Frequently Asked Questions

You must first establish an account. Click here to begin your licensure account via the portal.

Once an account is established, you should go to your email so you can verify your account and return to the website to complete your application. The application will not be complete until you have paid the fees. 

The application must be complete, and all required documentation must be received from other agencies as requested. Our new process for issuing a license under reciprocity can take as little as one hour during the work week but can take longer under rare circumstances. An initial license for new graduates may take a week or more, depending on the arrival of the college transcript and the NBRC results for the TMC exam.  

You may call the Board Office to inquire about the status of your application. You will receive notification if the application you submitted is incomplete in any way.

The total fees will be a total of $213.00. The individual  amounts are as follows:

1. $38.00 Background Fee
2. $50.00-Application Fee
3. $ 125.00-Initial Active License Fee

You will receive a wall certificate and we no longer provide wallet cards. 

Since 2018, wallet cards have not been required. A notice was sent to the licensees, and information was posted on the website in 2018. A hearing was held regarding this change. The download feature was removed in July 2021 to comply with the rule below, and a print feature was added to the License Look-up feature: 21 NCAC 61 .0301 (b) states: “Each individual who is issued a license shall be issued a license number that shall be displayed on the Board’s website.…A web-based license verification displaying the status, credentials, degree level, dates for registration, renewal, and expiration shall be accessible by the Licensee in their principal place of business so as to be available for inspection in a printed or electronic format.” Since we changed the rule, the wallet card no longer meets the requirements as proof of licensure, but the License Look-up does. The phrase accessible by the Licensee can be an electronic display or printed version for a file. For this reason, we added a print feature as well.  This change is part of our digital transition.

Licenses are valid for up to one year. You must renew each year. The cost is $75.00.

Under limited circumstances, persons who engage in another profession, students and trainees, and persons serving in the armed forces, Public Health Service or the VA may be exempted. Individuals should contact the Board to get additional information and clarification if they believe they fall within one of the exempted categories.

For your first renewal, you will need to complete the renewal form and pay the $75 renewal fee. 

If you have not already completed your background check, you will need to do so before you can renew.  If your account says it is under audit and will not let you renew, this means we have not received your background packet. 

You will also need to have earned 12 CEUs over the past year, with at least half of them being live/traditional style CEUs. 

If you earned your RRT or higher credential in the past year, this exempts you from the CEU requirement.  You will only be required to submit proof of your CEUs if you are selected for audit; you will be notified by email after renewal if you have been selected.

To renew online click LOGIN on the Home page, then type your email address in the first window. In the second window type in your password that you established. Select Renew license then proceed to complete  the renewal application and submit.  

If you forgot your password, you will need to select forgot password to reset it. You will need access to the email on file. If you no longer have access to the email, you will need to contact our office for instructions on how to correct this issue.

Effective July 1, 2007, you no longer have to list the CE you have completed. You simply attest to the continuing education you have completed that meets of the Board’s requirements.

You must maintain copies of the documentation for a period of at least 3 years (5 years if your NBRC credentials have an expiration date) and are subject to audit.

The Board will audit a percentage of renewals and ask that the RCP to submit verification of the continuing education that they attested they have completed. You will also be required to submit a copy of a current BLS card if audited.

With the license renewal, the licensee will attest to the continuing education completed during the renewal period period. Do not submit copies of certificates of attendance unless asked to do so. A percentage of renewals will be audited at which time the licensee will be asked to submit verification.

The application process is dictated by the requirements for licensure specified in G.S. 90-653 of the Practice Act, and accompanying Rules. Because the Board has a legal mandate to protect the public, applicants for licensure must demonstrate that they meet all requirements.

No, you can complete fingerprinting in any state and mail in your fingerprint card.  We cannot accept livescan fingerprinting from outside of NC. However, paper cards are accepted from anywhere.

Yes, we must have the paperwork back to accept your background report, even if you did the Livescan-style fingerprints.

I was fingerprinted for another state license. Can you pull that fingerprinting?

No, we cannot access background materials or fingerprint cards submitted to another state.

Licensees will receive a renewal notice approximately 30 days before the expiration date of his/her license. Licensees may renew online or must submit the renewal form, pay a renewal fee, and attest to completion of continuing education.

This is a “self-funded” regulatory program. All costs involved with operating the Board Office, paying professional staff, and carrying out the licensure program must come from the fees collected. No State, County or Municipal money may be provided to support this program.

No. It is not required by the Practice Act. It is a business decision left up to each licensee, but the Board encourages all licensees to assess the risks in their practices and determine whether prudence dictates that insurance against those risks be obtained.

