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EMT / Paramedic
Governing Authority
Montana Department of Labor and Industry, Emergency Care Providers Program
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.
Yes
NREMT Required?
120-150
EMT Training Hours
4 levels
Certification Levels
$800 (program) + $104 (NREMT exam) + $50 (state application)
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, 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
Montana EMT training requires approximately 170 hours. Montana uses ECP (Emergency Care Provider) terminology. SB 518 (2025 session, eff Jan 1, 2026) transferred individual ECP licensing from Board of Medical Examiners to DLI. DPHHS retains EMS agency licensing. High school diploma is required.
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Exam Requirements
VerifiedRequired
NREMT Certification
Required
Cognitive Exam
Required
Psychomotor Exam
No
State-Specific Exam
NREMT Details
Montana requires NREMT for both initial certification and recertification at all levels. 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. Montana uses ECP (Emergency Care Provider) terminology. SB 518 (2025 session, eff Jan 1, 2026) transferred individual ECP licensing from Board of Medical Examiners to DLI (Department of Labor and Industry). DPHHS retains EMS agency licensing (ambulances, transport services).
State Exam Details
No separate state exam; NREMT used for 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.
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 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.
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 Montana must operate under the authority of a licensed physician medical director. Each EMS agency must have approved 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 |
|---|---|
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 EMT initial application; $70 for AEMT | $15 |
State License Fee EMT; $70 for AEMT; late renewal is double the fee | $50 |
Renewal Fee EMT per 2-year cycle; $70 for AEMT; late renewal = double fee | $50 |
Total Initial EMT Cost Does not include textbooks or equipment | $800 (program) + $104 (NREMT exam) + $50 (state application) |
Total Initial Paramedic Cost Does not include textbooks or equipment | $7,000 (program) + $104 (NREMT exam) + $70 (state application) |
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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 per 2-year cycle; late renewal = double fee ($100)
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; EMS Compact member state
Transfer Details
Montana accepts out-of-state EMTs with current NREMT certification. Application through DLI Emergency Care Providers Program (post-SB 518 transition). Background check 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.
See all EMS Compact (REPLICA) member states & eligibility details →
Moving to another state? Use our Transfer Tool to see what you need →
Compare Montana with other states →
See how requirements, costs, and timelines differ across all 50 states.
SB 518 (2025 session, eff Jan 1, 2026) transferred individual ECP licensing from Board of Medical Examiners to DLI. DPHHS retains EMS agency licensing. The state uses ECP (Emergency Care Provider) terminology. License prefixes changed from MED- to ECP-. Renewal window is very narrow (September 1 - October 31) with March 31 expiration. Late renewal incurs double the fee. NREMT required for both initial and recertification.
SB 518 (2025 session, eff Jan 1, 2026) transferred individual ECP licensing from Board of Medical Examiners to DLI (Department of Labor and Industry). DPHHS retains EMS agency licensing (ambulances, transport services). License number prefixes changed from MED- to ECP-. Fees and biennial renewal cycle (March 31) unchanged.
Montana uses ECP (Emergency Care Provider) terminology for EMS certification levels.
Renewal window is narrow: September 1 through October 31, with certification expiring March 31.
Late renewal incurs double the regular fee.
NREMT is required for both initial certification and recertification.
High school diploma is explicitly required.
Montana is NOT an EMS Compact member state.
EMT requirements in nearby states
| State | Total Cost | |
|---|---|---|
| Montana (you) | $800 (program) + $104 (NREMT exam) + $50 (state application) | |
| Idaho | $0 (license) + $104 (NREMT exam) + background check fee + course tuition | → |
| North Dakota | ~$100-$115 (state licensure) + $104 (NREMT exam) + course tuition | → |
| South Dakota | Course + $104 (NREMT) + ~$25 (state app) + $30 (background check) | → |
| Wyoming | Course + $104 (NREMT) + $20 (state) + $44 (background check) | → |
Other professional licenses in Montana
See how Montana compares: EMT License Fees by State — Cheapest to Most Expensive →
Montana 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 Montana.
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Official Sources
EMT requirements in Montana verified against Montana Department of Labor and Industry, Emergency Care Providers Program, March 2026.
Moving to Montana? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your EMT license to Montana →
Transfer your EMT license from Montana to: Idaho → | North Dakota → | South Dakota → | Wyoming →
Montana requires NREMT certification for EMS providers. EMT training requires 120-150 hours. All certification is managed through the Montana Department of Labor and Industry, Emergency Care Providers Program.
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.
EMT Schools in Montana
Compare approved training programs, costs, and requirements.