RRT Certification Cost 2026: Complete Pricing Breakdown

The Fee Snapshot: What NBRC Charges for the Current RRT Route

The Registered Respiratory Therapist credential is awarded by the National Board for Respiratory Care (NBRC), and the 2026 route runs through two examinations: the Therapist Multiple-Choice Examination (TMC) at the high cut score, followed by the Clinical Simulation Examination (CSE). Passing the TMC alone does not award the RRT. Because the credential requires both, the real cost is the sum of two fees, not one.

Those totals cover examination fees only. They exclude your respiratory therapy program, study materials, professional membership dues, and any state licensure charges. If you are still deciding whether the whole investment makes sense, our ROI analysis of the RRT credential and the RRT salary guide put the exam fees in context against career earnings.

Why You Pay Twice: TMC and CSE Are Separate Examinations

A common budgeting mistake is assuming the RRT is a single appointment with a single fee. It is not. The TMC and CSE are separate examinations with separate fees, separate formats, and separate score outcomes. Understanding what each fee buys helps you judge where to invest preparation effort.

What the TMC fee covers

The TMC contains 160 multiple-choice questions: 140 scored and 20 pretest items, with three hours allowed. Pretest items are unscored questions NBRC uses to evaluate future content, and you cannot tell which ones they are. The TMC is organized around three exam-objective headings that you will see in the detailed content outline:

Interventions carries the most scored items on the TMC, which is worth remembering when you decide where practice-question spending will pay off. For a fuller breakdown of how these headings are organized, see our guide to the RRT exam content areas.

What the CSE fee covers

The CSE contains 22 interactive clinical-simulation problems: 20 scored and two pretest, with four hours allowed. Each problem can contain multiple sections and choices, so the CSE reads very differently from a list of independent questions. The CSE outline uses its own exam-objective headings, which intentionally repeat the TMC headings with one wording difference:

• Domain 4: Patient Data
• Domain 5: Troubleshooting and Quality Control of Equipment, and Infection Control
• Domain 6: Initiation and Modification of Interventions

Note the shift from "Devices" in Domain 2 to "Equipment" in Domain 5. The six domains are headings across two assessments, not a single combined six-domain examination. Per the 2026 Candidate Handbook, the CSE yields one score summed across the examination rather than separate pass thresholds for information gathering and decision making.

What a Retake Really Costs

The fee structure is deliberately asymmetric. A repeat TMC costs USD 150, which is USD 40 less than a new attempt. A repeat CSE costs USD 200, identical to a new attempt. A candidate who needs one extra try at each exam adds USD 350 on top of the original USD 390.

Beyond fees, retakes carry a time cost. For each examination, three initial attempts are permitted without the subsequent-attempt waiting interval; later attempts require 120 days between attempts. Each month of delay is a month at a lower pay tier if your employer ties compensation to credential status.

Published calendar-2025 figures show why budgeting for a retake is prudent rather than pessimistic. TMC high-cut pass rates were 68.2% for new candidates and 29.4% for repeat candidates, while CSE rates were 63.6% new and 53.0% repeat. These are separate cohorts, not a combined probability of earning the RRT, but they show that repeat attempts are common enough to plan around. Our pass rate analysis and difficulty guide unpack those numbers in more detail.

The One-Time AARC Member Discount

Eligible American Association for Respiratory Care (AARC) members can receive a one-time USD 40 discount on their first CSE, lowering the CSE fee from USD 200 to USD 160 and the standard route total from USD 390 to USD 350. Three details matter:

• The discount applies to the first CSE only, not to repeats and not to the TMC.
• It requires using the prescribed application process, so membership alone does not guarantee the reduction. Confirm the steps with NBRC before you submit payment.
• Whether it pays off depends on membership dues, which sit outside NBRC's exam fees. If you would join the AARC anyway for networking or resources, the discount is a bonus; if not, compare the dues against the USD 40 saved.

Costs the Exam Fees Do Not Include

The USD 350 to USD 390 range is only the visible slice of total expense. Most candidates spend more in the categories below, and none of them are set by NBRC.

