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Pennsylvania Respiratory Therapy — Requirements & Free Practice

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

Respiratory Therapist License

Respiratory therapy credential issued by Pennsylvania State Board of Medicine.

Licensing authority: Pennsylvania State Board of Medicine · Application information

Licensure by endorsement under 63 Pa.C.S. § 3111
No examination is required for this applicant pathway.
Application and fee
Apply in the Board-prescribed manner and pay the applicable application fee.
Child abuse training
Complete 3 hours of DHS-approved child abuse recognition and reporting training.
Conduct and discipline
Have no prohibited act or discipline, unless the Board determines it does not impede licensure.
English proficiency
Demonstrate proficiency through English education, English training, an entry examination taken in English, or an accepted language examination: TOEFL scores at least 83 internet-based, 220 computer-based or 550 paper-based, or OET 350 in each of four subtests, or a Board-approved equivalent. ECFMG certification is another accepted proficiency method.
Interview
The Board may request a personal interview and additional competency, experience or English proficiency information; remote interview may be requested for good cause.
Licensing law copy
Provide the other jurisdiction’s current governing law, regulation or rule, including its enactment date; obtain a complete, accurate professional English translation at applicant expense where necessary.
Prior license
Hold a current license, certificate, registration or permit in good standing in another jurisdiction whose licensing standards substantially equal or exceed the applicable Pennsylvania standards.
Professional liability
Satisfy any professional liability requirements applicable under the governing law and Board rules.
Recent practice
Establish licensed practice in a jurisdiction with substantially equivalent standards for at least 2 of the 5 years immediately preceding application.

Official no-examination sources

Effective from 2024-11-02.

Biennial renewal
No examination is required for this applicant pathway.
Continuing education
Complete 30 approved respiratory-care continuing education hours for the preceding biennium, including 1 hour medical ethics, 1 hour patient safety and at least 2 hours approved child abuse recognition and reporting; at least 10 hours must be live/traditional instruction with a presenter. The rule states at least 10 live hours in § 18.309a(a)(2) and at least 10 traditional hours in (a)(3).
Credit limits
Basic life support earns no credit; at most 8 advanced life support hours per biennium; duplicate course content earns no additional credit; office management and practice building are not qualifying respiratory-care education.
Documentation
Maintain supporting continuing education or waiver records for at least 2 years after the applicable biennium or completion/waiver date, whichever is later.
Initial cycle
The first biennium of initial Pennsylvania licensure is exempt from respiratory-care continuing education, subject to the applicable child abuse training requirement.
Renewal application
Apply in the Board-prescribed manner and pay the renewal fee; licenses expire December 31 of even-numbered years.
Waiver
The Board may waive continuing education for serious illness, hardship or military service upon a documented timely written request; after expiration, practice may resume only after the Board grants the waiver.

Official no-examination sources

Effective from 2022-03-26.

Reinstatement after controlled substance felony suspension or revocation
Therapist Multiple-Choice Examination
Application
Submit the Board application and satisfactory supporting evidence, and pay the applicable licensing fee.
Character and fitness
Be of good moral character and not unfit or unable to practice because of physical or mental impairment.
Child abuse training
Complete at least 3 hours of approved training in child abuse recognition and reporting.
General qualifications
Meet 49 Pa. Code § 16.12: legal age, good moral character, no intemperate alcohol or habitual narcotic use, and controlled-substance felony restrictions; where applicable, 10 years since conviction and satisfactory rehabilitation.
Other qualifications
Meet all other statutory licensing qualifications, including the examination requirement.
Rehabilitation
Demonstrate significant personal rehabilitation so reinstatement poses no substantial risk to patients, public health and safety, or of further criminal violations.
Waiting period
At least 10 years must have elapsed since the controlled-substance felony conviction.
Endorsement under Section 27
No examination is required for this applicant pathway.
Application
Submit the Board application and satisfactory supporting evidence, and pay the applicable licensing fee.
Board discretion
The Board must accept cumulative qualifications as equivalent to the standard licensing requirements when the applicant does not meet the standard requirements.
Character and fitness
Be of good moral character and not unfit or unable to practice because of physical or mental impairment.
Child abuse training
Complete at least 3 hours of approved training in child abuse recognition and reporting.
General qualifications
Meet 49 Pa. Code § 16.12: legal age, good moral character, no intemperate alcohol or habitual narcotic use, and controlled-substance felony restrictions; where applicable, 10 years since conviction and satisfactory rehabilitation.

