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Texas Respiratory Therapy — Requirements & Free Practice

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Respiratory Care Practitioner certificate

Licensing authority: Texas Board of Respiratory Care / Texas Medical Board · Application information

Modification or termination of a disciplinary restriction
Texas Jurisprudence examination (practice unavailable)
Automatic termination
Successful completion and verified compliance may terminate an order automatically, with no pending order violation and no tolling (§181.7). This may excuse an applicant from the discretionary examination.
Eligibility
Licensee seeking modification or termination of the restriction or suspension governing an existing certificate or temporary permit; no pending complaint, investigation or Board proceeding.
Examination discretion
The sanctions table in §180.5(h), applied to RCP proceedings by §187.25(c), identifies JP examination passage for some sanctions. It is a leaf when ordered; a holder with an order containing no JP requirement need not sit it. Any unnamed proficiency testing or competency evaluation is an applicant condition.
Order terms
Timing is set by the individual order. Submit a written request explaining changed circumstances, hardship or other grounds; satisfy the order and Board review. Subsequent requests are no more frequent than annually (§181.6).
First renewal after an initial registration period under 24 months
No examination is required for this applicant pathway.
Examinations
Neither §187.15 nor the explicitly exempt first-short-cycle CE requirement imposes an examination; JP is an initial or reapplication requirement.
Initial period
Initial registration cycle was less than 24 months; Board FAQ exempts CE for the first renewal.
Renewal
Submit renewal form and fee, update verification information, and provide required fingerprints and lawful-presence documentation.

Official no-examination sources

Effective from 2025-01-09.

Initial certification by examination

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Alternative military licensure

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Eligibility
Hold a current license similar in scope from another state and be in good standing with that licensing authority.
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Military status
Applicant is a military service member, military veteran or military spouse.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Waiver
The executive director may waive any prerequisite after reviewing credentials (§55.004(b)); §187.10(c) otherwise requires the general certification requirements. Record any individualized waiver as an applicant condition.
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Alternative military licensure

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Eligibility
Have held the Texas respiratory-care certificate during the five years preceding application.
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Military status
Applicant is a military service member, military veteran or military spouse.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Waiver
The executive director may waive any prerequisite after reviewing credentials (§55.004(b)); §187.10(c) otherwise requires the general certification requirements. Record any individualized waiver as an applicant condition.
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Initial certification with military training credit

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Military credit
For a military service member or veteran, verified military service, training and education count toward licensing requirements other than an examination requirement; restricted outside licenses and unacceptable criminal history are excluded (§55.007).
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Reactivation within three years

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Inactive duration
Inactive status has not exceeded three years.
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Reactivation
Notify the Board, meet §187.10 and Board requirements, and pay reinstatement and renewal fees (§604.156(b), §187.17(c)).
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Recertification or new application

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Previous status
At least one year has passed since application denial or certificate revocation.
Recertification
Meet statutory and general certification requirements, demonstrate competency to resume practice, and complete any Board-required remediation (§187.14).
Reinstatement review
For recertification under §187.14, review follows Tex. Occ. Code §§164.151 and 164.152: public and applicant best interests, Board-set form and fees, and applicable one-year waiting periods.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Recertification or new application

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Previous status
Certificate cancelled for nonpayment or expiration of at least one year.
Recertification
Meet statutory and general certification requirements, demonstrate competency to resume practice, and complete any Board-required remediation (§187.14).
Reinstatement review
For recertification under §187.14, review follows Tex. Occ. Code §§164.151 and 164.152: public and applicant best interests, Board-set form and fees, and applicable one-year waiting periods.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Recertification or new application

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Previous status
Inactive status exceeded three years and certificate was automatically cancelled.
Recertification
Meet statutory and general certification requirements, demonstrate competency to resume practice, and complete any Board-required remediation (§187.14).
Reinstatement review
For recertification under §187.14, review follows Tex. Occ. Code §§164.151 and 164.152: public and applicant best interests, Board-set form and fees, and applicable one-year waiting periods.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Recertification or new application

