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EMT certification · state by state

How to Become an EMT

In every state we have checked, the path has the same shape: finish a state-approved EMT course, pass the certification exam, and get certified by the state health department or EMS board. The rules for New Jersey, Ohio and Texas require the NREMT exam (70 to 120 questions, $104); the Arizona, Florida, New York and Washington rules call for an exam set or approved by the state health department. What also changes is the minimum age, the deadline after your course, and the extra checks.

Updated October 2026 · Sources: state EMS rules (linked per state), NREMT, IPEDS 2023–24, BLS May 2025

NREMT exam
$104per attempt · 70-120 questions
Colleges with EMT programs
681IPEDS 2023–24
Median college price
$2,00037 colleges reporting
U.S. median pay
$44,470$21.38/hr · BLS May 2025

EMT requirements by state

StateMin. ageExamTime limit after courseState feeCollegesMedian pay
Arizona18Set by state2 years—18$39,500
Florida—Set by state2 years—43$39,870
New Jersey18NREMT——5$53,610
New York17Set by state2 years—14$48,400
Ohio18NREMT2 years—39$40,220
Texas18NREMT2 years$6053$37,260
Washington18Set by state——13$52,690

Each state row comes from that state's EMT statute or rule, read in full in October 2026 (citations on each state page). "—" means the rule we read does not set it. Colleges: schools reporting EMT or paramedic programs to IPEDS 2023–24. Pay: BLS May 2025 median for EMTs. We add a state once we have read its rules; for the rest, see EMT classes by state.

The NREMT EMT exam

The National Registry exam is computer adaptive: it gives you 70 to 120 questions in up to 2 hours. It costs $104 per attempt and is given at Pearson test centers or proctored online. The current version launched on April 7, 2025 and adds drag-and-drop and build-a-list questions. To apply, your course must be finished within the past 2 years and your program director must confirm it; passed portions stay valid for 24 months (NREMT).

What the EMT exam coversShare of exam
Scene size-up and safety15–19%
Primary assessment39–43%
Secondary assessment5–9%
Patient treatment and transport20–24%
Operations10–14%

Source: NREMT EMT examination test plan. Pediatric care questions are spread across all areas.

How long EMT training takes

Award length (IPEDS)Colleges
Certificate (under 12 weeks)161
Certificate (12 weeks to 1 year)346
Certificate (1-2 years)345
Associate degree437

Colleges that graduated EMT or paramedic students at each award level in IPEDS 2023–24; one college can appear in several rows. Short certificates are usually EMT; longer ones and associate degrees are usually paramedic.

Becoming an EMT: FAQ

What is the NREMT exam?

The National Registry of Emergency Medical Technicians (NREMT) EMT exam is a computer-adaptive test of 70 to 120 questions with a 2-hour limit. It costs $104 per attempt. The current version launched on April 7, 2025. You also need a state-approved skills test.

Does every state use the NREMT exam?

Not every state rule names it. Of the states we have checked, the New Jersey, Ohio and Texas rules require the NREMT exam, while the Arizona, Florida, New York and Washington rules require an exam set or approved by the state health department.

How long does it take to become an EMT?

It depends on the program. In IPEDS 2023–24, 161 of 681 colleges with EMT or paramedic programs graduated students from a certificate shorter than 12 weeks and 346 from a certificate of 12 weeks to a year; paramedic programs are usually longer (437 colleges award an associate degree). After the course, states give you a deadline: Arizona 2 years, Florida 2 years, New York 2 years, Ohio 2 years and Texas 2 years.

How much does it cost to become an EMT?

37 colleges report a price for their EMT or paramedic program: median $2,000 for tuition plus books and supplies (IPEDS 2023–24). Add $104 per NREMT attempt and any state fee (Texas charges $60).

How much do EMTs make?

The U.S. median for EMTs was $44,470 a year ($21.38 an hour) in BLS May 2025 data, across 180,510 jobs.