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What changes on the 2027 NBRC RT exam
Starting January 4, 2027, the NBRC replaces the Therapist Multiple-Choice (TMC) exam and the Clinical Simulation Exam (CSE) with one test: the Respiratory Therapy Examination (RTE). Here is what is changing, in plain language, with a link to the NBRC source for each fact.
The short version
| What | 2027 Respiratory Therapy Examination |
|---|---|
| First available | January 4, 2027[2] |
| Items | 185 multiple-choice items: 160 scored + 25 pretest[2] |
| Time limit | 4 hours[2] |
| Sections | Breadth of Knowledge (100 scored items) and Depth of Clinical Judgment (60 scored items)[3] |
| Credentials | Two cut scores: the low cut score earns the CRT, the high cut score earns the RRT[2] |
| Fee | $360 new applicants, $300 repeat applicants[2] |
| Applications open | October 1, 2026, through the Practitioner Portal[2] |
Start free: 50 questions
Why the NBRC is changing the exam
The NBRC Board of Trustees voted on April 9, 2022, to move to a single multiple-choice exam and eliminate the Clinical Simulation Examination, to "minimize barriers to graduates" while keeping the standards of the CRT and RRT credentials.[1] The NBRC says it intends to keep the standards for both credentials the same, "rather than make it easier or more difficult." One practical change: from 2027, people who earn the CRT must also answer enough clinical-judgment items correctly to pass overall, because the clinical-judgment section is part of the one exam.[1]
Key dates if you are testing around the switch
- December 15, 2026: last day the NBRC accepts TMC applications.[2]
- December 31, 2026: last day to take the TMC. The CRT-to-Registry admission policy also ends on this date.[2]
- Through December 31, 2027: the CSE stays available, but only for people who passed the TMC at the high cut score before December 31, 2026. They can also choose the new exam instead and earn the RRT at its high cut score.[2][1]
- January 4, 2027: the Respiratory Therapy Examination launches.[2]
Who can take it
You must be 18 or older and a graduate of an entry-into-practice respiratory therapy program supported or accredited by CoARC, with at least an associate degree. Holders of the CSRT RRT credential also qualify.[2]
Retakes
You can attempt the RTE three times, then you must wait at least 120 days between attempts. Earlier TMC and CSE attempts do not count toward this limit. If you already hold the CRT and score below the low cut score on the RTE, you do not lose your CRT.[2]
What is on it
The Detailed Content Outline (DCO) is the official content definition. The Breadth of Knowledge section has three domains: Patient Data (25 items), Management of Devices and Patient Safety Procedures (25), and Initiation and Modification of Interventions (50). The Depth of Clinical Judgment section has 60 items organized by patient condition, clinical judgment type, and setting.[3] Our guide on how the clinical judgment section works breaks that down.
Official practice tools
- The NBRC offers a free RT practice examination built with the same software as the real exam.[2][5]
- Official Self-Assessment Examinations (SAEs) are sold through the NBRC's testing agency. The NBRC says SAEs are the only products that give the exam committees' rationale for each best answer.[2]
- A virtual calculator is built into the exam software.[4]
The NBRC "does not endorse or support any review programs."[4] That includes TidalPrep. Use the NBRC's own practice exam and SAEs, and use review tools like ours for volume and explanations.
What this means for how you study
This part is our advice, not NBRC policy. Study from the 2027 DCO, not an old TMC or CSE outline. Weight your time like the exam does: Interventions is half of the Breadth section. Practice clinical-judgment items as their own skill, because the CRT now depends on them too. And take a full-length timed practice exam at least once: 185 items in 4 hours is about 78 seconds per item.
Take the free mock