National Registry of EMTs

Paramedic - NRP Recertification Information

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Paramedics have three recertification option available: traditional model, the NCCP model, or recert by exam. Paramedics should verify with the State EMS Office to determine which option(s) are acceptable in your state.

All Paramedics due to recertify on or after March 2019 are required to utilize the NCCP. Paramedics recertifying prior to 2019, can utilize the 2016 NCCP Content (below), the 2012 NCCP Content, or traditional refresher education. Note, the NCCP renewal option has not implemented in all states. To see if your state is currently participating in the NCCP recertification model click here. To learn more about NCCP in general, click here.

Recertification By NCCP Model

The 2016 Paramedic National Continued Competency Program (NCCP) requires a total of 60 hours of continuing education to recertify. The model contains three components, or 'buckets': a national component, a local or state component, and an individual component.

2016 National Component: 30 Hours

The national competency component requires all Paramedics to obtain 30 hours of continuing education. The topic areas for the national component is published by the NREMT every four years. The most recent revision of the National Component was published in October 2016.


Airway/Respiration/Ventilation: 3.5 Hours

Ventilation [2 Hours]

Capnography [1 Hour]

Oxygenation [0.5 Hour]


Cardiovascular: 8.5 Hours

Post-Resuscitation Care [0.5 Hour]

Ventricular Assist Devices [0.5 Hour]

Stroke [1.5 Hours]

Cardiac Arrest [2 Hours]

Pediatric Cardiac Arrest [2.5 Hours]

Congestive Heart Failure [0.5 Hour]

Acute Coronary Syndrome [1 Hour]


Trauma: 3 Hours

Trauma Triage [1 Hour]

Central Nervous System (CNS) Injury [1 Hour]

Hemorrhage Control [0.5 Hour]

Fluid Resuscitation [0.5 Hour]


Medical: 8.5 Hours

Special Healthcare Needs [2 Hours]

OB Emergencies [0.5 Hour]

Infectious Diseases [0.5 Hour]

Medication Delivery [1 Hour]

Pain Management [1 Hour]

Psychiatric and Behavioral Emergencies[1 Hour]

Toxicological Emergencies – Opioids[0.5 Hour]

Neurological Emergencies – Seizures[0.5 Hour]

Endocrine Emergencies – Diabetes[1 Hour]

Immunological Emergencies [0.5 Hour]


Operations: 6.5 Hours

At-Risk Populations [1 Hour]

Ambulance Safety [0.5 Hour]

Field Triage—Disasters/MCIs [1 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[1 Hour]

Evidence Based Guidelines [0.5 Hour]


10 hours of distributive education may be applied in this category.


For detailed information on the National Component and ready-made lesson plans,
download the 2016 NCCP Training Guide.

2016 NCCP NRP Guide

Local or State Component: 15 Hours

The local or state competency component are developed at either the local EMS level or may be specified by your State EMS Office, EMS region directors (if applicable), or agency level administrators (for example Training Officers and Medical Directors). If specific state or local requirements 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) (Formerly known as CECBEMS) approved EMS–related education to fulfill these requirements.

10 hours of distributive education may be applied in this category.

Individual Component: 15 Hours

The individual hours are considered flexible content. You may use any state or Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) (Formerly known as CECBEMS) approved EMS–related education to fulfill these requirements.

15 hours of distributive education may be applied in this category.

Recertification By Traditional Model

The traditional Paramedic recertification program requires a total of 72 hours of continuing education to recertify. This model includes a refresher course and continuing education. All Paramedics recertifying with the traditional model are required to show proof of BLS-CPR (or healthcare provider level equivalent) certification and ACLS current through the NREMT expiration date (March 31).

