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    Entry Requirements
    Application Process
    Certification Process
    Cognitive Examination
    Cognitive Exam Retest Information
    Psychomotor Examination
    Expiration Date
    Lapsed Certification
    Re-Entry Policy
    ADA Compliancy
    Disciplinary Policy and Rights of Appeal
    Responsibilities of Certified EMT
    EMT Recertification
    Inactive Status

Entry Requirements

Individuals applying for Emergency Medical Technician (EMT) certification must meet the following requirements:

  • 18 years of age or older.

  • Successful completion of a state-approved Emergency Medical Technician (EMT) course that meets or exceeds the National Emergency Medical Services Education Standards for the Emergency Medical Technician. You must have completed the course within the past two years. Your Program Director must verify your successful completion of the course on the NREMT website.

    If your initial Emergency Medical Technician (EMT) educational program was completed more than two years ago and you are currently state licensed at the EMT level, you must submit documentation verifying completion of a state-approved EMT refresher course or 24 hours of equivalent continuing education topic hours within the past two years.

  • If your EMT state license has lapsed or your NREMT certification has lapsed for more than two years, see the EMT Re-Entry Policy

  • If you have never held a state license as an EMT or NREMT certification and it has been more than two years from the completion of your EMT course, you must complete an entire state-approved EMT course prior to applying for National Certification.

  • Verification from the Program Director that you hold a current CPR-BLS for Healthcare Providers or equivalent credential and have demonstrated competence in Emergency Medical Technician (EMT) skills.

  • Successful completion of a state-approved Emergency Medical Technician (EMT) psychomotor exam.

Application Process

  • Create a login on this website.

  • Complete a National Registry online application including truthfully completing the Licensing Action and criminal statements. click here for more information on the NREMT Criminal Policy. The NREMT may deny certification or take other appropriate actions in regards to applicants for certification or recertification when a criminal conviction has occurred.

  • Pay the application fee of $70.00 (US funds). The application fee is non-transferable and non-refundable. This fee is charged for each attempt of the cognitive examination.

  • You will receive an Authorization to Test (ATT) once you are eligible for the exam. The ATT letter contains scheduling instructions and important details concerning proper identification required at testing centers.

Certification Process

National Emergency Medical Technician (EMT) certification requires successful completion of both a cognitive and psychomotor exam. Passed portions of the exam (both cognitive and psychomotor) remain valid for a twelve (12) month period.

Cognitive Examination

The NREMT Emergency Medical Technician (EMT) cognitive exam is a computer adaptive test (CAT). The number of items a candidate can expect on the Emergency Medical Technician (EMT) exam will range from 70 to 120. The maximum amount of time given to complete the exam is 2 hours.

The exam will cover the entire spectrum of EMS care including: Airway, Respiration & Ventilation; Cardiology & Resuscitation; Trauma; Medical & Obstetrics/Gynecology; and EMS Operations. Items related to patient care are focused on adult and geriatric patients (85%) and pediatric patients (15%). In order to pass the exam, you must meet a standard level of competency. The passing standard is defined by the ability to provide safe and effective entry level emergency medical care.

Cognitive Exam Retest Information

In the event you are unsuccessful passing the cognitive exam, the NREMT will provide feedback on your performance. You may apply to retest 15 days after your last examination.

Candidates are given six opportunities to pass the cognitive examination provided all other requirements for National EMS Certification are met. After three attempts, candidates must submit official documentation verifying completion of 24 hours of remedial training. The candidate is given three additional attempts to pass, provided all other requirements for National Certification are met. Candidates who fail to pass after a total of six attempts are required to repeat the entire Emergency Medical Technician (EMT) course.

Psychomotor Examination

Throughout your Emergency Medical Technician (EMT) educational program you must demonstrate competence in a wide range of emergency care skills. Your instructor must attest that you have demonstrated competence in the following skills during your course: patient assessment/management of a trauma patient, patient assessment/management of a medical patient, cardiac arrest management/AED, bag-valve-mask ventilation of an apneic patient, spinal immobilization (both seated and supine patient), long bone fracture immobilization, joint dislocation immobilization, traction splinting, bleeding control/shock management, upper airway adjuncts and suction, mouth-to-mouth ventilation with supplemental oxygen, and supplemental oxygen administration to a breathing patient.

You must also successfully complete a state-approved Emergency Medical Technician (EMT) psychomotor examination. Speak with your instructor or State EMS Office about the format and logistics of completing a state-approved Emergency Medical Technician (EMT) psychomotor exam.

Expiration Date

Initial expiration dates are determined by the date of successful completion of the entire national certification process. Individuals successfully completing the national certification process between the dates of January 1 - June 30 will receive an expiration date of March 31 two years in the future. Individuals successfully completing the national certification process between July 1 and December 31 will receive an expiration date of March 31 three years in the future.

