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EMT / Paramedic
EMS certification requirements vary across the United States. Most states require NREMT certification, but training hours, scope of practice, and renewal requirements differ significantly. From EMT-Basic to Paramedic, each level has its own training and certification pathway.
51
Total States
40
Require NREMT
72
Avg EMT Hours
1,203
Avg Paramedic Hours
EMS certification follows a progression from Emergency Medical Responder (EMR) to Paramedic, with increasing training, skills, and scope of practice at each level.
EMT-Basic training typically requires 120-150 hours, while Paramedic programs range from 1,200 to 1,800 hours including classroom instruction, clinical rotations, and field internship. Programs must be accredited by CAAHEP or CoAEMSP.
The National Registry of Emergency Medical Technicians (NREMT) provides a standardized certification process. Most states require or accept NREMT certification, which includes both cognitive (computer-adaptive) and psychomotor (skills) exams.
Each state has its own EMS office that issues certifications. Requirements vary in training hours, exam requirements, reciprocity policies, renewal cycles, and continuing education hours. Some states have additional state-specific exams.
Side-by-side fees, hours, exams, and timelines across all 50 states. Sort by cost, hours, or any column.
Compare All StatesFind out if your license transfers to another state and what extra steps are needed.
Check ReciprocityBrowse approved programs by state — compare costs, requirements, and timelines.
Click any column header to sort. Click a state to view full requirements.
| State | NREMT Required? | EMT Hours | Paramedic Hours | EMT Cost | EMT CE Hours | Reciprocity | Verified |
|---|---|---|---|---|---|---|---|
| Alabama(AL) | Yes | 120-150 | 1,200 | $1,000-$2,500 (program) + $104 (NREMT) + $10 (state app) + background check | 40 | Yes | March 2026 |
| Alaska(AK) | No | 140-160 | 1,200 | $1,200-$3,000 (program) + $104 (NREMT, if chosen) + $25 (app) + $100 (license) | 40 | Yes | March 2026 |
| Arizona(AZ) | Yes | 120-150 | 1,200 | $1,000-$2,500 (program) + $104 (NREMT) + $0 (state cert) + ~$75-$90 (Fingerprint Clearance Card) | 40 | Yes | March 2026 |
| Arkansas(AR) | Yes | 120-150 | 1,200 | $1,000-$2,500 (program) + $104 (NREMT) + $20 (state app) + $22-$38.50 (background check) | 40 | Yes | March 2026 |
| California(CA) | No | 170 (146 didactic + 24 clinical) | 1200-1800 | $1,000-$3,500 (program) + $104 (NREMT) + $37 (EMSA) + ~$80 (Live Scan) + LEMSA fees | 24 | Yes | March 2026 |
| Colorado(CO) | Yes | 120-150 | 1,200 | $1,000-$2,500 (program) + $104 (NREMT) + $50 (state cert) + $2.55 (Peer Assistance) + $57.50 (background check) | 36 | Yes | March 2026 |
| Connecticut(CT) | Yes | 120-160 | 1,200 | $1,000-$2,500 (program) + $104 (NREMT) + $130 (state practical) + $15 (state cert) | 40 | Yes | March 2026 |
| Delaware(DE) | Yes | 120-150 | 1,200 | $1,000-$2,500 (program) + $104 (NREMT) + $25 (state app) | 40 | Yes | March 2026 |
| District of Columbia(DC) | Yes | 120-150 | 1,200 | $1,200-$3,000 (program) + $104 (NREMT) + $45 (DC cert) | 40 | Yes | March 2026 |
| Florida(FL) | Yes | 120-150 | 1,200 | $1,000-$2,500 (program) + $104 (NREMT) + $35 (state app) + background check fees | 40 | Yes | March 2026 |
| Georgia(GA) | Yes | 120-150 | 1,200 | $75 (application) + $104 (NREMT exam) + fingerprint/background check fee | 40 | Yes | March 2026 |
| Hawaii(HI) | No | 180 minimum (didactic + clinical) | 1,200 | $102-$171 (license) + $104 (NREMT exam) + course tuition | 72 | Yes | March 2026 |
| Idaho(ID) | Yes | 120-150 | 1,200 | $0 (license) + $104 (NREMT exam) + background check fee + course tuition | 40 | Yes | March 2026 |
| Illinois(IL) | No | 120-150 | 1,200 | $45 (application) + $104 (NREMT exam) + course tuition | 60 | Yes | March 2026 |
| Indiana(IN) | No | 144.5 | 1,200 | $104 (NREMT exam) + course tuition | 56 | Yes | March 2026 |
| Iowa(IA) | Yes | 120-150 | 1,200 | $30 (initial cert) + $104 (NREMT exam) + course tuition | 40 | Yes | March 2026 |
| Kansas(KS) | Yes | 120-150 | 1,200 | $60 (background check) + $104 (NREMT exam, if chosen) + course tuition | 28 | Yes | March 2026 |
| Kentucky(KY) | Yes | 120-150 | 1,200 | $10 (application) + $30 (initial cert) + $104 (NREMT exam) + ViewPoint background check fee + course tuition | 24 | Yes | March 2026 |