Official no-examination sources

Effective from 2022-03-26.

Restoration after unsupported temporary suspension
No examination is required for this applicant pathway.
Preliminary hearing
The preliminary hearing determines that no prima facie case supports the temporary suspension.
Restoration
The statute requires immediate restoration of the existing license on that determination.

Official no-examination sources

Effective from 2014-02-01.

Initial licensure with an equivalent out of state license
Therapist Multiple-Choice Examination
Application
Submit the Board application and satisfactory supporting evidence, and pay the applicable licensing fee.
Character and fitness
Be of good moral character and not unfit or unable to practice because of physical or mental impairment.
Child abuse training
Complete at least 3 hours of approved training in child abuse recognition and reporting.
Examination evidence
The qualifying examination may have been passed before application; submit evidence supporting equivalence of the prior license and its examination requirement.
Existing license
Hold a valid respiratory therapist license, certificate or registration in another state, territory or the District of Columbia based on substantially similar requirements, including the examination requirement.
General qualifications
Meet 49 Pa. Code § 16.12: legal age, good moral character, no intemperate alcohol or habitual narcotic use, and controlled-substance felony restrictions; where applicable, 10 years since conviction and satisfactory rehabilitation.
Initial licensure by examination
Therapist Multiple-Choice Examination
Application
Submit the Board application and satisfactory supporting evidence, and pay the applicable licensing fee.
Character and fitness
Be of good moral character and not unfit or unable to practice because of physical or mental impairment.
Child abuse training
Complete at least 3 hours of approved training in child abuse recognition and reporting.
Education
Graduate from a CoARC-approved respiratory care program.
General qualifications
Meet 49 Pa. Code § 16.12: legal age, good moral character, no intemperate alcohol or habitual narcotic use, and controlled-substance felony restrictions; where applicable, 10 years since conviction and satisfactory rehabilitation.
Passing examination
Pass the NBRC entry-level credentialing examination for the Certified Respiratory Therapist credential.
Reactivation of an inactive license
No examination is required for this applicant pathway.
Continuing education
Complete 30 approved respiratory-care continuing education hours for the preceding biennium, including 1 hour medical ethics, 1 hour patient safety and at least 2 hours approved child abuse recognition and reporting; at least 10 hours must be live/traditional instruction with a presenter. The rule states at least 10 live hours in § 18.309a(a)(2) and at least 10 traditional hours in (a)(3).
Credit limits
Basic life support earns no credit; at most 8 advanced life support hours per biennium; duplicate course content earns no additional credit; office management and practice building are not qualifying respiratory-care education.
Current fee
Pay fees due for the current biennium.
Documentation
Maintain supporting continuing education or waiver records for at least 2 years after the applicable biennium or completion/waiver date, whichever is later.
Initial cycle
The first biennium of initial Pennsylvania licensure is exempt from respiratory-care continuing education, subject to the applicable child abuse training requirement.
Past fees
No fee or penalty is assessed for prior biennia during which the applicant did not practice in Pennsylvania.
Request
Notify the Board in writing of the desire to reactivate.
Sworn statement
Submit a sworn statement specifying the period in which the licensee did not practice in Pennsylvania.
Waiver
The Board may waive continuing education for serious illness, hardship or military service upon a documented timely written request; after expiration, practice may resume only after the Board grants the waiver.

Official no-examination sources

Effective from 2022-03-26.

Late renewal of a lapsed license
No examination is required for this applicant pathway.
Continuing education
Complete 30 approved respiratory-care continuing education hours for the preceding biennium, including 1 hour medical ethics, 1 hour patient safety and at least 2 hours approved child abuse recognition and reporting; at least 10 hours must be live/traditional instruction with a presenter. The rule states at least 10 live hours in § 18.309a(a)(2) and at least 10 traditional hours in (a)(3).
Credit limits
Basic life support earns no credit; at most 8 advanced life support hours per biennium; duplicate course content earns no additional credit; office management and practice building are not qualifying respiratory-care education.
Documentation
Maintain supporting continuing education or waiver records for at least 2 years after the applicable biennium or completion/waiver date, whichever is later.
Initial cycle
The first biennium of initial Pennsylvania licensure is exempt from respiratory-care continuing education, subject to the applicable child abuse training requirement.
Late practice fee
A $5 fee per month or part-month of practice beyond the renewal date is charged in addition to the renewal fee; comply with restoration requirements applicable to the lapse.
Renewal application
Apply in the Board-prescribed manner and pay the renewal fee; licenses expire December 31 of even-numbered years.
Waiver
The Board may waive continuing education for serious illness, hardship or military service upon a documented timely written request; after expiration, practice may resume only after the Board grants the waiver.

