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How to become a certified EMT or Paramedic in Maryland. NREMT certification required. EMT training: 131 hours. Total initial EMT cost: $800 (program) + $104 (NREMT exam). Verified 2026-03-21. Data verified 2026-03-21. Source: LicenseMap (getlicensemap.com).
EMT / Paramedic
Governing Authority
Maryland Institute for Emergency Medical Services Systems (MIEMSS)
Official website →Most information on this page has been verified.
80% of data points are verified against official sources. 8 fields based on preliminary research. 4 fields need verification. We recommend confirming details with your state's licensing authority. See sources below · Report incorrect data
Yes
NREMT Required?
131
EMT Training Hours
4 levels
Certification Levels
$800 (program) + $104 (NREMT exam)
EMT Initial Cost
3 years
Renewal Period
24 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
131 hours
Scope of Practice
BLS care including patient assessment, vital signs, oxygen administration, BVM 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
Verified131
EMT Training Hours
1,200
Paramedic Hours
Notes
Maryland EMT training programs must be approved by MIEMSS. Approximately 131 hours of training required. Annual Maryland Medical Protocols updates are mandatory for all certified providers.
Exam Requirements
VerifiedRequired
NREMT Certification
Required
Cognitive Exam
Required
Psychomotor Exam
Yes
State-Specific Exam
NREMT Details
Maryland requires NREMT for initial certification at all levels. NREMT recertification is NOT required for EMT/EMR renewal (state CE-based), but IS required for Paramedic recertification. NREMT cognitive exam is CAT format, 70-120 questions for EMT, 2-hour time limit, $104/attempt, scaled score of 950/1500 to pass, up to 6 attempts with 15-day wait between attempts. Psychomotor exam is administered by the state.
State Exam Details
No separate state exam for initial certification; protocol exam required for reciprocity applicants
Passing Score
NREMT uses computer adaptive testing (CAT) with 70-120 questions for EMT level, 2-hour time limit. Scaled passing score is 950/1500. No fixed percentage.
Retake Policy
NREMT allows up to 6 attempts with a 15-day waiting period between attempts. After 3 failed attempts, 24 hours of remedial training required. $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 (Maryland Medical Protocols) developed by MIEMSS that authorize specific treatments without real-time physician contact
Protocol Requirements
All EMS providers in Maryland must operate under MIEMSS Maryland Medical Protocols. Annual protocol updates are mandatory for all certified providers. Providers must be affiliated with an EMS operational program with medical director oversight.
Minimum Age
Education
Background Check
Drug Screening
CPR/BLS Certification
Immunizations Required
Driver's License Required
| Fee | Amount |
|---|---|
EMT Course Cost Varies by program and institution | $800-$2,000 |
Paramedic Course Cost Varies by program; community college programs tend to be less expensive | $7,000-$15,000 |
NREMT Exam Fee NREMT EMT cognitive exam fee (increased from $70 in 2025) | $80 |
State Application Fee No separate state certification fee for initial certification | $25 |
Renewal Fee EMT per 2-year renewal cycle. Reciprocity application is $35. | $25 |
Total Initial EMT Cost No separate state certification fee; does not include textbooks or equipment | $800 (program) + $104 (NREMT exam) |
Total Initial Paramedic Cost No separate state certification fee; does not include textbooks or equipment | $7,000 (program) + $104 (NREMT exam) |
Renewal & CE Requirements
Verified3 years
Renewal Period
24 hrs
EMT CE Hours
48 hrs
Paramedic CE Hours
Required
Skills Verification
NREMT Recertification Accepted for State Renewal
CE Topics
Renewal Fee
$25
No separate state renewal fee for EMT
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; EMS Compact member state
Transfer Details
Maryland accepts out-of-state EMTs through reciprocity with a $35 application fee. Applicants must complete a 12-hour MD EMT Skills Refresher and pass a Maryland protocol exam. Must maintain EMS operational program affiliation in Maryland.
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.
Maryland requires EMS operational program affiliation for all certified providers. MIEMSS (Maryland Institute for Emergency Medical Services Systems) is a unique statewide coordinating body. NREMT recertification is split: NOT required for EMT/EMR but IS required for Paramedic. Reciprocity requires a 12-hour MD EMT Skills Refresher and protocol exam with a $35 fee. No separate state certification fee for initial certification.
Maryland does NOT require NREMT recertification for EMT/EMR renewal; state CE-based renewal instead. Paramedic level DOES require NREMT recertification.
Must maintain affiliation with an EMS operational program at all times.
Annual Maryland Medical Protocols updates are mandatory for all certified providers.
Reciprocity requires a 12-hour MD EMT Skills Refresher course and a protocol exam.
Background check is state-level only, not fingerprint-based for EMT level.
MIEMSS is a unique statewide EMS coordinating body that manages the entire Maryland EMS system.
Maryland is NOT an EMS Compact member state.
Explore requirements for other professional licenses in Maryland.
How this state compares to 50 others for this profession
Timeline
#1 of 51
Salary
#8 of 51
Cost
#30 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
$42,480
25th percentile
Median
$47,390
+15% vs. national avg ($41,340)Experienced
$64,230
75th percentile
Wage Distribution (Annual)
2,970 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+183% salary growth potential
You are here
EMT
$47,390
EMT-Basic course (120-150 hours) + NREMT
You are here
EMT
EMT-Basic course (120-150 hours) + NREMT
$47,390
Paramedic program (1-2 years) + NREMT-P
$67,670
Master's in PA Studies + PANCE
$134,100
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: 8–24 weeks
Timeline estimated from licensing requirements on this page.
Source: Maryland Institute for Emergency Medical Services Systems (MIEMSS) — Licensing Requirements
2–6 weeks
Estimated processing time
Source: Maryland Institute for Emergency Medical Services Systems (MIEMSS) — Licensing Requirements
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Maryland requires NREMT certification for EMS providers. EMT training requires 131 hours. All certification is managed through the Maryland Institute for Emergency Medical Services Systems (MIEMSS).
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.