The Board may publish a directory of licensees. A copy may be ordered from the Board Office. 

Complaints about licensees, or persons practicing respiratory care without a license must be submitted to the Board Office, and include the name, address and phone number of the person submitting the grievance. These reports will be investigated by the Board pursuant to a formal disciplinary procedure established to address violations of the Laws and Rules. Click Complaint to submit a complaint.
Once you become a licensee, it is your ethical responsibility to assist the Board in policing the profession to assure quality services and care to the public. If you have knowledge of or observe a possible infraction of the Laws and Rules, you must report it to the Board. 

The statute passed by the General Assembly sets the number, term, and qualifications of the Board members, and defines how members are appointed. There are ten members on the Board – two practitioner members, two public members, four physician members, one member appointed by the NC Hospital Association and one member appointed by the Atlantic Coast Medical Equipment Services Association (ACMESA) formerly known as the NC Association for Medical Equipment Services. The General Assembly appoints the two practitioner members and two physician members; the Governor appoints the public members; the NC Medical Society appoints one physician member; and the Old North State Medical Society appoints one physician member. Board members serve three-year terms, and may not serve more than two consecutive terms. Click Board Members for Board member names.

The Board meets every 3 months. All meetings are open to the public. Click Upcoming Events for a list of the upcoming meeting dates and location. This information is also available from the Board Office. 

All inquiries shall be directed to the North Carolina Respiratory Care Board, rather than to individual Board members. The office is located at 125 Edinburgh South Drive, Suite 100 in Cary, NC 27511. The phone number is 919-878-5595; the fax number is 919-878-5565; the e-mail address is bcroft@ncrcb.org.

According to the amended rule 21 NCAC 61 .0401 CONTINUING EDUCATION REQUIREMENTS: All courses and programs shall:

1. Contribute to the advancement, extension and enhancement of professional clinical skills and scientific knowledge in the practice of respiratory;
2. Provide experiences which contain scientific integrity, relevant subject matter and course materials; and
3. Be developed and presented by persons with education and/or experience in the subject matter of the program. At least six contact hours shall be obtained each reporting year from workshops, panel, seminars, lectures, or symposiums that provide for direct interaction between the speakers and the participants.

Online CE’s are allowed under the Board rules, so RCP’s may use approved online courses.

Six of the 12 required CE’s, as defined in 21 NCAC 61 .0401, must be approved as live or traditional credit and meet the following definition. A live or traditional credit is a “discourse given for instruction before an audience or through teleconference.” This allows for CE’s to be achieved in a live webinar, teleconference, or traditional face-to-face environment. Web-based supplemental content, when combined with direct interaction during a live teleconference or webinar with online assignments including but not limited to readings, chat rooms, and examinations, is considered blended or hybrid formats.

It is the Board’s position that continuing education through a hybrid or blended format is an acceptable form of educational activity to meet the new rules for direct interaction.

This means ACLS, PALS, and NRP qualify as 5 direct interaction credits when the classroom portion is offered online since these all require face-to-face interaction for skills testing. In addition, three hours of CE’s for clinical instruction or precepting were approved in the new rules by the Board to encourage professional engagement with future respiratory therapists and is considered direct interaction. These clinical instruction hours are outlined in the form section of the website under Clinical Precepting Documentation.

In conclusion, online or distance learning courses combined with interaction in some form between the presenter and the audience is equivalent to the traditional face-to-face format when attending a seminar, conference, or lecture.

In a statement revised by the AARC in 2012:

“It is critical for all health care practitioners to participate in continuing education in order to enhance their knowledge, improve their clinical practice and meet state licensure and national credentialing requirements. Participation in continuing education, whether mandatory or voluntary, offers the potential to be one of the most powerful tools to ensure safe, efficient, and quality patient care. The American Association for Respiratory Care (AARC) recognizes the value of, and need for, participation in continuing education and recommends that practitioners participate in educational activities on a continual basis. AARC members may utilize the Continuing Respiratory Care Education (CRCE) system as the mechanism for recognition and documentation of such activities.

The AARC encourages Respiratory Therapists who have completed the required entry level education to pursue baccalaureate and graduate degrees relevant to their professional pursuits. The AARC encourages Respiratory Therapists to select continuing education activities relevant to their personal and professional needs. Providers of continuing education activities (which can include clinical institutions, educational institutions, public and private associations or organizations, and proprietary corporations) are encouraged to conduct needs assessments in order to design and develop valuable educational activities that will enable practitioners to meet their professional goals. In addition, providers of continuing education are encouraged to review, evaluate and measure their activities’ effectiveness. Providers are also urged to use instructional technology, incorporate multiple learning styles, current research-based learning and assessment theories, and foster critical thinking to promote effective learning.”