State Refreshers

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

  1. Traditional refresher course: Completion of a State or CAPCE(F1, F2, F5) approved 48 hour Paramedic refresher course.
  2. Continuing education topic hours: Paramedic 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
Airway, Breathing and Cardiology 8 hours
Suggested Courses:
  • Provide ventilatory support for a patient
  • Attempt to resuscitate a patient in cardiac arrest
  • Provide care to a patient who is experiencing cardiovascular compromise
  • Provide post-resuscitation care for a cardiac arrest patient
Medical Emergencies 3 hours
Suggested Courses:
  • Assess and provide care to a patient experiencing an allergic reaction
  • Assess a patient who has a possible overdose
  • Assess and provide care to a drowning patient
Trauma 5 hours
Suggested Courses:
  • Perform a primary survey
  • Assess a patient who has a head injury
  • Assess and provide care to a patient with a suspected spinal injury
  • Provide care to a patient who has a chest injury
  • Provide care to a patient who has an open abdominal injury
  • Provide care to a patient who has shock/hypoperfusion
Obstetrics and Pediatrics 8 hours
Suggested Courses:
  • Assess and provide care to an infant or child in cardiac arrest
  • Assess and provide care to an infant or child who has respiratory distress
  • AAssess and provide care to an infant or child who has shock/hypoperfusion
  • Assess and provide care to an infant or child who has trauma

Flexible Core Content - 24 hours total
Airway, Breathing and Cardiology 8 hours
Suggested Courses:
  • Assess and provide care for an adult patient who has respiratory distress
  • Use oxygen delivery system components
  • Perform techniques to ensure a patent airway
  • Assess and provide care to a patient who is experiencing non-traumatic chest pain/discomfort
Medical Emergencies 5 hours
Suggested Courses:
  • Assess and provide care to a patient who has an altered mental status
  • Assess and provide care to a patient who has a history of diabetes
  • Assess and provide care to a patient who is experiencing a seizure
  • Assess and provide care to a patient who was exposed to heat or cold
  • Assess and provide care to a patient who is experiencing a behavioral problem
  • Assess and provide care to a patient who has a suspected communicable disease
Trauma 1 hour
Suggested Courses:
  • Provide care to a patient who has a painful, swollen, deformed extremity
  • Assess and provide care to a patient who has a burn injury
Obstetrics and Pediatrics 8 hours
Suggested Courses:
  • Assess and provide care to an infant or child who has suspected non-accidental trauma or neglect
  • Assess and provide care to an infant or child who has a fever
  • Assess and provide care to an obstetric patient
  • Provide care to a newborn
  • Provide care to a mother immediately following delivery of a newborn
Operational Tasks 2 hour
  • Use body mechanics when lifting and moving a patient
  • Communicate with a patient while providing care

* 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-24 hours The following are maximum hours per course that can be applied towards Additional EMS-Related Continuing Education hours:
  • A maximum number of 12 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 12 hours can be applied from distributive education towards this section and must be state or 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 12 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, EMR Course, instructor courses, management/leadership courses, performance of duty, preceptor hours, serving as a skill examiner, and volunteer time with agencies.

Recertification By Exam

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

  • Login to your NREMT 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 NREMT 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 April 1 (one year prior to your current expiration date) and March 31. A cognitive competency by exam form will become available through your NREMT 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.

'Active' or 'In-Active' Status

Active or In-Active Status

When renewing NREMT certification, Paramedics have the option of declaring their status as either "Active" or "In Active". Active status means the Paramedic is 'actively' working and providing patient care. To renew with an 'active status', Paramedics are required to be affiliated with an EMS Agency or Service with a Training Officer and a Medical Director.

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 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.

Returning to Active Status

Nationally Certified Advanced-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 NREMT is required to randomly audit applications. In addition to random quality assurance audits, the NREMT 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, individuals may seek reinstatement of the National EMS Certification until April 30. There is a $50 reinstatement fee in addition to the standard $20 recertification fee ($70 total).

Lapsed Paramedic Certification

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

Responsibilities of Nationally Certified EMS Personnel
Certified Paramedics 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.

Recertification Cycles

Recertification cycles start on the date the recertification application is successfully processed and approved by the NREMT. 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
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