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Previous status
Previously retired the certificate.
Recertification
Meet statutory and general certification requirements, demonstrate competency to resume practice, and complete any Board-required remediation (§187.14).
Reinstatement review
For recertification under §187.14, review follows Tex. Occ. Code §§164.151 and 164.152: public and applicant best interests, Board-set form and fees, and applicable one-year waiting periods.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Recertification or new application

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Previous status
Previously surrendered the certificate.
Recertification
Meet statutory and general certification requirements, demonstrate competency to resume practice, and complete any Board-required remediation (§187.14).
Reinstatement review
For recertification under §187.14, review follows Tex. Occ. Code §§164.151 and 164.152: public and applicant best interests, Board-set form and fees, and applicable one-year waiting periods.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Certification by reciprocity

All of the following:

Age document
Provide birth certificate or similar proof of age (§187.10(a)(3)(C)).
Application form
Submit the Board application; applications normally remain valid for one year (§187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Conditional records
When applicable, provide name-change, arrest, malpractice, physical/mental-health or substance-use treatment records, and military orders or DD214; the Board may require other documentation.
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Fees
Pay application fees, applicable surcharges and additional fees unless a statutory military waiver applies.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
Graduation document
Provide the Certification of Graduation and certified transcript demonstrating program completion.
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Npdb
Provide the NPDB/Health Integrity and Protection Data Bank report.
Out of state certificate
Hold another state respiratory-care license or certificate whose requirements were substantially equal to Texas requirements on its issue date (§604.106); the Board decides equivalence. This statutory permission does not itself waive the general implementing examination requirements.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
Work evaluations
Provide professional/work-history evaluations relating to respiratory-care practice during the preceding five years.
Late renewal, no more than 90 days
Alternate compliance
Hours used for another healthcare or outside-jurisdiction respiratory credential can count only if they meet Texas requirements; no excess RCP hours carry forward.
Ce
Complete 24 relevant CE hours per biennial period, at least 12 traditional and two ethics, with an HHSC-approved human-trafficking prevention course (§187.16).
Ce tracking
The Board requires CE Broker tracking beginning September 1, 2026; temporary permits are exempt from CE.
Exam alternative
Examinations are optional CE-credit alternatives to approved courses, teaching, academic credits or qualifying alternate compliance; an applicant completing CE without an examination need not sit either mounted examination. Named exam alternatives are represented by anyOf, and ordinary CE coursework or Board-granted exemption remains an applicant condition.
Exam credit limits
TMC and CSE each earn 10 contact hours. Each listed exam counts only once; the same initial credentialing examination later passed for recredentialing counts once every three renewal periods.
Exemptions
Written hardship requests are due at least 30 days before renewal; catastrophic illness, military service or residence outside the U.S. longer than one year, or other good cause may justify an Executive Director-approved exemption, maximum two years (§187.16(c)).
Fingerprints
Submit fingerprints unless previously submitted for initial issuance or an earlier renewal (§604.1523).
Late fee
Pay 1.5 times the ordinary renewal fee; no practice while expired.
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Other examinations
BRPT polysomnography registration and ACLS, PALS, NALS, NRP, basic/pre-hospital trauma life-support course examinations are other-profession or training assessments, recorded as conditions only.
Renewal
Submit renewal form, biennial registration fee, updated verification information and any other relevant information requested (§187.15).
Unregistered national exams