Therefore, increased continuing educational standards are essential in today’s health care environment; not only to improve the quality of care, but also to reduce inappropriate care and thereby reduce costs. Respiratory Care Professionals are expected to participate in the development, modification and evaluation of care plans, protocol administration, disease management, and patient education. Currently, the standards for online continuing education vary widely and are not consistent. As a result, the NCRCB has modified the continuing education requirements to facilitate continued growth and development of the respiratory care in NC.  As a collective group, we are devoted to our professional growth and development through higher levels of education in order to improve the most important aspect of our profession – the patient.

The most recent rule change in 21 NCAC 61 .0401 (Continuing Education Requirements) allows for licensees to earn 3 credits for clinical precepting towards the 12 credits required each year. Upon application for license renewal, a licensee shall attest to having completed clinical precepting as part of the learning activities when claiming the 12 CE credits during the preceding renewal cycle. The licensee must be prepared to submit evidence of completion if requested by the Board. This evidence shall include a copy of the licensee’s annual preceptor evaluation completed by the college that reflects an overall satisfactory rating. The board does not stipulate the number of hours required to earn this credit since the hours required are determined by the policies of each facility and educational institution. A licensee that provides clinical instruction as their primary employment status may not use this option for credit. 

The NC Respiratory Care Board is committed to the principles of civil rights and opposes any form of discrimination against individuals or groups of individuals based on sex, race, age, national origin, religion, disability, or sexual orientation. The NCRCB believes that all healthcare personnel have a right to and responsibility for a workplace free of sexual harassment. Sexual harassment has an adverse impact on the health care environment and is considered unlawful in NC as workplace violence. Any act related to workplace violence is considered a violation of North Carolina General Statute § 90-659(a)(1)(d) and Board Rules 21 NCAC 61 .0307 (10). Pursuant to North Carolina General Statute § 90-652(5), the Board will determine if there is sufficient credible information to begin an investigation into cases of this nature. The Board has the power to deny an application (if applicable), revoke a license or impose probationary conditions on a licensee and may also assess administrative penalties and costs if it determines that there has been a violation of the Respiratory Care Practice Act or the Board’s Rules, based on information received during an investigation. 

1. A person who provides only support activities as defined in G. S. 90-648(13) is exempt as an unlicensed individual. They may:
   
   1. Deliver, set up, and calibrate prescribed respiratory care equipment.
   2. Provide instructions on the use, fitting and application of apparatus.
   3. Demonstrate the mechanical operation for the patient, or caregiver.
2. In accordance with Board of Pharmacy rule 21 NCAC 46 .2611 as defined in G.S. 90-85.3(e),(l1),(r); 90-85.6; 90-85.22, the delivery of respiratory equipment may also include the following:
   
   1. Maintain testing equipment to ensure accurate calibration;
   2. Review safety precautions;
   3. Review cleaning procedures;
   4. Review maintenance procedures; and
   5. Return demonstrations on equipment delivered.
   6. Instruct the patient about emergency and routine contact procedures;
   7. Deliver and review with the patient written instruction materials to ensure that the patient receives adequate information to properly operate the equipment; and
   8. Provide a written plan of service which is developed, implemented, and documented in the patient record including an assessment of the safety of the home environment, the caregiver or patient ability to comply with the prescription, and the caregiver or patient ability to operate and clean the equipment as instructed.

1. Each of the following must be performed by a respiratory care practitioner licensed by the Board or other licensed practitioner operating within their scope of practice.
   
   1. Teaching, administration, or performance of respiratory care including instructions to the patient or caregiver regarding the clinical use of the equipment, and
   2. Patient monitoring, patient assessment, or other activities or procedures that are undertaken to assess the clinical effectiveness of an apparatus, or to evaluate the effectiveness of the treatment,
   3. For the purposes of this section, mechanical ventilation support procedures relative to set-up will require a licensed respiratory therapist.

