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EMT / Paramedic
Governing Authority
Virginia Department of Health, Office of Emergency Medical Services (OEMS)
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?
120-150
EMT Training Hours
4 levels
Certification Levels
Course + $104 (NREMT EMT exam) + state fees + background check
EMT Initial Cost
4 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
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
Virginia EMT training programs must meet NHTSA National EMS Education Standards. Challenge pathways are available for RN, LPN, NP, PA, MD, DO, and military personnel. A Legal Recognition pathway is available for out-of-state providers (1-year maximum, no NREMT required). Minimum age is 16 with parental consent.
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Exam Requirements
VerifiedRequired
NREMT Certification
Required
Cognitive Exam
Required
Psychomotor Exam
No
State-Specific Exam
NREMT Details
Virginia requires NREMT for initial certification. NREMT recertification is accepted but not required for renewal. 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. New NCCP requirements effective March 2026.
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. AEMT state exam costs $159.
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
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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. AEMT state exam costs $159.
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 Virginia 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 Virginia does not publicly post standard EMS certification fees | $30 |
State License Fee Virginia does not publicly post standard EMS certification fees | Not publicly posted |
Renewal Fee Virginia does not publicly post standard EMS certification fees | Not publicly posted |
Total Initial EMT Cost Approximate total; does not include course tuition, textbooks, or equipment | Course + $104 (NREMT EMT exam) + state fees + background check |
Total Initial Paramedic Cost Approximate total; does not include course tuition, textbooks, or equipment | Course + $104 (NREMT) + state fees (not publicly posted) + background check |
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Renewal & CE Requirements
Verified4 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
$30
4-year BLS renewal; 3-year ALS renewal; new NCCP requirements effective March 2026
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
Virginia is an EMS Compact member state. Reciprocity is available with current NREMT certification. A Legal Recognition pathway is available for out-of-state providers (1-year maximum, no NREMT required). Challenge pathways available for RN/LPN/NP/PA/MD/DO and military personnel.
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 Virginia with other states →
See how requirements, costs, and timelines differ across all 50 states.
Virginia allows EMS certification at age 16 with parental consent, one of the youngest minimum ages in the nation. The 4-year BLS certification period is one of the longest. Background checks via FieldPrint are required for ALL EMS agency members, not just providers. A Legal Recognition pathway allows out-of-state providers to practice for up to 1 year without NREMT. Challenge pathways are available for RN/LPN/NP/PA/MD/DO and military personnel. New NCCP requirements take effect March 2026.
Virginia allows certification at age 16 with parental consent, one of the youngest minimum ages in the nation.
Virginia has a 4-year BLS certification period, one of the longest in the nation.
Background checks via FieldPrint are required for ALL EMS agency members, not just providers.
Challenge pathways are available for RN, LPN, NP, PA, MD, DO, and military personnel.
A Legal Recognition pathway is available for out-of-state providers (1-year maximum, no NREMT required).
New NCCP requirements take effect in March 2026.
NREMT recertification is accepted but not required for renewal.
Virginia is an EMS Compact (REPLICA) member state, allowing cross-state EMS practice.
EMT requirements in nearby states
| State | Total Cost | Timeline | |
|---|---|---|---|
| Virginia (you) | Course + $104 (NREMT) + state fees (not publicly posted) + background check | — | |
| District of Columbia | $1,200-$3,000 (program) + $104 (NREMT) + $45 (DC cert) | — | → |
| Kentucky | $10 (application) + $30 (initial cert) + $104 (NREMT exam) + ViewPoint background check fee + course tuition | — | → |
| Maryland | $800 (program) + $104 (NREMT exam) | 8–24 wks | → |
| North Carolina | $68 (state exam) + $38 (background check) + course tuition | — | → |
Other professional licenses in Virginia
See how Virginia compares: EMT License Fees by State — Cheapest to Most Expensive →
✓ REPLICA Compact State — Virginia 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 Virginia.
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Official Sources
EMT requirements in Virginia verified against Virginia Department of Health, Office of Emergency Medical Services (OEMS), March 2026.
Moving to Virginia? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your EMT license to Virginia →
Transfer your EMT license from Virginia to: Kentucky → | Maryland → | North Carolina → | Tennessee → | West Virginia → | District of Columbia →
Virginia requires NREMT certification for EMS providers. EMT training requires 120-150 hours. All certification is managed through the Virginia Department of Health, Office of Emergency Medical Services (OEMS).
Requirements vary by state and local jurisdiction. Always verify current requirements with your state EMS office.
EMT Schools in Virginia
Compare approved training programs, costs, and requirements.