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]

Individuals applying for the Emergency Medical Technician national 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 National Registry website.
  3. Have a current CPR-BLS for "Healthcare Provider" or equivalent credential.
  4. Successful completion of the National Registry cognitive (knowledge) and a state approved psychomotor (skills) exams.
    • Passed portions of each examination (cognitive and psychomotor) remain valid for 24 months. This policy is effective for candidates with a course completion date on or after November 1, 2018. For candidates with a course completion date prior to November 1, 2018, passed portions of each examination is valid for 12 months.


  • 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.

Application Process

  • Create an account/login profile on this website.
  • Submit a National Registry application and answer all questions truthfully.
  • The National Registry 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 $80 (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.

Responsibilities of Nationally Certified EMS Personnel

Certified Emergency Medical Technicians (EMTs) 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.

Americans with Disabilities Act

The National Registry 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 National Registry Accommodations Disability Policy can be found here.

The Cognitive Exam Apply For A Cognitive Exam

The National Registry Emergency Medical Technician (EMT) cognitive exam is a computer adaptive test (CAT). The number of items a candidate can expect on the EMT exam will range from 70 to 120. Each exam will have between 60 to 110 ‘live’ items that count toward the final score. The exam will also have 10 pilot questions that do not affect the final score. 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 National Registry 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 & Gynecology 27%-31% 85% Adult; 15% Pediatric
EMS Operations 10%-14% N/A

Cognitive Exam Retest Information

If a candidate is not successful in passing the cognitive exam, the National Registry 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 remedial training. Remedial training must be completed by a state approved instructor or an approved CAPCE course. 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 EMT course.

Remedial Training Requirements

The EMT remedial training requirement can be satisfied through three different options:

  1. Traditional Refresher Course: Completion of a State or CAPCE(F1, F2, F5) approved 24 hour EMT refresher course.
  2. NCCR 20 hours of continuing education: Completion of the 20 hour National Competency Component from the NCCP model.
  3. Continuing education topic hours: EMT remedial may be completed by continuing education* and must include the topics and hours listed here under Traditional Model.

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 administered by the National Registry. 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.

The following performance checklists are a guide for the verification of required skills. The State EMS Office or training institution may use different forms.

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

Initial Certification

Initial Cycle

If you successfully completed the national certification process between: Your initial certification date will be March 31
January 01-June 30 2 years in the future
July 1-December 31 3 years in the future

How do I recertify?

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

Lapsed Certifications

Lapsed 0-24 Months

If the EMT did not meet all recertification requirements by the expiration date, the National EMS certification is considered to be lapsed. If the certification lapsed less than two years, or you are currently state licensed as an Emergency Medical Technician (EMT), you can regain National EMS Certification by completing the cognitive and psychomotor examinations.

To obtain authorization to test, lapsed EMTs must demonstrate proof of education requirements. The following methods are acceptable:

  • Complete a Traditional State Approved EMT Refresher
  • State approved continuing education equal to the EMT Refresher
  • If the EMT was licensed in a NCCP state, completion of the National Component meets the requirement

Lapsed More Than 2 Years

Entry and/or re-entry into the National Registry may be granted to a previously state licensed or Nationally Certified EMT provided you complete:

  • A state approved refresher course, or the national component of the NCCP program
  • A state administered practical examination
  • The Cognitive Examination
  • Hold current BLS CPR certification