The Board accepts NBRC Neonatal/Pediatric Respiratory Care Specialist (NPS), Adult Critical Care Specialist (ACCS), Sleep Disorder Specialist (SDS), CPFT/RPFT pulmonary-function examination credit, and Certified Asthma Educator (AE-C) examination credit (10 hours each). No version of these is in the frozen shared context; they remain conditions pending nationwide registration. CPFT and RPFT are the Board page labels for pulmonary-function examination credit; the owner states that the current PFT exam awards CPFT at its low cut score and RPFT at its high cut score. No separate CPFT/RPFT identity is registered here.
Late renewal, more than 90 days but less than one year
Alternate compliance
Hours used for another healthcare or outside-jurisdiction respiratory credential can count only if they meet Texas requirements; no excess RCP hours carry forward.
Ce
Complete 24 relevant CE hours per biennial period, at least 12 traditional and two ethics, with an HHSC-approved human-trafficking prevention course (§187.16).
Ce tracking
The Board requires CE Broker tracking beginning September 1, 2026; temporary permits are exempt from CE.
Exam alternative
Examinations are optional CE-credit alternatives to approved courses, teaching, academic credits or qualifying alternate compliance; an applicant completing CE without an examination need not sit either mounted examination. Named exam alternatives are represented by anyOf, and ordinary CE coursework or Board-granted exemption remains an applicant condition.
Exam credit limits
TMC and CSE each earn 10 contact hours. Each listed exam counts only once; the same initial credentialing examination later passed for recredentialing counts once every three renewal periods.
Exemptions
Written hardship requests are due at least 30 days before renewal; catastrophic illness, military service or residence outside the U.S. longer than one year, or other good cause may justify an Executive Director-approved exemption, maximum two years (§187.16(c)).
Fingerprints
Submit fingerprints unless previously submitted for initial issuance or an earlier renewal (§604.1523).
Late fee
Pay twice the ordinary renewal fee; expiration of one year requires a new application.
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Other examinations
BRPT polysomnography registration and ACLS, PALS, NALS, NRP, basic/pre-hospital trauma life-support course examinations are other-profession or training assessments, recorded as conditions only.
Renewal
Submit renewal form, biennial registration fee, updated verification information and any other relevant information requested (§187.15).
Unregistered national exams
The Board accepts NBRC Neonatal/Pediatric Respiratory Care Specialist (NPS), Adult Critical Care Specialist (ACCS), Sleep Disorder Specialist (SDS), CPFT/RPFT pulmonary-function examination credit, and Certified Asthma Educator (AE-C) examination credit (10 hours each). No version of these is in the frozen shared context; they remain conditions pending nationwide registration. CPFT and RPFT are the Board page labels for pulmonary-function examination credit; the owner states that the current PFT exam awards CPFT at its low cut score and RPFT at its high cut score. No separate CPFT/RPFT identity is registered here.
Military renewal extension
Alternate compliance
Hours used for another healthcare or outside-jurisdiction respiratory credential can count only if they meet Texas requirements; no excess RCP hours carry forward.
Ce
Complete 24 relevant CE hours per biennial period, at least 12 traditional and two ethics, with an HHSC-approved human-trafficking prevention course (§187.16).
Ce tracking
The Board requires CE Broker tracking beginning September 1, 2026; temporary permits are exempt from CE.
Exam alternative
Examinations are optional CE-credit alternatives to approved courses, teaching, academic credits or qualifying alternate compliance; an applicant completing CE without an examination need not sit either mounted examination. Named exam alternatives are represented by anyOf, and ordinary CE coursework or Board-granted exemption remains an applicant condition.
Exam credit limits
TMC and CSE each earn 10 contact hours. Each listed exam counts only once; the same initial credentialing examination later passed for recredentialing counts once every three renewal periods.
Exemptions
Written hardship requests are due at least 30 days before renewal; catastrophic illness, military service or residence outside the U.S. longer than one year, or other good cause may justify an Executive Director-approved exemption, maximum two years (§187.16(c)).
Fingerprints
Submit fingerprints unless previously submitted for initial issuance or an earlier renewal (§604.1523).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Military extension
