How to Become an EMT in Maryland

Checked against Maryland Institute for Emergency Medical Services Systems (MIEMSS), Office of EMS Clinician Services, for the Maryland EMS Board · Verified 2026-10-17

Exam: Required
Training: Required
Term: 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).
State fee: $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.
Certified by: Maryland Institute for Emergency Medical Services Systems (MIEMSS), Office of EMS Clinician Services, for the Maryland EMS Board

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Who can apply

You must be at least 16 years old. Applicants who are 16 or 17 need written permission from a parent or legal guardian.
You must complete an EMS Board-approved EMT course and a MIEMSS-approved internship.
You must pass the NREMT EMT cognitive exam and the Maryland EMT psychomotor exam.
You must be affiliated with a Maryland EMS operational program (EMSOP).
Your application may need approval from the MIEMSS Office of Integrity.

Step by step

Enroll in an EMS Board-approved EMT course.
Within two weeks of the course start, create a MIEMSS eLicensure account, request an ePINS number, submit part 1 of the Initial EMT Certification application, and start an NREMT application.
Have your EMS operational program approve your affiliation in the portal.
Complete the internship and submit the Internship Packet through the portal. Since July 2024 it must be approved before you can take the psychomotor exam.
After your education program reports your course completion, register for and pass the Maryland EMT psychomotor exam given by the Office of Clinician Services.
Pass the NREMT EMT cognitive exam and submit your NREMT active status to MIEMSS.
MIEMSS reviews the application (about 3 to 5 business days each for completeness and approval) and issues your certification in eLicensure.

Official application →

Training and exam

Training: You must finish an EMT course approved by the Maryland EMS Board plus a MIEMSS-approved internship. You must be at least 16 to take part in any BLS clinical training or internship.

Exam: Maryland requires two exams: the National Registry EMT cognitive exam and the Maryland EMT psychomotor (practical) exam, which is given by the MIEMSS Office of Clinician Services. You cannot take the psychomotor exam until MIEMSS has your course completion record and your approved internship packet.

Practice for the NREMT EMT exam free — airway, cardiology, trauma, medical and EMS operations →

What it costs in Maryland

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

EMT course tuition$
NREMT cognitive exam fee (paid to NREMT)$
Maryland EMT practical exam fee (waived for members/employees of qualifying fire, rescue, public safety or EMS agencies or licensed commercial ambulance services)$65
Reciprocity fee, if applicable (out-of-state applicants)(optional)$35

Estimated total in Maryland$65Plus 2 items with no state-set price. Add your quotes above to complete the total.

Cost details from the state

Maryland EMT practical (psychomotor) exam fee: $65, waived for members or employees of qualifying fire, rescue, public safety or EMS agencies or licensed commercial ambulance services.
EMT course tuition varies by program.
NREMT cognitive exam fee is paid to the NREMT.
$35 reciprocity fee, if applicable, for out-of-state EMTs.

Pay in Maryland

Maryland adds a local income tax on top of the state rate, so look up the local rate for your area before you budget.

How long it takes

MIEMSS lists 3 to 5 business days to decide whether an application is complete and 3 to 5 business days to approve it.

Keeping your certification

Renewal: Before expiration you must stay affiliated with a Maryland EMS operational program and complete the three most recent annual BLS protocol updates. Then either keep active NREMT registration (EMT or higher), or complete 24 hours of CE (airway 3, cardiovascular 3, trauma and burns 3, medical 2, pediatrics 2, OB/GYN 1, toxicology/environmental 1, technical skills 1 to 9, rest flexible). Submit at least two weeks before expiration. Extensions of up to six months are available by written request before expiration. NREMT does not have to be maintained if you use the 24-hour option.

Good to know in Maryland

Out-of-state EMTs: Apply to MIEMSS with proof of a current out-of-state EMT, AEMT or paramedic certification, or active NREMT registration at EMT level or higher. You must be at least 16, be affiliated with a Maryland BLS operational program, complete the BLS protocol orientation and a MIEMSS-approved technical proficiency verification, and pay the $35 reciprocity fee if applicable. A reciprocal certificate expires the following July 31 or January 31.

Lapsed certification: You can reinstate within three years of expiration (any time if you hold active NREMT registration) by meeting current renewal requirements, being affiliated with a Maryland EMS operational program, and completing a MIEMSS-approved protocol orientation.

Affiliation required: Maryland EMT certification depends on a current affiliation with a Maryland EMS operational program, both to get certified and to keep it.

Sources

General information, not legal advice. Fees and rules change — confirm with Maryland Institute for Emergency Medical Services Systems (MIEMSS), Office of EMS Clinician Services, for the Maryland EMS Board before you apply.