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TMC vs RTE: cut scores and format
How the old two-exam path (TMC, then CSE) compares with the single 2027 Respiratory Therapy Examination: items, time, scoring, and how the CRT and RRT are awarded.
| TMC (through Dec 31, 2026) | CSE (through Dec 31, 2027, eligible TMC high-cut passers only) | RTE (from Jan 4, 2027) | |
|---|---|---|---|
| Items | 160 multiple-choice (140 scored + 20 pretest)[1] | 22 problems (20 scored + 2 pretest)[2] | 185 multiple-choice (160 scored + 25 pretest)[3] |
| Time | 3 hours[1] | 4 hours[2] | 4 hours[3] |
| Low cut score | CRT[1] | One cut score; passing (with a high-cut TMC) leads to the RRT[2][5] | CRT[3] |
| High cut score | CRT + eligibility for the CSE[1] | RRT[3] | |
| Fee | Separate fees for each exam | $360 new / $300 repeat. The NBRC says this saves $30 compared with a first attempt at the TMC and CSE, and $50 for repeat candidates.[3] | |
How scoring works
For NBRC multiple-choice exams, scores are reported as raw scores: each item is worth one point, and your total is compared with the cut score. The cut score comes from a study that uses a panel of subject matter experts to define the minimum acceptable performance.[5] Pretest items don't count toward your score. On the RTE, that is 25 of the 185 items.[3]
On the NBRC pages we checked (October 30, 2026), the NBRC had not published numeric cut scores for the RTE. Be wary of anyone quoting an exact RTE passing number. Your score report is emailed to you after the exam.[5]
The RTE Breadth of Knowledge section
| Domain | Items per form |
|---|---|
| I. Patient Data | 25 |
| II. Management of Devices and Patient Safety Procedures | 25 |
| III. Initiation and Modification of Interventions | 50 |
| Total | 100 |
Of those 100 items, 23 are at the recall level and 77 are integration items, which ask you to apply or analyze information. Each Breadth pool also includes at least 5 ethics items, though a given form may not include one.[4] The other 60 scored items are the Depth of Clinical Judgment section.[4]
Pacing
Our own math: 4 hours for 185 items is about 78 seconds per item. The TMC was 3 hours for 160 items, about 68 seconds per item. You get a little more time per item, but the session is an hour longer. The NBRC lets you take breaks whenever you wish, but the clock keeps running.[5]
Retakes
The TMC, CSE, and RTE each allow 3 attempts without waiting, then 120 days between attempts.[5] Earlier TMC and CSE attempts do not count toward your RTE attempts.[3]
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Sources
- NBRC: Certified Respiratory Therapist (TMC and RT exam)
- NBRC: Registered Respiratory Therapist (TMC, CSE, and RT exam scoring)
- NBRC: CRT and RRT, RT Examination page and FAQs
- NBRC: The Respiratory Therapy Examination Detailed Content Outline, effective January 2027 (PDF)
- NBRC Candidate Handbook, rev. 09.08.26 (PDF)