National Registry of EMTs

Emergency Medical Responder Recertification


Nationally Registered EMRs (NREMR) are required to renew their certification every two years. NREMRs can recertify by either taking the cognitive examination or by completing continuing education. Note: We encourage you to reference the specific license renewal requirements for every state which you are licensed to practice.

Courses that cannot be applied towards recertification requirements include duplicate courses, clinical rotations, instructor courses, management/leadership courses, performance of duty, preceptor hours, serving as a skill examiner, and volunteer time with agencies. If you have questions on accepted education, please review the Agency Guide For Recertification.

The EMT National Continued Competency Program (NCCP) requires a total of 16 hours of continuing education to recertify. The model requires continuing education in three components: (1) a national component, (2) a local/state component, and (3) an individual component.

National Component: 8 Hours

The National Component requires EMRs to complete 8 hours of approved continuing education. A maximum of 3 hours of distributive education may be used to meet the 8 hour requirement.



Airway/Respiration/Ventilation: 1 Hour

Ventilation [0.5 Hour]

Oxygenation [0.5 Hour]


Cardiovascular: 2.5 Hours

Post-Resuscitation Care [0.5 Hour]

Stroke [0.5 Hour]

Cardiac Arrest [0.5 Hour]

Pediatric Cardiac Arrest [1 Hour]


Trauma: 0.5 Hour

Central Nervous System (CNS) Injury [0.5 Hour]


Medical: 3 Hours

OB Emergencies [0.5 Hour]

Infectious Diseases [0.25 Hour]

Psychiatric and Behavioral Emergencies[0.25 Hour]

Toxicological Emergencies – Opioids[0.5 Hour]

Neurological Emergencies – Seizures[0.5 Hour]

Endocrine Emergencies – Diabetes[0.5 Hour]

Immunological Emergencies [0.5 Hour]


Operations: 1 Hour

Field Triage—Disasters/MCIs [0.5 Hour]

EMS Provider Hygiene, Safety, and Vaccinations [0.25 Hours]

EMS Culture of Safety[0.25 Hours]


For detailed information on the National Component and sample lesson plans,
download the 2016 NCCP EMR Guide.

Local or State Component: 4 Hours

If specific local and/or state are not specified, these required hours are considered flexible content. You may use any state or Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) approved EMS–related education to fulfill these requirements. A maximum of 3 hours of distributive education may be used to meet the 4 hour requirement.

Individual Component: 4 Hours

The individual hours are considered flexible content. You may use any state or Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) approved EMS–related education to fulfill these requirements. A maximum of 4 hours of distributive education may be used to meet the 4 hour requirement.

Recertification By Traditional Model

The traditional EMR recertification program requires a total of 12 hours. Of these twelve hours, a maximum of six can be from distributive education
All EMRs recertifying with the traditional model are required to show proof of BLS-CPR (or healthcare provider level equivalent) certification current through the National Registry expiration date (September 30).

A. Continuing Education Option
  • Complete a State or CAPCE (F1, F2, F5) approved 12 hour EMR refresher or equivalent continuing education as outlined below.
  • Pay the $10 (U.S. funds) non-refundable processing fee at the time of submission of documentation

All continuing education hours must be completed within the current certification cycle. Education completed on or prior to your previous September 30 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.


B. Refresher
The EMR refresher course can be completed through two different options:
  • Traditional refresher course - Completion of a State or CAPCE (F1, F2, F5) approved 12 hour EMR refresher course.
  • Continuing education topic hours - EMR refresher may be completed by continuing education** and must include the topics and hours listed below:
Topics Hours Required**
Preparatory 1 hour
Roles and Responsibilities:
Well-being of the Emergency Medical Responder, Medical Direction, Quality Improvement, Personal Protection, Scene Safety, Medical/Legal, Human Anatomy, Lifting and Moving
Airway 2 hours
Roles and Responsibilities:
Basic Airway Management, Oxygen Delivery Systems and Techniques, Adjuncts, Oxygen Therapy
Patient Assessment 2 hours
Roles and Responsibilities:
Scene Size-up, Primary Survey, Vital Signs and History Taking, Assessment of Trauma Patients, Assessment of Medical Patients, Secondary Assessment, Communications, Documentation
Circulation 3 hours
Roles and Responsibilities:
Management of Shock, Cardiac Emergencies, Bleeding/Wounds/Shock, Cardiac Arrest Management
Illness & Injury 3 hours
Roles and Responsibilities:
General Pharmacology, Respiratory Emergencies, Environmental Emergencies, Acute Abdominal Emergencies, Diabetic Emergencies, Allergic Reactions, Poisoning and Overdose, Behavioral Emergencies, Soft Tissue Injuries, Musculoskeleta l Injuries, Injuries to Head and Spine
Childbirth & Children 1 hour
Roles and Responsibilities:
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
Total 12 hours

Recertification By Exam

This option enables you to demonstrate continued cognitive competency without documenting continuing education.

  • Login to your National Registry account. Complete a recertification by examination application and pay the exam fee.
  • NOTE: Be sure you complete the Recertification By Exam application.
  • After 24-48 hours, login to your National Registry account and print your Authorization to Test (ATT) letter. Follow the directions in the letter to schedule your exam.
  • You may make one attempt to take and pass the exam beginning on October 1 (one year prior to your current expiration date) and September 30. A cognitive competency by exam form will become available through your National Registry account upon successful completion of the exam.
  • Return your completed cognitive competency by exam form by your expiration date with signatures and supporting documentation. All other recertification requirements (including criminal conviction statement, verification of skills, etc.) must still be met and verified.

Why Was I Audited?

To comply with accreditation requirements, the National Registry is required to randomly audit applications. In addition to random quality assurance audits, the National Registry reserves the right to investigate certification and recertification material at any time. You must retain verification of attendance of all education submitted for at least 36 months. Failure to submit documentation when audited may result in denial of eligibility to recertify.

Reinstatement Information

If the recertification application was not received by the September 30 deadline, but all educational requirements were completed by September 30 deadline, individuals may seek reinstatement of the National EMS Certification until October 31. There is a $50 reinstatement fee in addition to the standard $10 recertification fee ($60 total).

Lapsed EMR Certification

Information on how to regain a lapsed certification is found on the EMR Certification Page

Responsibilities of Nationally Certified EMS Personnel
Certified Emergency Medical Responders (EMRs) must notify the National Registry within 30 days regarding the following matters:
  • change in mailing address (the best way to update a mailing address is by editing the user profile page)
  • 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 National Registry considers the individual to be solely responsible for their certification.

Disciplinary Policy and Rights of Appeal

The National Registry has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the National Registry Disciplinary Policy and Rights of Appeal can be found here.
Recertification Cycles

Recertification cycles start on the date the recertification application is successfully processed and approved by the National Registry. After a recertification application is approved, the new expiration date will be two years after the current expiration date listed on the individual's account.

Frequently Asked Recertification Questions