CRT Certification Cost 2026: Complete Pricing Breakdown

What CRT Certification Actually Costs in 2026

If you're researching the Certified Respiratory Therapist (CRT) credential through the National Board for Respiratory Care (NBRC), the single largest line item in your budget is the Therapist Multiple-Choice (TMC) Examination fee. Unlike some allied health credentials that bundle application fees, renewal fees, and study materials into a confusing patchwork, the NBRC keeps CRT pricing relatively simple: one exam fee to sit for the TMC, and one recurring maintenance fee once you're certified.

This article breaks down every dollar amount tied to the CRT pathway as it stands in 2026, explains what changes on the horizon mean for your timing, and shows you where candidates commonly underestimate the true cost of certification. For a broader look at how the exam itself is structured, see our CRT Exam Domains 2026: Complete Guide to All 3 Content Areas.

TMC Exam Fee Breakdown: New vs. Repeat Applicants

The NBRC contracts with PSI as its testing provider for the computer-based TMC Examination. The fee structure is straightforward and tiered by whether you're a first-time or repeat test-taker:

The exam itself is 160 multiple-choice questions delivered on a computer, with 140 scored items and 20 unscored pretest items mixed in indistinguishably - you won't know which is which while testing, so every question deserves your full attention. You have a three-hour limit, an onscreen calculator is available, and there is no penalty for guessing, which matters when you're weighing whether to budget extra study time versus simply answering strategically on test day.

Meeting the low cut score earns the CRT credential outright. Meeting the high cut score also establishes eligibility for the Clinical Simulation Examination (CSE) when RRT admission requirements are met - a detail that matters if you're planning to pursue RRT later rather than stopping at CRT. For a full explanation of how these two thresholds work, read CRT Passing Score 2026: Exactly What You Need to Pass.

What the Fee Covers - and What It Doesn't

Your USD 190 or USD 150 payment covers your seat at a PSI testing center (or approved remote-proctoring option, depending on availability) and one scored attempt at the TMC Examination. It does not include:

• Study materials, textbooks, or question banks
• Transcript verification or transfer fees from your respiratory therapy program
• Travel or time off work to reach a testing center
• Any coaching, tutoring, or formal review courses you choose to purchase

To sit for the TMC at all, you must meet the NBRC's standard entry requirements: you need to be at least 18 years old and have graduated with at minimum an associate degree from a CoARC-supported or accredited entry-to-practice respiratory therapy program. If you haven't confirmed your program's accreditation status or your eligibility timeline, our CRT Requirements 2026: Eligibility, Prerequisites & How to Qualify guide walks through the details before you spend a dime on the exam fee.

The CMP: Ongoing Costs After You Pass

Passing the TMC and earning your CRT is not a one-time transaction - the credential operates on a five-year maintenance cycle. Within that cycle, NBRC administers quarterly assessments, and depending on your performance on those assessments, you'll be required to complete 0, 15, or 30 continuing education (CE) credits. Alternatively, there's an eligible examination-based renewal route for those who prefer testing over accumulating CE credits.

Financially, the Continuing Competency Maintenance Program (CMP) fee is USD 125 per five-year cycle, which NBRC collects as USD 25 annually rather than as one lump sum. Practically speaking, this means your CRT credential carries a small, predictable annual cost on top of whatever CE coursework you choose or are required to complete based on your quarterly assessment results.

Why 2026 Pricing Won't Last: The 2027 Transition

Timing matters more than most candidates realize. The TMC Examination, as described above, applies through December 31, 2026 - applications for this version close December 15, 2026. After that, a replacement Respiratory Therapy Examination begins on January 4, 2027, and it comes with a materially different price tag and format.

The 2027 exam expands to 185 total questions (160 scored plus 25 pretest items) with a longer four-hour time limit, and it will retain separate CRT and RRT cut scores just as the current structure does. Fees rise substantially: USD 360 for new applicants and USD 300 for repeat applicants under the new version - roughly double the current 2026 pricing.

It's worth being precise here: the 2026 TMC and the 2027 replacement exam are two distinct question banks and formats - don't mix study materials or assumptions about question count, timing, or scoring between them. If your timeline is flexible, check our CRT Exam Dates 2026: Testing Windows, Deadlines & Scheduling guide to map out exactly when to register and test.

Hidden and Indirect Costs to Budget For

Beyond the official NBRC/PSI fees, candidates often underestimate a few indirect costs:

• Repeat attempts: Even at the discounted USD 150 repeat rate, a second attempt adds cost and pushes back your start date in the workforce. The 2025 TMC low-cut pass rates were 78.5% for new candidates but only 48.9% for repeat candidates - a gap that underscores how much value there is in thorough first-attempt preparation. See our CRT Pass Rate 2026: What the Data Shows breakdown for the full picture.
• Study resources: Question banks, practice exams, and review courses vary widely in price. A structured CRT Study Guide 2026: How to Pass on Your First Attempt can help you avoid buying redundant materials.
• Lost income during prep and retest delays: Time spent studying - or waiting to retest - is time not spent earning as a credentialed CRT.
• CMP compliance costs: Depending on your quarterly assessment results, you may need to pay for CE coursework beyond the base USD 25/year CMP fee.

Budgeting Study Time Around the Three Domains

Money and time are linked: the more efficiently you study, the less likely you are to pay for a repeat attempt. The TMC's 140 scored items break down across three content domains with an official scored-item allocation of 50/20/70:

A short, targeted study plan built around this weighting looks something like this:

For a more granular breakdown of what falls under each domain, our dedicated CRT Exam Domains 2026: Complete Guide to All 3 Content Areas article covers specific topics and question styles you're likely to see. And if you're still weighing how demanding the exam is relative to your background, How Hard Is the CRT Exam? Complete Difficulty Guide 2026 puts the pass-rate data in context.

Registration Deadlines That Affect Your Wallet

Because the 2026 TMC pricing structure is tied to a hard cutoff, your registration timing directly affects what you pay. Applications for the current TMC close December 15, 2026, and testing under this version ends December 31, 2026. Miss that window, and you're automatically into the 2027 pricing tier at roughly double the cost.

Is the Investment Worth It?

Weighed against the alternative - remaining uncredentialed in a field where employers specifically list CRT as a hiring requirement - the fee structure is modest. A USD 190 exam fee and USD 25/year maintenance cost is a small fraction of what most respiratory therapy programs already cost, and it's the final step standing between your degree and employment eligibility in hospitals, home care agencies, and skilled nursing facilities that hire for CRT Jobs. For a deeper financial comparison including career trajectory, see Is the CRT Certification Worth It? Complete ROI Analysis 2026 and CRT Salary Guide 2026: Complete Earnings Analysis.

If you're still building foundational knowledge of what the credential even represents, our primer on What Is CRT Certification? is a good starting point before you commit to a registration date.

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