How to Become an EMT: Certification Requirements by State
Checked against official state sources ·
Emergency Medical Technicians (EMTs) give basic life support on ambulances, at fire departments and in emergency settings. Every state certifies or licenses EMTs through its EMS office. Most states require a state-approved EMT course, the National Registry (NREMT) cognitive exam and a state-approved skills (psychomotor) check, plus a criminal-history screening — but the fees, renewal rules and whether you must keep NREMT current differ by state.
Of the 50 states covered here, 50 require a certification exam and 50 require a state-approved EMT course.
The steps most states share
- Meet the basic requirements — usually at least 18 (some states allow 16 or 17) and a current CPR card.
- Complete a state-approved EMT course; required hours vary by state (for example California 170, Illinois at least 150).
- Pass the NREMT cognitive (written) exam and complete your state's approved skills (psychomotor) verification, or take your state's own exam.
- Apply to your state EMS office with a background check and the state fee, and affiliate with an EMS agency if your state requires it.
- Renew on schedule with the continuing education your state requires (often through NREMT recertification).
Requirements by state
| State | Exam | Training | Term | State fee |
|---|---|---|---|---|
| Alabama | Yes | Yes | 2 yrs | $40 license fee (initial or renewal). A $50 late fee applies to expired licenses. |
| Alaska | Yes | Yes | 2 yrs | $25 nonrefundable application fee (initial or recertification). $50 late fee if you apply for recertification after your expiration date. |
| Arizona | Yes | Yes | 2 yrs | None. ADHS does not charge for EMCT certification or recertification. A $150 nonrefundable extension fee applies if you renew within 30 days after your certificate expires. |
| Arkansas | Yes | Yes | 2 yrs | An initial license fee set by Arkansas Code 20-13-211 applies; ADH's EMS pages do not state the amount. You may qualify for a waiver of the initial fee (Act 725 of 2021) if you receive Medicaid, SNAP, WIC, TEA or Lifeline, were approved for unemployment in the last 12 months, or earn no more than 200% of the federal poverty guidelines. |
| California | Yes | Yes | 2 yrs | $75 state fee for an initial EMT certificate (also charged when your DOJ background check is no longer active), and $37 for each renewal. Local EMS agencies may add their own fees. |
| Colorado | Yes | Yes | 3 yrs | — |
| Connecticut | Yes | Yes | 2 yrs | None. OEMS lists $0.00 for initial EMT certification by exam, by out-of-state endorsement, renewal and reinstatement. |
| Delaware | Yes | Yes | 2 yrs | Official sources differ on the initial fee: the Commission's 2026 fee table and initial-certification instructions list $20 for initial EMT certification, while the 2026 EMT application lists a $25 processing fee. Recertification is $25. Reinstating an expired certification is $50 (includes the application fee). |
| Florida | Yes | Yes | 2 yrs | $35 EMT certification application fee (nonrefundable); $20 renewal every 2 years. |
| Georgia | Yes | Yes | 2 yrs | $75 initial license application fee (plus $2.75 if paid by credit/debit card). A $75 late fee applies to late renewals. |
| Hawaii | Yes | Yes | 2 yrs | $171 if licensed between February 1 of an even-numbered year and January 31 of an odd-numbered year ($20 non-refundable application fee, $32 license fee, $19 half renewal fee, $100 Compliance Resolution Fund); $102 if licensed between February 1 of an odd-numbered year and January 31 of an even-numbered year. |
| Idaho | Yes | Yes | 3 yrs | No state license fee for EMR or EMT (the $35 fee applies only to AEMT and Paramedic). |
| Illinois | Yes | Yes | 4 yrs | $45 EMT license fee (pay online, or by certified check or money order; no personal checks or cash). |
| Indiana | Yes | Yes | 2 yrs | — |
| Iowa | Yes | Yes | 2 yrs | $30 initial certification application fee (nonrefundable). |
| Kansas | Yes | Yes | Certificates expire December 31 of the second full calendar year after issue. | $50 EMT application for certification fee (nonrefundable). |
| Kentucky | Yes | Yes | 2 yrs | No fee for initial EMT certification (202 KAR 7:030). Reciprocity applicants pay $100. A $100 late fee applies to renewals postmarked after the expiration date. |
| Louisiana | Yes | Yes | Initial and reciprocity licenses for applicants with a current NREMT certification are issued with the same expiration date as the NREMT certification (March 31). Renewal applications open October 1 of the renewal cycle, after the NREMT renewal, and must be completed before the March 31 expiration date. | $30 initial EMT license fee. It is $15 if you work for the State of Louisiana, a municipal fire department, fire protection district, volunteer fire department or municipal law enforcement agency and do not do paid EMS work elsewhere. Out-of-state applicants pay $60; the fee is waived for military applicants. |
| Maine | Yes | Yes | A new license expires on the same date as your NREMT certificate. Licenses expire at midnight on the last day of the month listed. | $21 for a new EMT license; it covers the State of Maine background check. |
| Maryland | Yes | Yes | Certificates issued February 1 to July 31 expire July 31 three years later; those issued August 1 to January 31 expire January 31 three years later (3 to 3.5 years). | $65 for the Maryland EMT practical exam and $35 for reciprocal certification (COMAR 30.02.02.02). These and certification/renewal fees are waived if you are a member or employee of a government fire, rescue, public safety or EMS agency, a volunteer fire, rescue or ambulance company, or a licensed commercial ambulance service. |
