The National Registry of Emergency Medical Technicians (NREMT) certifies EMTs and paramedics at the national level. All levels of NREMT certification—including EMT-Basic, EMT-Intermediate, and paramedics—require completing an approved education program and passing the written national exam. EMT-Intermediates and paramedics have a higher level of skill and must complete an additional hands-on component to complete their certifications.
All states require EMTs and paramedics to be licensed; requirements vary by state. Most states require candidates to have NREMT certification, but others require passage of an equivalent state exam. States also may have other requirements for licensing, such as a minimum age and passing a background check.