Nationally Registered EMRs (NREMR) are required to renew their certification every two years. NREMRs can recertify by either taking the cognitive examination or by completing continuing education. Note: We encourage you to reference the specific license renewal requirements for every state which you are licensed to practice.
The EMR National Continued Competency Program (NCCP) requires a total of 16 hours of continuing education to recertify. The model requires continuing education in three components: (1) a national component, (2) a local/state component, and (3) an individual component.
Courses that cannot be applied towards recertification requirements include duplicate courses, clinical rotations, instructor courses, management/leadership courses, performance of duty, preceptor hours, serving as a skill examiner, and volunteer time with agencies. If you have questions on accepted education, please review the Recertification Guide.
National Component: 8 Hours
The National Component requires EMRs to complete 8 hours of approved continuing education. A maximum of 3 hours of distributive education may be used to meet the 8 hour requirement. (*Distributive Education (DE) is a method of delivering EMS education where the educator and student are not able to interact in real time. Examples include online courses, journal article reviews, and videos.)
Airway/Respiration/Ventilation - 1 Hour
Trauma - 0.5 Hour
- Central Nervous System (CNS) Injury
Medical - 3 Hours
- OB Emergencies
- Infectious Diseases
- Psychiatric and Behavioral Emergencies
- Toxicological Emergencies – Opioids
- Neurological Emergencies – Seizures
- Endocrine Emergencies – Diabetes
- Immunological Emergencies
Operations - 1 Hour
- Field Triage—Disasters/MCIs
- EMS Provider Hygiene, Safety, and Vaccinations
- EMS Culture of Safety
Cardiovascular - 2.5 Hours
- Post-Resuscitation Care
- Cardiac Arrest
- Pediatric Cardiac Arrest
Local or State Component: 4 HoursIf specific local and/or state are not specified, these required hours are considered flexible content. You may use any state or Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) approved EMS–related education to fulfill these requirements. A maximum of 3 hours of distributive education may be used to meet the 4 hour requirement. (*Distributive Education (DE) is a method of delivering EMS education where the educator and student are not able to interact in real time. Examples include online courses, journal article reviews, and videos.)
Individual Component: 4 HoursThe individual hours are considered flexible content. You may use any state or Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) approved EMS–related education to fulfill these requirements. A maximum of 4 hours of distributive education may be used to meet the 4 hour requirement. (*Distributive Education (DE) is a method of delivering EMS education where the educator and student are not able to interact in real time. Examples include online courses, journal article reviews, and videos.)
This option enables you to demonstrate continued cognitive competency without documenting continuing education.
- Login to your National Registry account. Complete a recertification by examination application and pay the exam fee.
- NOTE: Be sure you complete the Recertification By Exam application.
- After 24-48 hours, login to your National Registry account and print your Authorization to Test (ATT) letter. Follow the directions in the letter to schedule your exam.
- You may make one attempt to take and pass the exam beginning on October 1 (one year prior to your current expiration date) and September 30. A cognitive competency by exam form will become available through your National Registry account upon successful completion of the exam.
- Return your completed cognitive competency by exam form by your expiration date with signatures and supporting documentation. All other recertification requirements (including criminal conviction statement, verification of skills, etc.) must still be met and verified.
Active or Inactive Status
An inactive status is designated for Nationally Certified EMS Professionals who are currently not providing patient care at their certification level. For example, inactive status may be helpful for EMS professionals who:
- are not actively engaged in an EMS service or healthcare/patient care activity;
- are not actively treating patients at their certification level but are involved as educators, administrators or regulators; are unable to actively provide patient care for any variety of reasons - such as, moving, illness, pursuit of education, family responsibilities, etc.
Inactive status is not for those unable to obtain and meet the educational requirements or those who have had limitations or revocation of a health care license.
Registrants who request inactive status at the EMT level do not need to obtain verification of skills from their Training Officer/Supervisor. These registrants must complete all refresher, continuing education and CPR requirements. These registrants are eligible to recertify by examination if they so choose. CPR certification remains a requirement even for those who pass the examination and request Inactive Status.
Returning to Active StatusNationally Certified EMRs may request a return to active status at any time once they gain active affiliation with an EMS service. A request to return to active status must be accompanied by a completed Inactive to Active Registration form which may be downloaded here.
Why Was I Audited?
Lapsed EMR Certification
Responsibilities of Nationally Registered EMS Personnel
- Change in mailing address (the best way to update a mailing address is by editing the user profile page)
- Any criminal conviction.
- Disciplinary action taken by any state has resulted in suspension, revocation, or expiration of state registration/licensure; termination of right to practice; voluntary surrender of state registration/licensure while under investigation.
The National Registry considers the individual to be solely responsible for their certification.
Disciplinary Policy and Rights of Appeal
The National Registry has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the National Registry Disciplinary Policy and Rights of Appeal can be found here.