ClassMetric

EMT certification

The National Registry (NREMT) certifies EMTs nationally. Your state grants the license you need to work, and many states require that certification for it.

NREMT PrepHigh-quality compressions The pumpYour heart is a pump. Every beat sends blood to your brain and body, carrying the oxygen they need.Cardiac arrestIn cardiac arrest the heart stops pumping. Blood stops, and the brain gets no oxygen.You are the pumpNow you are the pump. The heart sits between breastbone and spine.DepthAdult compressions go two to two point four inches deep. That’s the green band.
70–120questions, adaptive
$104per exam attempt
2 hourstime limit
$44,470median EMT pay, May 2025

How to get it, step by step

  1. Check your state’s rules

    Every state licenses EMTs and may add rules like a minimum age or a background check. Most require national certification; some use their own exam instead.8

  2. Finish a state-approved EMT course

    Courses usually ask for a high school diploma or equivalent and CPR certification, and most EMT-Basic programs take under a year. Your course counts for two years after you finish.1,3,8

  3. Apply to the National Registry

    Create an account while you’re enrolled and apply about four weeks before your course ends. Your program director approves it, and the fee is $104 per attempt.2,3

  4. Pass the cognitive exam

    It’s adaptive: 70 to 120 questions in 2 hours, at a Pearson VUE center or online, within 90 days of your authorization to test. Our practice class helps you get ready.2,4,5,6

  5. Pass your state’s skills exam

    Each state sets and approves the hands-on (psychomotor) exam. The National Registry sets no order for the two, so ask your program which comes first.4,5

  6. Get your state license

    National certification alone doesn’t let you practice. Your state grants the license, and in many states the certification is one of its requirements.2

  7. Recertify every two years

    Renew with 40 credits of continuing education or by passing the exam again, and check your state’s license renewal rules too.7

NREMT Prep: lesson plan and practice →

The exam, and the money

The exam

Questions
70 to 120, adaptive; 10 are unscored4,5
Time limit
2 hours6
Content
5 areas; primary assessment is the largest, at 39–43%4
Passing score
950 on a 100–1500 scale; you see your score only if you don’t pass4
Where
A Pearson VUE test center, or online from home with a remote proctor4,6
Fee
$104 per attempt3
Retakes
Six attempts, 15 days apart; remedial education after a third fail4

The money

To certify
$104 per exam attempt; your course and state license are separate2,3
Renewal
$29 every two years, plus 40 credits of continuing education7
Typical pay
$44,470 a year, the median for EMTs (BLS, May 2025)8

Study for the exam

31 lessons in 5 chapters · about 5 minutes each

  1. 1Primary assessment10
    1. CPR compression depth and rate Lesson 1 · free
    2. General impression from the doorway
    3. AVPU and level of consciousness
    4. Airway: head-tilt or jaw-thrust
    5. Breathing: rate, depth, effort
    6. Circulation: pulse, skin, bleeding
    7. Tourniquets for life-threatening bleeding
    8. Shock: spot it early
    9. Vital signs and pulse oximetry
    10. When to load and go
    39–43%
  2. 2Scene size-up and safety5
    1. Scene safety before patient care
    2. PPE for the hazard you expect
    3. Count patients, call resources early
    4. Triage at a crowded scene
    5. Hazmat, traffic and violent scenes
    15–19%
  3. 3Secondary assessment3
    1. SAMPLE and OPQRST histories
    2. Head-to-toe or focused exam
    3. Reassessment: what changed and why
    5–9%
  4. 4Treatment and transport9

    Patient Treatment and Transport

    1. AED: pads, analyze, shock
    2. Oxygen: cannula or nonrebreather
    3. Bag-mask ventilation that works
    4. Chest pain and stroke calls
    5. Epi, naloxone, aspirin, oral glucose
    6. Splints and spinal motion restriction
    7. Childbirth and newborn care
    8. Kids and older adults are different
    9. Radio report and handoff
    20–24%
  5. 5Operations4
    1. Rig check before the call
    2. Documentation and patient refusals
    3. Lifting, stress and your health
    4. Test day: adaptive exam, explained
    10–14%

Built on NREMT Emergency Medical Technician (EMT) Examination Specifications · 2025

The full class, $34 at launch.

Paid once, when it opens. Lesson 1 is free now.

  • Adaptive practice exam
  • Scenario lessons, voiced
  • Readiness by domain

Not affiliated with the National Registry of EMTs.

Questions

Is EMT certification national or by state?

Both. The National Registry certifies you nationally, but only a state license lets you practice, and in many states national certification is one of the license requirements.2

How long does it take to become an EMT?

EMT-Basic programs typically take less than a year, says the BLS. After you test, the National Registry posts your result within 1–2 business days.2,8

Can you take the NREMT online?

Yes: you can take the cognitive exam at a Pearson VUE test center or from home through Pearson’s online proctoring. Your state sets the skills exam.4,5

What score do you need to pass the NREMT?

950 on a scale of 100 to 1500. If you pass, you don’t get a score; if you don’t, your report shows how far you were from passing.4

How many times can you take the NREMT?

Six. You wait 15 days between attempts, and after three fails you complete remedial education, such as a state or CAPCE-approved EMT refresher course, first.4

Sources

Read on . Rules change, so check the source before you pay a fee or book a test.

  1. EMT Candidate Handbook, Part 2: Candidate Responsibilities · National Registry of Emergency Medical Technicians
  2. EMT Candidate Handbook, Part 1: Introduction · National Registry of Emergency Medical Technicians
  3. EMT Candidate Handbook, Part 3: Certification Process · National Registry of Emergency Medical Technicians
  4. EMT Candidate Handbook, Part 4: About the Examination · National Registry of Emergency Medical Technicians
  5. BLS (EMR, EMT) Examination Information · National Registry of Emergency Medical Technicians
  6. National Registry Emergency Medical Technician (EMT) Examination Specifications · National Registry of Emergency Medical Technicians
  7. EMT Recertification · National Registry of Emergency Medical Technicians
  8. Occupational Outlook Handbook: EMTs and Paramedics · U.S. Bureau of Labor Statistics

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