National Registry of EMTs

Emergency Medical Technician Recertification Information

Nationally Registered EMTs (NREMT) are required to renew their certification every two years. NREMTs 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 40 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: 20 Hours

The National Component requires EMTs to complete 20 hours of approved continuing education. A maximum of 7 hours of distributive education may be used to meet the 20 hour requirement.

Airway/Respiration/Ventilation: 1.5 Hours

Ventilation [1 Hours]

Oxygenation [0.5 Hour]

Cardiovascular: 6 Hours

Post-Resuscitation Care [0.5 Hour]

Ventricular Assist Devices [0.5 Hour]

Stroke [1 Hour]

Cardiac Arrest [2 Hours]

Pediatric Cardiac Arrest [2 Hours]

Trauma: 1.5 Hours

Trauma Triage [0.5 Hour]

Central Nervous System (CNS) Injury [0.5 Hour]

Hemorrhage Control [0.5 Hour]

Medical: 6 Hours

Special Healthcare Needs [1.5 Hours]

OB Emergencies [0.5 Hour]

Infectious Diseases [0.5 Hour]

Pain Management [0.5 Hour]

Psychiatric and Behavioral Emergencies[0.5 Hour]

Toxicological Emergencies – Opioids[0.5 Hour]

Neurological Emergencies – Seizures[0.5 Hour]

Endocrine Emergencies – Diabetes[1 Hour]

Immunological Emergencies [0.5 Hour]

Operations: 5 Hours

At-Risk Populations [0.5 Hour]

Ambulance Safety [0.5 Hour]

Field Triage—Disasters/MCIs [0.5 Hour]

EMS Provider Hygiene, Safety, and Vaccinations [0.5 Hour]

EMS Culture of Safety[0.5 Hour]

Pediatric Transport [0.5 Hour]

Crew Resource Management [1 Hour]

EMS Research[0.5 Hour]

Evidence Based Guidelines [0.5 Hour]

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

Local or State Component: 10 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 7 hours of distributive education may be used to meet the 10 hour requirement.

Individual Component: 10 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 10 hours of distributive education may be used to meet the 10 hour requirement.

Recertification By Traditional Model

The traditional EMT recertification program requires a total of 72 hours of continuing education to recertify. This model includes a refresher course and continuing education. All EMTs 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 (March 31).

State Refreshers

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

  1. Traditional Refresher Course: Completion of a State or CAPCE(F1, F2, F5) approved 24 hour EMT refresher course.
  2. Continuing Education Topic Hours: EMT refresher may be completed by continuing education* and must include the topics and hours listed below.

A maximum number of 10 hours can be applied from distributive education All hours must be state or CAPCE approved.

Topics Hours Required**
Mandatory Core Content - 24 hours total
Preparatory 1 hour
Suggested Courses:
  • 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
Suggested Courses:
  • Basic Airway Management
  • Oxygen Delivery Systems and Techniques
  • Oxygen Therapy
  • Adjuncts
OB, Infants & Children 2 hours
Suggested Courses:
  • 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
Suggested Courses:
  • 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
Suggested Courses:
  • General Pharmacology, Respiratory Emergencies, Environmental Emergencies, Acute Abdominal Emergencies, Diabetic Emergencies, Allergic Reactions, Poisoning and Overdose, Behavioral Emergencies
Trauma 4 hours
Suggested Courses:
  • Management of Shock, Bleeding/Wounds, Soft Tissue Injuries, Musculoskeletal Injuries, Chest Trauma, Injuries to Head and Spine, Burns
Electives 8 hours
Suggested Courses:
  • Emergency Driving, HAZMAT, Ambulance Operations, Incident Command System

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

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 Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) 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: EMS Course Instruction, and Wilderness EMS Training.

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

Recertification By Examination

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

  • Login to your National Registry account. Complete a Recertification By Exam application and pay the exam fee.
  • 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 between April 1 (one year prior to your current expiration date) and March 31 (your expiration date). 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 March 31 with signatures and supporting documentation. All other recertification requirements (including criminal conviction statement, verification of skills, etc.) must still be met and verified.

Renewing Late

If the renewal application was not submitted prior to the March 31 deadline, the EMT may pay a $50 late application fee and submit the application until April 30.  However, all continuing education requirement must have been satisfied prior to March 31.

'Active' or 'Inactive' Status

When renewing National Registry certification, EMTs have the option of declaring their status as either "Active" or "In Active". Active status means the EMT is 'actively' working and providing patient care. To renew with an 'active status', EMTs are required to be affiliated with an EMS Agency or Service.

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 an EMS service or healthcare/patient care activity;
  • are not actively treating patients at their certification level but are involved as educators, administrators or regulators;
  • are unable to actively provide patient care for any variety of reasons - such as, moving, illness, pursuit of education, family responsibilities, etc.
Registrants who wish to declare inactive status must continue to meet the National Registry 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.

Returning to Active Status

Nationally Certified EMTs may request return to active status at any time once they gain active affiliation with an EMS service. A request to return to active status must be accompanied by a completed Inactive to Active Registration form which may be downloaded here.

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 March 31 deadline, but all educational requirements were completed by March 31 deadline, individuals may seek reinstatement of the National EMS Certification until April 30. There is a $50 reinstatement fee in addition to the standard $15 recertification fee ($65 total).

Lapsed EMT Certification

Information on how to regain a lapsed certification is found on the EMT Certification 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.
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