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The cheapest state to get a emt / paramedic license is New York at $0. The most expensive is Connecticut at $155. The national average is $38.
Lowest
$0
New York
Average
$38
across 50 states
Median
$30
26 states at or below
Range
$155
spread across states
| # | State | Renewal Fee | Initial Fees | Renewal Cycle |
|---|---|---|---|---|
| #1 | New York | $0 | $25 | 48 months (4 years) for certifications issued after July 1, 2024 |
| #1 | Pennsylvania | $0 | $104 | 3 years |
| #1 | Washington | $0 | $104 | 3 years (coinciding with supervisory EMS agency license expiration month) |
| #4 | Louisiana | $10 | $50 | 2 years |
| #5 | Iowa | $15 | $30 | 2 years |
| #5 | Montana | $15 | $800 | 2 years |
| #5 | West Virginia | $15 | $104 | 2 years (NREMT recertification); 4 years (SETS application to state) |
| #8 | Arkansas | $20 | $1,000 | 2 years |
| #8 | Rhode Island | $20 | $224 | 2 years |
| #8 | South Carolina | $20 | $100 | 4 years |
| #8 | South Dakota | $20 | $104 | 2 years |
| #8 | Wyoming | $20 | $104 | 2 years |
| #13 | Wisconsin | $22 | $104 | 3 years |
| #14 | Oklahoma | $22.50 | $189 | 2 years |
| #15 | Delaware | $25 | $1,000 | 2 years |
| #15 | Maryland | $25 | $800 | 3 years |
| #15 | Michigan | $25 | $1,000 | 3 years |
| #15 | Missouri | $25 | $800 | 5 years (inferred from relicensing window language) |
| #15 | North Carolina | $25 | $68 | 4 years (NC state credential) |
| #15 | North Dakota | $25 | $100 | 2 years |
| #15 | Tennessee | $25 | $104 | 2 years |
| #22 | Massachusetts | $26 | $1,000 | 2 years (certifications expire March 31, 2026; next cycle expires March 31, 2028) |
| #23 | Arizona | $30 | $1,000 | 2 years |
| #23 | Kansas | $30 | $60 | 2 years |
| #23 | Maine | $30 | $21 | 2 years |
| #23 | Virginia | $30 | $104 | 4 years |
| #27 | Idaho | $35 | $0 | 3 years (EMR/EMT); 2 years (AEMT/Paramedic) |
| #27 | Mississippi | $35 | $800 | 2 years |
| #27 | Nebraska | $35 | $800 | 2 years |
| #27 | New Jersey | $35 | $1,000 | 3 years |
| #27 | New Mexico | $35 | $65 | 2 years |
| #32 | Nevada | $36 | $1,000 | 2 years |
| #33 | California | $37 (EMSA) + LEMSA fees vary | $1,000 | 2 years |
| #34 | Minnesota | $37.50 | $800 | 2 years |
| #35 | Ohio | $40 | $104 | 3 years |
| #36 | District of Columbia | $45 | $1,200 | 2 years |
| #36 | Utah | $45 | $104 | 2 years (biennial), may be shorter to standardize renewal cycles |
| #38 | Florida | $50 | $1,000 | 2 years |
| #38 | Illinois | $50 | $45 | 4 years |
| #38 | Indiana | $50 | $104 | 2 years |
| #38 | Oregon | $50 | $214 | 2 years (EMRs renew every even year; EMT/AEMT/EMT-I/Paramedics renew every odd year) |
| #38 | Vermont | $50 | $104 | Tied to NREMT expiration cycle (2 years for EMT/AEMT, 2 years for Paramedic); VEFR expires December 31 two years after initial certification |
| #43 | Kentucky | $60 | $10 | 2 years |
| #44 | Texas | $64 | $104 | 4 years |
| #45 | Colorado | $75 | $1,000 | 3 years |
| #45 | Georgia | $75 | $75 | 2 years |
| #47 | New Hampshire | $80 | $900 | 2 years |
| #48 | Alaska | $100 | $1,200 | 2 years |
| #49 | Hawaii | $102-$171 | $102 | 2 years |
| #50 | Connecticut | $155 | $1,000 | 2 years |
| — | Alabama | $Aligned with NREMT recertification cycle | $1,000 | 2 years |
Renewal fees are per renewal cycle as reported by state licensing boards. Where fee ranges are listed, the lower bound is used for ranking. Click any state for full renewal details.
New York has the lowest renewal fee at $0. The national average renewal fee is $38.
There is significant variation across the 50 states with data. Values range from $0 to $155, with a median of $30.
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