South Dakota Respiratory Therapist Practice in 2026: No State License Required

How to Become a Licensed Respiratory Therapist in South Dakota

South Dakota is one of the few remaining states that does not require a state-issued respiratory therapist license. If you are planning to practice as an RT in South Dakota, you do not need to apply to a state licensing board. There is no state RT licensing board for this purpose. Instead, NBRC credentials (CRT or RRT) serve as the primary professional standard, and employers rely directly on these national credentials to verify practitioner competence.

This credential-only model is similar to the approach used in a small number of other Great Plains and Mountain West states. It does not mean respiratory therapy is unregulated, NBRC credentialing, employer credentialing standards, and Joint Commission requirements all apply, but the regulatory framework operates through national credentialing rather than state licensure.

Step 1: Complete a CoARC-Accredited Respiratory Therapy Program

Even without a state license requirement, every hospital employer and healthcare organization in South Dakota will require graduation from a CoARC-accredited respiratory therapy program as a condition of employment. Dakota State University (Madison) and Southeast Technical College (Sioux Falls) are among the in-state CoARC-accredited options. Students also attend programs in neighboring Minnesota (including Northland Community College's joint program with East Grand Forks) and return to South Dakota to work.

A two-year AAS in Respiratory Therapy is the standard entry credential. BSRT completion programs are available for working RTs seeking advancement.

Step 2: Pass the NBRC Examinations

In South Dakota's credential-based system, NBRC examinations are your primary professional qualification:

• TMC (Therapist Multiple Choice) Examination, 160 questions. A high-cut score earns the Registered Respiratory Therapist (RRT); a low-cut score earns the Certified Respiratory Therapist (CRT).
• CSE (Clinical Simulation Examination), 22 advanced clinical scenarios required for full RRT designation.

Because there is no state license, both the CRT and the RRT are legally valid credentials for practice in South Dakota. However, most employers, particularly the large health systems, require the RRT for all clinical staff positions as part of their internal credentialing standards. You should treat RRT attainment as a practical employment requirement even though it is not a legal one.

Step 3: Apply for Your [State] License

There is no South Dakota state respiratory therapist license application. After passing the NBRC examinations, you are eligible to seek employment as an RT in South Dakota. Your employer's HR and credentialing team will verify your NBRC credentials directly through the NBRC registry.

You may also register with the South Dakota Association for Respiratory Care (SDARC), the state chapter of the AARC, for professional networking, CE resources, and advocacy, but this is professional membership, not a state license.

If you plan to practice in additional states, those states will have their own licensure requirements that you must meet separately.

CRT vs. RRT: Which Do You Need in South Dakota?

Legally, either credential allows practice in South Dakota since there is no state licensing requirement. In practice, Sanford Health, Avera Health, and virtually every South Dakota hospital system require the RRT for all RT staff positions and often for agency/contract RT placements as well. Pursue the RRT unless you have strong reason to believe a specific employer will accept CRT. It is the universal professional standard in the state's major health systems.

NBRC specialty credentials (ACCS, NPS, SDS, CPFT, RPFT) are valued for subspecialty roles such as pulmonary function, sleep disorders, and neonatal care, particularly at Sanford and Avera's larger facilities.

Continuing Education Requirements

South Dakota does not impose state-mandated CE requirements for RT practice because there is no state license to renew. However:

• NBRC credentials require annual renewal through the NBRC Credential Maintenance Program (CMP), which requires demonstrating ongoing professional activity.
• Most South Dakota employers require annual competency validation and in-service training as part of Joint Commission accreditation standards.
• The SDARC offers annual CE events; AARC national congress attendance counts toward NBRC CMP requirements.

Even without a state CE mandate, plan to engage in 20-30 hours of relevant CE annually to maintain your NBRC credentials and meet employer expectations.

South Dakota Respiratory Therapist Salary Ranges

South Dakota RT salaries are competitive for the northern Great Plains:

• Entry-level RRT (0-2 years): $50,000-$60,000/year
• Mid-career (3-7 years): $58,000-$70,000/year
• Senior/Lead RT (8+ years): $68,000-$78,000/year
• Critical care / NICU specialist: $72,000-$82,000/year
• Travel RT contracts in SD: $1,700-$2,300/week

Sioux Falls is the highest-paying market due to health system competition between Sanford and Avera. Rapid City is the second market. Rural South Dakota positions often include enhanced sign-on packages and relocation assistance given the challenge of recruiting to smaller communities.

Top Employers

South Dakota's RT market is dominated by two health systems and their extensive regional networks:

• Sanford Health, Based in Sioux Falls, Sanford is the largest rural health system in the US and the dominant employer of RTs in South Dakota. Sanford operates a level II trauma center in Sioux Falls, a large children's hospital, and dozens of regional facilities across the state. Sanford's size creates strong career ladders and specialist roles in NICU, cardiac surgery, and pulmonary rehabilitation.
• Avera Health, The second major system in South Dakota, with flagship facilities at Avera McKennan Hospital and Avera St. Luke's (Aberdeen). Avera Health serves much of eastern and central South Dakota and competes with Sanford for RT talent in the Sioux Falls market.
• Regional Health / Monument Health (Rapid City), The western South Dakota market, centered in Rapid City, is served primarily by Monument Health (formerly Regional Health). This system employs RTs for the Black Hills region and serves as a referral center for Wyoming and Nebraska patients.
• Critical Access Hospitals, South Dakota has more critical-access hospitals per capita than most states. These rural facilities employ single or small teams of RTs, often with strong communities and relocation packages.

South Dakota's no-state-license model simplifies the pathway to practice while relying on employer standards and NBRC credentials to maintain quality, a practical framework for a state where recruiting healthcare professionals to rural communities is a persistent challenge.