Military service members receive two additional years to complete CE and other renewal requirements (§55.003); qualifying service-related delay is exempt from increased late fee or penalty (§55.002).
Other examinations
BRPT polysomnography registration and ACLS, PALS, NALS, NRP, basic/pre-hospital trauma life-support course examinations are other-profession or training assessments, recorded as conditions only.
Renewal
Submit renewal form, biennial registration fee, updated verification information and any other relevant information requested (§187.15).
Unregistered national exams
The Board accepts NBRC Neonatal/Pediatric Respiratory Care Specialist (NPS), Adult Critical Care Specialist (ACCS), Sleep Disorder Specialist (SDS), CPFT/RPFT pulmonary-function examination credit, and Certified Asthma Educator (AE-C) examination credit (10 hours each). No version of these is in the frozen shared context; they remain conditions pending nationwide registration. CPFT and RPFT are the Board page labels for pulmonary-function examination credit; the owner states that the current PFT exam awards CPFT at its low cut score and RPFT at its high cut score. No separate CPFT/RPFT identity is registered here.
Biennial renewal
Alternate compliance
Hours used for another healthcare or outside-jurisdiction respiratory credential can count only if they meet Texas requirements; no excess RCP hours carry forward.
Ce
Complete 24 relevant CE hours per biennial period, at least 12 traditional and two ethics, with an HHSC-approved human-trafficking prevention course (§187.16).
Ce tracking
The Board requires CE Broker tracking beginning September 1, 2026; temporary permits are exempt from CE.
Exam alternative
Examinations are optional CE-credit alternatives to approved courses, teaching, academic credits or qualifying alternate compliance; an applicant completing CE without an examination need not sit either mounted examination. Named exam alternatives are represented by anyOf, and ordinary CE coursework or Board-granted exemption remains an applicant condition.
Exam credit limits
TMC and CSE each earn 10 contact hours. Each listed exam counts only once; the same initial credentialing examination later passed for recredentialing counts once every three renewal periods.
Exemptions
Written hardship requests are due at least 30 days before renewal; catastrophic illness, military service or residence outside the U.S. longer than one year, or other good cause may justify an Executive Director-approved exemption, maximum two years (§187.16(c)).
Fingerprints
Submit fingerprints unless previously submitted for initial issuance or an earlier renewal (§604.1523).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Other examinations
BRPT polysomnography registration and ACLS, PALS, NALS, NRP, basic/pre-hospital trauma life-support course examinations are other-profession or training assessments, recorded as conditions only.
Renewal
Submit renewal form, biennial registration fee, updated verification information and any other relevant information requested (§187.15).
Unregistered national exams
The Board accepts NBRC Neonatal/Pediatric Respiratory Care Specialist (NPS), Adult Critical Care Specialist (ACCS), Sleep Disorder Specialist (SDS), CPFT/RPFT pulmonary-function examination credit, and Certified Asthma Educator (AE-C) examination credit (10 hours each). No version of these is in the frozen shared context; they remain conditions pending nationwide registration. CPFT and RPFT are the Board page labels for pulmonary-function examination credit; the owner states that the current PFT exam awards CPFT at its low cut score and RPFT at its high cut score. No separate CPFT/RPFT identity is registered here.
New certificate for returning Texas practitioner
No examination is required for this applicant pathway.
Board instruction
The Board Jurisprudence Exam FAQ states: "However, if your license is cancelled for any reason (by request, for non-renewal, etc.) and you reapply for licensure, you will be required to take the exam as part of meeting current licensure requirements." This lower-ranked general instruction is retained for applicants covered by the statutory no-reexamination exception.
Board nbrc instruction
The Board checklist requires every full RCP applicant to submit a current NBRC certificate or direct NBRC verification; preserve this implementing documentation instruction alongside the controlling statutory no-reexamination exception.
Eligibility
Previously certified in Texas, moved away, currently certified in another state and practiced there for the two years preceding application.
Fee
Pay twice the usual renewal fee.
No reexamination
Section 604.1522 expressly allows a new certificate without reexamination, controlling over the general §187.14/§187.10 reapplication provisions.

