Key Takeaways

  • You must complete a state-approved EMT course with a minimum of 170 hours of classroom and clinical instruction
  • Certification requires passing both the cognitive (written) exam and the psychomotor (skills) exam
  • Apply and register through NREMT.org — the Authorization to Test (ATT) is valid for 90 days
  • You must complete the entire certification process within 2 years of finishing your EMT course
  • Up to 6 exam attempts are allowed within the 2-year eligibility window
  • After 3 failed attempts, a 15-day waiting period and remedial training documentation are required
Last updated: February 2026

NREMT Certification Process

Becoming a nationally certified EMT requires completing several steps in sequence. Understanding this process helps you plan your timeline and avoid common pitfalls that delay certification.

Step-by-Step Certification Process

Step 1: Complete an Approved EMT Course

  • Minimum 170 hours of classroom and clinical instruction
  • Must be a state-approved or CoAEMSP-accredited program
  • Includes didactic (classroom), lab, clinical, and field experience
  • Your program director must verify your course completion in the NREMT system

Step 2: Create an NREMT Account

  • Register at NREMT.org
  • Complete the application and background information
  • Pay the $104 exam fee

Step 3: Receive Your Authorization to Test (ATT)

  • Once your program director verifies your completion, you receive an ATT
  • The ATT is valid for 90 days
  • If it expires, you must reapply and pay the fee again

Step 4: Schedule Your Cognitive Exam

  • Schedule through Pearson VUE (online at pearsonvue.com/nremt or by phone)
  • Choose in-person at a Pearson VUE center or online proctored testing
  • Bring a valid government-issued photo ID

Step 5: Pass the Psychomotor (Skills) Exam

  • Administered separately by your state or training program
  • Tests hands-on skills: patient assessment, interventions, and medical/trauma scenarios
  • Must be passed in addition to the cognitive exam
  • Some states administer this before the cognitive exam, others after

Step 6: Receive Certification

  • Once both exams are passed, your NREMT certification is issued
  • Apply for state licensure in the state where you want to practice
  • NREMT certification must be maintained with continuing education

Important Timelines

TimelineRequirement
ATT Validity90 days from issuance
Completion Window2 years from course completion
Maximum Attempts6 attempts within 2-year window
Waiting Period15 days between all attempts
Recertification CycleEvery 2 years

Re-Examination Policy

If you do not pass on your first attempt:

  • All re-attempts (1-6): Must wait 15 days between each attempt, pay $104 each time
  • After 3 failures: Must submit documentation of remedial training before scheduling attempt 4 (hours and format vary by state — check with your state EMS office)
  • Attempts 4-6: Additional remedial training documentation required before each attempt
  • After 6 failures: Must complete an entire new EMT course
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NREMT EMT Certification Process Flow
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How long do you have to complete the entire NREMT certification process after finishing your EMT course?

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Test Your KnowledgeOrdering

Put the NREMT EMT certification process steps in the correct order from first to last.

Arrange the items in the correct order

1
Receive NREMT certification
2
Complete a state-approved EMT course
3
Pass the psychomotor (skills) exam
4
Receive your Authorization to Test (ATT)
5
Schedule and pass the cognitive exam
6
Create an NREMT account and pay the $104 fee