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EMT / Paramedic
Governing Authority
Texas Department of State Health Services (DSHS), EMS and Trauma Systems
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?
150-170
EMT Training Hours
4 levels
Certification Levels
Course + $104 (NREMT) + $64 (state cert) + background check
EMT Initial Cost
4 years
Renewal Period
72 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
150-170 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. Licensed Paramedic (LP) has expanded scope requiring college degree.
NREMT Required
Yes
Additional Requirements
Training Program Requirements
Verified150-170
EMT Training Hours
1,200
Paramedic Hours
Notes
Texas has 5 EMS certification levels: ECA (Emergency Care Attendant), EMT-Basic, AEMT, EMT-Paramedic, and Licensed Paramedic. Licensed Paramedic requires a college degree. All training programs must be DSHS-approved and meet NHTSA National EMS Education Standards.
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Exam Requirements
VerifiedRequired
NREMT Certification
Required
Cognitive Exam
Required
Psychomotor Exam
No
State-Specific Exam
NREMT Details
Texas requires NREMT for initial certification but does NOT require NREMT for recertification (uses state CE-based renewal instead). 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
Jurisprudence CE course with exam required for reciprocity applicants
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. State retest fee is $30.
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 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
All EMS providers in Texas 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 |
|---|---|
NREMT Exam Fee NREMT EMT cognitive exam fee (increased from $70 in 2025) | $80 |
State Application Fee Initial EMT certification fee | $86 |
State License Fee Initial EMT certification fee | $64 |
Renewal Fee On-time renewal; within 90 days late $94; 91 days-1 year late $124; inactive status $30 | $68 |
Total Initial EMT Cost Approximate total; military fee exemptions available; does not include course tuition | Course + $104 (NREMT) + $64 (state cert) + background check |
Total Initial Paramedic Cost Approximate total; military fee exemptions available; does not include course tuition | Course + $104 (NREMT) + $64 (state cert) + background check |
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Renewal & CE Requirements
Verified4 years
Renewal Period
72 hrs
EMT CE Hours
72 hrs
Paramedic CE Hours
Required
Skills Verification
NREMT Recertification Not Accepted for State Renewal
CE Topics
Renewal Fee
$64
On-time renewal every 4 years; within 90 days late $94; 91 days-1 year late $124
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
Texas accepts reciprocity applications with current NREMT certification. Reciprocity fee is $126. A Jurisprudence CE course with exam is REQUIRED for all reciprocity applicants. Military fee exemptions are available.
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 Texas with other states →
See how requirements, costs, and timelines differ across all 50 states.
Texas has a 4-year recertification cycle with 72 CE hours required (54 content area + 18 flexible), and does NOT require NREMT for recertification. The state has 5 unique certification levels including ECA (Emergency Care Attendant) and Licensed Paramedic (LP), which requires a college degree. A Jurisprudence CE course with exam is mandatory for all reciprocity applicants. Military fee exemptions are available. Texas is an EMS Compact (REPLICA) member state.
Texas has a 4-year recertification cycle, one of the longest in the nation.
Texas does NOT require NREMT for recertification; uses state CE-based renewal (72 hours: 54 content area + 18 flexible).
A Jurisprudence CE course with exam is REQUIRED for all reciprocity applicants.
Texas has 5 certification levels: ECA, EMT-Basic, AEMT, EMT-Paramedic, and Licensed Paramedic (LP). Licensed Paramedic requires a college degree.
Military fee exemptions are available for active-duty military, veterans, and military spouses.
Late renewal fees escalate: within 90 days $94, 91 days-1 year $124; inactive status $30.
Texas is an EMS Compact (REPLICA) member state, allowing cross-state EMS practice.
EMT requirements in nearby states
| State | Total Cost | |
|---|---|---|
| Texas (you) | Course + $104 (NREMT) + $64 (state cert) + background check | |
| Arkansas | $1,000-$2,500 (program) + $104 (NREMT) + $20 (state app) + $22-$38.50 (background check) | → |
| Louisiana | $50 (in-state license) + $104 (NREMT exam) + course tuition | → |
| New Mexico | $65 (state application) + $104 (NREMT exam) + background check fee | → |
| Oklahoma | $189 | → |
Other professional licenses in Texas
See how Texas compares: EMT License Fees by State — Cheapest to Most Expensive →
✓ REPLICA Compact State — Texas is a member of the EMS Compact (REPLICA). Licensed emts from other member states may be eligible for expedited practice privileges.
Related Guides
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Official Sources
EMT requirements in Texas verified against Texas Department of State Health Services (DSHS), EMS and Trauma Systems, March 2026.
Moving to Texas? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your EMT license to Texas →
Transfer your EMT license from Texas to: Arkansas → | Louisiana → | New Mexico → | Oklahoma →
Texas requires NREMT certification for EMS providers. EMT training requires 150-170 hours. All certification is managed through the Texas Department of State Health Services (DSHS), EMS and Trauma Systems.
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.
EMT Schools in Texas
Compare approved training programs, costs, and requirements.