Respiratory Therapy Prerequisites by State: What Programs Require- applicants often ask whether respiratory therapy prerequisites by state are different from one place to the next. The reassuring answer: the academic prerequisites are remarkably consistent across the country, because they are shaped by a single national accreditor. What varies state to state is licensure — the rules for practicing after you graduate. This guide separates the two so you know what to prepare and where to verify. For the full requirement list, see the complete respiratory therapy prerequisites guide.
Respiratory therapy programs are accredited by the Commission on Accreditation for Respiratory Care (CoARC), and graduates everywhere sit for the same National Board for Respiratory Care examinations. That national pipeline keeps the prerequisite science very similar from coast to coast:
Differences you will see between programs are usually about degree level (associate vs. bachelor’s) and competitiveness, not the state line.
After you graduate and credential, the rules for practicing are set by each state’s respiratory care board:
While the academic preparation is national, the right to practice is granted state by state, and the details differ even when the underlying NBRC credential is identical. Some states license under the title Respiratory Care Practitioner; others use Respiratory Therapist. Continuing-education requirements for renewal, application fees, jurisprudence components, and background-check rules all vary. A handful of states layer additional steps on top of the national credential. The throughline is simple: earn the national credential first, then satisfy your state’s specific licensing steps.
Because the RRT is a national credential, respiratory therapists who relocate generally apply for licensure in the new state rather than starting over. Processes for licensing by endorsement or reciprocity differ, so therapists planning to move — or to work near a state border — should confirm each board’s rules early. The prerequisite and program stage is unaffected; mobility is a post-licensure consideration.
Effective January 1, 2027, the NBRC consolidates its credentialing into a single Respiratory Therapy (RT) Examination — a lower cut score earns the CRT, a higher score the RRT — and retires the older CRT-to-Registry route at the end of 2026. This applies nationwide and reinforces the same bottom line for every state: graduate from a CoARC-accredited program, which means clearing your prerequisites first.
How to verify your state. Confirm two things directly: your target program’s prerequisite list (on its admissions page) and your state respiratory care board’s licensure requirements. The NBRC credential is national; the license to practice is state-specific.
Because the academic prerequisites travel well, you can complete them now — online and self-paced — without knowing your final program or state: Anatomy & Physiology I (BIO 270), Anatomy & Physiology II (BIO 275), Microbiology (BIO 210), General Chemistry (CHEM 151), and College Algebra (MATH 107).
The academic prerequisites are largely the same nationwide because CoARC accredits programs and the NBRC credentials graduates. Licensure rules are what vary by state.
Alaska is the long-standing exception. Nearly every other state requires a license — often the RRT — to practice.
The RRT is a national credential, but you still apply for a license in the state where you will practice. Check that state’s board for specifics.
Yes — it is national. From January 1, 2027 a single RT Examination yields the CRT or RRT. Your state’s licensure steps still apply on top of the national credential.
No. The RRT is national; you apply for licensure in the new state, usually by endorsement. Confirm that board’s process before relocating.
Continue with the RT prerequisite checklist, the complete respiratory therapy prerequisites guide, and all allied health prerequisite courses. State-society and licensure resources are available through the American Association for Respiratory Care.
