Emergency Medical Responder StickerNationally 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.

The National Registry accepts State EMS Office accepted and CAPCE accredited education, education from EMS education programs, and U.S. accredited academic credit, college course, or credit provided by the National Registry Alternative Recertification Credits Policy. All education must be directly related to EMS patient care. International providers must complete education from the list of approved United States education sources.

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.

Airway/Respiration/Ventilation - 1 Hour

  • Ventilation
  • Oxygenation

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
  • Stroke
  • Cardiac Arrest
  • Pediatric Cardiac Arrest


For detailed information on the National Component and sample lesson plans, download the 2016 NCCP EMR Guide.

Local or State Component: 4 Hours

If the agency and/or state EMS office requires specific education, that education may be entered into this section. If specific education is not specified, these required 4 hours are considered flexible but must be directly related to EMS patient care.

Individual Component: 4 Hours 

The 4 hours required for the individual component are flexible but must be directly related to EMS patient care.

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
When renewing National Registry certification, EMRs have the option of declaring their status as either "Active" or "Inactive". Active status means the EMR is 'actively' working and providing patient care. To renew with an 'active status', EMRs are required to be affiliated with an EMS Agency or Service.

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.
Registrants who wish to declare inactive status must continue to meet the National Registry continuing education recertification requirements in subsequent cycles.

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 Status

Nationally 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?
To comply with accreditation requirements, the National Registry is required to randomly audit applications. In addition to random quality assurance audits, the National Registry reserves the right to investigate certification and recertification material at any time. You must retain verification of attendance of all education submitted for at least 36 months. Failure to submit documentation when audited may result in denial of eligibility to recertify.
Reinstatement Information
If the recertification application was not received by the September 30 deadline, but all educational requirements were completed by September 30 deadline, individuals may seek reinstatement of the National EMS Certification until October 31. There is a $50 reinstatement fee in addition to the standard $15 recertification fee ($65 total).
Lapsed EMR Certification
Information on how to regain a lapsed certification is found on the EMR Certification Page.
Responsibilities of Nationally Registered EMS Personnel
Registered Emergency Medical Responders (EMRs) must notify the National Registry within 30 days regarding the following matters:
  • 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.

Recertification Cycles
Recertification cycles start on the date the recertification application is successfully processed and approved by the National Registry. After a recertification application is approved, the new expiration date will be two years after the current expiration date listed on the individual's account.
Frequently Asked Recertification Questions