Respiratory Therapist Salary by State 2026: What RTs Actually Earn and Where the Jobs Are

U.S. News & World Report ranked Respiratory Therapist #12 overall and #4 among all healthcare careers on its 2026 Best Jobs list — and the reasons are hard to argue with. The median annual wage sits at $80,450, the field is projected to grow 12% from 2024 to 2034 (well above the 4% average for all occupations), and the aging U.S. population guarantees sustained demand for decades. Yet most people outside healthcare don't know the career exists. That gap between visibility and opportunity makes respiratory therapy one of the most undervalued paths in allied health right now. Here's exactly what RTs earn by state, how credentials affect pay, and where the field is heading.

💡 Why Respiratory Therapy Is Growing Faster Than Almost Everything Else

Respiratory therapists work with patients who have cardiopulmonary conditions — COPD, asthma, pneumonia, COVID-19 complications, lung cancer, neonatal respiratory distress, and more. They manage mechanical ventilators, administer breathing treatments, perform diagnostic tests like pulmonary function studies and arterial blood gas analysis, and are central to ICU care teams during respiratory emergencies.

The demand drivers are structural and worsening:

An aging population: Baby Boomers are moving into the age bracket (65+) where respiratory conditions are most prevalent. COPD alone affects over 16 million Americans and is the third leading cause of death in the U.S.. Each percentage point increase in the 65+ population translates directly to more respiratory therapy demand.

Smoking and air quality: Despite decades of decline in smoking rates, 28.6 million Americans still smoke (CDC data), and the long-term consequences — emphysema, COPD, lung cancer — are arriving in hospitals now. Additionally, wildfire smoke and urban air pollution have measurably increased the incidence of respiratory conditions in previously low-risk populations.

Post-COVID sequelae: Long COVID respiratory complications created a sustained, partially new patient population requiring ongoing RT services — including pulmonary rehabilitation, supplemental oxygen management, and exercise tolerance work that didn't exist at scale before 2020.

The Bureau of Labor Statistics projects 8,800 job openings per year on average over the next decade. That's a field where the demand for replacement and growth hires consistently outpaces the number of graduates.

📊 Respiratory Therapist Salary by State — 2026

The national median is $80,450 (BLS, May 2024 data — the most recent available). The bottom 10% earn under $61,900; the top 10% earn over $108,820.

State	Annual Mean Salary	Notes
California	$105,000-$122,000+	Highest in country; strict staffing ratios
New York	$88,695-$110,000	NYC premium; strong union contracts
Hawaii	$95,000-$108,000	High cost of living, high pay
Washington	$90,000-$102,000	Strong healthcare system
Massachusetts	$88,000-$99,000	Academic medical centers
Nevada	$85,000-$95,000	High demand, moderate supply
Texas	$72,000-$84,000	Large market; rural areas below average
Florida	$68,000-$80,000	High volume; competitive market
Tennessee	$65,000-$75,000	Growing market
Mississippi	$58,000-$68,000	Lowest-paying states

Sources: BLS Occupational Outlook Handbook, Respiratory Therapy Zone, Vivian Health — RT Salary.

New York leads entry-level salaries, with new graduates averaging $88,695 across 39 metro areas — partly driven by New York City hospital contract rates. California's range is the widest: entry-level RTs in smaller markets may start at $70,000, while experienced RRTs at major Bay Area health systems can earn $120,000+. The gap between California and Mississippi at peak experience is approximately $50,000–$60,000 per year — a difference that, over a 30-year career, represents well over $1 million in cumulative earnings before accounting for pension differences.

🎓 CRT vs. RRT: The Certification Decision That Changes Your Pay

All respiratory therapists must be licensed by their state — and all states require certification through the National Board for Respiratory Care (NBRC). The NBRC offers two primary credentials:

Certified Respiratory Therapist (CRT): The entry-level credential. Passing the Therapist Multiple-Choice Examination (TMC) at the "CRT cut score" earns this designation. Many states accept the CRT as the minimum for licensure.

Registered Respiratory Therapist (RRT): The advanced credential. Passing the TMC at the "RRT cut score" (higher), plus passing the Clinical Simulation Examination (CSE), earns the RRT designation. This is the standard that most hospitals, ICUs, and high-acuity settings require or strongly prefer.

The financial difference is significant: RRTs earn $5,000 to $8,000 more per year on average than CRTs, and holding the RRT credential at the time of hire typically adds $3,000 to $5,000 over CRT-only starting salaries, according to Respiratory Therapist Pay. Over a 30-year career, that initial differential compounds significantly — especially when it affects pension calculations based on final salary.

Strategic recommendation: Always sit for both exams together after graduation while the material is fresh. The incremental effort to achieve RRT over CRT is modest; the payoff is substantial. Programs accredited by the Commission on Accreditation for Respiratory Care (CoARC) prepare graduates for both exams.

