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2027 RTE explained: the TMC and CSE combined into one exam
The short answers to the questions RT students and CRTs are asking about the 2027 NBRC Respiratory Therapy Examination, the exam that merges the TMC and the clinical simulation exam. Every answer links to the NBRC source.
What is the 2027 Respiratory Therapy Examination (RTE)?
It is the single NBRC exam that replaces the Therapist Multiple-Choice (TMC) exam and the Clinical Simulation Exam (CSE). It launches January 4, 2027, and one test now leads to both the CRT and the RRT.[1][2]
Are the TMC and CSE really being combined into one exam?
Yes. The NBRC Board of Trustees voted on April 9, 2022, to move to one multiple-choice exam and eliminate the CSE. Clinical judgment is still tested, but as multiple-choice items in the Depth of Clinical Judgment section instead of branching simulations.[2]
How many questions are on the RTE, and how long is it?
185 multiple-choice items (160 scored and 25 unscored pretest items), with a 4-hour time limit.[1] That works out to about 78 seconds per item.
How is the RTE split up?
The 160 scored items are 100 Breadth of Knowledge items (Patient Data 25, Management of Devices and Patient Safety Procedures 25, Initiation and Modification of Interventions 50) and 60 Depth of Clinical Judgment items.[3]
How do I earn the CRT versus the RRT on one exam?
The RTE has two cut scores. Scoring at or above the low cut earns the CRT; scoring at or above the high cut earns the RRT.[1]
How much does the RTE cost?
$360 for new applicants and $300 for repeat applicants. The NBRC says this saves $30 for first-time candidates and $50 for repeat candidates compared with taking the TMC and CSE separately.[1]
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When can I apply?
Applications opened October 1, 2026, through the NBRC Practitioner Portal.[1]
What is the last day to take the TMC?
The NBRC accepts TMC applications through December 15, 2026, and the last day to take the TMC is December 31, 2026.[1]
Can I still take the CSE in 2027?
Only if you passed the TMC at the high cut score before December 31, 2026. For those candidates the CSE stays available through December 31, 2027, or they can take the RTE instead and earn the RRT at its high cut.[1]
Who is eligible for the RTE?
You must be at least 18 and a graduate of a CoARC-supported or accredited entry-into-practice respiratory therapy program with at least an associate degree. Holders of the CSRT RRT credential also qualify. The CRT-to-Registry admission policy ends December 31, 2026.[1]
How many times can I retake the RTE?
Three attempts, then at least 120 days between attempts. Earlier TMC and CSE attempts do not count toward this limit.[1]
If I already hold the CRT and score below the low cut, do I lose it?
No. Your CRT stays in place, and you can keep attempting the RTE for the RRT.[1]
Is the RTE harder than the TMC?
The NBRC says it intends to keep the standards for both credentials the same, "rather than make it easier or more difficult." One real change: CRT candidates must now also pass the clinical judgment portion.[2]
Does the Credential Maintenance Program (CMP) change?
No. The NBRC says the CMP is not changing.[1]
Is there an official RTE practice test?
Yes. The NBRC offers a free RT practice exam built in the same software as the real exam, plus paid Self-Assessment Examinations (SAEs): version 1 released in July 2026 and version 2 is planned for March 2027.[1] See our guide to RTE practice exams.
The NBRC "does not endorse or support any review programs,"[4] and that includes TidalPrep. We are an independent study aid.
Related guides
- What changes on the 2027 NBRC RT exam
- From the CSE to RTE clinical judgment
- TMC vs RTE: cut scores and format
- Free 6-week RTE study plan (PDF)
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