How to Become an EMT in New York

Checked against New York State Department of Health, Bureau of Emergency Medical Services and Trauma Systems (BEMS) · Verified 2026-10-17

Exam: Required
Training: Required
Term: 4 years
State fee: See state office
Certified by: New York State Department of Health, Bureau of Emergency Medical Services and Trauma Systems (BEMS)

Take the free EMT practice test →

Who can apply

You must be at least 17 years old by the last day of the month in which your EMT course ends or is scheduled to end (10 NYCRR 800.6).
You must complete a state-approved EMT course given by a Bureau-approved course sponsor.
You must not have certain misdemeanor or felony convictions listed in 10 NYCRR Part 800. The Department reviews every conviction case by case; a conviction does not stop you from taking the course but can delay or block certification.

Step by step

Enroll in an EMT course with a Bureau of EMS approved course sponsor (the Bureau publishes lists of approved sponsors and upcoming courses).
Finish the course and pass the practical skills evaluation accepted by the Bureau.
After your course sponsor files the end-of-course paperwork, watch for an Authorization to Test email from PSI.
Schedule and pass the New York State cognitive (written) exam with PSI, at a test center or by live remote proctoring. Or, through your course sponsor, take the NREMT cognitive exam instead.
If you passed the NREMT exam, submit your results on the Bureau's EMS Forms page. Without this step the Bureau will not process your certification.
The Bureau issues your New York State EMT certification. Cards are mailed and can take 4 to 6 weeks.

Official application →

Training and exam

Training: You must complete a New York State-approved EMT course with a Bureau-approved course sponsor. Only approved sponsors may teach courses that lead to state certification. Courses follow the National EMS Education Standards. If you are a member of a New York EMS agency (form DOH-3312), the state may pay your tuition through the course sponsor. Sponsors cannot charge those students extra tuition but may charge a non-refundable enrollment fee of up to $250 (Policy 25-07).

Exam: New York accepts two cognitive exams: the New York State exam, delivered by PSI at test centers or by live remote proctoring, or the NREMT EMT cognitive exam. You also need a Bureau-accepted practical skills evaluation from your course. You get three attempts per eligibility and two years from your end-of-course date to pass. You must wait at least 24 hours between attempts. Candidates pay the costs of either exam. NREMT charges $104 per attempt.

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

What it costs in New York

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

New York State cognitive exam (PSI; amount not published by the Bureau)$
NREMT EMT cognitive exam, optional instead of state exam (per attempt)$104
EMT course tuition or enrollment fee (up to $250 for state-funded agency members)$
Reciprocity filing fee (up to $99, set by the Department)(optional)$

Estimated total in New York$0Plus 2 items with no state-set price. Add your quotes above to complete the total.

Cost details from the state

State cognitive exam fee paid to PSI when you register; the Bureau does not list the amount.
NREMT EMT cognitive exam, if you choose it instead: $104 per attempt.
Course enrollment fee of up to $250 for state-funded students, or full tuition if you are not eligible for state reimbursement.

Pay in New York

Before you compare job offers, see what a paycheck takes home in New York after taxes.

Keeping your certification

Renewal: Certifications issued after July 1, 2024 last 48 months. You can recertify through an agency's CME-Based Recertification Program without a refresher course or exam if you stay in continuous practice with a participating agency. The EMT form (DOH-5065) lists 20 hours of core refresher topics, 5 hours of mandatory topics (including 2 hours of emergency vehicle driver training), 20 additional CE hours, current CPR and skills verification. Submit at least 45 days before your expiration. Otherwise, take a refresher course and pass the state exams. If your certification has lapsed, you recertify by completing a refresher course.

Good to know in New York

Moving from another state: If you hold a current EMT certification from another state, the military or NREMT, you can apply for reciprocity online instead of taking a New York course. You must show a need for certification (such as a job or school in New York). Your course must meet the National EMS Education Standards, and no more than half of its lecture portion can have been self-paced online. Initial review can take 60 to 90 days. A reciprocity certification expires when your out-of-state certification does.

Reciprocity fee: The 2024 rule change lets the Department charge a non-refundable reciprocity filing fee of up to $99, set on the application. The old rule set it at $25 for EMTs.

Exam retakes: After three failed cognitive attempts you must complete approved remedial training before you can try three more times. After six total attempts, you must take a full original course again.

NREMT and state certification: Holding NREMT certification does not by itself let you work in New York. You need New York State certification, either from a New York course or through reciprocity.

Sources

General information, not legal advice. Fees and rules change — confirm with New York State Department of Health, Bureau of Emergency Medical Services and Trauma Systems (BEMS) before you apply.