- What Is A CRT, Exactly?
- Who Issues the CRT and Through What Exam
- TMC Exam Format and Question Style
- The Three Content Domains a CRT Candidate Must Master
- CRT vs. High-Cut: Understanding the Two Score Lines
- Who Can Sit for the CRT Credential
- Fees, Deadlines, and the 2027 Transition
- Keeping the CRT Active After You Pass
- Who Hires Respiratory Therapists With a CRT
- Mapping a Study Plan to the Blueprint
- Frequently Asked Questions
- CRT stands for Certified Respiratory Therapist, awarded by the NBRC after passing the TMC Exam's low cut score.
- The TMC Exam has 160 questions (140 scored, 20 unscored pretest) with a 3-hour limit, delivered by PSI.
- Scored items split 50/20/70 across three domains, with Interventions carrying 70 of 140 points.
- New applicants pay USD 190; repeat applicants pay USD 150, through the December 31, 2026 testing window.
What Is A CRT, Exactly?
CRT stands for Certified Respiratory Therapist. It is a credential issued by the National Board for Respiratory Care (NBRC) to candidates who pass the Therapist Multiple-Choice (TMC) Examination at or above the low cut score. It is one of the two credentialing tiers respiratory therapists pursue early in their careers, and it is the entry-level professional certification most graduates of accredited respiratory therapy programs target immediately after finishing school.
If you've landed here after searching a more general phrase like What Is CRT? or CRT Meaning, it's worth noting that several unrelated industries use the same three letters. This article, and everything else on this site, refers specifically to the respiratory care credential - not any other certification that happens to share the initials.
Who Issues the CRT and Through What Exam
The NBRC develops and owns the credentialing pathway; the actual computer-based testing is administered through PSI test centers. The exam that leads to the CRT credential - through the end of 2026 - is the TMC Exam. Passing this single exam at the low cut score earns the CRT designation. Candidates who clear the higher cut score on the same exam also establish eligibility for the Clinical Simulation Examination (CSE), which is the next step toward the RRT credential, provided they also meet the separate RRT admission requirements.
This two-tier scoring structure means the TMC Exam is really doing two jobs at once: it certifies entry-level competence (CRT) and, for stronger performers, opens the door to advanced-practice credentialing. For a deeper breakdown of how those two cut lines work, see CRT Passing Score 2026: Exactly What You Need to Pass.
TMC Exam Format and Question Style
The TMC Exam is a computer-based test consisting of 160 multiple-choice questions: 140 are scored and 20 are unscored pretest items used by the NBRC to evaluate future questions. Candidates don't know which items are scored and which are pretest, so every question should be treated as if it counts. The exam has a 3-hour time limit, and an onscreen calculator is provided for any computation-based items. There is no penalty for guessing, so leaving a question blank is never strategically better than selecting an answer.
Because the exam blends recall-based questions with application and analysis items - asking you to interpret data, troubleshoot equipment, or decide on a clinical intervention - it rewards candidates who can reason through scenarios, not just memorize facts. A closer look at how difficult that reasoning actually is can be found in How Hard Is the CRT Exam? Complete Difficulty Guide 2026.
Key Takeaway
Practice under a 3-hour timed format before test day. Pacing across 160 questions - many involving multi-step clinical reasoning - is its own skill, separate from knowing the content.
The Three Content Domains a CRT Candidate Must Master
The TMC Exam blueprint, effective from January 2020 through December 2026, organizes scored content into three domains. Official scored-item allocations are 50/20/70 across the three areas, meaning Interventions alone accounts for 70 of the 140 scored items - exactly half the scored exam.
Domain 1: Patient Data
This domain covers gathering and interpreting the clinical information that drives every respiratory care decision.
- Reviewing patient history, physical findings, and chart data
- Interpreting lab values, arterial blood gases, and imaging results
- Performing and evaluating bedside assessments and monitoring data
Domain 2: Troubleshooting and Quality Control of Devices, and Infection Control
This domain tests your ability to keep equipment functioning safely and to prevent transmission of infection in respiratory care settings.
- Recognizing equipment malfunction and taking corrective action
- Performing quality control checks on devices before and during use
- Applying infection-control principles to equipment and patient care
Domain 3: Initiation and Modification of Interventions
As the largest domain by far, this is where most of the exam's weight sits - clinical decision-making about what therapy to start, adjust, or stop.
- Initiating oxygen therapy, airway management, and ventilatory support
- Modifying treatment plans based on patient response
- Executing emergency and life-support procedures appropriately
Because Interventions represents half the scored questions, candidates who allocate study time evenly across all three domains often shortchange the area with the greatest point value. A full breakdown of each domain's subtopics and sample question styles is available in CRT Exam Domains 2026: Complete Guide to All 3 Content Areas.
| Domain | Scored Items | Share of Scored Exam |
|---|---|---|
| Patient Data | 50 | ~36% |
| Troubleshooting, QC & Infection Control | 20 | ~14% |
| Initiation and Modification of Interventions | 70 | ~50% |
CRT vs. High-Cut: Understanding the Two Score Lines
The TMC Exam uses two cut scores. Meeting the lower cut score earns the CRT credential outright. Meeting the higher cut score does two things: it also earns the CRT, and it establishes eligibility to sit for the CSE - the pathway toward RRT - assuming the separate RRT admission requirements (like degree level) are satisfied.
According to NBRC's 2025 data, low-cut pass rates were 78.5% for new candidates and 48.9% for repeat candidates; high-cut pass rates were 68.2% for new candidates and 29.4% for repeat candidates. The gap between new-candidate and repeat-candidate performance is significant, which underscores why first-attempt preparation matters more than treating the exam as something you can simply retake until it sticks. For the full data context, see CRT Pass Rate 2026: What the Data Shows.
