Close icon
Join Renew CRCE Transcript AARC University
AARConnect The Journal RC Reports Career Center Jobs
My Profile

Advocacy

Guidance Document Regarding RRT Entry to Licensure

Updated July 2026

Introduction

The American Association for Respiratory Care (AARC) supports the Registered Respiratory Therapist (RRT) credential as the minimum standard for entry into the profession. As respiratory care has evolved, an increasing number of states have adopted laws or regulations requiring the RRT credential (or equivalent registry-level qualification) for initial licensure.

As of July 2026, 9 states have enacted RRT entry-to-licensure requirements, with Missouri’s law taking effect January 1, 2027. These states have demonstrated that successful implementation is achievable through careful planning, collaboration, and appropriate grandfather provisions.

View the current list of states requiring the RRT credential for initial licensure.

This guidance is intended to help state respiratory care societies evaluate, develop, and implement legislation or regulations establishing the RRT credential as the minimum qualification for new license applicants.

Why Move to RRT Entry to Licensure?

All graduates of Commission on Accreditation for Respiratory Care (CoARC)-accredited respiratory therapy programs are educated to meet eligibility requirements for the National Board for Respiratory Care (NBRC) registry-level examination.

Requiring the RRT credential for initial licensure:

  • Promotes a consistent national standard for entry into practice.
  • Reflects the increasing complexity of respiratory care.
  • Aligns licensure with employer expectations in many states.
  • Supports professional recognition and workforce mobility.
  • Reinforces the respiratory therapist’s role as an essential member of the healthcare team.

States should carefully evaluate workforce implications and ensure that implementation does not unintentionally reduce patient access to care.

Recommended Steps

Before pursuing legislation or rulemaking:

  • Survey respiratory therapists and employers.
  • Review the number of CRT- and RRT-credentialed practitioners in the state.
  • Determine whether employers already require or prefer the RRT credential.
  • Assess the potential workforce impact

Depending on state law, implementation may occur through:

  • Legislation
  • Administrative rulemaking
  • A combination of both

Engage early with:

  • State licensing boards
  • State medical societies
  • Hospital associations
  • Respiratory care educators
  • Legislative champions
  • Professional partners

Every successful state has included appropriate grandfather provisions.

Generally, legislation should:

  • Allow currently licensed CRTs to continue renewing their licenses.
  • Address reciprocity for therapists licensed in other states.
  • Provide sufficient implementation time before new requirements take effect.

Transparent communication is essential.

Successful states have:

  • Published FAQs.
  • Held town halls and stakeholder meetings.
  • Regularly updated members and employers.
  • Addressed misinformation quickly.
  • Kept legislative language publicly available.

After passage:

  • Allow adequate time before the law becomes effective.
  • Educate employers, educators, students, and licensing boards.
  • Clearly communicate grandfather provisions.
  • Monitor implementation and answer stakeholder questions.

Experience from states that have successfully implemented RRT entry to licensure demonstrates several common themes:

  • Early stakeholder engagement builds support.
  • Employer support is critical.
  • Grandfathering existing licensees minimizes disruption.
  • Clear communication prevents misinformation.
  • Adequate implementation timelines support workforce stability

The AARC Government Affairs Department provides technical assistance to state affiliates considering RRT entry-to-licensure legislation or rulemaking, including:

  • Model legislative language
  • Strategic planning
  • Testimony and advocacy support
  • Stakeholder education
  • Letters of support (when appropriate)
  • Lessons learned from states that have successfully implemented RRT entry requirements