For example:

NREMT- Expiration Date and Recertification Cycles

Initial Certification

Initial Cycle

Following Cycles

If you successfully completed the national certification process between:

Your initial recertification cycle is:

Every cycle after your initial cycle:

  • January 1-June 30


Completed national certification on February 14, 2014

  • Your initial certification date-March 31, 2 years in the future


February 14, 2014-March 31, 2016

  • April 1-March 31 (2 years)


April 1, 2016-March 31, 2018
(2 years expiring on even years)

  • July 1-December 31


Completed national certification on July 7, 2014

  • Your initial certification date-March 31, 3 years in the future


July 7, 2014-March 31, 2017

  • April 1- March 31  (2 years)


April 1, 2017-March 31, 2019
(2 years expiring on odd years)

Download a Certification Brochure.

Lapsed Certification If your National EMS Certification lapsed as an Emergency Medical Technician (EMT) within a two year period or you are currently state licensed as an Emergency Medical Technician (EMT), you can obtain National EMS Certification by completing a state-approved Refresher course and successfully completing the cognitive and psychomotor examinations. If your National EMS certification lapsed beyond a two-year period and state certification at the EMT level has not been maintained, you must apply to re-enter the National Registry via the EMT Re-Entry Policy that follows:

Re-Entry Policy

Entry and/or re-entry into the NREMT may be granted to a previously state licensed Emergency Medical Technician (EMT) or Nationally Certified Emergency Medical Technician (NREMT) provided you:

  1. Officially document completion of an EMT course, including transition course documentation if required, equivalent to the 2009 National EMS Education Standards and Instructional Guidelines for EMT.
  2. Provide documentation of prior state licensure as an EMT or NREMT certification.
  3. Meet the eligibility requirements for NREMT certification currently in effect to include:
    1. An approved EMT refresher course or 24 hours of equivalent continuing education topic hours within the past two years.
    2. Current CPR equivalent to BLS for Healthcare Providers.
  4. Successfully complete a state-approved EMT psychomotor examination within the past 12 months.
  5. Successfully complete the NREMT cognitive examination within the past 12 months.

ADA Compliancy

The NREMT complies with the Americans with Disabilities Act (ADA) of 1990 and offers reasonable accommodations for individuals with disabilities. Pearson VUE test centers are also ADA compliant.

Complete information about the NREMT Accommodations Disability Policy can be found here.

Disciplinary Policy and Rights of Appeal

The NREMT has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the NREMT Disciplinary Policy and Rights of Appeal can be found here. Requests to appeal must be submitted within forty-five (45) days of receipt of notice of determination.

Responsibilities of Certified Emergency Medical Technician (EMTs)

Certified Emergency Medical Technician (EMTs) must notify the NREMT within 30 days regarding the following matters:

  • change in mailing address.

  • any criminal conviction.

  • disciplinary action taken by any state has resulted in suspension, revocation, or expiration of state registration/licensure; termination of right to practice; voluntary surrender of state registration/licensure while under investigation.

The NREMT considers the individual to be solely responsible for their certification.

Emergency Medical Technician (NREMT) Recertification

In applying for recertification, certified EMS professionals agree to comply with all recertification requirements, rules and standards of the National Registry of Emergency Medical Technicians (NREMT). The recertification applicant bears the burden of demonstrating and maintaining compliance at all times.

To Apply For Recertification You Must:

  1. Be actively working within an emergency medical service, rescue service, or patient health care facility using your EMT skills.

  2. Demonstrate continued cognitive competency by examination or documentation of continuing education.

  3. Maintain skills as verified by your Training Officer/Supervisor (requires signature or electronic signature on your recertification application validating competency of skills).

  4. Have a BLS-CPR for Healthcare Providers credential that is current on your March 31 expiration date. Verification may be in the form of an instructor's signature on the recertification application or a copy of both sides of the card.

  5. Submit your completed recertification application by March 31 of the year your certification expires.

Cognitive Competency Options (2):
  1. Exam Option

    The recertification by examination option enables you to demonstrate continued cognitive competence without requiring you to document your continuing education.

    • Log in to your NREMT account. Complete a recertification by examination application and pay the exam fee. Be sure you are completing the recertification application and not the initial entry application.
    • After 24 - 48 hours, go to the NREMT website, log in to your account and print your Authorization to Test (ATT) letter. Follow the directions on the letter to schedule your exam.
    • Take and pass the exam between October 1 and March 31 of the year your certification expires. You may make one attempt in the last six (6) months of your certification cycle to demonstrate continued cognitive competency by taking an exam in lieu of documenting continuing education. You will receive an abbreviated recertification application upon successful completion of the exam.
    • Return the completed abbreviated recertification application by March 31 of the year your certification expires with signatures and supporting documentation.
    All other recertification requirements (including criminal statement, CPR, active affiliation/practice and verification of skills) must still be met and verified.

