Emergency medical responder levels by U.S. state


In the United States, the licensing of prehospital emergency medical providers and oversight of emergency medical services are governed at the state level. Each state is free to add or subtract levels as each state sees fit. Therefore, due to differing needs and system development paths, the levels, education requirements, and scope of practice of prehospital providers varies from state to state. Even though primary management and regulation of prehospital providers is at the state level, the federal government does have a model scope of practice including minimum skills for EMRs, EMTs, Advanced EMTs and Paramedics set through the National Highway Traffic Safety Administration.
While states are able to set their own additional requirements for state certification, a quasi-national certification body exists in the form of the National Registry of Emergency Medical Technicians. The NREMT offers a national certification based on the NHTSA National Standard curriculum for the levels of EMR, EMT, Advanced EMT and Paramedic. Individual states are allowed to use NREMT certification as part of their certification process, but are not required to. As of 2011, 38 states use the NREMT examination for EMT certification and 45 states use the NREMT examination for Paramedic certification. These levels are denoted below using an asterisk. At present time, use of the NREMT examination for EMT-Intermediate 85 and 99 have not been included in this list.
Any provider between the levels of Emergency medical technician and Paramedic is either a form of EMT-Intermediate or an Advanced EMT. The use of the terms "EMT-Intermediate/85" and "EMT-Intermediate/99" denotes use of the NHTSA EMT-Intermediate 1985 curriculum and the EMT-Intermediate 1999 curriculum respectively. In addition, not all states use the "EMT" prefix for all levels. Finally, some states have levels that have partially been phased out. While no new certifications are provided at this level, providers can sometimes be grandfathered in provided they meet recertification requirements. Any level that has been completely phased out is not listed.
Some states have certifications allowing other healthcare providers, such as Registered Nurses and Physician Assistants, to practice in the prehospital setting. Others require all EMS responders to obtain EMT or paramedic qualifications regardless of other licensure.
In the list, each state's certification levels are provided from most basic at the top to most advanced at the bottom.

Alabama

Alaska

  • Emergency Trauma Technician
  • Emergency Medical Technician I
  • Emergency Medical Technician II
  • Emergency Medical Technician III
  • Advanced Emergency Medical Technician
  • Mobile Intensive Care Paramedic

Arizona

  • EMT-Basic
  • Advanced EMT
  • EMT-Intermediate. Please note: Arizona is no longer certifying new EMT-Is. However, existing certifications continue to be allowed to practice under this level of certification.
  • Paramedic

Arkansas

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic
  • Community Paramedic

California

  • Public Safety
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician*
  • Paramedic
  • Critical Care Paramedic Endorsement for Paramedic Level*

Colorado

  • Emergency Medical Responder
  • Emergency Medical Technician
  • *EMT with intravenous authorization
  • Advanced EMT
  • EMT-Intermediate
  • Paramedic
  • *Paramedic with Critical Care endorsement
  • *Paramedic with Community Paramedic endorsement

Connecticut

  • Emergency Medical Responder Medical Services - Licensure/Certification/Exams">
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic

Delaware

  • First Responder
  • EMT-Basic
  • EMT-Paramedic

District of Columbia

Florida

  • Emergency Medical Technician
  • Paramedic

Georgia

  • Emergency Medical Technician-Responder
  • Emergency Medical Technician
  • Emergency Medical Technician-Intermediate
  • Advanced Emergency Medical Technician
  • Cardiac Technician
  • Paramedic

Hawaii

  • EMT
  • Paramedic

Idaho

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician-85
  • Advanced Emergency Medical Technician-2011
  • Paramedic-2011

Illinois

  • Emergency Medical Responder
  • EMT-Basic
  • Advanced EMT
  • Paramedic
  • Pre-hospital Registered Nurse

Indiana

  • Emergency Medical Responder
  • EMT
  • Advanced EMT
  • Paramedic

Iowa

  • First Responder
  • EMT-Basic
  • EMT-Intermediate
  • EMT-Advanced
  • EMT-Paramedic
  • Paramedic Specialist
  • Critical Care Paramedic Endorsement for Paramedic
Transition to new levels began January 2011, and finished in March 2015.
  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic
  • Critical Care Paramedic Endorsement for Paramedic level certification

Kansas

  • Emergency Medical Responder - Formerly known as First Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic

Kentucky

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic
  • Advanced Practice Paramedic
  • *Community Paramedic
  • *Wilderness Paramedic
  • *Critical Care Paramedic
  • *Flight Paramedic
  • *Tactical Paramedic

Louisiana

  • EMR-Emergency Medical Responder
  • EMT-Emergency Medical Technician
  • AEMT-Advanced EMT
  • Paramedic

