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EMT / Paramedic
Some details on this page are not yet confirmed against an official source. See sources below or contact the licensing board to verify.
Yes
NREMT Required?
120-150
EMT Training Hours
4 levels
Certification Levels
$30 (initial cert) + $104 (NREMT exam) + course tuition
EMT Initial Cost
2 years
Renewal Period
40 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
120-150 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
Verified120-150
EMT Training Hours
1,200
Paramedic Hours
24
Clinical Rotation
36
Field Internship
Notes
Iowa requires approximately 150 hours of classroom instruction plus 36 field hours and 24 clinical internship hours for EMT certification. Candidates must be at least 17 to enroll in an EMT course but must be 18 for certification. All CE must be through an authorized Iowa sponsor.
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Exam Requirements
VerifiedRequired
NREMT Certification
Required
Cognitive Exam
Required
Psychomotor Exam
No
State-Specific Exam
NREMT Details
Iowa requires NREMT certification for initial licensure. For recertification, NREMT renewal is optional; state CE requirements may be met through either NREMT recertification or Iowa-specific CE. 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
Iowa 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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EMT Exam Prep Books
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Difficulty rating based on education, exam, and experience requirements. Individual experience may vary.
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NREMT Cognitive Exam
Questions
120 questions
Time Limit
2 hours
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.
Format
Computer adaptive testing (CAT)
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 Iowa 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 Initial certification fee | $15 |
State License Fee Initial certification fee | $30 |
Renewal Fee EMT renewal is $0; AEMT renewal is $10; Paramedic renewal is $25 | $0 |
Total Initial EMT Cost Does not include course costs | $30 (initial cert) + $104 (NREMT exam) + course tuition |
Total Initial Paramedic Cost Does not include textbooks, uniforms, or equipment | $30 (initial cert) + $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
40 hrs
EMT CE Hours
60 hrs
Paramedic CE Hours
Required
Skills Verification
NREMT Recertification Accepted for State Renewal
CE Topics
Renewal Fee
$15
EMT renewal is free; AEMT is $10; Paramedic is $25
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
Iowa accepts out-of-state EMS providers with current NREMT certification or equivalent out-of-state certification through a reciprocity process.
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 Iowa with other states →
See how requirements, costs, and timelines differ across all 50 states.
Iowa charges no renewal fee for EMT level ($0). CE hours have specific topic distribution requirements and all CE needs an authorized Iowa sponsor. Candidates may enroll in training at 17 but must be 18 for certification. NREMT or state CE pathway accepted for recertification.
Iowa has NO renewal fee for EMT level certification ($0). AEMT renewal is $10 and Paramedic renewal is $25.
NREMT is required for initial certification but optional for recertification (can use state CE pathway instead).
CE hours have specific topic distribution requirements.
All CE must be through an authorized Iowa sponsor.
Candidates may enroll at age 17 but must be 18 for certification.
Iowa is an EMS Compact (REPLICA) member state, allowing cross-state EMS practice.
EMT requirements in nearby states
| State | Total Cost | |
|---|---|---|
| Iowa (you) | $30 (initial cert) + $104 (NREMT exam) + course tuition | |
| Illinois | $45 (application) + $104 (NREMT exam) + course tuition | → |
| Minnesota | $800 (program) + $104 (NREMT exam) + $15 (state certification) | → |
| Missouri | $800 (program) + $104 (NREMT exam) + fingerprint fee | → |
| Nebraska | $800 (program) + $104 (NREMT exam) + $55 (FBI background) | → |
Other professional licenses in Iowa
See how Iowa compares: EMT License Fees by State — Cheapest to Most Expensive →
✓ REPLICA Compact State — Iowa is a member of the EMS Compact (REPLICA). Licensed emts from other member states may be eligible for expedited practice privileges.
Related Guides
Explore requirements for other professional licenses in Iowa.
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EMT requirements in Iowa verified against Iowa Department of Health and Human Services, Bureau of EMS, March 2026.
Moving to Iowa? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your EMT license to Iowa →
Transfer your EMT license from Iowa to: Illinois → | Minnesota → | Missouri → | Nebraska → | South Dakota → | Wisconsin →
Iowa requires NREMT certification for EMS providers. EMT training requires 120-150 hours. All certification is managed through the Iowa Department of Health and Human Services, Bureau of EMS.
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.
EMT Schools in Iowa
Compare approved training programs, costs, and requirements.