Keep people breathing: ventilators, oxygen, blood gases and the worst nights in the hospital. Two years of college to get licensed.
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The median pay is about $82,280 a year. Across everyone in the job it runs from about $63,660 at the lower end to about $118,050 at the upper end. The source is listed under Sources at the end of this page.
2 to 4 years after high school, on the usual route.
$5,500 to $48,000 all in for tuition, fees, exams and kit. Living costs are not counted.
It depends where you work. You need a license, certificate or registration in Alabama, Arkansas, Arizona, California, Colorado, Connecticut, District of Columbia, Delaware, Florida, Georgia, Hawaii, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, Mississippi, Montana, North Carolina, North Dakota, Nebraska, New Hampshire, New Jersey, New Mexico, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Vermont, Washington, Wisconsin, West Virginia and Wyoming. Elsewhere there is none to hold, though many employers still ask for training or a certificate.
Very high demand nationally, from government outlook data. Demand varies by region, so check your area.
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What you earn and what it costs to get there.
Median
$82,280
Bottom tenth
$63,660
Top tenth
$118,050
The national median is $82,280 a year. The bottom tenth earn $63,660 or less and the top tenth $118,050 or more (2025 federal wage survey). This job has its own line in the federal wage survey, so nothing here is borrowed from a wider group. Pay varies a lot between states.
$107,810 a year
The median in New York, the highest of any state
The District of Columbia is higher still at $111,950. California ($104,820) and Massachusetts ($102,170) follow. The lowest is Mississippi, at $63,270 (2025 wage survey).
$118,050 or more
What the top tenth of respiratory therapists earn, 2025
Overtime and extra shifts add to pay, and many hospitals are short staffed enough that they are often on offer.
Roughly, all in
$5,500 to $48,000
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a two year community college associate degree at in district rates, about $5,000 for the whole program, plus a few hundred dollars for the entry level national board exam and roughly $300 for the state license, uniforms, a stethoscope and immunizations. The high end is a four year bachelor's degree at an in state public university at roughly $12,000 a year, plus the same exam and license costs. Either way you finish owing far less than the job pays. Continuing education and license renewal are small ongoing costs after that.
The community college route usually leaves under $15,000 of debt against a job with a national median of $82,280. File the FAFSA (Free Application for Federal Student Aid) every year, because Pell Grants cover much of community college tuition and never have to be repaid.
Shift differentials
Extra pay per hour for nights, weekends and holidays, which is most of the schedule in this job.
Three-day weeks
Twelve-hour shifts mean three days on and four off in most hospitals.
Public Service Loan Forgiveness
Nonprofit and government hospitals qualify, cancelling federal loans after 10 years of payments.
Tuition help to finish a bachelor's
Hospitals commonly pay for staff to top an associate degree up to a four-year one.
Overtime
Extra shifts are often on offer, paid at overtime rates past 40 hours.
The exact path from high school to qualified.
An accredited two-year degree, national board exams, then a state license.
High school
Grades 11 and 12
Biology, chemistry, algebra and physics. Physics matters more here than in most health careers, because you spend your life on gases and pressure.
Get into an accredited program
Apply a year ahead
It must be accredited by the Commission on Accreditation for Respiratory Care, or the national exams are closed to you. Most are associate degrees at community colleges; some are bachelor's degrees.
Classroom, lab and clinical rotations
2 years
Lung anatomy, ventilator mechanics, blood gas analysis and pharmacology, alongside hundreds of supervised hours in real hospital units.
Pass the board exam
2 to 4 months
From January 2027 there is one exam. Pass at the lower cut score for the CRT (Certified Respiratory Therapist) credential, or at the higher one for the RRT (Registered Respiratory Therapist), which most hospitals now require.
State license and first job
1 to 3 months
Apply to your state's licensing board, then join a hospital respiratory department, usually with several months of supervised orientation.
Biology
Anatomy and physiology of the lungs and heart is the spine of the whole program.
Chemistry
Blood gases are chemistry, and you read them several times a shift.
Physics
Pressure, flow and volume are the entire mechanical side of the job.
Algebra
Ventilator settings and drug doses are calculations you cannot get wrong.
Every state except Alaska licenses respiratory therapists, and so does the District of Columbia. Where there is a license, you cannot work without it. The credential behind it is national and comes from NBRC (the National Board for Respiratory Care), which reports more than 313,000 professionals holding its credentials. Two levels matter: the certified level to get started and the registered level that most hospitals actually hire at. From January 2027 both come from a single exam, scored at two cut points.
Community colleges
Valencia College in Florida and hundreds like it run the standard two-year respiratory care degree.
State universities
A growing number offer it as a four-year degree, which helps later if you want to teach or supervise.
Hospital-linked programs
Some large hospital systems partner with a college and hire their graduates directly.
Check accreditation first
The national accreditation commission lists every approved program. If a school is not on that list, the exams are closed to you.
Things you don't need, but that help.
All earned after you are working, from the same national board.
Adult critical care specialist
For therapists who live in the intensive care unit. One of the most respected add-ons.
Neonatal and pediatric specialist
Babies in the newborn intensive care unit, some weighing under two pounds. Highly specialized and hard to staff.
Sleep disorders specialist
Sleep labs and home testing. Daytime and evening work with no emergencies.
Pulmonary function technologist
Lung function testing in clinics, with regular hours and no weekends.
CPR certification
Required anyway, and you will be on the resuscitation team from your first week.
A job as a hospital transporter or aide
Paid work that teaches you how a hospital actually moves.
Calm under pressure
You are called to the worst moments in the building, and you arrive ahead of the doctor.
A driver's license
Home care and sleep lab jobs involve driving between patients.
Most therapists stay at the bedside because the work and the schedule suit them. Others move into charge or supervisor roles, into teaching in a college program, or into selling and supporting ventilators for a device manufacturer, which usually ends the night shifts. A growing number top up to a bachelor's or master's and move into advanced practice, management or pulmonary research.
Day to day, pros and cons, where you'd work.
Twelve hours, often overnight. You start with a list of patients across several floors: breathing treatments, checking oxygen, drawing arterial blood and reading the gases. In the intensive care unit you manage ventilators, adjusting settings when a patient's lungs change. Then the alarm goes: a cardiac arrest, a trauma, a baby in trouble. You run, and you are the one who manages the airway. Between all that, charting, equipment checks and teaching a patient with asthma how to use an inhaler.
The good
The hard parts
Things people don't tell you.
Until the end of 2026, becoming registered took two board exams, a multiple choice test and a clinical simulation. From January 2027 a single Respiratory Therapy Examination does both jobs: the lower cut score makes you certified, the higher one registered.
When a patient stops breathing anywhere in the hospital, the respiratory therapist is part of the response and usually takes the airway.
About 142,000 people worked as respiratory therapists in 2025. The government occupation profile expects the job to grow much faster than average, by 7% or more, from 2025 to 2035, and gives it a Bright Outlook.
Every list is built from the same numbers shown above, so you can see where this career sits next to the others.
Therapy and rehab first, then the rest of the field. See every career in health.
Last checked October 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise. How every figure on this site is sourced and checked.
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