• Education. Standard eligibility requires age 18 or older and at least an associate degree from an eligible CoARC-supported or accredited entry-into-practice respiratory program. Tuition is by far the largest cost on the path. Read the details in our RRT requirements guide, and see RRT training for program options.
• Preparation materials. Question banks, review texts, and simulation practice. The CSE's interactive format makes simulation-style practice a different purchase than flashcards.
• Membership dues. AARC or similar professional memberships are optional but may reduce the CSE fee as described above.
• State licensure. Most states license respiratory therapists separately from NBRC credentialing, with their own fees and renewal schedules. These vary by state, so check your state board directly.
• Testing logistics. Examinations are delivered at supervised PSI assessment centers. Live remote proctoring ended December 31, 2024, so at-home delivery is not a current option for initial examinations. Budget for travel, parking, and possibly time off work. Examinations are closed book, only the supplied virtual calculator is allowed, and break time counts against examination time.

The 2027 Transition: Why the Calendar Affects Your Budget

NBRC is replacing the two-exam RRT route with a single Respiratory Therapy Examination effective January 2027. The new exam contains 185 multiple-choice questions (160 scored, 25 pretest) with four hours allowed, and fees of USD 360 new and USD 300 repeat, with lower and higher cut scores leading directly to CRT or RRT. Applications opened October 1, 2026, and first examination availability is January 4, 2027. That is a different examination with its own outline and should not be blended with the TMC and CSE content discussed above.

For current-route candidates, the key dates are:

• TMC applications close December 15, 2026, and TMC testing ends December 31, 2026.
• The CSE remains available through December 31, 2027, but only for the eligible transition cohort.
• The CRT-to-registry admission policy expires December 31, 2026.

Conditional legacy CRT routes exist, such as four CRT years plus 62 specified college hours, but those exceptions do not automatically continue into the 2027 pathway. Candidates deciding between finishing the TMC/CSE route and waiting for the 2027 exam should compare fee totals (USD 390 for the current route versus USD 360 for the single new exam) alongside eligibility, timing risk, and retake structure. Our exam dates and deadlines guide tracks the scheduling windows.

After the Credential: Five-Year Maintenance Costs

Earning the RRT starts a maintenance obligation through NBRC's five-year Credential Maintenance Program (CMP), with a published exemption for credentials earned before July 1, 2002. CMP payment is USD 25 per payment year before 2027 and USD 30 beginning in 2027. The CMP brochure's parsed text and rendered page show mixed old and new fee versions, but the live NBRC FAQ confirms the 2027 effective date, so budget at the higher figure for later years.

Maintenance routes include:

• Assessment-based continuing education of zero, 15, or 30 Category I credits depending on performance.
• Passing the highest relevant examination during the final year of the maintenance cycle.
• Earning an additional qualifying NBRC credential.

The assessment-based route is the notable budgeting lever: stronger performance can reduce the number of continuing education credits you must buy or earn, which lowers out-of-pocket cost over the cycle.

Where to Spend Prep Money by Domain

Because a retake is costly, allocate preparation spending where the scored items concentrate. On the TMC, Domain 3 (Initiation and Modification of Interventions) carries 70 scored items versus 50 for Domain 1 and 20 for Domain 2. No percentages are published in the outline excerpt we rely on, so think in item counts rather than weights.

• Domain 1 and Domain 4 (Patient Data): Practice interpreting blood gases, imaging findings, pulmonary function results, and bedside assessments. On the CSE, this appears as the information-gathering portion of each simulation.
• Domain 2 and Domain 5 (Troubleshooting, Quality Control, Infection Control): Ventilator alarms, circuit and humidification problems, calibration, and infection prevention. This is the smallest TMC allocation, so avoid over-investing here relative to Domain 3.
• Domain 3 and Domain 6 (Initiation and Modification of Interventions): Ventilator adjustments, oxygen and aerosol therapy changes, airway management decisions, and weaning. This is the heaviest scored area on the TMC and the decision-making core of every CSE case.

The CSE draws its 20 scored problems from case-assembly groups: Adult Chronic Airways Disease (seven), Adult Medical or Surgical (five), Adult Cardiovascular (two), Pediatric (two), Neonatal (two), Adult Trauma (one), and Adult Neurological or Neuromuscular (one). These are case groups, not additional domains, but they tell you that adult chronic airways disease and adult medical or surgical cases dominate the exam, so simulation practice should lean that way. Our cheat sheet and study guide cover the content itself.

A Practical Budgeting Timeline

This is the one place where scheduling advice belongs: tying spending to the exam sequence so you never pay for a CSE before you are eligible for it.

You can test your readiness cheaply before paying any exam fee by working through realistic questions on our main practice test site. Spending a few hours on timed practice to find weak domains costs far less than a repeat fee. If you are weighing a job outlook before committing, see RRT jobs for who hires, and the passing score explainer for what we can and cannot say about cut scores (current numeric cut scores are unverified).

Frequently Asked Questions