Can you work there? EMT Reciprocity










If you are deciding on changing locations you need to check the EMT reciprocity rules for the state to which you are transferring. You should have already checked an EMT salary survey to see what you are worth. Click here to see a current emt salary survey from the US government..

Each state sets its own rules for whether your current certification will be accepted. For the best chance at EMT reciprocity at all provider levels you should become nationally registered. The National Registry of EMTs provides a list of states which accept their standards. Unfortunately each state changes its rules without notifying the National Registry. I visited the EMS website for each state and backed out the rules for EMT reciprocity.

Here are some general guidelines for EMT reciprocity. All states and the District of Columbia accept the certification of the state in which you are currently certified. Most states require the following:

  • Your current certification is valid in the state where it was issued
  • The training in your state is based on the latest US-DOT curriculum for your level
  • Your current state training meets or exceeds the training requirements for the state in which you are applying
  • You can provide documentation of course completion of either your initial certification at your level and/or course completion of a refresher course

Most states will require a written exam if you are not nationally registered (NREMT). Some states will also require a skills verification for more advanced levels. Many states will waive further testing if you are an NREMT.

Almost, if not all, states will require a background check and possible finger printing.


For the purposes of EMT reciprocity, the National Registry of EMTs is possibly the best certifying agency for credentials. Here are the numbers:

  • EMT-B: 39 states
  • EMT-I: 30 states
  • EMT-P: 38 states

Not all states offer an EMT-I level or offer it as part of either EMT-B or EMT-P.

The list of states that do not offer any EMT Reciprocity with the National Registry is still quite large. Here is a list of states that do not recognize National Registry at the EMT-B level:

  • Delaware
  • Georgia
  • Illinois
  • Maryland
  • Massachusetts
  • New York
  • Oregon
  • Pennsylvania
  • Vermont
  • Viginia
  • Utah
  • Wyoming

There is a similar list of states that do not offers EMT Reciprocity with the National Registry at the EMT-P level:

  • Alaska
  • Delaware
  • Georgia
  • Illinois
  • Maryland
  • Massachusetts
  • Oregon
  • Pennsylvania
  • South Carolina
  • South Dakota
  • Virginia
  • Utah
  • Wyoming

This list is difficult to compile. In fact the National Registry website is not current with this information.


The following table lists in detail each state and the requirements for EMT reciprocity. The are some keywords for you to know:

NREMT-B
Current certification as a National registry Basic
NREMT-I
Current certification as a National Registry Intermediate or more advanced than a basic level
NREMT-P
Current certification as a National Registry Paramedic or more advanced than an intermediate level
All States
Current certification in all states in the United States is accepted
Exam
A written exam is required
Refresher
A refresher course covering the DOT refresher curriculum is required
Skills Verification
You might be required to provide documentation that you can perform certain advanced skills and also provide how many were provided in the last 12 months.
EMT Reciprocity
State Reciprocity EMT-B