Maine

  • Emergency Medical Responder
  • Ambulance Attendant
  • EMT
  • Advanced AEMT
  • EMT-Critical Care
  • Paramedic

Maryland

  • Emergency Medical Responder
  • Emergency Medical Technician-Basic *
  • Cardiac Rescue Technician-Intermediate*
  • Paramedic

Massachusetts

  • EMS First Responder
  • EMT-Basic
  • EMT-Advanced
  • EMT-Paramedic

Michigan

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic

Minnesota

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Paramedic
  • Community Paramedic
  • Registered Physician Assistant-EMT

Mississippi

  • Medical First Responder
  • EMT-Basic
  • EMT-Intermediate/99
  • AEMT
  • EMT-Paramedic

Missouri

  • EMT-Basic
  • Advanced EMT
  • EMT-Paramedic

Montana

  • EMR-Emergency Medical Responder
  • *Monitoring
  • EMT-Emergency Medical Technician
  • *Airway
  • *IV and IO administration
  • *IV and IO maintenance
  • *Medication
  • Advanced EMT
  • Paramedic
  • *Critical Care Transport
  • *

Nebraska

  • Emergency Medical Responder
  • EMT-Basic
  • AEMT
  • EMT-Paramedic

Nevada

  • First Responder
  • EMT
  • Advanced EMT
  • Paramedic
  • CCT-Paramedic
  • EMS RN

New Hampshire

  • First Responder
  • EMT
  • Advanced EMT
  • EMT-Paramedic

New Jersey

  • Emergency Medical Responder
  • Emergency Medical Technician *
  • Mobile Intensive Care Paramedic
  • Mobile Intensive Care Nurse

New Mexico

  • EMS First Responder
  • EMT-Basic
  • EMT-Intermediate
  • EMT-Paramedic

New York

North Carolina

  • Emergency Medical Responder
  • EMT
  • AEMT
  • Paramedic

North Dakota

  • First Responder
  • Advanced First Aid Ambulance
  • EMT
  • EMT-Basic
  • AEMT-Advanced EMT
  • EMT-Paramedic

Ohio

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced EMT
  • Paramedic

Oklahoma

  • Emergency Medical Responder
  • EMT-Basic
  • EMT-Intermediate/85
  • EMT-Paramedic

Oregon

  • Emergency Medical Responder
  • EMT
  • Advanced EMT
  • EMT Intermediate
  • Paramedic

Pennsylvania

  • Emergency Medical Services Vehicle Operator
  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic
  • Prehospital Registered Nurse
  • Prehospital Physician Extender
  • Prehospital Physician
  • Medical Command Physician
  • EMS-Instructor

Puerto Rico

  • EMT-Provisional License
  • EMT-Basic
  • EMT-Paramedic

Rhode Island

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Advanced Emergency Medical Technician Cardiac
  • Paramedic

South Carolina

  • EMT-Basic
  • EMT-Advanced
  • EMT-Paramedic

South Dakota

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Emergency Medical Technician - Intermediate/85
  • Advanced Emergency Medical Technician
  • Emergency Medical Technician - Intermediate/99
  • Emergency Medical Technician - Paramedic

Tennessee

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic
  • Critical Care Paramedic

Texas

  • Emergency Care Attendant
  • EMT
  • AEMT
  • Certified Paramedic
  • Licensed Paramedic

Utah

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic
Now have been phased out of the state of Utah:
  • EMT-Intermediate
  • EMT-Intermediate Advanced

Vermont

  • Vermont Emergency First Responder
  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • Paramedic
  • Critical Care Paramedic

Virginia

  • Emergency Medical Responder
  • Emergency Medical Technician
  • Advanced Emergency Medical Technician
  • EMT-Intermediate
  • Paramedic

Washington

  • Emergency Medical Responder
  • EMT
  • AEMT
  • Paramedic

West Virginia

  • Emergency Medical Responder
  • EMT-Mining
  • EMT-Basic
  • Advanced Care Technician
  • EMT-Paramedic
  • Mobile Critical Care Paramedic

Wisconsin

Source:
  • EMR
  • EMT
  • AEMT
  • EMT-Intermediate No new EMT-Intermediates certified.
  • Paramedic
  • Community Paramedic
  • Critical Care Paramedic Endorsement
  • TEMS Primarily for SWAT teams

Wyoming

  • EMR
  • Paramedic
Wyoming has adopted the National Registry model with an addition of IEMT. The IEMT has all of the skills of an AEMT with the addition of additional medications, endotracheal intubation, cardiac drugs and skills chest darts and pain management. National Registry is NOT required, and not accepted for licensing in Wyoming.