Official no-examination sources

Effective from 2025-01-09.

Temporary Respiratory Care Practitioner permit

Licensing authority: Texas Board of Respiratory Care / Texas Medical Board · Application information

Modification or termination of a disciplinary restriction
Texas Jurisprudence examination (practice unavailable)
Automatic termination
Successful completion and verified compliance may terminate an order automatically, with no pending order violation and no tolling (§181.7). This may excuse an applicant from the discretionary examination.
Eligibility
Licensee seeking modification or termination of the restriction or suspension governing an existing certificate or temporary permit; no pending complaint, investigation or Board proceeding.
Examination discretion
The sanctions table in §180.5(h), applied to RCP proceedings by §187.25(c), identifies JP examination passage for some sanctions. It is a leaf when ordered; a holder with an order containing no JP requirement need not sit it. Any unnamed proficiency testing or competency evaluation is an applicant condition.
Order terms
Timing is set by the individual order. Submit a written request explaining changed circumstances, hardship or other grounds; satisfy the order and Board review. Subsequent requests are no more frequent than annually (§181.6).
Temporary permit before national certification
Texas Jurisprudence examination (practice unavailable)
Application
Submit sworn eligibility evidence and other Board-required documents, application fees, fingerprints and respiratory-care JP passage at 75 or higher.
Duration
No longer than 12 months; terminates when a full certificate is issued or permit conditions are violated (§187.12(d)-(e)).
Eligibility
Graduate of an approved respiratory care education program; national certification examination not yet completed.
National exam
Section 187.12(b)(2) expressly permits issuance without the national certification examination; any certificate held and individual remediation are conditions, not an additional nationwide leaf for this permit.
Temporary permit for an outside jurisdiction practitioner
Texas Jurisprudence examination (practice unavailable)
Application
Submit sworn eligibility evidence and other Board-required documents, application fees, fingerprints and respiratory-care JP passage at 75 or higher.
Duration
No longer than 12 months; terminates when a full certificate is issued or permit conditions are violated (§187.12(d)-(e)).
Eligibility
Licensed in another state or country and practicing, or practiced respiratory care during the preceding 12 months (§604.107(1)(A)).
National exam
Section 187.12(b)(2) expressly permits issuance without the national certification examination; any certificate held and individual remediation are conditions, not an additional nationwide leaf for this permit.
Temporary permit for a fully qualified applicant awaiting Board approval

All of the following:

Application
Submit the Board application and applicable fees, graduation documentation, age document, five-year work history evaluations, NBRC verification if applicable, NPDB report, and applicable name-change, arrest, malpractice, treatment and military records (22 TAC §187.10).
Application validity
Application valid one year, extendable for processing delay, committee referral, unexpected military assignments, medical or catastrophic events, or other extenuating circumstances (§187.10(b)).
Current practice
Demonstrate patient-treatment practice, enrollment in an approved program, or active teaching in an approved program; absence of current practice within three years can require supervised practice, remedial education or other Board-selected measures (§187.11).
Duration
No longer than 12 months; terminates at full certification or violation of permit conditions.
Eligibility
Qualified for a full certificate but subject to terms or conditions requiring Advisory Board approval (§187.12(b)(1)); all statutory temporary eligibility conditions still apply.
Fingerprints
Submit legible fingerprints for the DPS/FBI criminal-history check (Tex. Occ. Code §604.1031).
Fitness
Be mentally and physically able to practice respiratory care safely; supply any additional information required by the Board (§604.105).
High school
Complete an approved four-year high-school course or equivalent as determined by the appropriate education agency (§604.104(1)).
Jp score
Pass the respiratory-care Texas jurisprudence examination with a score of at least 75 (§187.10(a)(3)(M)).
Lawful presence
The Board application page requires unexpired documentation of U.S. citizenship or lawful presence before an initial license or renewal is approved.
Nb rc certification
Full applicants supply current NBRC certification. Previously earned passing scores remain examination leaves; national credential maintenance and any equivalent examination approved by the Board are applicant conditions.
Respiratory education
Complete a respiratory-care education program approved by the advisory board (§604.104(2)).
Temporary jp credit
The Board states: "Temporary certificate holders who have passed the JP exam within one year of submitting an application for their full certificate will not be required to pass the exam again." (Jurisprudence Exam FAQ).
New temporary permit application after expiration
Texas Jurisprudence examination (practice unavailable)
Eligibility
An expired temporary permit holder submits a fresh application and fee and meets statutory temporary eligibility and current Board requirements.
Jp
An application for a new temporary permit carries the JP requirement; an individual credited prior pass is an applicant condition.
National certification
Temporary issuance may occur before the national certification examination under §187.12(b)(2).
New temporary application after denial or revocation
Texas Jurisprudence examination (practice unavailable)
Eligibility
Meet current temporary eligibility, fingerprints, JP and Board-required competency/remediation; the Board is not required to approve the application.
Waiting period
At least one year after denial or revocation (§604.204).
One statutory temporary permit renewal
No examination is required for this applicant pathway.
Board instruction
The Board application FAQ states: "There are no extensions for temporary permits at this time." It also states an expired temporary holder may apply again with a new application and fee. Renewal is discretionary, so this records the Board exercise of that discretion; the statutory renewal pathway remains visible.
Fingerprints
Fingerprints required unless already submitted as provided by §604.1523(c).
No new exam
The renewal provision adds no reexamination requirement; existing JP qualification continues.
Renewal
Apply before expiration; Board may renew once for an additional six to 12 months, pending compliance with the Act and rules (§604.157).

