To become a respiratory therapist in the US, you earn at least an associate's degree in respiratory therapy from an accredited program and get licensed, which every state except Alaska requires. Licensing usually means passing a state or professional certification exam, and many therapists go on from the CRT credential to the higher RRT.
Some employers want the RRT before they hire you, or within a set time after. So it's worth planning for both exams from the start.
The facts below come from the US Bureau of Labor Statistics (BLS) Occupational Outlook Handbook page for respiratory therapists, read on 26 October 2026. It's a careers guide about training, licensing and pay. It isn't clinical or health advice.
Respiratory therapist pay and jobs at a glance
| Measure | BLS figure |
|---|---|
| Median pay (May 2025) | $82,280 a year, $39.56 an hour |
| Lowest 10 in every 100 earned less than | $63,660 |
| Highest 10 in every 100 earned more than | $118,050 |
| Jobs in 2025 | 142,000 |
| Projected growth 2025 to 2035 | 9%, much faster than average |
| Openings each year | About 8,600 on average |
Those pay figures are as of October 2026, from the May 2025 BLS wage survey.
The route in, step by step
- Take biology, algebra, chemistry and physics in high school if you can. Some programs have prerequisites.
- Enrol in an accredited respiratory therapy program at a college or vocational-technical institute. An associate's degree is the typical minimum, and some employers prefer a bachelor's.
- Study human anatomy and physiology, and therapeutic and diagnostic procedures and tests, with supervised clinical experience built in.
- Sit the Certified Respiratory Therapist (CRT) exam, which is where most candidates start.
- Apply for your state licence. Requirements vary, but they usually include passing a state or professional certification exam.
- Take the additional exam to earn the Registered Respiratory Therapist (RRT) credential, if your employer requires it or you want the higher level.
CRT first, RRT next: why it matters
BLS describes two main levels of certification. Candidates typically sit the CRT exam first, and after passing it, CRTs may take an additional exam to earn the RRT. Some employers require the RRT before hiring or within a specified time on the job.
That's the part to plan around. If the hospitals near you ask for the RRT, you'll want to schedule that second exam soon after the first, rather than treating it as something for later. Ask employers in your area which credential they expect, because it can decide how quickly you're hired. Program staff usually know which local hospitals ask for the RRT, so that's a good first question at an open day.
| Credential | Full name or rule | When people take it |
|---|---|---|
| CRT | Certified Respiratory Therapist | Usually first, after the program |
| RRT | Registered Respiratory Therapist | After the CRT, via an additional exam |
| State licence | Required in every state except Alaska | Usually after passing a certification exam |
The Alaska exception and the military route
Alaska is the one state where BLS says respiratory therapists don't need a licence, although national certification is recommended there. Everywhere else, you'll need a licence to practise.
There's also a route people don't always consider. BLS says an accredited program in the Armed Forces leads to an associate's degree in respiratory therapy, alongside the programs offered by colleges and vocational-technical institutes.
Where respiratory therapists work
Hospitals dominate, employing 80% of respiratory therapists. Skilled nursing facilities and offices of physicians come next, at 4 and 3 in every 100. In hospitals, therapists work in emergency rooms, critical care units and neonatal intensive care units, treating patients in every age group.
| Industry | Median pay, May 2025 |
|---|---|
| Hospitals; state, local and private | $82,730 |
| Nursing care facilities (skilled nursing facilities) | $79,270 |
| Offices of physicians | $77,890 |
Hospitals pay the highest median of the top industries, at $82,730, as of October 2026, and they're also where most of the jobs are. Because hospitals are always open, expect shifts that include nights, weekends or holidays. Most therapists work full time.
What the job asks of you
- Standing for long periods, and lifting or turning patients.
- Taking precautions against infectious diseases.
- Working in fast-paced areas such as emergency and critical care.
- Caring for patients from newborns to older adults.
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How long it takes
An accredited associate's degree is the typical starting point, followed by the CRT exam and your state licence. If your employer wants the RRT, add the time to prepare for that second exam. A bachelor's takes longer, but BLS says some employers prefer it, so it can be worth considering if you want to move into more senior roles later.
My verdict
Respiratory therapy is a strong option if you want a well-paid clinical career without a four-year degree: an accredited associate's program, the CRT exam and a state licence, then the RRT. BLS expects 9% growth and about 8,600 openings a year. The thing to plan for is the RRT, because some employers want it before they hire you. Budget for both exams from the start and you won't get caught out. And if you'd like regular daytime hours, ask about them early, because most of the jobs sit in hospitals that run around the clock.
Frequently asked questions
How long does it take to become a respiratory therapist?
Respiratory therapists typically need at least an associate's degree from an accredited program, then a certification exam and a state licence.
Do respiratory therapists need a licence?
Yes, in every state except Alaska, where BLS says national certification is recommended.
What is the difference between a CRT and an RRT?
The CRT is the first certification level most candidates sit. After passing it, CRTs may take an additional exam to earn the RRT.
How much do respiratory therapists make?
BLS reports a median of $82,280 a year in May 2025, as of October 2026. Hospitals had a median of $82,730.
Where do respiratory therapists work?
Hospitals employ 80% of respiratory therapists, according to BLS. Others work in skilled nursing facilities and offices of physicians.
Can you train as a respiratory therapist in the military?
Yes. BLS says an accredited program in the Armed Forces leads to an associate's degree in respiratory therapy.