| Massachusetts | Yes | Yes | 2 yrs | $150 nonrefundable initial application fee (paid by card or eCheck; a processing fee may apply to card payments). |
| Michigan | Yes | Yes | 3 yrs | $40 EMT license fee (covers the three-year license). Waived for applicants honorably discharged from the armed forces, and not charged to volunteers at a life support agency that does not charge for its services. |
| Minnesota | Yes | Yes | 2 yrs | None listed. Minn. Stat. 144E.29 sets no fee for individual EMT certification; a duplicate certification costs $25. |
| Mississippi | Yes | Yes | — | $40 for EMT certification and $40 for each recertification. Card payments add a $3.00 + 2.2% processing fee. |
| Missouri | Yes | Yes | 5 yrs | — |
| Montana | Yes | Yes | 2 yrs | $35 EMT application fee. Since July 1, 2025, applicants and licensees of qualifying programs may also be charged an extra $5 litigation-fund fee under HB 227. |
| Nebraska | Yes | Yes | 2 yrs | No fee is listed for an initial EMT license application; the $35 fee on the DHHS application is for reinstatement applicants only. You pay the $75 FBI nationwide background check fee separately (online through PAYPORT) for the Nebraska State Patrol fingerprint check. |
| Nevada | Yes | Yes | Since September 1, 2023, a new certificate's expiration date is tied to your date of birth and is no more than two years away; after that it renews every two years. | $24 for an initial EMT certificate and $24 for each renewal (NAC 450B.700). Late renewal adds $50. Certification by reciprocity costs $45. |
| New Hampshire | Yes | Yes | Licenses for nationally registered EMTs are valid for up to two years and expire on April 30. | No separate license fee is listed. You pay the state background check fee: $50 (raised from $47 on October 1, 2026). |
| New Jersey | Yes | Yes | 3 yrs | — |
| New Mexico | Yes | Yes | Licenses run in 27-month periods that start January 1 and end March 31. Your first period is shorter or longer depending on when you were licensed. | $65 initial EMT-Basic license fee for graduates of New Mexico programs; $130 for reciprocity applicants. |
| New York | Yes | Yes | 4 yrs | — |
| North Carolina | Yes | Yes | 4 yrs | — |
| North Dakota | Yes | Yes | Your North Dakota license expires 90 days after your NREMT EMT certification expires. | — |
| Ohio | Yes | Yes | Your certificate expires on your birthday in the third year. If your first cycle is shorter than three years, you need only part of the CE hours (none for 12 months or less, 30 percent for 12 to 24 months, 60 percent for 24 to 36 months). | None. Ohio charges no fee to apply for or renew an EMT certificate to practice (Ohio Adm. Code 4765-8-02 and 4765-8-16). Reciprocity applicants pay $75. |
| Oklahoma | Yes | Yes | Your first license runs from the date of issue through the second June 30 after it is issued. After that, licenses run two years, from July 1 to June 30. | $85 for an initial EMT license ($75 license fee plus $10 line-of-duty death benefit fee). Non-refundable unless the application is rejected. |
| Oregon | Yes | Yes | All EMT licenses expire June 30 of odd-numbered years, so your first license may be shorter or longer than two years; an initial license can run up to 30 months. | $110 initial EMT license fee, prorated if you apply with less than 12 months left before the June 30 expiration. $140 for reciprocity. $55 to renew. |
| Pennsylvania | Yes | Yes | 3 yrs | — |
| Rhode Island | Yes | Yes | The rules do not state how long a license lasts. Renewal is tied to keeping your NREMT certification, which runs two years. | $120 initial EMT license application; $120 to renew. Non-refundable. City, town, fire district, volunteer and nonprofit EMS providers are exempt from the fee (R.I. Gen. Laws 23-4.1-10). |
| South Carolina | Yes | Yes | The certificate is valid for up to four years from the date it is issued. | — |
| South Dakota | Yes | Yes | 2 yrs | $0. South Dakota charges no fee for an initial, reciprocity, or renewal EMT license (ARSD 20:61:01:11). |
| Tennessee | Yes | Yes | 2 yrs | $50 application fee (non-refundable) plus $75 license fee. Reciprocity is $100. |
| Texas | Yes | Yes | 4 yrs | $64 initial EMT application (non-refundable). Reciprocity is $126. |
| Utah | Yes | Yes | 2 yrs | $45 initial EMT QA review fee (fee schedule effective July 1, 2024, the latest BEMS has posted). A $75 late fee applies if you apply more than 30 days after the course starts. |
| Vermont | Yes | Yes | Your Vermont license expires three months after your NREMT certification expires (NREMT runs on two-year cycles). | — |
| Virginia | Yes | Yes | 4 yrs | — |
| Washington | Yes | Yes | 3 yrs | $0. DOH says there are currently no fees for EMS certifications or recertification. |
| West Virginia | Yes | Yes | 2 yrs | $37.50 initial certification fee plus $47.50 national criminal background check (64 CSR 48-6.8). Fees are non-refundable. |
| Wisconsin | Yes | Yes | 3 yrs | No state application fee is listed for in-state initial EMT licenses. Out-of-state (reciprocity) applicants pay $50 (DHS 110.16). |
| Wyoming | Yes | Yes | 2 yrs | — |
More states are added only once their rules are checked against the state's own commissioning office.
General information, not legal advice. Fees and rules change — confirm with your state's commissioning office before you apply.