EMT and paramedic state license or certification
Granted by state EMS offices, not by a national exam alone. A state-approved EMT program (typically under 1 year); paramedic programs require EMT-Intermediate certification and lead to a nondegree award, an associate or a bachelor's degree (BLS).
How to get licensed
A state-approved EMT program (typically under 1 year); paramedic programs require EMT-Intermediate certification and lead to a nondegree award, an associate or a bachelor's degree (BLS).
- High school diploma and CPR / basic life support certification
- State-approved EMT course (under 1 year)
- NREMT EMT exam, or the state's own examExam
- State EMT license or certificationLicense
- Work as an EMT, then a paramedic program (nondegree award, associate or bachelor's)
- NREMT Paramedic examExam
- State paramedic license or certificationLicense
The exams
National bodies write the exams; the state board decides who is licensed. NREMT (National Registry of Emergency Medical Technicians) — national certification exams for EMR, EMT, AEMT and Paramedic.
- NREMT EMT, AEMT or Paramedic certification examNational certification used by many states as the licensing exam. NREMT says its certification by itself does not give the right to practice: the state EMS office grants that.
NREMT
Legal differences between certification and licensureNational Registry of Emergency Medical Technicians (NREMT)- Checked
- 20 Oct 2026
- State EMS exam (some states)Some states give their own exam instead. New York, for example, delivers a state written certification exam through PSI after an approved course (BLS: most states require certification, others an equivalent state exam).
NYS DOH
NYS EMS examination informationNew York State Department of Health, Bureau of EMS and Trauma Systems- Checked
- 20 Oct 2026
State rules and other states
All states require EMTs and paramedics to be licensed, and requirements vary by state; many states call the authorization a certification. States may add a minimum age and a background check (BLS, NREMT).
What 3 state boards publish
| State | What the board asks for | Exam | Fee | Renewal |
|---|---|---|---|---|
| Texas Department of State Health Services (DSHS) | At least 18, high school diploma or GED, a DSHS-approved EMS course, the state application and fee, the National Registry exam and fingerprints. Paramedics: EMT-Paramedic certification after a paramedic course, or Paramedic Licensure with a two-year EMS degree or a four-year degree in any field. Texas DSHSEMS initial certification and licensureTexas Department of State Health Services (DSHS)
| |||
| New York Department of Health, Bureau of EMS and Trauma Systems | After an approved course, students take the New York State written certification exam by computer through PSI (EMT students may use live remote proctoring). Reciprocity is possible with a current certification from another state, the military or the NREMT. NYS DOHNYS EMS examination informationNew York State Department of Health, Bureau of EMS and Trauma Systems
NYS DOHEMS reciprocity informationNew York State Department of Health, Bureau of EMS and Trauma Systems
| |||
| Florida Department of Health, Division of Medical Quality Assurance | Uses the NREMT exam. Florida-trained applicants must pass within 2 years of finishing the course or retake the course. Paramedic students must graduate from a CAAHEP-accredited program (or one with a CoAEMSP letter of review). Florida DOHEmergency medical technicians and paramedicsFlorida Department of Health, Division of Medical Quality Assurance
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Each row is copied from that board's own page and cites it. A dash means the board page we read did not state it. Other states have their own rules: check the board where you will work, or open the state pages.
Good to know
Not always required
- Ambulance driver certification is not a license; employers may prefer it, and typically require a driver's license (BLS).