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EMT / Paramedic
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
Course + $104 (NREMT) + ~$25 (state app) + $30 (background check)
EMT Initial Cost
2 years
Renewal Period
20 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 therapy, 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 and cardioversion, transcutaneous pacing, needle chest decompression, surgical cricothyrotomy, comprehensive medication administration, and rapid sequence intubation where authorized
NREMT Required
Yes
Additional Requirements
Training Program Requirements
Verified120-150
EMT Training Hours
1,200
Paramedic Hours
Notes
South Dakota EMT training requires a minimum of 165 hours, including 10 hours of hospital/ambulance observation and 10 patient assessments. Two different agencies oversee EMS: the Board of Medical and Osteopathic Examiners handles ALS (AEMT/Paramedic), while the DOH Office of Rural Health handles BLS (EMR/EMT).
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Exam Requirements
VerifiedRequired
NREMT Certification
Required
Cognitive Exam
Required
Psychomotor Exam
No
State-Specific Exam
NREMT Details
South Dakota requires NREMT certification for initial EMT certification. For recertification, NREMT is accepted or candidates may complete 24 CE hours plus current CPR card. The NREMT cognitive exam is a Computer Adaptive Test (CAT) with 70-120 questions for EMT level, a 2-hour time limit, and costs $104 per attempt. A scaled passing score of 950/1500 is required. Candidates are allowed 6 attempts with a 15-day waiting period between attempts. Psychomotor exam is administered by the state.
State Exam Details
No state-specific exam. NREMT cognitive and/or psychomotor exam required for certification.
Passing Score
NREMT uses Computer Adaptive Testing (CAT). EMT exam has 70-120 questions with a 2-hour time limit. A scaled passing score of 950/1500 is required. Cost is $80 per attempt.
Retake Policy
NREMT allows 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.
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). EMT exam has 70-120 questions with a 2-hour time limit. A scaled passing score of 950/1500 is required. Cost is $80 per attempt.
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
Confirmed: EMS Compact criteria on SDBMOE page state providers must 'practice under the supervision of a physician (MD/DO) medical director.'
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 Approximate application fee | $20 |
State License Fee Approximate certification fee | $25 |
Renewal Fee Approximate renewal fee | $25 |
Total Initial EMT Cost Approximate total; does not include course tuition, textbooks, or equipment | Course + $104 (NREMT) + ~$25 (state app) + $30 (background check) |
Total Initial Paramedic Cost Approximate total; does not include course tuition, textbooks, or equipment | Course + $104 (NREMT) + ~$25 (state app) + $30 (background check) |
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Renewal & CE Requirements
Verified2 years
Renewal Period
20 hrs
EMT CE Hours
40 hrs
Paramedic CE Hours
Required
Skills Verification
NREMT Recertification Accepted for State Renewal
CE Topics
Renewal Fee
$20
Approximate renewal fee; alternative to NREMT recertification is 24 CE hours + current CPR card
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
South Dakota is an EMS Compact member state, allowing cross-state practice for EMS personnel from other compact states. Applicants must hold current NREMT certification and submit a state application with background check.
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 South Dakota with other states →
See how requirements, costs, and timelines differ across all 50 states.
South Dakota EMT-Basic requires only certification, not a state license, distinguishing it from ALS levels. Two separate agencies oversee EMS: the Board of Medical and Osteopathic Examiners handles ALS (AEMT/Paramedic) while the DOH Office of Rural Health handles BLS (EMR/EMT). The state has heavy reliance on volunteer EMS in rural and tribal areas. Training requires 165 hours minimum including 10 hours of hospital/ambulance observation and 10 patient assessments.
South Dakota EMT-Basic does not require a state license, only certification, making it distinct from higher EMS levels.
Two different agencies oversee EMS: the Board of Medical and Osteopathic Examiners handles ALS levels (AEMT/Paramedic), while the DOH Office of Rural Health handles BLS levels (EMR/EMT).
Heavy reliance on volunteer EMS in rural and tribal areas throughout the state.
NREMT recertification is accepted for renewal, or candidates may complete 24 CE hours plus current CPR card as an alternative.
South Dakota is an EMS Compact (REPLICA) member state, allowing cross-state EMS practice.
EMT requirements in nearby states
| State | Total Cost | |
|---|---|---|
| South Dakota (you) | Course + $104 (NREMT) + ~$25 (state app) + $30 (background check) | |
| Iowa | $30 (initial cert) + $104 (NREMT exam) + course tuition | → |
| Minnesota | $800 (program) + $104 (NREMT exam) + $15 (state certification) | → |
| Montana | $800 (program) + $104 (NREMT exam) + $50 (state application) | → |
| North Dakota | ~$100-$115 (state licensure) + $104 (NREMT exam) + course tuition | → |
Other professional licenses in South Dakota
See how South Dakota compares: EMT License Fees by State — Cheapest to Most Expensive →
✓ REPLICA Compact State — South Dakota is a member of the EMS Compact (REPLICA). Licensed emts from other member states may be eligible for expedited practice privileges.
Related Guides
Explore requirements for other professional licenses in South Dakota.
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EMT requirements in South Dakota verified against South Dakota Department of Health, EMS Program, March 2026.
Moving to South Dakota? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your EMT license to South Dakota →
Transfer your EMT license from South Dakota to: Iowa → | Minnesota → | Montana → | Nebraska → | North Dakota → | Wyoming →
South Dakota requires NREMT certification for EMS providers. EMT training requires 120-150 hours. All certification is managed through the South Dakota Department of Health, EMS Program.
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.
EMT Schools in South Dakota
Compare approved training programs, costs, and requirements.