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

## How to Become a Licensed Respiratory Therapist in Virginia Virginia licenses respiratory therapists through the Virginia Board of Medicine, which oversees RT licensure as a distinct regulated health profession. With major health systems anchored in Northern Virginia, Richmond, and Hampton Roads, Virginia is one of the stronger RT job markets on the East Coast. Here is a complete step-by-step guide to getting licensed in 2026. ### Step 1: Complete a CoARC-Accredited Respiratory Therapy Program Virginia has a solid network of CoARC-accredited respiratory therapy programs, offering in-state options for students at both the Associate and Bachelor degree levels. Programs are available at community colleges and universities across the state, including institutions in Northern Virginia, Richmond, and the Hampton Roads area. Graduation from a CoARC-accredited program is a non-negotiable prerequisite for Virginia licensure. Before enrolling, confirm your program's accreditation status at coarc.com. Programs typically run 2 years for an AAS or 4 years for a BS in Respiratory Therapy. Bachelor's degree holders often have an advantage in competitive urban markets like Northern Virginia, where large academic and tertiary care centers favor candidates with expanded clinical training and leadership potential. For NICU/pediatric or ECMO positions especially, a BS or post-professional certification is increasingly expected. ### Step 2: Pass the NBRC Examinations The NBRC credentials respiratory therapists at two levels, and Virginia requires the higher RRT credential for licensure. **Therapist Multiple-Choice (TMC) Examination:** Taken after program completion, this computer-based exam assesses clinical knowledge across the respiratory care domain. You must achieve the "RRT cut score" (higher than the CRT cut score) to advance to the CSE. **Clinical Simulation Examination (CSE):** The CSE tests clinical reasoning and decision-making in complex patient scenarios. Passing both the TMC at RRT level and the CSE earns you the Registered Respiratory Therapist (RRT) credential. Virginia does not accept the CRT credential alone for state licensure. The full RRT credential is required. Register for NBRC exams at nbrc.org. Combined exam fees run approximately $390 (subject to annual adjustment by NBRC). ### Step 3: Apply for Your Virginia License Once you hold the RRT credential, you apply to the Virginia Board of Medicine for your RT license. The Board oversees this application and issues licenses through the Department of Health Professions. **Virginia RT license application requirements:** - Completed application through the Virginia Department of Health Professions online portal (dhp.virginia.gov) - Official NBRC RRT certificate or primary-source verification through NBRC - Official transcripts from your CoARC-accredited program - Application fee of approximately $75–$130 (verify current amount on the DHP website) - Professional history and background disclosure Virginia's Department of Health Professions is generally efficient, with standard processing times of 4–8 weeks. Applications with any criminal history disclosures or disciplinary flags from other states will require additional Board review time. Virginia participates in the Interstate Medical Licensure Compact's broader healthcare endorsement ecosystem. If you are already licensed in another state, the endorsement pathway allows you to submit your primary-state license verification and NBRC documentation rather than starting a full application from scratch. ### CRT vs. RRT: Which Do You Need in Virginia? Virginia requires the **RRT** for state licensure. There is no Virginia-issued CRT-only license. Employers in all major Virginia markets — Northern Virginia health systems like Inova and Children's National, VCU Health in Richmond, and Sentara across Hampton Roads — list RRT as a minimum qualification, often alongside preferred additional credentials (ACCS, NPS) for specialty roles. If you graduated and passed the TMC at the CRT level but have not yet passed the CSE, you are not yet eligible for Virginia licensure. Focus your preparation on the CSE before applying. ### Continuing Education Requirements Virginia RT licenses are renewed on a 2-year cycle. License renewal requires **30 contact hours of continuing education** completed during the renewal period. Virginia currently accepts CE from a range of approved sources: - AARC-sponsored CE programs and state society continuing education events - Hospital in-service programs with documented CE credit - Online CE modules from NBRC-recognized or AARC-recognized providers - Accredited academic coursework There is no currently mandated subject-matter list for Virginia RT CE (unlike some states that require specific infection control or opioid modules), but you should verify current requirements through DHP each renewal cycle, as requirements can change. Licenses not renewed by the expiration date enter a grace period before lapsing. Lapsed licenses require reinstatement fees and may require CE completion documentation before reinstatement is approved. ### Virginia Respiratory Therapist Salary Ranges Virginia's RT salary market is bifurcated between Northern Virginia (which competes with the Washington, DC metropolitan area labor market) and the rest of the state. **Northern Virginia / DC metro area:** - Entry-level RRT: $64,000–$74,000/year - Mid-career RT: $72,000–$85,000/year - Senior/specialty RT (ACCS, NPS, ECMO): $85,000–$98,000/year **Richmond / Central Virginia:** - Entry-level RRT: $54,000–$64,000/year - Mid-career RT: $62,000–$74,000/year - Senior RT: $70,000–$82,000/year **Hampton Roads / Virginia Beach / Norfolk:** - Entry-level RRT: $52,000–$62,000/year - Mid-career RT: $60,000–$72,000/year - Senior RT: $68,000–$80,000/year Northern Virginia's premium reflects the DC area's higher cost of living and competition for skilled clinicians from major academic medical centers on both the Virginia and Maryland sides of the metro. ### Top Employers **Inova Health System (Falls Church / Northern Virginia)** — The dominant health system in Northern Virginia, Inova operates multiple acute care hospitals and is a major employer of RTs in the region. Inova Fairfax is a Level I trauma center with robust critical care and specialty RT programs. **VCU Health (Richmond)** — Virginia Commonwealth University's academic medical center is one of the top RT employers in Central Virginia, with significant critical care, transplant, and specialty respiratory therapy positions. **Sentara Healthcare (Norfolk/Virginia Beach/Hampton Roads)** — Sentara is the dominant health system in Hampton Roads and operates across the Tidewater region. It is consistently among the largest RT employers in southeastern Virginia. **Children's National Hospital (Washington, DC / Northern Virginia footprint)** — While headquartered in DC, Children's National draws significant NoVA-area RT staff for its Northern Virginia outpatient facilities. Pediatric-specialized RTs with NPS credentials are in high demand. **Carilion Clinic (Roanoke)** and **Ballad Health (Bristol/Southwest Virginia)** — These systems serve western and southwestern Virginia, offering smaller-market RT positions with lower competition and often rural premium or loan repayment incentives.