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Paramedic — EMS
Paramedic licensing requires completing an accredited paramedic program and passing the NREMT exam in most states. Requirements for medical direction, scope of practice (including RSI and advanced procedures), and participation in the EMS Compact (REPLiCATE) vary significantly by state.
51
Total States
50
NREMT Required
25
EMS Compact
48 hrs
Avg CE Hours
Paramedic licensing involves completing an accredited program, passing the NREMT exam, and meeting state-specific requirements for medical direction and scope of practice.
Most states require passing the National Registry of Emergency Medical Technicians (NREMT) Paramedic exam, which includes both cognitive (computer adaptive) and psychomotor (skills) components. NREMT certification must be maintained through continuing education.
The Recognition of EMS Personnel Licensure Interstate CompAct (REPLiCATE) allows paramedics to practice across state lines in member states without obtaining additional licenses. The compact continues to grow as more states adopt legislation.
Paramedics operate under the medical direction of a licensed physician. This includes online (real-time) direction for critical interventions and offline (standing orders/protocols) for routine care. Some states maintain statewide protocols while others use regional systems.
Click any column header to sort. Click a state to view full requirements.
| State | Credential | NREMT | EMS Compact | CE Hours | Fees | Verified |
|---|---|---|---|---|---|---|
| Alabama(AL) | Paramedic | Yes | Yes | 48 | $235 | Mar 2026 |
| Alaska(AK) | Mobile Intensive Care Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| Arizona(AZ) | Paramedic | Yes | No | 48 | $242 | Mar 2026 |
| Arkansas(AR) | Paramedic | Yes | Yes | 48 | $320 | Mar 2026 |
| California(CA) | Paramedic | Yes | No | 48 | $474 | Mar 2026 |
| Colorado(CO) | Paramedic | Yes | Yes | 48 | $290 | Mar 2026 |
| Connecticut(CT) | Paramedic | Yes | No | 48 | $400 | Mar 2026 |
| Delaware(DE) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| District of Columbia(DC) | Paramedic | Yes | No | 48 | $300 | Mar 2026 |
| Florida(FL) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| Georgia(GA) | Paramedic | Yes | Yes | 48 | $295 | Mar 2026 |
| Hawaii(HI) | Paramedic | Yes | No | 48 | $247 | Mar 2026 |
| Idaho(ID) | Paramedic | Yes | Yes | 48 | $260 | Mar 2026 |
| Illinois(IL) | Paramedic | Yes | No | 48 | $330 | Mar 2026 |
| Indiana(IN) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| Iowa(IA) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| Kansas(KS) | Paramedic | Yes | Yes | 48 | $285 | Mar 2026 |
| Kentucky(KY) | Paramedic | Yes | No | 48 | $300 | Mar 2026 |
| Louisiana(LA) | Paramedic | Yes | Yes | 48 | $325 | Mar 2026 |
| Maine(ME) | Paramedic | Yes | No | 48 | $196 | Mar 2026 |
| Maryland(MD) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| Massachusetts(MA) | Paramedic | Yes | No | 48 | $375 | Mar 2026 |
| Michigan(MI) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| Minnesota(MN) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| Mississippi(MS) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| Missouri(MO) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| Montana(MT) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| Nebraska(NE) | Paramedic | Yes | Yes | 48 | $260 | Mar 2026 |
| Nevada(NV) | Paramedic | Yes | No | 48 | $324 | Mar 2026 |
| New Hampshire(NH) | Paramedic | Yes | Yes | 48 | $272 | Mar 2026 |
| New Jersey(NJ) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| New Mexico(NM) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| New York(NY) | Paramedic | No | No | 48 | $180 | Mar 2026 |
| North Carolina(NC) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| North Dakota(ND) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| Ohio(OH) | Paramedic | Yes | Yes | 48 | $300 | Mar 2026 |
| Oklahoma(OK) | Paramedic | Yes | No | 48 | $385 | Mar 2026 |
| Oregon(OR) | Paramedic | Yes | No | 48 | $345 | Mar 2026 |
| Pennsylvania(PA) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| Rhode Island(RI) | Paramedic | Yes | No | 48 | $345 | Mar 2026 |
| South Carolina(SC) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| South Dakota(SD) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| Tennessee(TN) | Paramedic | Yes | Yes | 48 | $400 | Mar 2026 |
| Texas(TX) | Paramedic | Yes | Yes | 48 | $351 | Mar 2026 |
| Utah(UT) | Paramedic | Yes | Yes | 48 | $290 | Mar 2026 |
| Vermont(VT) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| Virginia(VA) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| Washington(WA) | Paramedic | Yes | No | 48 | $225 | Mar 2026 |
| West Virginia(WV) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
| Wisconsin(WI) | Paramedic | Yes | No | 48 | $275 | Mar 2026 |
| Wyoming(WY) | Paramedic | Yes | Yes | 48 | $275 | Mar 2026 |
Paramedics often work alongside other licensed EMS and healthcare professionals. Explore related licensing requirements.
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