interview the applicant or knowledgeable persons under .0203.
Copies: Supply notarized copies of the education, life-support and passing-examination evidence in G.S. 90-653(a)(3)-(5) while waiting for official issuing-agency copies.
Duration: Board may grant a temporary license for no more than ninety days from application.
Education: Provide sworn evidence of completing the accredited respiratory-care education required by G.S. 90-653(a)(3).
Life support: Provide sworn evidence of recognized basic cardiac life support under G.S. 90-653(a)(4).

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

NBRC Clinical Simulation Examination Detailed Content Outline
CSE Detailed Content Outline, page 1 header
NBRC Clinical Simulation Examination Detailed Content Outline
CSE Detailed Content Outline, page 1 classification note
NBRC Clinical Simulation Examination Detailed Content Outline
CSE Detailed Content Outline, final page, Test Form Assembly Specifications
NBRC Content Outlines page
Credentialing Examinations Detailed Content Outlines list, CSE entry
NBRC Clinical Simulation Examination (CSE) / RRT examination page
RRT/CSE page, CSE description
NBRC Candidate Handbook
After You Finish the Examination, CSE cut score, p. 12
NBRC Candidate Handbook
After You Finish the Examination, CSE positively-scored options, p. 12
NBRC news: Examination Changes Coming in 2027 - New Details Added
FAQ: What if I pass the TMC at the high cut score and don’t complete the CSE before December 31, 2026?
NBRC Clinical Simulation Examination (CSE) / RRT examination page
RRT/CSE page FAQ: What are the examination fees?
NBRC Clinical Simulation Examination (CSE) / RRT examination page
RRT/CSE page, availability notice
NBRC Candidate Handbook
Admission Policy - CSE heading, p. 4

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

NBRC Therapist Multiple-Choice Examination Detailed Content Outline
TMC Detailed Content Outline, page 1 header
NBRC Therapist Multiple-Choice Examination Detailed Content Outline
TMC Detailed Content Outline, page 1, domain I allocation row
NBRC Therapist Multiple-Choice Examination Detailed Content Outline
TMC Detailed Content Outline, page 12, totals row and Additional Specifications
NBRC Content Outlines page
Credentialing Examinations Detailed Content Outlines list, TMC entry
NBRC Therapist Multiple-Choice Examination Detailed Content Outline
TMC Detailed Content Outline, pp. 1, 6, 8: scored-item totals 50/20/70; lettered topic totals throughout pp. 1–12; section and topic proportions converted from the original fixed counts
NBRC Certified Respiratory Therapist (CRT) examination page
CRT page, Detailed Content Outline and examination description
NBRC Certified Respiratory Therapist (CRT) examination page
CRT page FAQ: What do the cut scores mean?
NBRC Candidate Handbook
After You Finish the Examination, p. 12
NBRC Certified Respiratory Therapist (CRT) examination page
CRT page FAQ: What are the examination fees?
NBRC Certified Respiratory Therapist (CRT) examination page
CRT page FAQ: When and where are NBRC examinations administered?
NBRC Candidate Handbook
Special Accommodations request form, examination list