How to Become an EMT in California

Who can apply

• You must be 18 or older.
• You must pass the NREMT EMT cognitive exam and complete your course's skills competency verification within two years before you apply, and have an approved EMT course completion record issued within two years. Or you must hold a current National Registry EMT (or higher) registration.
• You must complete the state and federal criminal background check (Live Scan fingerprints). The certifying entity must receive both results before it issues your certificate.
• You must disclose past and pending certification or license actions, criminal investigations, pending charges, and prior convictions on your application.

Step by step

1. Complete a California-approved EMT course of at least 170 hours.
2. Pass the NREMT EMT cognitive exam and complete the skills competency verification your approved course or LEMSA requires.
3. Get Live Scan fingerprints for the state (DOJ) and federal (FBI) background check, sent to your county's EMT certifying entity.
4. Apply to the local EMS agency (LEMSA) or certifying entity in the county where you will work, and pay the $75 state fee plus any county fee.
5. Receive your wallet card within 45 days after meeting all requirements. Your certificate is listed on the state EMT Central Registry.
6. Renew every 2 years with 24 hours of CE or a refresher course and a skills competency form.

Training and exam

Training: California EMT courses must be approved by an EMT approving authority (usually the LEMSA) and be at least 170 hours: at least 146 hours of classroom and skills lab, and at least 24 hours of supervised clinical experience with at least 10 documented patient contacts. High-fidelity simulation can replace up to 6 clinical hours and up to 3 patient contacts. Exam time does not count toward the hours.

Exam: California uses the National Registry exams: the NREMT EMT cognitive exam and the NREMT EMT psychomotor exam. You must pass both within two years before you apply for certification. NREMT charges $104 per cognitive exam attempt.

What it costs in California

Fixed amounts are set by the state. Items marked “your quote” are priced by private sellers, so enter what you’re quoted.

How long it takes

Certifying entities must issue the wallet card within 45 days to eligible applicants who complete all requirements.

Keeping your certification

Renewal: Certification lasts two years and expires on the last day of the month. To renew, complete a 24-hour refresher course or 24 hours of approved CE within the prior 24 months, submit a skills competency verification form (EMSA-SCV) signed after direct observation, and pay the $37 state renewal fee plus any local fee. First-time renewers must also show training in naloxone, epinephrine auto-injector and glucometer use. If you change certifying entities you need a new background check. Lapsed certificates have added CE requirements depending on how long they lapsed.

Good to know in California

Already NREMT certified or from another state: You are eligible for California initial certification (with the age, background check, disclosure and fee requirements) if you hold a current National Registry EMT, Advanced EMT or Paramedic registration, or a current out-of-state Advanced EMT or Paramedic certificate. An out-of-state EMT certificate qualifies only if you also passed the NREMT exams within two years before applying.

One certifying entity at a time: You can be certified by only one California certifying entity during a certification period. Tell it in writing within 30 days of any mailing address change.

Military deployment: If your certificate expires while you are deployed on active duty, or within six months after you return, you have six months after returning to complete renewal requirements.

Sources

• EMSA - California Code of Regulations, Title 22, Division 9 (effective January 1, 2025)
• EMSA - EMT/AEMT Certification Requirements and Fees (June 2021)
• NREMT EMT Candidate Handbook - Certification Process