Official no-examination sources

Effective from 2022-03-26.

Return to active practice from volunteer status
No examination is required for this applicant pathway.
Continuing education
Complete 30 approved respiratory-care continuing education hours for the preceding biennium, including 1 hour medical ethics, 1 hour patient safety and at least 2 hours approved child abuse recognition and reporting; at least 10 hours must be live/traditional instruction with a presenter. The rule states at least 10 live hours in § 18.309a(a)(2) and at least 10 traditional hours in (a)(3).
Credit limits
Basic life support earns no credit; at most 8 advanced life support hours per biennium; duplicate course content earns no additional credit; office management and practice building are not qualifying respiratory-care education.
Current fee
Pay fees due for the current biennium.
Documentation
Maintain supporting continuing education or waiver records for at least 2 years after the applicable biennium or completion/waiver date, whichever is later.
Initial cycle
The first biennium of initial Pennsylvania licensure is exempt from respiratory-care continuing education, subject to the applicable child abuse training requirement.
Past fees
No fee or penalty is assessed for prior biennia during which the applicant did not practice in Pennsylvania.
Request
Notify the Board in writing of the desire to reactivate.
Sworn statement
Submit a sworn statement specifying the period in which the licensee did not practice in Pennsylvania.
Underlying license
If the underlying professional license is expired, inactive or active-retired, reactivate it under the Board’s applicable rules before returning to active practice.
Volunteer status
Change the volunteer license to inactive status.
Waiver
The Board may waive continuing education for serious illness, hardship or military service upon a documented timely written request; after expiration, practice may resume only after the Board grants the waiver.

Official no-examination sources

Effective from 2026-04-25.

Reinstatement after revocation
Therapist Multiple-Choice Examination
Application
Submit the Board application and satisfactory supporting evidence, and pay the applicable licensing fee.
Board decision
Reinstatement is subject to the statutory Board and judicial provisions.
Character and fitness
Be of good moral character and not unfit or unable to practice because of physical or mental impairment.
Child abuse training
Complete at least 3 hours of approved training in child abuse recognition and reporting.
General qualifications
Meet 49 Pa. Code § 16.12: legal age, good moral character, no intemperate alcohol or habitual narcotic use, and controlled-substance felony restrictions; where applicable, 10 years since conviction and satisfactory rehabilitation.
Waiting period
Apply at least 5 years after revocation and satisfy all licensing qualifications, including the examination requirement; a competent court order is the stated statutory exception.
Restoration of unregistered status
No examination is required for this applicant pathway.
Continuing education
Complete 30 approved respiratory-care continuing education hours for the preceding biennium, including 1 hour medical ethics, 1 hour patient safety and at least 2 hours approved child abuse recognition and reporting; at least 10 hours must be live/traditional instruction with a presenter. The rule states at least 10 live hours in § 18.309a(a)(2) and at least 10 traditional hours in (a)(3).
Credit limits
Basic life support earns no credit; at most 8 advanced life support hours per biennium; duplicate course content earns no additional credit; office management and practice building are not qualifying respiratory-care education.
Current fee
Pay fees due for the current biennium.
Documentation
Maintain supporting continuing education or waiver records for at least 2 years after the applicable biennium or completion/waiver date, whichever is later.
Initial cycle
The first biennium of initial Pennsylvania licensure is exempt from respiratory-care continuing education, subject to the applicable child abuse training requirement.
Past fees
No fee or penalty is assessed for prior biennia during which the applicant did not practice in Pennsylvania.
Prolonged nonpractice
After more than 4 years without Pennsylvania practice, the Board may require an interview to assess physical and mental fitness.
Request
Notify the Board in writing of the desire to reactivate.
Restoration evidence
Submit the notarized nonpractice affidavit, resume of activities since last registration and required disciplinary/criminal/other-license disclosures; pay accrued fees and penalties for practice during unregistered periods.
Sworn statement
Submit a sworn statement specifying the period in which the licensee did not practice in Pennsylvania.
Waiver
The Board may waive continuing education for serious illness, hardship or military service upon a documented timely written request; after expiration, practice may resume only after the Board grants the waiver.

