National Registry of EMTs

Emergency Medical Technicians (EMT)

Emergency Medical Technicians provide out of hospital emergency medical care and transportation for critical and emergent patients who access the emergency medical services (EMS) system. EMTs have the basic knowledge and skills necessary to stabilize and safely transport patients ranging from non-emergency and routine medical transports to life threatening emergencies. Emergency Medical Technicians function as part of a comprehensive EMS response system, under medical oversight. Emergency Medical Technicians perform interventions with the basic equipment typically found on an ambulance. Emergency Medical Technicians are a critical link between the scene of an emergency and the health care system.
[From the: National EMS Scope of Practice Model]

How to become a Nationally Certified Emergency Medical Technician?

Individuals applying for Emergency Medical Technician certification must meet the following requirements:
  1. 18 years of age or older.
  2. 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.
    • Candidates must have completed the course within the past two years and the course Program Director must verify successful course completion on the NREMT website.
    • If the initial Emergency Medical Technician (EMT) educational program was completed more than two years ago, and the candidate is currently state licensed at the EMT level, the candidate must document successful completion of a state-approved EMT refresher course or 24 hours of equivalent continuing education topic hours within the past two years.
    • If the candidate is not currently state licensed as an EMT and it has been more than two years from the completion of an approved EMT course, the candidate must complete a new state-approved EMT course prior to applying for National Certification.
  3. Have a current CPR-BLS for Healthcare Providers or equivalent credential.
  4. Successful completion of a state-approved Emergency Medical Technician (EMT) psychomotor exam.
  5. Successful completion of the EMT Cognitive Exam

Application Process

  • Create an account/login profile on this website.
  • Submit a NREMT application and answer all questions truthfully.
  • 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 (US funds). The application fee is non-transferable and non-refundable. This fee is charged for each attempt of the cognitive examination.
  • Candidates will receive an electronic Authorization to Test (ATT) once you are eligible for the exam. The electronic ATT contains scheduling instructions and important details concerning proper identification required at testing centers. You can find the ATT in the 'Check Application Status' page.

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 up to a twelve (12) month period, provided all other requirements for NREMR certification are met.

The Cognitive Exam Apply For A Cognitive Exam

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; 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, candidates 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.

We strongly encourage candidates to review the following information:

EMT Cognitive Exam Test Plan

Based on the most recent practice analysis, the NREMT Board approves a cognitive exam test plan. A test plan is a blue-print that tells the computer testing software how to build a candidate's exam. The table below indicates what percent of the test will focus on each topic area.

Content Area Percent of Exam Adult / Pediatric Mix
Airway, Respiration & Ventilation 18%-22% 85% Adult; 15% Pediatric
Cardiology & Resuscitation 20%-24% 85% Adult; 15% Pediatric
Trauma 14%-18% 85% Adult; 15% Pediatric
Medical; Obstetrics & Gyn 27%-31% 85% Adult; 15% Pediatric
EMS Ops 10%-14% N/A

Cognitive Exam Retest Information

If a candidate is not successful in passing the cognitive exam, the NREMT will provide a candidate feedback on their performance. Candidates may apply to retest 15 days after the last examination.

Candidates are given a total of six opportunities to pass the EMT 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.* After remedial training is complete, the candidate is given three additional attempts to pass the EMT cognitive exam, 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.
Note: 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 CAPCE approved.

The Psychomotor Exam

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.

Emergency Medical Technician psychomotor examinations are not scheduled by the NREMT. All EMT psychomotor exams are administered by either the State EMS Office or at the training institution (with approval and oversight provided by the State EMS Office). EMT course instructors should provide candidates information regarding this examination.

All Nationally Certified Emergency Medical Technicians are required to demonstrate proficiency on the following skills:

Expiration Dates

Initial expiration dates are determined by the date the candidate successfully completes the entire national certification process (cognitive and psychomotor exams). EMT, AEMT, and Paramedic candidates completing the national certification process between the January 1 and 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.

Expiration Dates and Recertification Cycles

Initial Certification

Initial Cycle

Following Cycles

If you successfully completed the national certification process between: Your initial certification date will be March 31 Every cycle, after your initial cycle, will be:
January 01-June 30 2 years in the future April 1-March 31 (2 years)
July 1-December 31 3 years in the future April 1- March 31  (2 years)

How do I recertify?

Detailed information about the recertification process for Emergency Medical Technicians is on the EMT Recertification Page.

Frequently Asked Questions

Responsibilities of Nationally Certified EMS Personnel

Certified Emergency Medical Technicians (EMTs) must notify the NREMT 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 NREMT considers the individual to be solely responsible for their certification.

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.

Americans with Disabilities Act

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.

Cognitive Exam
Exam Type: Computer Adaptive
Questions: 70-120
Time Limit: 2 hours
EMT Info
Cognitive Exam Fee: $70
(Per exam attempt)
2017 Cognitive Exam Fee: $80
(Per exam attempt)
Renewal Fee: $15
Late Fee: $50+Renewal Fee
Age: 18 Years Old