| Louisiana(LA) | Yes | 120-150 | 1,200 | $50 (in-state license) + $104 (NREMT exam) + course tuition | 40 | Yes | March 2026 |
| Maine(ME) | No | 120-150 | 1,200 | $21 (initial license/background check) + $104 (NREMT EMT exam) + course tuition | 52 | Yes | March 2026 |
| Maryland(MD) | Yes | 131 | 1,200 | $800 (program) + $104 (NREMT exam) | 24 | Yes | March 2026 |
| Massachusetts(MA) | Yes | 120-150 | 1,200 | $1,000 (program) + $104 (NREMT exam) + $150 (state certification) | 40 | Yes | March 2026 |
| Michigan(MI) | No | 120-150 | 1,200 | $1,000 (program) + $104 (NREMT exam) + $40 (state application) | 30 | Yes | March 2026 |
| Minnesota(MN) | Yes | 120-150 | 1,200 | $800 (program) + $104 (NREMT exam) + $15 (state certification) | 40 | Yes | March 2026 |
| Mississippi(MS) | Yes | 120-150 | 1,200 | $800 (program) + $104 (NREMT exam) + $35 (state cert) + $50 (SAFER background) | 40 | Yes | March 2026 |
| Missouri(MO) | Yes | 120-150 | 1,200 | $800 (program) + $104 (NREMT exam) + fingerprint fee | 100 | Yes | March 2026 |
| Montana(MT) | Yes | 120-150 | 1,200 | $800 (program) + $104 (NREMT exam) + $50 (state application) | 40 | Yes | March 2026 |
| Nebraska(NE) | Yes | 120-150 | 1,200 | $800 (program) + $104 (NREMT exam) + $55 (FBI background) | 40 | Yes | March 2026 |
| Nevada(NV) | Yes | 120-150 | 1,200 | $1,000 (program) + $104 (NREMT exam) + $37 (certificate) + $61 (attendant license) | 24 | Yes | March 2026 |
| New Hampshire(NH) | Yes | 120-150 | 1,200 | $900 (program) + $104 (NREMT exam) + $48.25 (licensure) + $47 (LiveScan background) | 40 | Yes | March 2026 |
| New Jersey(NJ) | No | 120-150 | 1,200 | $1,000 (program) + $104 (NREMT exam) | 48 | Yes | March 2026 |
| New Mexico(NM) | Yes | 120-150 | 1,200 | $65 (state application) + $104 (NREMT exam) + background check fee | 40 | Yes | March 2026 |
| New York(NY) | No | 120-150 | 1,200 | ~$25 (state exam) or $104 (NREMT alternative) + course tuition | 50 | Yes | March 2026 |
| North Carolina(NC) | Yes | 120-150 | 1,200 | $68 (state exam) + $38 (background check) + course tuition | 40 | Yes | March 2026 |
| North Dakota(ND) | Yes | 110 minimum | 1,200 | ~$100-$115 (state licensure) + $104 (NREMT exam) + course tuition | 40 | Yes | March 2026 |
| Ohio(OH) | No | 120-150 | 1,200 | $104 (NREMT exam) + course tuition + background check | 40 | Yes | March 2026 |
| Oklahoma(OK) | Yes | 120-150 | 1,050 | $189 | 40 | Yes | March 2026 |
| Oregon(OR) | Yes | 120-150 | 1,200 | $214 | 36 | Yes | March 2026 |
| Pennsylvania(PA) | Yes | 120-150 | 1,400 | $104 (NREMT EMT exam fee only; no state application fee) | 24 | Yes | March 2026 |
| Rhode Island(RI) | Yes | 120-150 | 1,300 | $224 | 40 | Yes | March 2026 |
| South Carolina(SC) | Yes | 120-150 | 1,200 | — | 40 | Yes | March 2026 |
| South Dakota(SD) | Yes | 120-150 | 1,200 | Course + $104 (NREMT) + ~$25 (state app) + $30 (background check) | 20 | Yes | March 2026 |
| Tennessee(TN) | Yes | 120-150 | 1,200 | Course + $104 (NREMT) + $20 (app) + $25 (license) + background check | 20 | Yes | March 2026 |
| Texas(TX) | Yes | 150-170 | 1,200 | Course + $104 (NREMT) + $64 (state cert) + background check | 72 | Yes | March 2026 |
| Utah(UT) | Yes | 120-150 | 1,200 | Course + $104 (NREMT) + $10 (document verification) + $74 (background check) | 40 | Yes | March 2026 |
| Vermont(VT) | Yes | 120-150 | 1,200 | Course + $104 (NREMT) + state fees (not publicly posted) | 40 | Yes | March 2026 |
| Virginia(VA) | Yes | 120-150 | 1,200 | Course + $104 (NREMT EMT exam) + state fees + background check | 40 | Yes | March 2026 |
| Washington(WA) | Yes | 120-150 | 1,200 | Course + $104 (NREMT) + $0 (state fees) + possible background check | 40 | Yes | March 2026 |
| West Virginia(WV) | Yes | 120-150 | 1,200 | Course + $104 (NREMT) + $75 (state cert) + background check | 40 | Yes | March 2026 |
| Wisconsin(WI) | No | 120-150 | 1,200 | Course + $104 (NREMT) + $0 (state fees) + background check | 40 | Yes | March 2026 |
| Wyoming(WY) | Yes | 120-150 | 1,200 | Course + $104 (NREMT) + $20 (state) + $44 (background check) | 40 | Yes | March 2026 |
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See the full comparison table above for all 51 states.
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