Official no-examination sources

Effective from 2022-03-26.

Temporary Respiratory Therapist Permit

Respiratory therapy credential issued by Pennsylvania State Board of Medicine.

Licensing authority: Pennsylvania State Board of Medicine · Application information

Temporary permit: graduate
Therapist Multiple-Choice Examination
Duration
The permit lasts 12 months and any additional period specially determined by the Board; it expires upon failure of the entry-level examination.
Examination application
Apply for the next regularly scheduled licensure examination as required by Medical Practice Act of 1985 Section 36.1(c).
Failed examination
An applicant who fails the entry-level examination may apply to retake it.
Licensure application
Have applied to the Board for respiratory therapist licensure.
Qualification
Have graduated from a CoARC-approved respiratory care program.
Temporary permit: nbrc credentialed
Therapist Multiple-Choice Examination
Duration
The permit lasts 12 months and any additional period specially determined by the Board; it expires upon failure of the entry-level examination.
Examination application
Apply for the next regularly scheduled licensure examination as required by Medical Practice Act of 1985 Section 36.1(c).
Failed examination
An applicant who fails the entry-level examination may apply to retake it.
Licensure application
Have applied to the Board for respiratory therapist licensure.
Qualification
Meet applicable requirements and be recognized by NBRC as a credentialed respiratory therapist.
Temporary permit: near graduation
Therapist Multiple-Choice Examination
Duration
The permit lasts 12 months and any additional period specially determined by the Board; it expires upon failure of the entry-level examination.
Examination application
Apply for the next regularly scheduled licensure examination as required by Medical Practice Act of 1985 Section 36.1(c).
Failed examination
An applicant who fails the entry-level examination may apply to retake it.
Licensure application
Have applied to the Board for respiratory therapist licensure.
Qualification
Be enrolled in a CoARC-approved respiratory care program and expect to graduate within 30 days of applying for the temporary permit.
Temporary permit extension
Therapist Multiple-Choice Examination
Board discretion
The Board specially determines any additional period beyond 12 months.
Examination
Continue to comply with the licensure examination application requirement; examination failure terminates the permit.
Existing permit
Hold a temporary permit based on one of the stated eligibility criteria.

Respiratory Therapist License

Respiratory therapy credential issued by Pennsylvania State Board of Osteopathic Medicine.

Licensing authority: Pennsylvania State Board of Osteopathic Medicine · Application information

Licensure by endorsement under 63 Pa.C.S. § 3111
No examination is required for this applicant pathway.
Application and fee
Apply in the Board-prescribed manner and pay the applicable application fee.
Child abuse training
Complete 3 hours of DHS-approved child abuse recognition and reporting training.
Conduct and discipline
Have no prohibited act or discipline, unless the Board determines it does not impede licensure.
English proficiency
Demonstrate proficiency through English education, English training, an entry examination taken in English, or an accepted language examination: TOEFL scores at least 83 internet-based, 220 computer-based or 550 paper-based, or OET 350 in each of four subtests, or a Board-approved equivalent. Prior-jurisdiction licensure that required English proficiency is another accepted method.
Interview
The Board may request a personal interview and additional competency, experience or English proficiency information; remote interview may be requested for good cause.
Licensing law copy
Provide the other jurisdiction’s current governing law, regulation or rule, including its enactment date; obtain a complete, accurate professional English translation at applicant expense where necessary.
Prior license
Hold a current license, certificate, registration or permit in good standing in another jurisdiction whose licensing standards substantially equal or exceed the applicable Pennsylvania standards.
Professional liability
Satisfy any professional liability requirements applicable under the governing law and Board rules.
Recent practice
Establish licensed practice in a jurisdiction with substantially equivalent standards for at least 2 of the 5 years immediately preceding application.

Official no-examination sources

Effective from 2025-01-18.

