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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.
Side-by-side fees, hours, exams, and timelines across all 50 states. Sort by cost, hours, or any column.
Compare All StatesFind out if your license transfers to another state and what extra steps are needed.
Check ReciprocityLook up a license on the official state board — fast links to every state's verification portal.
Practice Tests for the NREMT Paramedic (EMT-P) Exam
Exam Edge offers realistic timed practice tests for the NREMT Paramedic (EMT-P) Exam with detailed answer explanations — ideal complement to a study guide.
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Click any state to see full requirements, costs, and step-by-step instructions →
| State | Credential | NREMT | EMS Compact | CE Hours | Fees | Verified |
|---|---|---|---|---|---|---|
| Alabama(AL) | Paramedic | Yes | Yes | 48 | $235 | March 2026 |
| Alaska(AK) | Mobile Intensive Care Paramedic | Yes | No | 48 | $275 | March 2026 |
| Arizona(AZ) | Paramedic | Yes | No | 48 | $242 | March 2026 |
| Arkansas(AR) | Paramedic | Yes | Yes | 48 | $320 | March 2026 |
| California(CA) | Paramedic | Yes | No | 48 | $474 | March 2026 |
| Colorado(CO) | Paramedic | Yes | Yes | 48 | $290 | March 2026 |
| Connecticut(CT) | Paramedic | Yes | No | 48 | $400 | March 2026 |
| Delaware(DE) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| District of Columbia(DC) | Paramedic | Yes | No | 48 | $300 | March 2026 |
| Florida(FL) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| Georgia(GA) | Paramedic | Yes | Yes | 48 | $295 | March 2026 |
| Hawaii(HI) | Paramedic | Yes | No | 48 | $247 | March 2026 |
| Idaho(ID) | Paramedic | Yes | Yes | 48 | $260 | March 2026 |
| Illinois(IL) | Paramedic | Yes | No | 48 | $330 | March 2026 |
| Indiana(IN) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| Iowa(IA) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| Kansas(KS) | Paramedic | Yes | Yes | 48 | $285 | March 2026 |
| Kentucky(KY) | Paramedic | Yes | No | 48 | $300 | March 2026 |
| Louisiana(LA) | Paramedic | Yes | Yes | 48 | $325 | March 2026 |
| Maine(ME) | Paramedic | Yes | No | 48 | $196 (based on $21 state application fee + $175 NREMT fee) | March 2026 |
| Maryland(MD) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| Massachusetts(MA) | Paramedic | Yes | No | 48 | $375 | March 2026 |
| Michigan(MI) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| Minnesota(MN) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| Mississippi(MS) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| Missouri(MO) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| Montana(MT) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| Nebraska(NE) | Paramedic | Yes | Yes | 48 | $260 | March 2026 |
| Nevada(NV) | Paramedic | Yes | No | 48 | $324 | March 2026 |
| New Hampshire(NH) | Paramedic | Yes | Yes | 48 | $272 | March 2026 |
| New Jersey(NJ) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| New Mexico(NM) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| New York(NY) | Paramedic | No | No | 48 | $180 | March 2026 |
| North Carolina(NC) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| North Dakota(ND) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| Ohio(OH) | Paramedic | Yes | Yes | 48 | $300 | March 2026 |
| Oklahoma(OK) | Paramedic | Yes | No | 48 | $385 | March 2026 |
| Oregon(OR) | Paramedic | Yes | No | 48 | $345 | March 2026 |
| Pennsylvania(PA) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| Rhode Island(RI) | Paramedic | Yes | No | 48 | $345 | March 2026 |
| South Carolina(SC) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| South Dakota(SD) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| Tennessee(TN) | Paramedic | Yes | Yes | 48 | $400 | March 2026 |
| Texas(TX) | Paramedic | Yes | Yes | 48 | $351 | March 2026 |
| Utah(UT) | Paramedic | Yes | Yes | 48 | $290 | March 2026 |
| Vermont(VT) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| Virginia(VA) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| Washington(WA) | Paramedic | Yes | No | 48 | $225 | March 2026 |
| West Virginia(WV) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
| Wisconsin(WI) | Paramedic | Yes | No | 48 | $275 | March 2026 |
| Wyoming(WY) | Paramedic | Yes | Yes | 48 | $275 | March 2026 |
Paramedics often work alongside other licensed EMS and healthcare professionals. Explore related licensing requirements.