  2. Continuing Education Option

Complete a total of 72 hours of education including:

  • Completion of a State or CECBEMS (F1, F2, F5) approved 24 hour EMT refresher course or equivalent continuing education as outlined below

  • Completion of 48 hours of additional continuing EMS related education as outlined below

  • Pay the $15.00 (US funds) non-refundable processing fee at the time of submission of documentation

All continuing education hours, to include the refresher, must be completed within the current certification cycle. Education completed on or prior to your previous March 31 expiration date will NOT be accepted. If this is your first certification cycle, only education completed after the date of your initial certification will be accepted. See below for detailed recertification requirements.


Completion of a State or CECBEMS (F1, F2, F5) approved EMT Refresher Course OR Continuing Education

    The EMT Refresher course can be completed through two different options:

    • Traditional refresher course - Completion of a State or CECBEMS (F1, F2, F5) approved 24 hour EMT Refresher course.

    • Continuing education topic hours - EMT refresher may be completed by continuing education* and must include the topics and hours listed below:

    Topics Hours Required** Suggested Courses
    Preparatory 1 hour Roles and Responsibilities, Well-being of the Emergency Medical Technician, Medical Direction, Quality Improvement, Personal Protection, Scene Safety, Medical/Legal, Human Anatomy, Lifting and Moving
    Airway 2 hours Basic Airway Management, Oxygen Delivery Systems and Techniques, Adjuncts, Oxygen Therapy
    OB, Infants, Children 2 hours Obstetrical Emergencies, Gynecological Emergencies, Childbirth and Complications, Care of the Newborn, Assessing the Pediatric Patient, Medical Emergencies in Pediatric Patients, Airway Management in Pediatric Patients, Trauma Emergencies and Care in Pediatric Patients
    Patient Assessment 3 hours Scene Size-up, Primary Survey, Vital Signs and History Taking, Assessment of Trauma Patients, Assessment of Medical Patients, Secondary Assessment, Communications, Documentation
    Medical/Behavioral 4 hours General Pharmacology, Respiratory Emergencies, Environmental Emergencies, Acute Abdominal Emergencies, Diabetic Emergencies, Allergic Reactions, Poisoning and Overdose, Behavioral Emergencies
    Trauma 4 hours Management of Shock, Bleeding/Wounds, Soft Tissue Injuries, Musculoskeletal Injuries, Chest Trauma, Injuries to Head and Spine, Burns
    Elective 8 hours Emergency Driving, HAZMAT, Ambulance Operations, Incident Command System
    Total 24 hours

    * Some states require the traditional refresher course and will not accept continuing education hours. Please refer to your state’s particular requirements.

    ** A maximum number of 10 hours can be applied from Distributive Education towards this section and must be state or CECBEMS approved.

    Additional EMS-Related Continuing Education-48 hours

    The following are maximum hours per course that can be applied towards Additional EMS-Related Continuing Education hours:

    • A maximum number of 24 hours can be applied from any one topic area.

    • Hour-for-hour credit can be applied for standardized courses (including, but not limited to, ABLS, ACLS, AMLS, EMPACT, EPC, ITLS, PHTLS, PALS, PEPP, etc.)

    • A maximum number of 12 hours can be applied from each of the following courses: Teaching CPR - Emergency Driving - Dispatch Training

    • A maximum number of 24 hours can be applied from Distributive Education towards this section and must be State or CECBEMS approved.

    • Credit can be applied for college courses that relate to your role as an EMS professional (1 college credit = 8 hours of continuing education, not to exceed 24 hours per topic). For example, but not limited to anatomy, physiology, biology, chemistry, pharmacology, psychology, sociology, statistics, etc.

    • Hours from the following courses can be applied hour-for-hour with no maximum: Advanced Trauma Life Support, EMS Course Instruction, and Wilderness EMS Training.

    Courses that Cannot Be Applied towards Additional Continuing Education Hours: Clinical Rotations, CPR, Emergency Medical Responder Course, instructor courses, management/leadership courses, performance of duty, preceptor hours, serving as a skill examiner, and volunteer time with agencies.

Inactive Status

An inactive status is designated for Nationally Certified EMS Professionals who are currently not providing patient care at their certification level. For example, inactive status may be helpful for EMS professionals who:

  • are not actively engaged in ambulance/rescue service or health/patient care activity.
  • must be inactive for a period of time - such as, moving, illness, pursuit of education, family responsibilities, etc.
  • are not actively treating patients at their certification level such as educators, administrators or regulators.
Registrants who wish to declare inactive status must continue to meet the NREMT continuing education recertification requirements in subsequent cycles.

Inactive status is not for those unable to obtain and meet the educational requirements or those who have had limitations or revocation of a health care license.

Registrants who request inactive status at the EMT level do not need to obtain verification of skills from their Training Officer/Supervisor. These registrants must complete all refresher, continuing education and CPR requirements. These registrants are eligible to recertify by examination if they so choose. CPR certification remains a requirement even for those who pass the examination and request Inactive Status.

Applying for Active Status when registered as Inactive

Nationally Certified EMTs may request return to active status at any time once they gain active affiliation with a BLS service.

A request to return to active status must be accompanied by a completed Inactive to Active Registration form which may be downloaded here.

Download the EMT Recertification Requirements Brochure.

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