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How to become a certified EMT or Paramedic in Missouri. NREMT certification required. EMT training: 120-150 hours. Total initial EMT cost: $800 (program) + $104 (NREMT exam) + fingerprint fee. Verified 2026-03-21. Data verified 2026-03-21. Source: LicenseMap (getlicensemap.com).
EMT / Paramedic
Governing Authority
Missouri Department of Health and Senior Services, Bureau of EMS
Official website →Most information on this page has been verified.
82% of data points are verified against official sources. 8 fields based on preliminary research. 3 fields need verification. We recommend confirming details with your state's licensing authority. See sources below · Report incorrect data
Yes
NREMT Required?
120-150
EMT Training Hours
4 levels
Certification Levels
$800 (program) + $104 (NREMT exam) + fingerprint fee
EMT Initial Cost
5 years
Renewal Period
100 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, 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
Verified120-150
EMT Training Hours
1,200
Paramedic Hours
Notes
Missouri EMT training ranges from 120-172 hours depending on the program. A valid driver's license is required in addition to standard education requirements. Missouri has a 5-year renewal cycle, among the longest in the nation.
Exam Requirements
VerifiedRequired
NREMT Certification
Required
Cognitive Exam
Required
Psychomotor Exam
No
State-Specific Exam
NREMT Details
Missouri requires NREMT for initial certification. NREMT recertification is NOT required for renewal; Missouri accepts NREMT recertification OR 100 hours CE plus current CPR over the 5-year renewal cycle. 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. Missouri is an EMS Compact member state.
State Exam Details
No separate state exam; NREMT used for initial certification
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 developed by the EMS medical director that authorize specific treatments without real-time physician contact
Protocol Requirements
All EMS providers in Missouri must operate under the authority of a licensed physician medical director. Each ambulance district/service must have approved protocols.
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 and institution | $7,000-$14,000 |
NREMT Exam Fee NREMT EMT cognitive exam fee (increased from $70 in 2025) | $80 |
State Application Fee No separate initial application fee noted | $25 |
Renewal Fee EMT-B recertification fee per 5-year renewal cycle | $15 |
Total Initial EMT Cost Does not include textbooks or equipment; fingerprint fee via IdentoGO varies | $800 (program) + $104 (NREMT exam) + fingerprint fee |
Total Initial Paramedic Cost Does not include textbooks or equipment; fingerprint fee via IdentoGO varies | $7,000 (program) + $104 (NREMT exam) + fingerprint fee |
Renewal & CE Requirements
Verified5 years
Renewal Period
100 hrs
EMT CE Hours
144 hrs
Paramedic CE Hours
Required
Skills Verification
NREMT Recertification Accepted for State Renewal
CE Topics
Renewal Fee
$25
EMT-B per 5-year renewal cycle
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
Missouri is an EMS Compact member state. Out-of-state EMTs from compact states can practice under their home-state license. Non-compact applicants need current NREMT or equivalent certification. Fingerprint background check via IdentoGO required. Valid driver's license required.
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.
Missouri has a 5-year renewal cycle (among the longest nationally) requiring 100 CE hours over 5 years. NREMT recertification is accepted in lieu of the CE requirement. Fingerprint background check is conducted via IdentoGO. A valid driver's license is required. Missouri is an EMS Compact member state. Recertification fee is only $15.
Missouri has a 5-year renewal cycle, among the longest in the nation.
100 hours of CE are required over the 5-year renewal period for EMT-B.
NREMT recertification is accepted in lieu of the 100 CE hours plus CPR requirement.
Fingerprint background check is conducted via IdentoGO.
A valid driver's license is required for certification.
Recertification fee is only $15 for EMT-B.
Missouri is an EMS Compact (REPLICA) member state, allowing cross-state EMS practice.
Explore requirements for other professional licenses in Missouri.
How this state compares to 50 others for this profession
Salary
#34 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
$35,070
25th percentile
Median
$38,580
-7% vs. national avg ($41,340)Experienced
$46,150
75th percentile
Wage Distribution (Annual)
3,320 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+261% salary growth potential
You are here
EMT
$38,580
EMT-Basic course (120-150 hours) + NREMT
You are here
EMT
EMT-Basic course (120-150 hours) + NREMT
$38,580
Paramedic program (1-2 years) + NREMT-P
$55,600
Master's in PA Studies + PANCE
$139,200
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.
Source: Missouri Department of Health and Senior Services, Bureau of EMS — Licensing Requirements
2–6 weeks
Estimated processing time
Source: Missouri Department of Health and Senior Services, Bureau of EMS — Licensing Requirements
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Missouri requires NREMT certification for EMS providers. EMT training requires 120-150 hours. All certification is managed through the Missouri Department of Health and Senior Services, Bureau of EMS.
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.