The field of respiratory therapy involves specialized healthcare professionals who treat patients with cardiopulmonary disorders, such as asthma, emphysema, and acute respiratory failure. These therapists manage life-supporting ventilation, administer medical gases, and perform diagnostic procedures to help individuals breathe more effectively. Entry into this career requires professional credentialing, with the industry recognizing two primary credentials: Certified Respiratory Therapist (CRT) and Registered Respiratory Therapist (RRT). Both designations are granted by the National Board for Respiratory Care (NBRC). Understanding the differences between the CRT and RRT is important, as the level of credentialing directly influences a therapist’s career trajectory, earning potential, and scope of practice.
Defining the Respiratory Therapy Credentials
The two main professional credentials in the field of respiratory care are the Certified Respiratory Therapist (CRT) and the Registered Respiratory Therapist (RRT). The National Board for Respiratory Care (NBRC) issues both designations, which signify different levels of assessed knowledge and clinical competency. The CRT is the entry-level qualification and is often the minimum requirement for state licensure. Conversely, the RRT is the advanced credential, representing a higher standard of expertise and clinical skill.
The Path to Becoming a Certified Respiratory Therapist
Earning the CRT credential is the initial step for entering the respiratory care field. Candidates must graduate from a respiratory therapy education program accredited by the Commission on Accreditation for Respiratory Care (CoARC). The minimum educational requirement is an associate degree from a CoARC-accredited program. Candidates must then pass the Therapist Multiple-Choice (TMC) Examination, which assesses fundamental knowledge and skills. Achieving the lower of two established cut scores on the TMC Examination awards the Certified Respiratory Therapist credential.
Achieving the Registered Respiratory Therapist Credential
The RRT credential signifies advanced professional achievement and requires a more rigorous examination process. To qualify, a candidate must first achieve the higher of the two cut scores on the Therapist Multiple-Choice (TMC) Examination. For instance, a score of at least 86 out of 140 scored items on the TMC typically earns the CRT, while a score of at least 92 is necessary to become eligible for the RRT track. Achieving this higher score qualifies the candidate to sit for the second required examination: the Clinical Simulation Examination (CSE). The CSE is a four-hour, scenario-based test composed of 22 patient management problems designed to simulate complex clinical practice situations.
Key Differences in Clinical Scope and Duties
While both CRTs and RRTs perform the core functions of a respiratory therapist, the RRT credential often translates to increased autonomy and preference for more complex roles. Both professionals administer oxygen therapy, manage mechanical ventilators, and perform diagnostic tests for cardiopulmonary conditions. However, the advanced knowledge demonstrated by passing the Clinical Simulation Examination allows RRTs to function with greater independence in decision-making, particularly in high-acuity environments.
Hospitals often prefer RRTs for specialized settings like Intensive Care Units (ICUs) or Neonatal Intensive Care Units (NICUs), where complex decision-making is routine. Employers view the RRT credential as an indication of a therapist’s ability to handle intricate cases and implement advanced respiratory care protocols. While CRTs can perform virtually all the same job duties, RRTs are more likely to be involved in developing patient treatment plans and taking on greater decision-making roles in critical situations.
Career Advancement and Salary Potential
Holding the RRT credential impacts a respiratory therapist’s potential for career advancement and higher earning power. The RRT is frequently a prerequisite for specialized roles, such as pulmonary function testing, or for pursuing advanced specializations like neonatal or pediatric respiratory care. Furthermore, the RRT is commonly required for supervisory, management, and educator positions within a healthcare facility.
Registered Respiratory Therapists consistently earn a higher annual salary than Certified Respiratory Therapists, reflecting their advanced qualifications. While salaries vary by region and experience, the median annual salary for RRTs typically ranges several thousand dollars higher than that of CRTs. For example, the median annual salary for CRTs is approximately $72,503, while RRTs earn a median of about $77,969 annually. This salary differential provides a tangible return on the investment required to achieve the advanced RRT certification.