Reciprocity EMT-I

Reciprocity EMT-P Comments
Alabama NREMT-B NREMT-I, Exam NREMT-P, Exam Written exam is required for EMT-I and EMT-P
Alaska NREMT-B, All States NREMT-I, All States State Cert, Exam, Dr. Sponsor For EMT-P your current state certification is required. Also your potential employer must sponsor you.
Arizona NREMT-B, Refresher   NREMT-P, Refresher A refresher course is required to be completed for full certification. No EMT-I in this state.
Arkansas NREMT-B, State, Practical Exam NREMT-I, State, Skill Verification (note 12) NREMT-P, State, Skill Verification (note 12)  
California NREMT-B, All States NREMT-I, All States NREMT-P, State, Skill Verification (note 12)  
Colorado NREMT-B NREMT-I, ACLS NREMT-P, ACLS An ACLS course will have to be taken if indicated
Connecticut NREMT-B, All States NREMT-B, All States NREMT-P, All States, Dr. Sponsor (Exempt ME, MA, NH, NJ, NY, RI, VT) For EMT-P you will need to have a sponsoring doctor before applying for certification. The listed states are exempt from this requirement
Delaware ? ? ? No information is available
District of Columbia NREMT-B, All States NREMT-I, All States NREMT-P, All States  
Florida NREMT-B, All States NREMT-I, All States NREMT-P, All States  
Georgia All States All States All States  
Hawaii NREMT-B, All States None NREMT-P (Note 11)  
Idaho NREMT-B NREMT-I NREMT-P  
Illinois All States All States All States  
Indiana NREMT-B, All States NREMT-I, All States NREMT-P, All Sates  
Iowa NREMT-B, Training NREMT-I NREMT-P  
Kansas All States, Training All States, Training NREMT-P, All States, Training Additional training may be required since Kansas has more skills than the DOT set.
Kentucky NREMT-B None NREMT-P, All States, Skill Verification (note 12)  
Louisiana NREMT-B, All States NREMT-I, All States NREMT-P, All States  
Maine NREMT-B, All States NREMT-I, All States NREMT-P, All States  
Maryland All States, Refresher, Exam All States, Refresher, Exam All States, ACLS Refresher A refresher course is required for the level of certification follwed by a written exam. EMT-P require an ACLS course but no exam.
Massachusetts All States, Exam All States, Exam All States, Exam  
Michigan NREMT-B, All States NREMT-I, All States NREMT-P, All States  
Minnesota NREMT-B, All States - Practical Exam NREMT-I, All States - Practical Exam NREMT-P, All States - Practical Exam Practical skills tested is required if not NREMT
Mississippi NREMT-B NREMT-I NREMT-P  
Missouri NREMT-B None NREMT-P  
Montanna NREMT-B NREMT-I NREMT-P  
Nebraska NREMT-B NREMT-I NREMT-P  
Nevada NREMT-B NREMT-I NREMT-P  
New Hampshire NREMT-B NREMT-I NREMT-P  
New Jersey NREMT-B,DC, DE, MD, NY, PA, VA, WV (See Note 1), All states - Refresher None

NREMT-P, Skills Verification(note 12)

A refresher course is required for EMT-B if not part of listed states.
New Mexico NREMT-B, All States NREMT-I, All States NREMT-P, All States  
New York All States All States All States Note (2)
North Carolina NREMT-B, All States NREMT-I, All States NREMT-P, All States  
North Dakota NREMT-B, All States NREMT-I, All States NREMT-P  
Ohio NREMT-B and State NREMT-I and State NREMT-P and State  
Oklahoma NREMT-B, All States NREMT-I, All States, Skills Verification(Note 3) NREMT-P, All states  
Oregon All States (Note 4) All States, See (Note 5)  
Pennsylvania All States (Note 6) All States (note 6) All States (note 6)  
Rhode Island NREMT-B, All States with written Exam (Note 4) NREMT-P  
South Carolina NREMT-B (Note 7) All states (note 13) All States (note 13)  
South Dakota NREMT-B, All States with refresher Note (8) Note (8)  
Tennessee NREMT-B and State NREMT-I and State NREMT-P and State Must have both current state certification and NREMT
Texas NREMT-B, All states NREMT-I, all States NREMT-P, All States, For EMT-P AAS in EMS or any higher degree in any major
Utah NREMT-B, All states, refresher, written & practical exam, (Note 9) NREMT-B, all states, refresher, written & practical exam, (note 9) NREMT-P, all states, refresher, written & practical exam, (note 9)  
Vermont All States All States written & practical exam NREMT-P  
Virgina All States All States All States  
Washington NREMT-B, All States, written exam None NREMT-P, All States, Written Exam (Note 10)  
West Virginia NREMT-B, All States NREMT-I, All States NREMT-P, All States  
Wisconsin NREMT-B, All States NREMT-I, All States NREMT-P, all states  
Wyoming All States All States All States  

Notes

1 NJ allows EMT-B of list states to practice in NJ without further certification
2 If you live in border state, you can recertify with refresher courses in those border states.
3 EMT-I candidates must test for ET Tube placement.
4 Out of state certification not regonized for this level
5 Initial Certifications later than 1999 require an AAS degree in paramedicine
6 The state is divided into 16 regions. Reciprocity must be applied for in each region.
7 NREMT certification accepted if expiration date is more than 6 months away. Practical and written exams may apply.
8 Applicants must be licensed by the board of Medical and Osteopathic Examiners
9 Must have TB test with in past 12 months
10 NREMT-P tests with in 18 months of application do not need to take a written test.
11 Must have completed paramedic training within past 12 months.
12 If not NREMT-I or P, a record of various skills (e.g., intubation) will have to be provided.
13 NREMT is not accepted at this level. A written and practical exam is required in addition to the current state certification

Download a PDF of the EMT Reciprocity report here.
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