Biennial renewal
No examination is required for this applicant pathway.
Continuing education
Complete 30 approved respiratory-care continuing education hours for the preceding biennium, including 1 hour medical ethics, 1 hour patient safety and at least 2 hours approved child abuse recognition and reporting; at least 10 hours must be live/traditional instruction with a presenter.
Credit limits
Basic life support earns no credit; at most 8 advanced life support hours per biennium; duplicate course content earns no additional credit; office management and practice building are not qualifying respiratory-care education.
Documentation
Maintain supporting continuing education or waiver records for at least 2 years after the applicable biennium or completion/waiver date, whichever is later.
Initial cycle
The first biennium of initial Pennsylvania licensure is exempt from respiratory-care continuing education, subject to the applicable child abuse training requirement.
Renewal application
Apply in the Board-prescribed manner and pay the renewal fee; licenses expire December 31 of even-numbered years.
Waiver
The Board may waive continuing education for serious illness, hardship or military service upon a documented timely written request; after expiration, practice may resume only after the Board grants the waiver.

Official no-examination sources

Effective from 2023-12-30.

Restoration after unsupported temporary suspension
No examination is required for this applicant pathway.
Preliminary hearing
The preliminary hearing determines that no prima facie case supports the temporary suspension.
Restoration
The statute requires immediate restoration of the existing license on that determination.

Official no-examination sources

Effective from 2014-02-01.

Initial licensure with an equivalent out of state license
Therapist Multiple-Choice Examination
Application
Submit the Board application and satisfactory supporting evidence, and pay the applicable licensing fee.
Character and fitness
Be of good moral character and not unfit or unable to practice because of physical or mental impairment.
Child abuse training
Complete at least 3 hours of approved training in child abuse recognition and reporting.
Examination evidence
The qualifying examination may have been passed before application; submit evidence supporting equivalence of the prior license and its examination requirement.
Existing license
Hold a valid respiratory therapist license, certificate or registration in another state, territory or the District of Columbia based on substantially similar requirements, including the examination requirement.
Initial licensure by examination
Therapist Multiple-Choice Examination
Application
Submit the Board application and satisfactory supporting evidence, and pay the applicable licensing fee.
Character and fitness
Be of good moral character and not unfit or unable to practice because of physical or mental impairment.
Child abuse training
Complete at least 3 hours of approved training in child abuse recognition and reporting.
Education
Graduate from a CoARC-approved respiratory care program.
Passing examination
Pass the NBRC entry-level credentialing examination for the Certified Respiratory Therapist credential.
Reactivation of an inactive license
No examination is required for this applicant pathway.
Continuing education
Complete 30 approved respiratory-care continuing education hours for the preceding biennium, including 1 hour medical ethics, 1 hour patient safety and at least 2 hours approved child abuse recognition and reporting; at least 10 hours must be live/traditional instruction with a presenter.
Credit limits
Basic life support earns no credit; at most 8 advanced life support hours per biennium; duplicate course content earns no additional credit; office management and practice building are not qualifying respiratory-care education.
Current fee
Pay fees due for the current biennium.
Documentation
Maintain supporting continuing education or waiver records for at least 2 years after the applicable biennium or completion/waiver date, whichever is later.
Initial cycle
The first biennium of initial Pennsylvania licensure is exempt from respiratory-care continuing education, subject to the applicable child abuse training requirement.
Past fees
No fee or penalty is assessed for prior biennia during which the applicant did not practice in Pennsylvania.
Request
Notify the Board in writing of the desire to reactivate.
Sworn statement
Submit a sworn statement specifying the period in which the licensee did not practice in Pennsylvania.
Waiver
The Board may waive continuing education for serious illness, hardship or military service upon a documented timely written request; after expiration, practice may resume only after the Board grants the waiver.

Official no-examination sources

Effective from 2023-12-30.

Late renewal of a lapsed license
No examination is required for this applicant pathway.
Continuing education
Complete 30 approved respiratory-care continuing education hours for the preceding biennium, including 1 hour medical ethics, 1 hour patient safety and at least 2 hours approved child abuse recognition and reporting; at least 10 hours must be live/traditional instruction with a presenter.
Credit limits
Basic life support earns no credit; at most 8 advanced life support hours per biennium; duplicate course content earns no additional credit; office management and practice building are not qualifying respiratory-care education.
Documentation
Maintain supporting continuing education or waiver records for at least 2 years after the applicable biennium or completion/waiver date, whichever is later.
Initial cycle
The first biennium of initial Pennsylvania licensure is exempt from respiratory-care continuing education, subject to the applicable child abuse training requirement.
Late practice fee
A $5 fee per month or part-month of practice beyond the renewal date is charged in addition to the renewal fee; comply with restoration requirements applicable to the lapse.
Renewal application
Apply in the Board-prescribed manner and pay the renewal fee; licenses expire December 31 of even-numbered years.
Waiver
The Board may waive continuing education for serious illness, hardship or military service upon a documented timely written request; after expiration, practice may resume only after the Board grants the waiver.

