Key Takeaways

  • The NREMT EMT cognitive exam uses Computer Adaptive Testing (CAT) with 70-120 questions
  • You have 2 hours to complete the exam; most candidates finish in 1-1.5 hours
  • The passing score is 950 on a scale of 100-1500 (updated June 2023)
  • The exam fee is $104 per attempt, paid directly to NREMT
  • First-time pass rate is approximately 60-75% depending on the program
  • Testing is available at Pearson VUE centers and via online proctoring (since 2024)
Last updated: February 2026

NREMT EMT Certification Exam Overview

The National Registry of Emergency Medical Technicians (NREMT) cognitive exam is the standardized certification exam for Emergency Medical Technicians in the United States. Passing this exam, along with the psychomotor skills exam, is required to become a nationally certified EMT. Most states recognize NREMT certification as a prerequisite for state licensure.

Exam Details at a Glance

DetailInformation
FormatComputer Adaptive Testing (CAT)
Number of Questions70-120 items
Time Limit2 hours
Passing Score950 (scale 100-1500)
Exam Fee$104 per attempt
Testing VendorPearson VUE
Testing OptionsIn-person or online proctored (since 2024)
First-Time Pass Rate~60-75%
Question TypesMultiple-choice (4 options) + Technology Enhanced Items (TEIs)
Unscored Items~10 pilot questions (do not count toward your score)
ResultsAvailable within 2 business days

What Is Computer Adaptive Testing (CAT)?

Unlike a traditional fixed-length exam, the NREMT uses Computer Adaptive Testing. This means the exam adjusts the difficulty of questions based on your performance:

  • Answer correctly → The next question gets harder
  • Answer incorrectly → The next question gets easier
  • The exam continues until the algorithm is confident you are above or below the passing standard
  • You will receive at least 70 questions and no more than 120 questions
  • You cannot go back to previous questions — once you submit an answer, it is final

Scoring

As of June 2023, NREMT changed from a pass/fail-only model to a scaled scoring system:

  • Scores range from 100 to 1500
  • The passing score is 950
  • If you fail, your score report shows how you performed in each content domain
  • Domain-level feedback uses categories: Above Passing, Near Passing, and Below Passing

Online Proctored Testing

Starting in 2024, NREMT expanded testing options to include online proctored exams through Pearson VUE's OnVUE platform:

  • Take the exam from home or any quiet, private location
  • Requires a computer with webcam, microphone, and reliable internet
  • Same exam content and scoring as in-person testing
  • Government-issued photo ID required
  • Your testing space must be free of notes, books, and other materials
Test Your Knowledge

How many questions can you expect on the NREMT EMT cognitive exam?

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What is the passing score on the NREMT EMT cognitive exam?

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Which of the following is TRUE about the NREMT CAT format?

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Test Your KnowledgeFill in the Blank

The NREMT cognitive exam uses _____ Adaptive Testing (CAT) to adjust question difficulty based on your performance.

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