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How to become a certified EMT or Paramedic in Hawaii. NREMT accepted. EMT training: 180 minimum (didactic + clinical) hours. Total initial EMT cost: $102-$171 (license) + $104 (NREMT exam) + course tuition. Verified 2026-03-21. Data verified 2026-03-21. Source: LicenseMap (getlicensemap.com).
EMT / Paramedic
Governing Authority
Hawaii Department of Health, Emergency Medical Services and Injury Prevention System Branch
Official website →Most information on this page has been verified.
80% of data points are verified against official sources. 6 fields based on preliminary research. 6 fields need verification. We recommend confirming details with your state's licensing authority. See sources below · Report incorrect data
No
NREMT Required?
180 minimum (didactic + clinical)
EMT Training Hours
4 levels
Certification Levels
$102-$171 (license) + $104 (NREMT exam) + course tuition
EMT Initial Cost
2 years
Renewal Period
72 hrs
EMT CE Hours
Training Hours
60 hours
Scope of Practice
Basic emergency care including bleeding control, CPR, AED use, oxygen administration, and basic patient assessment
NREMT Required
Yes
Additional Requirements
Training Hours
180 minimum (didactic + clinical) hours
Scope of Practice
BLS care including patient assessment, vital signs monitoring, oxygen therapy, bag-valve-mask ventilation, CPR/AED, splinting, bleeding control, assisted medication administration (epinephrine auto-injector, nitroglycerin, albuterol), emergency childbirth, and spinal motion restriction
NREMT Required
Yes
Additional Requirements
Training Hours
350 hours
Scope of Practice
All EMT-Basic skills plus IV/IO access, fluid administration, supraglottic airway devices, blood glucose monitoring, CPAP, and limited medication administration per protocol
NREMT Required
Yes
Additional Requirements
Training Hours
1,200 hours
Scope of Practice
All AEMT skills plus endotracheal intubation, cardiac monitoring/12-lead ECG, manual defibrillation/cardioversion, transcutaneous pacing, needle chest decompression, surgical cricothyrotomy, comprehensive medication administration, and RSI where authorized
NREMT Required
Yes
Additional Requirements
Training Program Requirements
Verified180 minimum (didactic + clinical)
EMT Training Hours
1,200
Paramedic Hours
96
Clinical Rotation
Notes
Hawaii requires 96 hours of clinical training through a board-approved agency for EMT certification. Training programs must be approved by the Hawaii Medical Board. Dual oversight exists between DCCA and DOH EMS Branch, which is unusual among states.
Exam Requirements
VerifiedAccepted
NREMT Certification
Not Required
Cognitive Exam
Not Required
Psychomotor Exam
Yes
State-Specific Exam
NREMT Details
Hawaii requires NREMT certification for initial licensure. For recertification, NREMT renewal is optional; an alternative pathway of 24-hour refresher course plus 48 hours CE is accepted. The NREMT cognitive exam is CAT format with 70-120 questions for EMT level, 2-hour time limit, $104 per attempt, scaled score passing at 950/1500, up to 6 attempts with 15-day wait between attempts. Psychomotor exam is administered by the state.
State Exam Details
Hawaii relies on the NREMT cognitive and psychomotor exams. No separate state-specific written exam is required.
Passing Score
NREMT cognitive exam uses computer adaptive testing (CAT) with 70-120 questions for EMT level. Scaled score passing threshold is 950 out of 1500. The exam adapts difficulty based on candidate performance.
Retake Policy
NREMT allows up to 6 attempts with a 15-day waiting period between attempts. After the 3rd failed attempt, candidates must complete 24 hours of remedial training. After 6 failed attempts, full course completion is required. Exam fee is $80 per attempt.
What Each Level Can Do
VerifiedOnline Medical Direction (Real-Time)
Real-time physician contact via radio or phone for consultation on patient care decisions beyond standing orders
Offline Medical Direction (Standing Orders)
Standing orders and protocols developed by the EMS medical director that authorize specific treatments without real-time physician contact
Protocol Requirements
All EMS providers in Hawaii must operate under the authority of a licensed physician medical director. Each EMS agency must have approved medical protocols.