Official no-examination sources

Effective from 2025-01-09.

Temporary permit for a student approaching graduation
Texas Jurisprudence examination (practice unavailable)
Application
Submit sworn eligibility evidence and other Board-required documents, application fees, fingerprints and respiratory-care JP passage at 75 or higher.
Board graduation instruction
The Board application FAQ states: "No. All applicants are required to submit a copy of their certified transcript that documents completion/graduation from the program." The controlling statute explicitly includes students expecting graduation within 30 days; its statutory route is preserved, with the Board instruction shown as a condition.
Duration
No longer than 12 months; terminates when a full certificate is issued or permit conditions are violated (§187.12(d)-(e)).
Eligibility
Student in an approved program expecting to graduate within 30 days after permit issuance (§604.107(1)(B)).
National exam
Section 187.12(b)(2) expressly permits issuance without the national certification examination; any certificate held and individual remediation are conditions, not an additional nationwide leaf for this permit.
Supervised temporary permit for current practice remediation
Texas Jurisprudence examination (practice unavailable)
Application
Submit sworn eligibility evidence and other Board-required documents, application fees, fingerprints and respiratory-care JP passage at 75 or higher.
Duration
No longer than 12 months; terminates when a full certificate is issued or permit conditions are violated (§187.12(d)-(e)).
Eligibility
Cannot demonstrate current clinical practice within the three years before application; Board offers supervised remediation (§187.11(b), §187.12(b)(3)).
National exam
Section 187.12(b)(2) expressly permits issuance without the national certification examination; any certificate held and individual remediation are conditions, not an additional nationwide leaf for this permit.
Supervisor
Physician or RCP with an unrestricted Texas license, no pending investigation, no familial relationship, no prior revocation, suspension, restriction or cancellation for cause, and any other Board-required eligibility (§187.12(c)).
Restoration after voluntary surrender
Texas Jurisprudence examination (practice unavailable)
Eligibility
Meet current temporary eligibility, Board application and fingerprint requirements, JP passage and any individualized competency remediation.
National exam
The Board may issue a temporary permit before national certification under §187.12(b)(2).
Previous status
Voluntarily surrendered a temporary permit; cannot resume practice until the Board is satisfied the practitioner is able to resume (§604.2011).

Texas Jurisprudence examination

Practice scope

Inferred from the examination name; the authority has not published an examination outline.

  • Texas Occupations Code Chapter 604. Respiratory Care Practitioners
  • Texas Occupations Code Chapter 53. Consequences of Criminal Conviction
  • Texas Occupations Code Chapter 55. Licensing of Military Service Members, Military Veterans, and Military Spouses
  • Texas Occupations Code §§164.151 and 164.152. Application for License Reinstatement and Application Period
  • Texas Occupations Code Chapter 167. Texas Physician Health Program
  • 22 Texas Administrative Code Chapter 187. RESPIRATORY CARE PRACTITIONERS
  • 22 Texas Administrative Code Chapter 177. COMPLAINTS AND INVESTIGATIONS
  • 22 Texas Administrative Code Chapter 179. PROCEDURAL RULES
  • 22 Texas Administrative Code Chapter 180. DISCIPLINARY GUIDELINES
  • 22 Texas Administrative Code Chapter 181. COMPLIANCE PROGRAM
  • 22 Texas Administrative Code Chapter 182. TEXAS PHYSICIAN HEALTH PROGRAM
Examination sources

Clinical Simulation Examination

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

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