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EMT / Paramedic
Governing Authority
Hawaii Department of Health, Emergency Medical Services and Injury Prevention System Branch
Official website →Some details on this page are not yet confirmed against an official source. See sources below or contact the licensing board to verify.
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.
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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.
Didn't pass on the first try? Learn what to do if you fail the NREMT.
Overall licensing difficulty: 1/100
Study recommendation: 1–2 weeks of focused review is usually sufficient
Practice with realistic exam questions
NREMT (EMT Certification Exam)
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Difficulty rating based on education, exam, and experience requirements. Individual experience may vary.
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NREMT Cognitive Exam
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.
Cost of failing
Retake fee: $80Invest in preparation to pass the first time.
How long should you study? Most candidates study 2–4 weeks before taking the NREMT Cognitive Exam.
Study Materials & Exam Prep — NREMT Certification Exam
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Study guides and practice tests for the NREMT certification exam.
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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
Not sure if you need a emt license? Check whether your state requires one.
| 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 |
Use our licensing cost calculator to estimate your total investment including education and exam fees.
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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.
For a deeper dive into CE requirements and deadlines, see our emt license renewal guide.
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 is not reciprocal with any other state or with the NREMT or any other organization.
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.
See all EMS Compact (REPLICA) member states & eligibility details →
Moving to another state? Use our Transfer Tool to see what you need →
Compare Hawaii with other states →
See how requirements, costs, and timelines differ across all 50 states.
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.
EMT requirements in nearby states
| State | Total Cost | |
|---|---|---|
| Hawaii (you) | $102-$171 (license) + $104 (NREMT exam) + course tuition | |
| California | $1,000-$3,500 (program) + $104 (NREMT) + $37 (EMSA) + ~$80 (Live Scan) + LEMSA fees | → |
| Alaska | $1,200-$3,000 (program) + $104 (NREMT, if chosen) + $25 (app) + $100 (license) | → |
Other professional licenses in Hawaii
See how Hawaii compares: EMT License Fees by State — Cheapest to Most Expensive →
Hawaii is not currently a member of the EMS Compact (REPLICA). EMT licensees must apply through standard reciprocity or endorsement. See which states are in the REPLICA →
Related Guides
Explore requirements for other professional licenses in Hawaii.
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Official Sources
EMT requirements in Hawaii verified against Hawaii Department of Health, Emergency Medical Services and Injury Prevention System Branch, March 2026.
Moving to Hawaii? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your EMT license to Hawaii →
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.
EMT Schools in Hawaii
Compare approved training programs, costs, and requirements.