Beyond CRT and RRT — specialty credentials from NBRC:

Credential	Full Name	Best For
RRT-NPS	Neonatal/Pediatric Specialist	NICU, pediatric ICU
RRT-ACCS	Adult Critical Care Specialist	MICU, SICU, trauma
RRT-SDS	Sleep Disorders Specialist	Sleep labs, home sleep testing
AE-C	Asthma Educator (NAECB)	Pulmonary rehab, outpatient

Specialty credentials typically push compensation to the top 10–25% of the salary range for a given state. RRT-ACCS holders in California or Washington routinely earn $110,000–$130,000.

📍 Where Respiratory Therapists Are Needed Most

California: The highest-paying state for RTs in the country, driven by AB 394 nurse-to-patient ratios and their extension to other clinical staff in ICU settings at many facilities. Travel RT rates in California have averaged $2,200–$2,800/week according to Vivian Health — substantially above the national travel RT average.

Texas: The sheer volume of the Texas healthcare market means constant demand. Large urban systems (HCA, Tenet, UT Southwestern, Texas Children's) hire continuously, and rural Texas has persistent RT shortages across West Texas and the Panhandle where healthcare access is limited.

Southeast and Appalachia: Kentucky, West Virginia, Tennessee, and Alabama have disproportionately high rates of COPD, smoking-related disease, and opioid-linked respiratory complications — creating concentrated RT demand. Pay is lower, but cost of living is substantially lower too, and competition for positions is often less intense.

Travel RT Market: Travel respiratory therapists earned an average of $116,000–$145,600 annually in 2026 (based on $2,200–$2,800/week for 52 weeks), with crisis rates at California facilities occasionally reaching $3,200/week. Travel RTs work 13-week contracts with housing stipends, travel reimbursements, and completion bonuses. According to UHC Staffing, California and New York continue to lead travel RT compensation in 2026.

💼 RT Career Path: From New Graduate to Clinical Specialist

Year 1–2 (Staff RT, $65,000–$80,000): General floor and ER assignments. Focus on achieving RRT credential if not already held, and demonstrating reliability in all modalities. Most systems rotate new RTs through general floor, ER, and (where possible) ICU.

Years 2–4 (Lead RT / Charge RT, $78,000–$90,000): Charge RT roles carry shift leadership responsibility and typically add a $1.50–$3.00/hour differential. This is also when specialty credential pursuit begins.

Years 4–7 (Clinical Specialist, $88,000–$108,000): RRTs with NPS or ACCS credentials move into NICU, PICU, MICU, or SICU specialist roles. These positions require demonstrated proficiency and usually involve more complex ventilator management and independent clinical decision-making.

Years 7–12 (Education, Management, or Travel, $95,000–$130,000+): Three branches emerge: management (RT supervisor, department director), education (clinical coordinator, program director), or travel/per diem. See our CNA to RN bridge programs guide for a comparison with the nursing advancement ladder.

🚀 Practical Tips for Maximizing Your RT Career

1. Pursue RRT before applying for your first job. Sit for both the TMC (at RRT cut score) and the CSE while still in school or immediately post-graduation. This single decision is worth $5,000–$8,000 more per year — starting immediately. Employers often reimburse exam fees, but your credential category at hire establishes your starting grid placement.

2. Target ICU experience as early as possible. ICU-capable RTs are the most in-demand and highest-paid. The learning curve is steeper, but the pay, career options, and travel RT opportunities are dramatically better than floor-only experience. Seek out programs and first jobs that offer ICU rotation.

3. Know the difference between hospital pay and travel pay. Staff hospital positions offer stability, pension, and benefits. Travel positions offer 40–80% higher weekly gross pay but typically no pension contribution. Many experienced RTs do 3–5 years of travel after building skills to accelerate savings, then return to a staff position.

4. The NBRC specialty exams reward focused preparation. The RRT-ACCS and RRT-NPS exams have pass rates around 60–70%. NBRC publishes detailed content outlines — studying from those, plus a clinical simulation platform, is the most efficient preparation strategy.

5. California is worth the effort to get into. If you're willing to relocate, California's RT salaries are 30–50% above the national median. California requires its own Respiratory Care Practitioner (RCP) license in addition to NBRC certification — but the process is straightforward for licensed RTs from other states. The salary differential pays back any transition costs within 6–12 months.

Start Your Search 🔍

Find respiratory therapist jobs across the United States:

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• Healthcare jobs by state
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🔗 Further Reading

• BLS — Respiratory Therapists Occupational Outlook Handbook
• NBRC — National Board for Respiratory Care
• US News & World Report — Respiratory Therapist Best Jobs 2026
• Vivian Health — Respiratory Therapist Salary by State
• Research.com — How to Become a Respiratory Therapist 2026
• Respiratory Therapy Zone — Salary by State

Data from BLS, Vivian Health, US News, and NBRC. Updated July 2026.