Minimum Age
Education
Background Check
Drug Screening
CPR/BLS Certification
Immunizations Required
Driver's License Required
| Fee | Amount |
|---|---|
NREMT Exam Fee NREMT EMT cognitive exam fee (increased from $70 in 2025) | $80 |
State Application Fee Fee varies by year: odd years $171, even years $102 | Contact agency |
State License Fee Included in application fee; odd years $171, even years $102 | $102-$171 |
Renewal Fee Fee varies by year: odd years $171, even years $102; renewal by January 31 | $102-$171 |
Total Initial EMT Cost Total varies by year and does not include course costs | $102-$171 (license) + $104 (NREMT exam) + course tuition |
Total Initial Paramedic Cost Total varies by year and does not include course costs | $102-$171 (license) + $104 (NREMT exam) + program tuition |
Renewal & CE Requirements
Verified2 years
Renewal Period
72 hrs
EMT CE Hours
72 hrs
Paramedic CE Hours
Required
Skills Verification
NREMT Recertification Accepted for State Renewal
CE Topics
Renewal Fee
Contact agency
Varies by year; odd years $171, even years $102; due by January 31
Regulatory Board
EMS certifications must be renewed on schedule. Most states require continuing education covering patient assessment, trauma care, cardiac emergencies, and applicable protocol updates.
Out-of-State Reciprocity
VerifiedAccepts Out-of-State Credentials
NREMT-Based Reciprocity Available
Reciprocity Type
NREMT-based; NOT an EMS Compact member state
Transfer Details
Hawaii does NOT have reciprocity with any state. Out-of-state EMS providers must meet full Hawaii licensing requirements including NREMT certification and application through the Medical Board/DCCA.
Additional Requirements for Transfer
EMT/Paramedic reciprocity is often facilitated through NREMT certification. States that require NREMT typically allow easier transfer for certified providers. Always verify current reciprocity policies with your state EMS office.
Hawaii has NO reciprocity with any state. EMS licensing is through the Medical Board/DCCA rather than a dedicated EMS office, with dual oversight from DCCA and DOH EMS Branch. License fees alternate by year ($171 odd years, $102 even years). NREMT recertification is optional with a 24-hour refresher plus 48-hour CE alternative.
Hawaii does NOT have reciprocity with any state. Out-of-state providers must meet full Hawaii licensing requirements.
EMS licensing in Hawaii is managed through the Medical Board/DCCA, which is unusual among states where EMS is typically under the Department of Health.
Dual oversight exists between DCCA and DOH EMS Branch.
License fees vary by year: odd years $171, even years $102.
Renewal is due by January 31 every 2 years.
For recertification, NREMT renewal is optional; a 24-hour refresher course plus 48 hours CE is an alternative pathway.
Hawaii is NOT an EMS Compact member state.
Explore requirements for other professional licenses in Hawaii.
How this state compares to 50 others for this profession
Salary
#1 of 51
Cost
#13 of 51
Processing
#1 of 51
Based on May 2024 Bureau of Labor Statistics OEWS data for Emergency Medical Technicians (SOC 29-2042)
Entry Level
$51,590
25th percentile
Median
$61,310
+48% vs. national avg ($41,340)Experienced
$84,910
75th percentile
Wage Distribution (Annual)
550 employed in this state
Note: BLS EMT category includes EMT-Basic level. Paramedics (EMT-P) are classified separately under SOC 29-2043 with higher wages.
Source: BLS OEWS – Emergency Medical Technicians (May 2024)
National employment projections for 2024-2034
Projected Growth
+8.8%
High DemandNew Jobs
+12,900
over 10 years
Annual Openings
19,600
per year (avg.)
147,300 currently employed nationwide (2024)
Source: BLS Employment Projections 2024-2034 (September 2025)
Emergency Medicine Career Ladder+166% salary growth potential
You are here
EMT
$61,310
EMT-Basic course (120-150 hours) + NREMT
Paramedic program (1-2 years) + NREMT-P
You are here
EMT
EMT-Basic course (120-150 hours) + NREMT
$61,310
Paramedic program (1-2 years) + NREMT-P
Master's in PA Studies + PANCE
$163,020
Salary data from BLS OEWS May 2024 for this state. Career paths represent common advancement routes — actual progression may vary. Bureau of Labor Statistics — Occupational Outlook Handbook
Government fees and exam costs to obtain your initial license
Note: These are government licensing fees only. Education/training program costs (tuition, books, etc.) are not included as they vary widely by institution.
Estimated total: ~null weeks
Timeline estimated from licensing requirements on this page.
2–6 weeks
Estimated processing time
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Hawaii accepts NREMT certification for EMS providers. EMT training requires 180 minimum (didactic + clinical) hours. All certification is managed through the Hawaii Department of Health, Emergency Medical Services and Injury Prevention System Branch.
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.