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EMT / Paramedic
Governing Authority
North Dakota Department of Health and Human Services, Division of EMS
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?
110 minimum
EMT Training Hours
4 levels
Certification Levels
~$100-$115 (state licensure) + $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
110 minimum 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
Verified110 minimum
EMT Training Hours
1,200
Paramedic Hours
Notes
North Dakota requires a minimum of 110 hours for EMT training. The minimum age is 16, making it one of the youngest in the nation. Providers must be affiliated with a ND licensed EMS operation or have ND physician medical direction. ND is a member of the EMS Compact since April 2019.
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Exam Requirements
VerifiedRequired
NREMT Certification
Required
Cognitive Exam
Required
Psychomotor Exam
No
State-Specific Exam
NREMT Details
North Dakota requires NREMT certification for both initial certification and recertification. 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 allowed with 15-day wait between attempts. Psychomotor exam is administered by the state for EMT level.
State Exam Details
North Dakota uses NREMT cognitive and psychomotor exams. No separate state-specific written 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.
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
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NREMT (EMT Certification Exam)
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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 North Dakota must operate under the authority of a licensed physician medical director. Must be affiliated with a ND licensed EMS operation or have ND physician medical direction.
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 Licensure fee | $25 |
State License Fee Included in application | ~$100-$115 |
Renewal Fee Included with NREMT recertification alignment | $25 |
Total Initial EMT Cost Does not include course tuition, textbooks, or equipment costs | ~$100-$115 (state licensure) + $104 (NREMT exam) + course tuition |
Total Initial Paramedic Cost Does not include textbooks, uniforms, or equipment | ~$100-$115 (state licensure) + $104 (NREMT exam) + program tuition |
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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
$25
Aligned with NREMT recertification
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
North Dakota is a member of the EMS Compact (since April 2019), allowing inter-state practice privileges. Also accepts NREMT certification for traditional reciprocity. Must be affiliated with ND licensed EMS operation or have ND physician medical direction.
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 North Dakota with other states →
See how requirements, costs, and timelines differ across all 50 states.
North Dakota has a minimum age of 16 -- one of the youngest nationally for EMS certification. Providers must be affiliated with a ND licensed EMS operation or have ND physician medical direction. ND is a member of the EMS Compact since April 2019.
North Dakota has a minimum age of 16 -- one of the youngest in the nation for EMS certification.
NREMT certification is required for both initial certification and recertification.
Providers must be affiliated with a ND licensed EMS operation or have ND physician medical direction.
Renewal is every 2 years with expiration on June 30.
40 hours NCCP continuing education required for EMT renewal.
North Dakota is an EMS Compact (REPLICA) member state, allowing cross-state EMS practice.
EMT requirements in nearby states
| State | Total Cost | |
|---|---|---|
| North Dakota (you) | ~$100-$115 (state licensure) + $104 (NREMT exam) + course tuition | |
| Minnesota | $800 (program) + $104 (NREMT exam) + $15 (state certification) | → |
| Montana | $800 (program) + $104 (NREMT exam) + $50 (state application) | → |
| South Dakota | Course + $104 (NREMT) + ~$25 (state app) + $30 (background check) | → |
Other professional licenses in North Dakota
See how North Dakota compares: EMT License Fees by State — Cheapest to Most Expensive →
North Dakota 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 North Dakota.
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Official Sources
EMT requirements in North Dakota verified against North Dakota Department of Health and Human Services, Division of EMS, March 2026.
Moving to North Dakota? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your EMT license to North Dakota →
Transfer your EMT license from North Dakota to: Minnesota → | Montana → | South Dakota →
North Dakota requires NREMT certification for EMS providers. EMT training requires 110 minimum hours. All certification is managed through the North Dakota Department of Health and Human Services, Division of EMS.
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.
EMT Schools in North Dakota
Compare approved training programs, costs, and requirements.