Who Can Sit for the CRT Credential
Standard entry requirements for the TMC Exam are straightforward: candidates must be at least 18 years old and must have graduated with at least an associate degree from a CoARC-supported or accredited entry-to-practice respiratory therapy program. There is no separate work-experience requirement layered on top for the CRT-level exam itself - program completion and age are the gating factors.
If you're still in school or evaluating programs, a detailed walkthrough of documentation, program accreditation checks, and application steps is covered in CRT Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Fees, Deadlines, and the 2027 Transition
The TMC Exam fee is USD 190 for new applicants and USD 150 for repeat applicants. This fee structure and the current exam itself remain in effect only through a fixed window: TMC applications close December 15, 2026, and testing under this blueprint ends December 31, 2026.
Starting January 4, 2027, a replacement exam - the Respiratory Therapy Examination - takes over. It expands to 185 questions (160 scored plus 25 pretest), extends the time limit to 4 hours, and carries higher fees of USD 360 for new applicants and USD 300 for repeat applicants. It still retains separate CRT and RRT cut scores, similar in spirit to today's dual cut-score model, but it is a distinct question bank from the current TMC Exam. Anyone planning their timeline should treat 2026 and 2027 as two separate exam eras rather than assume continuity of content or pricing.
For candidates weighing when to apply, a full cost comparison - including CE maintenance fees - is broken out in CRT Certification Cost 2026: Complete Pricing Breakdown, and exact scheduling windows are detailed in CRT Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Key Takeaway
If you're eligible now, testing before the December 31, 2026 deadline means a shorter exam, a lower fee, and a familiar 140-scored-item blueprint - advantages that disappear once the 2027 exam begins.
Keeping the CRT Active After You Pass
Passing the TMC Exam is not a one-time event that certifies you for life without upkeep. The CRT credential follows a five-year maintenance cycle. Within each cycle, credential holders complete quarterly assessments, and depending on performance, either 0, 15, or 30 continuing education (CE) credits are required. There is also an examination-based renewal route available as an alternative to the CE pathway.
Maintenance carries its own cost: a Continuing Membership/Maintenance Program (CMP) fee of USD 125 per five-year cycle, typically collected as USD 25 per year. Budgeting for this ongoing fee - on top of the initial exam fee - is part of realistically planning the full cost of holding the credential over time.
Who Hires Respiratory Therapists With a CRT
The CRT credential is the baseline hiring qualification at most hospitals, skilled nursing facilities, home care companies, and durable medical equipment providers that employ respiratory therapists. Common CRT-holder roles include:
- Acute-care hospital respiratory therapist covering general floors, emergency departments, and step-down units
- Skilled nursing and long-term acute care respiratory support
- Home respiratory equipment setup and patient education
- Sleep lab and pulmonary function testing support (often alongside additional credentials)
Employers frequently use the CRT as a minimum floor and prefer or require RRT for more advanced clinical roles, ICU assignments, or supervisory positions. If you're evaluating career trajectory and pay ranges tied to the credential, see CRT Salary Guide 2026: Complete Earnings Analysis and Is the CRT Certification Worth It? Complete ROI Analysis 2026. For active openings and how employers describe the credential in postings, browse CRT Jobs.
Mapping a Study Plan to the Blueprint
Because the domains carry unequal weight, a generic week-by-week study calendar wastes time if it treats all three domains equally. A blueprint-aligned plan spends the most hours where the points are - Interventions - while still building enough Patient Data and Troubleshooting/Infection Control competency to avoid leaving easy points on the table.
Patient Data Foundations
- Drill ABG interpretation, lab values, and chart-review scenarios
- Practice bedside assessment question formats under timed conditions
Troubleshooting, QC & Infection Control
- Work through device malfunction scenarios for ventilators, nebulizers, and oxygen delivery systems
- Review quality-control check sequences and infection-control protocols
Interventions - Heaviest Weight
- Focus the majority of remaining study time here, since it's 70 of 140 scored items
- Run full-length timed practice sets mixing all three domains to build exam-day pacing
For a structured, week-by-week version of this approach with more detail on resources and pacing benchmarks, see CRT Study Guide 2026: How to Pass on Your First Attempt. For a condensed reference you can review in the final days before testing, check the CRT Cheat Sheet 2026: One-Page Review of Must-Know Facts.
Whichever schedule you follow, timed practice testing that mirrors the real 160-question, 3-hour format matters more than passive review. You can run full-length simulated exams on our practice test platform to get comfortable with pacing before you sit for the real TMC Exam. Repeated exposure to realistic practice questions also helps surface knowledge gaps in Interventions early, while there's still time to correct them.
Frequently Asked Questions
CRT stands for Certified Respiratory Therapist, a credential awarded by the NBRC after passing the TMC Exam at the low cut score. For more on the terminology itself, see What Does CRT Stand For?
No. CRT is earned by meeting the TMC Exam's low cut score. Meeting the higher cut score on the same exam instead establishes eligibility for the Clinical Simulation Examination, which leads to the RRT credential once separate RRT admission requirements are also met.
The TMC Exam has 160 multiple-choice questions total: 140 are scored and 20 are unscored pretest items. Candidates have a 3-hour time limit to complete it.
New applicants pay USD 190 and repeat applicants pay USD 150 for the TMC Exam. This applies through the December 31, 2026 testing window; fees change under the exam replacing it starting in 2027.
Yes. The CRT follows a five-year maintenance cycle involving quarterly assessments, 0-30 CE credits depending on performance (or an exam-based renewal route), and a CMP fee of USD 125 per cycle, usually billed as USD 25 annually.