Respiratory therapists earn a median salary of about $80,660 in hospital settings, with the national figures climbing above $100,000 in the highest-paying states. Getting into the field requires an associate or bachelor’s degree from an accredited program, passing national credentialing exams, and obtaining a state license. Here’s what the full path looks like and what you can expect to earn at each stage.
What Respiratory Therapists Do
Respiratory therapists treat patients who have trouble breathing, from premature newborns with underdeveloped lungs to adults managing chronic conditions like asthma, COPD, and emphysema. Day-to-day work includes operating ventilators, administering breathing treatments, drawing and analyzing arterial blood gases, and responding to emergency codes when a patient stops breathing. Most work in hospitals, but you’ll also find respiratory therapists in outpatient clinics, skilled nursing facilities, home health agencies, and sleep disorder centers.
Education Requirements
You need at minimum an associate degree in respiratory care from a program accredited by the Commission on Accreditation for Respiratory Care (CoARC). An associate program typically takes two years of full-time study and covers anatomy, pharmacology, patient assessment, mechanical ventilation, and cardiopulmonary diagnostics. Clinical rotations in hospitals are built into the curriculum so you graduate with hands-on experience.
That said, the field is shifting toward a bachelor’s degree as the standard. Many employers now prefer or require a four-year degree, and some programs have begun offering master’s degrees in respiratory care for those interested in leadership, education, or advanced clinical roles. If you start with an associate degree to enter the workforce faster, bridge programs let you complete a bachelor’s while working.
Credentialing Exams
After graduating from a CoARC-accredited program, you’re eligible to sit for the national exams administered by the National Board for Respiratory Care (NBRC). There are two credential levels:
- Certified Respiratory Therapist (CRT): The entry-level credential, earned by passing a multiple-choice exam covering patient assessment, treatment protocols, and equipment management.
- Registered Respiratory Therapist (RRT): The advanced credential. After passing the CRT multiple-choice exam, you take an additional clinical simulation exam that tests your ability to make real-time patient care decisions. Graduates of all CoARC-accredited programs qualify to sit for the RRT exam.
The RRT is the credential most employers want. It opens the door to higher pay, specialty roles, and advancement opportunities. Even if your state only requires the CRT for licensure, earning the RRT early in your career is worth the effort.
State Licensing
State licensure is mandatory for respiratory therapists practicing in every U.S. state except Alaska. Requirements vary, but nearly all states require graduation from an accredited program, passing the NBRC exams, and submitting a license application with a fee. Most states also require continuing education credits to renew your license, typically every one to two years. Check your state’s medical or respiratory care licensing board for specific requirements and fees.
How Long the Process Takes
If you pursue an associate degree, you can be working as a licensed respiratory therapist in roughly two and a half years, accounting for the time to complete your degree, pass the NBRC exams, and process your state license. A bachelor’s degree adds another two years on the front end. Some students complete prerequisite courses like anatomy, chemistry, and college math before entering a respiratory care program, which can add a semester or two depending on your starting point.
Salary by Work Setting
Where you work has a meaningful impact on your paycheck. According to the Bureau of Labor Statistics, median annual wages for respiratory therapists in May 2024 broke down as follows by industry:
- Hospitals (state, local, and private): $80,660
- Skilled nursing facilities: $75,910
- Physician offices: $75,240
Hospitals employ the majority of respiratory therapists and tend to pay the most, partly because hospital RTs handle the most critical patients and work rotating shifts that include nights, weekends, and holidays. Shift differentials for overnight or weekend work can add several thousand dollars a year to your base pay.
Salary by Location
Geography creates significant pay differences. Based on May 2023 BLS data, the highest-paying states offered annual mean wages well above the national figure. The top of the range exceeded $100,000 in some states, while others fell closer to $93,000 or $94,000. Cost of living plays a role in these differences, so a higher salary in an expensive metro area doesn’t always translate to more spending power. Still, respiratory therapists in high-demand urban markets and states with large hospital systems generally earn more than those in rural areas.
How to Increase Your Earning Potential
Several factors push respiratory therapy salaries higher over the course of a career. Earning the RRT credential rather than stopping at the CRT is the single most important step, since most hospitals tie pay scales to credential level. Beyond that, specialty certifications from the NBRC in areas like neonatal/pediatric care, adult critical care, and pulmonary function testing signal advanced expertise and often come with pay bumps.
A bachelor’s or master’s degree also opens doors to roles that pay more: clinical specialist positions, department supervisors, education coordinators, and program directors at respiratory care schools. Some respiratory therapists move into related fields like polysomnography (sleep studies) or case management, where their clinical background commands a premium.
Experience matters, too. Entry-level respiratory therapists typically start at the lower end of the pay scale, but salaries climb steadily with three to five years of hospital experience. Travel respiratory therapy, where you take short-term contracts at hospitals facing staffing shortages, can pay significantly more than permanent positions, though the work requires flexibility and willingness to relocate.
Job Outlook
Demand for respiratory therapists remains strong. An aging population, rising rates of chronic respiratory diseases, and the ongoing need for critical care staffing keep this field growing faster than the average for all occupations. Hospitals, in particular, have struggled to fill respiratory therapy positions in recent years, which gives new graduates leverage when negotiating starting salaries and signing bonuses.