Respiratory Therapist Licensing by State

Respiratory therapists (RTs) in the United States must hold a state-issued license to practice in most states. Licensing is governed by individual state boards, with the NBRC examination — either the CRT (Certified Respiratory Therapist) or RRT (Registered Respiratory Therapist) — serving as the primary national credentialing standard. Requirements vary significantly by state in several important ways: some states require the RRT as the minimum credential while others accept the CRT; CE requirements range from 12 to 30 hours per renewal cycle; and a small but growing number of states have enacted the Respiratory Care Interstate Compact (RCIC).

A small number of states do not require individual RT licensure — instead regulating at the facility level. Each state guide identifies which model applies and what it means for travel RTs and relocating practitioners.

The Respiratory Care Interstate Compact (RCIC) — What You Need to Know

The Respiratory Care Interstate Compact (RCIC) is a new interstate agreement that allows eligible licensed respiratory therapists to obtain compact privileges to practice in other member states without obtaining a separate full license in each state. The RCIC was developed by the American Association for Respiratory Care (AARC) in partnership with the Council of State Governments (CSG) and the Department of Defense.

Respiratory Therapist Licensing Guides by State

Select a state below to view complete initial licensing and renewal requirements, including fees, CE hours, NBRC credential requirements, and RCIC status.

* RCIC enacted but compact privileges not yet being issued as of June 2026 — commission in early implementation. Verify current status at respiratorycarecompact.org.

Frequently Asked Questions

Do respiratory therapists need a state license in every state?

Most states require respiratory therapists to hold a state-issued license or certification to practice. A small number of states do not regulate RT practice at the individual level — check your specific state guide for the model that applies. In all states, employer credentialing standards (typically requiring active NBRC certification) apply independently of state licensing requirements.

What is the difference between the CRT and RRT credentials?

Both are NBRC credentials. The CRT (Certified Respiratory Therapist) is the entry-level credential; the RRT (Registered Respiratory Therapist) is the advanced credential requiring additional examination. Some states accept the CRT as sufficient for initial licensure while others require the RRT. Check your state guide for the minimum credential requirement — and always confirm employer standards separately, as many health systems require the RRT regardless of what the state mandates.

What is the RCIC and how does it affect multi-state practice?

The Respiratory Care Interstate Compact (RCIC) is a new interstate agreement allowing eligible licensed RTs to obtain compact privileges to practice in member states without a full separate license application. The RCIC reached its activation threshold in April 2026 and is in early implementation — compact privileges are not yet being issued as of June 2026. Of the 25 states in this database, Washington and Virginia have enacted the RCIC. Monitor current membership and implementation status at respiratorycarecompact.org.

How many CE hours are required to renew an RT license?

CE requirements vary by state, typically ranging from 12 to 30 hours per renewal period. Many states accept AARC-approved CE activities. Some states also accept current NBRC certification as satisfying CE requirements. Check your specific state renewal guide for current requirements.

What governing body oversees respiratory therapist licensing?

Respiratory therapy licensing is administered by different agencies depending on the state — some states have a dedicated respiratory care board, others regulate through a board of medicine, allied health board, or department of health. The NBRC administers the CRT and RRT national credentialing examinations accepted by all licensing states.