Official no-examination sources

Effective from 2023-12-30.

Return to active practice from volunteer status
No examination is required for this applicant pathway.
Continuing education
Complete 30 approved respiratory-care continuing education hours for the preceding biennium, including 1 hour medical ethics, 1 hour patient safety and at least 2 hours approved child abuse recognition and reporting; at least 10 hours must be live/traditional instruction with a presenter.
Credit limits
Basic life support earns no credit; at most 8 advanced life support hours per biennium; duplicate course content earns no additional credit; office management and practice building are not qualifying respiratory-care education.
Current fee
Pay fees due for the current biennium.
Documentation
Maintain supporting continuing education or waiver records for at least 2 years after the applicable biennium or completion/waiver date, whichever is later.
Initial cycle
The first biennium of initial Pennsylvania licensure is exempt from respiratory-care continuing education, subject to the applicable child abuse training requirement.
Past fees
No fee or penalty is assessed for prior biennia during which the applicant did not practice in Pennsylvania.
Request
Notify the Board in writing of the desire to reactivate.
Sworn statement
Submit a sworn statement specifying the period in which the licensee did not practice in Pennsylvania.
Underlying license
If the underlying professional license is expired, inactive or active-retired, reactivate it under the Board’s applicable rules before returning to active practice.
Volunteer status
Change the volunteer license to inactive status.
Waiver
The Board may waive continuing education for serious illness, hardship or military service upon a documented timely written request; after expiration, practice may resume only after the Board grants the waiver.

Official no-examination sources

Effective from 2026-04-25.

Reinstatement after revocation
Therapist Multiple-Choice Examination
Application
Submit the Board application and satisfactory supporting evidence, and pay the applicable licensing fee.
Board decision
Reinstatement is subject to the statutory Board and judicial provisions.
Character and fitness
Be of good moral character and not unfit or unable to practice because of physical or mental impairment.
Child abuse training
Complete at least 3 hours of approved training in child abuse recognition and reporting.
Waiting period
Apply at least 5 years after revocation and satisfy all licensing qualifications, including the examination requirement; a competent court order is the stated statutory exception.

Temporary Respiratory Therapist Permit

Respiratory therapy credential issued by Pennsylvania State Board of Osteopathic Medicine.

Licensing authority: Pennsylvania State Board of Osteopathic Medicine · Application information

Temporary permit: graduate
Therapist Multiple-Choice Examination
Duration
The permit lasts 12 months and any additional period specially determined by the Board; it expires upon failure of the entry-level examination.
Examination application
Apply for the next regularly scheduled licensure examination as required by Osteopathic Medical Practice Act Section 10.2(c).
Failed examination
An applicant who fails the entry-level examination may apply to retake it.
Licensure application
Have applied to the Board for respiratory therapist licensure.
Qualification
Have graduated from a CoARC-approved respiratory care program.
Temporary permit: nbrc credentialed
Therapist Multiple-Choice Examination
Duration
The permit lasts 12 months and any additional period specially determined by the Board; it expires upon failure of the entry-level examination.
Examination application
Apply for the next regularly scheduled licensure examination as required by Osteopathic Medical Practice Act Section 10.2(c).
Failed examination
An applicant who fails the entry-level examination may apply to retake it.
Licensure application
Have applied to the Board for respiratory therapist licensure.
Qualification
Meet applicable requirements and be recognized by NBRC as a credentialed respiratory therapist.
Temporary permit: near graduation
Therapist Multiple-Choice Examination
Duration
The permit lasts 12 months and any additional period specially determined by the Board; it expires upon failure of the entry-level examination.
Examination application
Apply for the next regularly scheduled licensure examination as required by Osteopathic Medical Practice Act Section 10.2(c).
Failed examination
An applicant who fails the entry-level examination may apply to retake it.
Licensure application
Have applied to the Board for respiratory therapist licensure.
Qualification
Be enrolled in a CoARC-approved respiratory care program and expect to graduate within 30 days of applying for the temporary permit.
Temporary permit extension
Therapist Multiple-Choice Examination
Board discretion
The Board specially determines any additional period beyond 12 months.
Examination
Continue to comply with the licensure examination application requirement; examination failure terminates the permit.
Existing permit
Hold a temporary permit based on one of the stated eligibility criteria.

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