RT (CRT/RRT)
Therapist Multiple-Choice (TMC) Examination - CRT/RRT
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ExploreAbout this exam
The Certified Respiratory Therapist (CRT) is the entry-level credential in respiratory care. Candidates earn it by passing the Therapist Multiple-Choice (TMC) Examination, a computer-based test delivered at PSI assessment centers. The TMC objectively measures the essential knowledge, skills, and abilities required of respiratory therapists at entry into practice, and it doubles as the gateway to the Registered Respiratory Therapist credential: a high cut score makes a candidate eligible for the Clinical Simulation Examination, provided the other eligibility requirements are met. All 49 states that regulate respiratory care use the CRT or RRT credential as the basis for licensure, so most candidates treat the TMC as the highest-stakes test of their training.
Scored content runs across the full entry-level scope of practice - collecting and evaluating patient data, oxygen supply and therapy, bronchial hygiene, airway management, and mechanical ventilation - presented largely as clinical scenarios and data interpretation rather than isolated recall. Preparation should be built around the detailed content outline in force for your test date, the free practice examination, and timed runs that rehearse the three-hour pacing. The sections below cover format, scoring, fees, retakes, and study strategy.
What you'll study
About RT (CRT/RRT) preparation
How many questions are on the TMC Examination, and how much time do I get?
The TMC Examination has 160 multiple-choice items - 140 scored and 20 pretest items that do not count toward your score - taken over a three-hour period. Pretest items are mixed in and not identified, so treat every question as if it counts. You receive information about your score at the test center after completing the examination.
What score do I need in order to pass?
Two cut scores are established. Achieving the low cut score earns the CRT credential; achieving the high cut score earns the CRT credential and makes you eligible for the Clinical Simulation Examination, provided you meet the other eligibility requirements. Numeric cut scores are not published. If you do not reach the low cut score, you must reapply for the TMC Examination.
Does a high cut score automatically make me eligible for the CSE?
No. You must meet the CSE eligibility requirements regardless of your examination score. A high cut score opens the door only if you also satisfy the admission requirements for the examinations associated with the RRT credential. Confirm your eligibility with the NBRC before paying for and scheduling the Clinical Simulation Examination.
How many times can I retake the examination?
Candidates may attempt the TMC Examination three times; after three attempts, a minimum wait of 120 days is required between any subsequent attempt. If you already hold the CRT credential and score below the low cut score, you do not lose it - you may retake as many times as needed to regain RRT eligibility or become CSE-eligible.
What does the examination cost?
The TMC Examination costs $190 for new applicants and $150 for repeat applicants. There are no application deadlines: once you meet the admission requirements you may submit your application and fee at any time. Credit-card applications submitted online are processed immediately, while mailed applications take approximately five to seven business days.
How hard is it, and where do candidates typically go wrong?
It is an entry-level examination, but it spans the entire scope of practice, and three hours for 160 items leaves little slack. Common mistakes are slow starts that force a rushed final third, guessing at data-interpretation items instead of working the numbers, and studying by topic comfort rather than by the question counts in the content outline.
What should I study first?
Start with the detailed content outline in force for your test date, since the examination changes in January 2027. Use the number of questions per section to set study priorities, take the free practice examination to see how items are written, then consider the Self-Assessment Examination, which has the same number of questions as the credentialing examination and supplies the committees' rationale for each answer.
What changes in January 2027?
Beginning January 2027 the TMC Examination is replaced by the Respiratory Therapy Examination: 185 multiple-choice items (160 scored and 25 pretest) taken over a four-hour period. On that examination the low cut score earns the CRT credential and the high cut score earns the RRT credential. The CRT-to-Registry admission policies are eliminated effective December 31, 2026.
Can foreign education qualify me for the examination?
No. Foreign respiratory therapy education does not qualify for admission to the TMC Examination; you must have a minimum of an associate degree from an accredited respiratory therapy education program. Coursework taken abroad counts toward related admission pathways only if an accredited U.S. college or university awards transfer credit and documents it on an official transcript.