Respiratory therapists hold either the Certified Respiratory Therapist (CRT) or Registered Respiratory Therapist (RRT) credential, both awarded by the National Board for Respiratory Care (NBRC). Understanding how these credentials differ helps learners evaluate education requirements, scope of practice and long-term career options.
Northern Kentucky University’s online Bachelor of Science in Respiratory Care program equips students with the advanced clinical knowledge necessary for advanced respiratory practice and career advancement. If you’re interested in the respiratory therapy industry, learn about how CRT and RRT credentials influence your education needs, exam preparation and advancement opportunities in healthcare.
What Is a Certified Respiratory Therapist?
A certified respiratory therapist (CRT) is an entry-level healthcare professional who offers a range of respiratory care procedures under the supervision of experienced therapists or physicians. In practice, CRT professionals perform foundational respiratory care tasks such as administering oxygen therapy, monitoring ventilated patients, conducting pulmonary function testing and assisting with airway management. They may work in various settings, most commonly hospitals, long-term care facilities and outpatient clinics.
CRTs must graduate from a respiratory therapy program accredited by the Commission on Accreditation for Respiratory Care (CoARC) at the associate, bachelor’s or graduate level. Coursework in respiratory care programs provides advanced knowledge in the care of patients with cardiopulmonary disease and covers competencies such as:
- Cardiopulmonary physiology
- Acute and chronic respiratory disease pathophysiology
- Cardiopulmonary diagnostics and monitoring
- Advanced respiratory pharmacologic agents
- Patient education and preventive strategies
After completing a program, graduates can take the Therapist Multiple-Choice (TMC) exam to earn the CRT credential. Within the range of passing standards, lower-scoring candidates earn the CRT credential, which demonstrates baseline competence in respiratory care and qualifies graduates for state licensure. Higher-scoring candidates also earn the CRT credential and become eligible for the Clinical Simulation Examination (CSE).
What Is a Registered Respiratory Therapist?
A registered respiratory therapist (RRT) serves many of the same functions as a CRT, but has a greater level of expertise in advanced clinical skills, critical thinking and leadership. In addition to the same educational and certification requirements as a CRT, RRTs must pass the CRT at the high-cut threshold to take the CSE, which evaluates decision-making in complex patient care scenarios.
The RRT designation signals proficiency in clinical reasoning, patient assessment and therapeutic intervention beyond entry-level practice. Employers often recognize the RRT credential as the standard for advanced practice, particularly in intensive care units and specialty departments.
How Do CRT and RRT Requirements Differ?
Both CRT and RRT credentials require graduation from a CoARC-accredited program. The examination process has two pathways: CRT candidates pass the TMC examination at the lower cut score, while RRT candidates must achieve the higher cut score and then complete the CSE. The TMC exam evaluates foundational respiratory therapy knowledge and measures abilities to assess patients, operate respiratory care equipment and monitor and adjust treatments according to standard protocols, while the CSE focuses on clinical decision-making and practical skills in complex, evolving scenarios.
The timeline for obtaining each credential varies depending on preparation and exam timing. Many graduates first earn the CRT credential and later pursue RRT status after gaining experience or completing additional coursework. If you earn a low-cut score, work as a CRT and later choose to pursue an RRT pathway, you can retake the TMC to attempt a high-cut score.
Each state sets its own licensure requirements for practicing respiratory therapy. Some states license therapists with a CRT, while others require the RRT or maintain additional conditions, such as continuing education or background checks. Because licensure rules and scope of practice vary by state, prospective students should review the requirements in the state where they plan to work.
What Are the Career Differences Between CRT and RRT?
CRTs typically work in entry-level respiratory care positions in hospitals, clinics, rehabilitation facilities and home healthcare. In these settings, they administer prescribed treatments, monitor patients’ respiratory status and operate respiratory equipment according to standard protocols. Since the CRT certification qualifies professionals for entry-level responsibilities, these roles are the first step for most careers and provide a foundation for professional growth. Many CRTs refer to their experiences to consider future work settings or specializations they want to pursue.
RRTs often qualify for positions in higher-acuity environments such as intensive care units, trauma centers and neonatal intensive care units. These roles involve managing complex ventilators, interpreting advanced diagnostic data and making critical care decisions alongside physicians and other healthcare professionals. Many RRTs work in leadership roles or pursue specialized positions by earning additional certifications, such as the Adult Critical Care Specialty (ACCS), Sleep Disorders Specialist (SDS) or Registered Pulmonary Function Technologist (RPFT).
Compensation and advancement opportunities reflect the differences in responsibility and expertise between CRTs and RRTs. According to the U.S. Bureau of Labor Statistics (BLS), respiratory therapists, regardless of credentials, earn a median annual salary of $80,450. Specifically, CRTs earn $70,818 annually, while RRTs earn $75,227. But while the top 10% of CRTs earn $80,119, the top 10% of RRTs average $110,266 annually. Higher earnings for either pathway generally correlate with more experience or specialized roles.
Should You Pursue RRT Certification After CRT?
Advancing from CRT to RRT offers a wider variety of professional options and signals readiness for complex clinical responsibilities. Therapists with the RRT credential often qualify for specialized roles, preceptorships and department-level initiatives that involve protocol development and interprofessional collaboration.
Healthcare systems increasingly prefer or require RRT credentials for new hires, particularly in acute care and specialty settings. Additional education through a B.S. in Respiratory Care program enhances clinical reasoning, research literacy and leadership skills to support RRT-level practice.
Advance Your Respiratory Care Career
Choosing a CRT or RRT pathway determines the education and exams required and the careers you can pursue. Clarifying your career goals helps you plan the credentials and academic steps you need.
NKU’s online B.S. in Respiratory Care program prepares respiratory therapists for expanded clinical responsibilities and advanced RRT practice through rigorous coursework and professional development opportunities. Explore the program and apply to take the next step in advancing your respiratory care career.
Learn more about NKU’s online B.S. in Respiratory Care program.
