How to Get Your Texas Respiratory Therapist License in 2026

## How to Become a Licensed Respiratory Therapist in Texas Texas licenses respiratory therapists through the **Texas Department of Licensing and Regulation (TDLR)**, which administers the Respiratory Care Practitioners Act. Texas is one of the largest RT employment markets in the nation, driven by the state's massive population, four major metro areas (Houston, Dallas/Fort Worth, Austin, San Antonio), and a diverse healthcare landscape that includes world-class academic medical centers, large for-profit systems, pediatric specialty hospitals, and extensive rural and border healthcare needs. Texas RT compensation ranks among the highest in the South and competes with East and West Coast markets for experienced practitioners. ### Step 1: Complete a CoARC-Accredited Respiratory Therapy Program Texas requires graduation from a **CoARC-accredited** respiratory therapy program. Texas has an extensive network of in-state CoARC programs, including those at Lone Star College System, Houston Community College, South Texas College (McAllen), Del Mar College (Corpus Christi), Texas State Technical College (Waco), Collin College (McKinney), and the University of Texas Health Science Center programs. Both AAS (two-year) and BSRT programs are available across multiple campuses. Curriculum must include mechanical ventilation, neonatal and pediatric respiratory care, pulmonary function testing, critical care pharmacology, hemodynamic monitoring, and cardiopulmonary resuscitation. Texas's large academic medical centers — including UT Southwestern, UTHealth Houston, and UT Health San Antonio — provide exceptional clinical training environments for students. ### Step 2: Pass the NBRC Examinations Texas RT licensure is built on NBRC credentialing: - **TMC (Therapist Multiple Choice) Examination** — 160-question exam covering entry-level and advanced respiratory care. High-cut score earns the **RRT** credential; low-cut score earns the **CRT**. - **CSE (Clinical Simulation Examination)** — 22 advanced patient management scenarios; required for full RRT designation. Texas requires the **RRT credential** for TDLR licensure. CRT holders must pass the CSE before submitting their Texas license application. Pearson VUE test centers are widely available throughout Texas in Houston, Dallas, Austin, San Antonio, Lubbock, Amarillo, El Paso, and Midland. ### Step 3: Apply for Your Texas License With your RRT credential, complete the TDLR licensure process: 1. Submit the RT licensure application through the TDLR's online licensing system (mylicense.tdlr.texas.gov). 2. Pay the licensure fee (approximately **$75–$115**; verify current fees on the TDLR website, as Texas fees have a structured fee schedule). 3. Provide NBRC credential verification (request through NBRC to be sent directly to TDLR). 4. Submit official transcripts from your CoARC-accredited program. 5. Authorize a Texas DPS criminal history check as required. 6. If licensed in another state, provide verification of good standing from that state's licensing board. Processing times for complete applications are typically two to four weeks. Texas does not currently participate in the RT Licensure Compact, requiring full licensure application from out-of-state practitioners. ### CRT vs. RRT: Which Do You Need in Texas? Texas requires the **RRT** for TDLR licensure. The CRT does not qualify an applicant for a Texas license. Given the size and competitiveness of Texas's RT market — particularly in Houston and Dallas where applicant pools are large — RRT status is both the legal requirement and the practical baseline that employers use. Most major Texas employers (Texas Health Resources, UT Southwestern, Houston Methodist, Texas Children's) require RRT for all clinical staff positions. The NBRC's advanced specialty credentials are strongly valued in Texas's large academic medical centers: - **ACCS (Adult Critical Care Specialist)** — Preferred for ICU positions at UT Southwestern, Houston Methodist, and Baylor Scott & White. - **NPS (Neonatal Pediatric Specialist)** — In high demand at Texas Children's Hospital, Dell Children's, and Cook Children's. - **CPFT / RPFT (Pulmonary Function)** — Sought for pulmonary function lab positions at academic centers statewide. ### Continuing Education Requirements Texas RTs must complete **30 continuing education hours per two-year renewal cycle**. Requirements include: - Activities must be relevant to respiratory care practice - AARC-approved, NBRC specialty credential, or accredited college coursework all qualify - TDLR does not currently mandate specific topic areas (such as opioid training) for RT CE specifically Texas has a large AARC chapter infrastructure — the Texas Society for Respiratory Care (TSRC) organizes strong annual conferences and regional CE events in Houston, Dallas, San Antonio, and Austin. Online CE through AARC Connect, Respiratory Therapy Cave, and the NBRC CMP are widely used by Texas RTs. Retain all CE documentation for potential TDLR audit. Texas conducts targeted CE audits as part of its renewal compliance program. ### Texas Respiratory Therapist Salary Ranges Texas offers among the highest RT salaries in the South, with significant variation across its four major metro areas: - **Entry-level RRT (0–2 years):** $62,000–$72,000/year - **Mid-career (3–7 years):** $70,000–$84,000/year - **Senior/Lead RT (8+ years):** $80,000–$96,000/year - **NICU/PICU NPS specialist:** $85,000–$100,000/year - **Travel RT contracts in Texas:** $1,950–$2,800/week **Houston** is the highest-paying Texas market, driven by Texas Medical Center — the largest medical complex in the world by institutional count. **Dallas/Fort Worth** tracks slightly below Houston but has strong competition among Texas Health Resources, UT Southwestern, Baylor Scott & White, and multiple large HCA and Tenet facilities. **Austin** has seen the fastest wage growth of any Texas RT market over the past three years, driven by population growth and hospital expansion. **San Antonio** offers competitive wages with a relatively lower cost of living. ### Top Employers Texas's enormous healthcare market offers extensive RT employment options: - **Texas Health Resources** — Fort Worth-based system with 29 hospitals across North Texas; one of the largest RT employers in the Dallas/Fort Worth market. - **UT Southwestern Medical Center (Dallas)** — National leader in research and clinical care; employs RTs in advanced critical care, ECMO, and pulmonary transplant programs. - **Houston Methodist** — Houston's premier not-for-profit academic system; known for cardiac surgery, organ transplant, and top-percentile RT compensation. - **Texas Children's Hospital (Houston)** — The nation's largest children's hospital by patient volume; a major employer of neonatal and pediatric RTs with NPS credential requirements. - **Children's Hospital of San Antonio / Christus Health** — San Antonio market anchor; growing system with pediatric and adult divisions. - **Baylor Scott & White Health** — Largest not-for-profit health system in Texas; expansive presence across Dallas, Temple/Waco, and Round Rock/Austin markets. - **Dell Children's Medical Center (Austin)** — Central Texas's primary children's hospital; consistent recruiter of NPS-credentialed RTs. Texas's scale, competitive compensation, and diverse healthcare environment — from world-class academic medical centers to rural critical-access facilities — make it one of the deepest and most opportunity-rich RT markets in the United States.