Under the Respiratory Care Practice Act, “the Practice of Respiratory Care” is defined irrespective of the setting in which it is delivered. With this in mind, the following definitions apply:

In G.S. 90-648 paragraph ten, the practice of respiratory care is defined by the written order of a physician licensed under Article 1 of this Chapter, which includes observing and monitoring of signs and symptoms, general behavior, and general physical response to respiratory care treatment and diagnostic testing, including the determination of whether such signs, symptoms, reactions, behavior, or general response exhibit abnormal characteristics, and the performance of diagnostic testing and therapeutic application of:

1. Medical gases, humidity, and aerosols including the maintenance of associated apparatus, except for the purpose of anesthesia.
2. Pharmacologic agents related to respiratory care procedures, including those agents necessary to perform hemodynamic monitoring.
3. Mechanical or physiological ventilatory support.
4. Cardiopulmonary resuscitation and maintenance of natural airways, the insertion maintenance of artificial airways under the direct supervision of a recognized medical director in a health care environment which identifies these services within the scope of practice by the facility’s governing Board.
5. Hyperbaric oxygen therapy.
6. New and innovative respiratory care and related support activities in appropriately identified environments and under the training and practice guidelines established by the American Association of Respiratory Care. The term also means the interpretation and implementation of a physician’s written or verbal order pertaining to the acts described in this subdivision.

In 2018, the Board adopted the following definitions to clarify the scope of respiratory care:

1)         21 NCAC 61 .0103 (1) “Assessment” means a clinical evaluation of an individual patient by a respiratory care practitioner (RCP) or other licensed health care provider within their scope of practice to determine the ability and efficacy of a respiratory care procedure, protocol, or treatment, including an assessment of the suitability and efficacy of equipment for an individual patient if equipment is to be used in the procedure or treatment.

2)         21 NCAC 61 .0103 (2) “Respiratory care” means the health care discipline that specializes in the promotion of optimum cardiopulmonary function and health and wellness using scientific principles to identify, treat and prevent acute or chronic dysfunction of the cardiopulmonary system pursuant to G.S. 90-648(11) that is taught in accredited educational programs pursuant to G.S. 90-653(3) or in approved continuing education programs pursuant to the rules of this Chapter within the guidelines established by the American Association for Respiratory Care, incorporated by reference including subsequent amendments and editions, pursuant to G.S. 90-648(10)(f). Copies of the guidelines may be found at https://www.aarc.org/resources/clinical-resources/clinical-practice-guidelines/ at no cost.

3)         21 NCAC 61 .0103 (3) “The practice of respiratory care” means the performance of assessments and diagnostic tests, and implementation of treatment procedures and protocols related to the cardiopulmonary system pursuant to G.S. 90-648(10) and the activities defined by the American Association of Respiratory Care clinical guidelines, incorporated by reference including subsequent amendments and editions, pursuant to G.S. 90-648(10)(f). Copies of the guidelines may be found at https://www.aarc.org/resources/clinical-resources/clinical-practice-guidelines/ at no cost.

In addition to the general activities identified in G.S. 90-648(10), each of the following specific activities constitutes the practice of Respiratory care:

1. the performance of pulmonary diagnostic and sleep-related testing;
2. the administration of pharmacologic agents related to respiratory care procedures;
3. establishment and maintenance of arterial lines for hemodynamic monitoring;
4. therapeutic evaluation and assessment relating to mechanical or physiological ventilator support, including positive pressure support apparatus;
5. airway clearance techniques, postural drainage, and chest percussion;
6. assistance with bronchoscopy;
7. asthma and respiratory disease management;
8. cardiopulmonary rehabilitation;
9. alleviating respiratory impairment and functional limitation by designing, implementing, and modifying therapeutic care plans;
10. patient instruction in respiratory care, functional training in self-care and home respiratory care management, and the promotion and maintenance of respiratory care fitness, health, and quality of life;

Regarding paragraph two of 21 NCAC 61 .0103, respiratory care includes any acts, tests, procedures, treatments, or modalities that are routinely taught in educational programs or in continuing education programs for respiratory care practitioners and are routinely performed in respiratory care practice settings. All of these aspects have been well defined in the literature. In addition, the National Board for Respiratory Care provides credentialing examinations to verify competencies in the areas listed above.

The NBRC exam matrix outlines the competencies required and expected within the scope. All accredited respiratory programs in the United States are required to include these competencies as part of their curriculum. In addition, these competencies must also be included in the clinical portion of the degree program as required by the Commission on Accreditation for Respiratory Care (COARC). The  COARC  and its sponsoring organizations cooperate to establish,  maintain,  and promote educational standards of quality to prepare individuals for respiratory care practice and to provide recognition for postsecondary educational programs that meet the minimum requirements outlined in these Standards.

The Board has published declaratory rulings, interpretive letters, and position statements when the statute or rules are unclear. These documents are under the Practice Guidance Documents on the main page. Any further clarifications should directed to the Executive Director, Dr. William L. Croft, Ed.D., Ph.D., RRT, RCP, FAARC at bcroft@ncrcb.org.