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How to become a certified EMT or Paramedic in Texas. NREMT certification required. EMT training: 150-170 hours. Total initial EMT cost: Course + $104 (NREMT) + $64 (state cert) + background check. Verified 2026-03-21. Data verified 2026-03-21. Source: LicenseMap (getlicensemap.com).
EMT / Paramedic
Governing Authority
Texas Department of State Health Services (DSHS), EMS & Trauma Systems Section
Official website →Most information on this page has been verified.
81% of data points are verified against official sources. 12 fields based on preliminary research. We recommend confirming details with your state's licensing authority. See sources below · Report incorrect data
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.
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.
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
| 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 |
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.
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.
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.
Explore requirements for other professional licenses in Texas.
How this state compares to 50 others for this profession
Salary
#40 of 51
Cost
#14 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
$33,070
25th percentile
Median
$37,000
-10% vs. national avg ($41,340)Experienced
$44,940
75th percentile
Wage Distribution (Annual)
13,550 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+259% salary growth potential
You are here
EMT
$37,000
EMT-Basic course (120-150 hours) + NREMT
You are here
EMT
EMT-Basic course (120-150 hours) + NREMT
$37,000
Paramedic program (1-2 years) + NREMT-P
$53,960
Master's in PA Studies + PANCE
$132,810
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.
2–6 weeks
Estimated processing time
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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 & Trauma Systems Section.
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.