How to Get Your Respiratory Therapist License in California (2026)

## How to Become a Licensed Respiratory Therapist in California California is home to one of the most active respiratory therapy job markets in the United States. RTs here work across massive urban hospital systems in Los Angeles and the San Francisco Bay Area, leading academic medical centers, NICUs and PICUs, specialized pulmonology practices, and home health agencies serving the state's enormous aging population. Salaries are among the highest in the country. Here's the complete California RT licensure process for 2026. ### Step 1: Complete an Accredited Respiratory Therapy Program All California RT license applicants must graduate from a **Commission on Accreditation for Respiratory Care (CoARC)** accredited program. California has a large number of CoARC-accredited RT programs at community colleges and universities statewide, including programs at institutions in Los Angeles, San Francisco, Sacramento, San Diego, and across the Central Valley. The standard entry-level credential is the **Associate of Applied Science (AAS) in Respiratory Therapy** (two years). **Bachelor's programs (BSRT)** are available and significantly strengthen your candidacy at Kaiser Permanente, Cedars-Sinai, UCLA Health, and other major California health systems that prioritize BSRT holders for leadership tracks. ### Step 2: Pass the NBRC Examinations California requires an active NBRC credential issued by the **National Board for Respiratory Care**. **TMC (Therapist Multiple Choice) Exam** - 160 questions, 3 hours - Passing earns the **CRT** credential - Fee: approximately $190 **CSE (Clinical Simulation Exam)** - 22 simulated clinical cases, 4 hours - High-cut TMC score required to sit - Passing earns the **RRT** credential - Fee: approximately $200 California requires the **RRT** for full licensure. The CRT alone is not sufficient to obtain an unrestricted California RT license. ### Step 3: Apply for Your California License RT licensure in California is overseen by the **California Board of Respiratory Care**, which operates under the California Department of Consumer Affairs. The application process includes: - Completed California Board of Respiratory Care application - License fee of approximately **$100–$150** (one of the higher state fees, reflecting California's regulatory framework) - Official NBRC RRT credential verification - Criminal background check - Official transcript from your CoARC-accredited program California processes applications through a formal review period. Plan for four to eight weeks. If you're relocating from another state, California does not participate in the national RT compact—you must apply for a California-specific license. ### Continuing Education Requirements California requires **30 CE hours every two years** for license renewal. Acceptable CE includes AARC-accredited courses, NBRC specialty exam preparation, employer-sponsored clinical education, and approved online programs. California occasionally updates its CE content requirements; confirm current standards on the Board's website before each renewal cycle. ### CRT vs. RRT: Which Do You Need in California? California requires the **RRT** for an unrestricted license. A CRT is not accepted as a standalone credential for independent California practice. Given the competitive California job market—where large health systems receive dozens of applications per open RT position—RRT is essentially the minimum viable credential regardless of state rules. ### California Respiratory Therapist Salary Ranges California is consistently the highest-paying state for respiratory therapists in the country. Staff RTs in Los Angeles and the San Francisco Bay Area typically earn **$75,000–$100,000+ per year**. ICU-level, NICU, and ECMO-specialized RTs at major academic medical centers can exceed $110,000 annually. The Central Valley and inland regions pay somewhat lower—closer to **$65,000–$82,000**—but still above the national median. **Travel RT contracts** in California often pay **$50–$70+ per hour** all-in, with San Francisco among the highest-paying markets nationally. ### Top Employers for Respiratory Therapists in California - **Kaiser Permanente** — the state's largest integrated health system with RT positions across Northern and Southern California - **Cedars-Sinai Medical Center (Los Angeles)** — flagship academic medical center with high RT volume and ECMO capabilities - **UCLA Health (Los Angeles)** — major academic system, strong NICU and pulmonology RT demand - **UCSF Health (San Francisco)** — leading academic medical center - **Stanford Health Care (Palo Alto)** — high-acuity RT roles including transplant and ECMO programs - **Children's Hospital Los Angeles** — top NICU and PICU RT employer - **VA Medical Centers** (Los Angeles, San Francisco, San Diego, and others) - **Dignity Health (CommonSpirit)** and **Sutter Health** — major regional systems - **Home health and home oxygen** — Lincare, Apria, and BioScrip serve California's enormous senior and COPD population - **Sleep labs** — Southern California has one of the highest concentrations of sleep medicine programs in the country