How to Become an EMT in 2026: The National Path, Then Your State

30-second answer. Every state licenses its own EMTs, but the path is the same shape everywhere: finish a state-approved EMT course, pass the National Registry of EMTs cognitive exam and the psychomotor skills verification, then apply to your state EMS office for certification. The NREMT EMT exam fee is $104 per attempt. Nationally, EMTs earned a median of $44,470 in May 2025, with the bottom tenth under $34,130 and the top tenth above $62,500, and the Bureau of Labor Statistics projects about 6 percent growth for EMTs and paramedics through 2035.

The four steps, in order

1. Meet the entry rules. Most states require you to be 18 by the time of certification, hold a high school diploma or GED, and clear a background check and a current CPR credential before or during the course. The exact rule is your state's, not NREMT's; the state pages below print each one.
2. Complete a state-approved EMT course. Programs run through community colleges, hospital systems and fire departments, typically one semester. The course must be approved by your state EMS office for its graduates to sit the National Registry exam.
3. Pass the NREMT exams. The cognitive exam is computer adaptive; the psychomotor portion verifies hands-on skills. The exam fee is $104 per attempt. A passing NREMT result is a national credential, not a license to practice.
4. Apply to your state for certification. The state EMS office issues the certification or license that lets you work. Some states, Texas among them, certify on the NREMT result; others add a state exam or background steps of their own.

What EMTs earn

Bureau of Labor Statistics Occupational Employment and Wage Statistics, May 2025, for EMTs (SOC 29-2042):

Pay varies far more by employer type and state than by the credential. Fire-based EMS, private ambulance, hospital transport and municipal third-service agencies pay on different scales, and the state pages on this site carry the employer figures each state publishes.

The outlook, as BLS prints it

The Employment Projections 2025-35 release puts EMTs at 181,900 jobs in 2025 and 192,500 in 2035, a gain of 10,600. The Occupational Outlook Handbook rounds the combined EMT and paramedic growth to 6 percent and prints about 18,200 openings a year for the two occupations together. Table 1.10 of the same release splits that: about 13,800 a year for EMTs, most of them replacement openings as people leave the occupation.

Keeping it

NREMT recertification runs on a two-year cycle: 40 hours of continuing education for an EMT. Your state may set its own renewal interval and fee on top.

Your state

• How to become an EMT in Texas
• How to become an EMT in California
• How to become an EMT in Florida
• How to become an EMT in New York