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How to become a certified EMT or Paramedic in North Dakota. NREMT certification required. EMT training: 110 minimum hours. Total initial EMT cost: ~$100-$115 (state licensure) + $104 (NREMT exam) + course tuition. Verified 2026-03-21. Data verified 2026-03-21. Source: LicenseMap (getlicensemap.com).
EMT / Paramedic
Governing Authority
North Dakota Department of Health and Human Services, Division of EMS
Official website →Most information on this page has been verified.
80% of data points are verified against official sources. 6 fields based on preliminary research. 6 fields need verification. We recommend confirming details with your state's licensing authority. See sources below · Report incorrect data
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.
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.
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
| 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 |
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.
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.
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.
Explore requirements for other professional licenses in North Dakota.
How this state compares to 50 others for this profession
Salary
#38 of 51
Cost
#12 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
$34,180
25th percentile
Median
$37,670
-9% vs. national avg ($41,340)Experienced
$46,740
75th percentile
Wage Distribution (Annual)
1,270 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+235% salary growth potential
You are here
EMT
$37,670
EMT-Basic course (120-150 hours) + NREMT
You are here
EMT
EMT-Basic course (120-150 hours) + NREMT
$37,670
Paramedic program (1-2 years) + NREMT-P
$59,950
Master's in PA Studies + PANCE
$126,180
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: North Dakota Department of Health and Human Services, Division of EMS — Licensing Requirements
2–6 weeks
Estimated processing time
Source: North Dakota Department of Health and Human Services, Division of EMS — Licensing Requirements
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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.