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RECERTIFICATION GUIDE
Version 4- 02/01/2023
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INTRODUCTION
The National Registry is committed to the protection of the public by oering ongoing
improvements in the recertification process and updating requirements that will favorably
impact EMS for many years to come. Specifically, the National Continued Competency
Program incorporates the use of evidence-based medicine, gives state and local agencies the
freedom to dictate a portion of their education requirements, and provides a foundation for
EMS professionals to embrace life-long learning.
This recertication guide provides an overview of the recertication requirements and process
as well as background information regarding National Registry certication and recertication.
The National Registry of EMTs wishes to extend our sincere gratitude to the State EMS Oces,
Agencies, Training Ocers, Medical Directors, and EMS Professionals who are committed to
maintenance of provider certication through the established requirements
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RECERTIFICATION METHODS
You can recertify by two methods:
+ Documentation of continuing education (recertication application)
+ Recertication by Examination (RBE)
Recertication Requirements:
+ Meet eligibility requirements related to criminal conviction and licensure limitation statements
+ Submit payment for recertification application or Recertification by Examination (RBE)
+ Complete one of the two methods listed below to renew your certification:
• Complete and submit the application for recertification by continuing education by your
current expiration date (see Important Dates section)
• Complete and submit an application for Recertification by Examination (RBE).
Successfully test before your current expiration date (see Important Dates section for
application submission deadlines)
All education must be completed within your certication cycle listed on your dashboard and before
your current expiration date. All materials must be submitted electronically or postmarked by the
expiration date of your expiration year. See the Important Dates section for more information.
If applying during the reinstatement period, which is 30-days following your current expiration date,
all education must have been completed before your current expiration. The reinstatement period, for
an additional fee, is for completion and submission of your application only. Refer to the
Reinstatement Period section for more information.
NOTE: All fees related to recertication by examination and recertication applications are
non-refundable.
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RECERTIFICATION BY DOCUMENTATION OF
CONTINUING EDUCATION
The continuing education option allows the individual to demonstrate continued cognitive
competency by documentation of continuing education (CE, CEU, CME, competency credits, etc.)
completed during the recertification cycle using the latest National Continued Competency
Program (NCCP) recertification model.
The Online electronic recertification submission is a much faster and more efficient way to
recertify. Average processing of electronic applications is 72 hours from when the National
Registry receives the application after all application components are completed (including
verifications for active status). Using the inactive status will bypass all Training Officer or Medical
Director verifications. Mailed applications can take up to eight weeks for processing and review.
To apply for recertification, you need to:
+ Meet certification eligibility criteria concerning criminal conviction and licensure limitation
statements.
• Demonstrate cognitive competency through continuing education.
∙ All education must be completed within your recertification cycle dates.
• National Continued Competency Program (NCCP) total hours required by level.
Level Total Hours
EMR 16
EMT 40
AEMT 50
NRP 60
+ Enter completed education on your transcript.
• Upload/import supporting documentation or proof of education.
+ Assign education to national, local, and individual sections under "
Manage Education."
+ Apply recertification payment and any additional fees, paper processing fees, reinstatement
fee, and so on.
+ Complete and submit the recertification application by your expiration date.
• Applications do not automatically submit once payment is complete. You need to return
to the "Recert Application" to submit the completed application.
• Failure to submit the application will result in the lapsing of your certification.
Application Review
If education does not meet the minimum requirements after being reviewed by a
Registry staff
member, the application will be marked incomplete.
If the application is returned incomplete, the
individual will need to check the message center to determine the issues presented with the
application and make the necessary changes before resubmission.
Individuals are encouraged to check their account frequently after submitting their recertication
application to ensure no additional actions are needed.
Any application that is incomplete after the reinstatement window closes cannot be resubmitted
and your certification will lapse. (Refer to the IMPORTANT DATES FOR EMT, AEMT, AND
PARAMEDICS section)).
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CONTINUING EDUCATION REQUIREMENTS
OVERVIEW
The National Continued Competency Program (NCCP) has three components:
+ National Component
+ Local Component
+ Individual Component
All education must either be recognized by the State EMS Office, accredited by CAPCE
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, or
by accepted through the National Registry Alternative Recertification Credit Policy.
Each of the components is explained in detail in the following sections. This table lists the
required number of hours of continuing education by each level of National EMS Certification
and by the specific component:
Table 1. NCCP Hour Requirements
Level National Local Individual
Total
Hours
EMR 8 4 4 16
EMT 20 10 10 40
AEMT 25 12.5 12.5 50
NRP 30 15 15 60
The National Registry endorses the latest NCCP Model, which is the 2016 requirements. Identied
topics are approved and incorporated into the National Continued Competency Program by the
National Registry Certication Committee.
National Component
The National Component replaces the material taught in the traditional refresher and represents 50%
of the overall requirements necessary to renew the National EMS Certification. Requirements for the
National Component should include the most recent evidence-based guidelines available and an
updated scope of practice.
Topics chosen are inuenced by:
+ Evidenced-based medicine.
+ Changes in the National EMS Scope of Practice Model.
+ Science-based position papers that affect EMS patient care.
+ Patient care tasks that have low frequency yet high criticality.
+ Peer-reviewed articles that feature contemporary trends in EMS.
Education or credits claimed within the National Component must be at or above the individual’s
certication level.
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Local Component
The local component is developed and delivered at the local (agency) or state EMS level and
represents 25% of the recertication requirements for all individual levels. The topics may be
determined by State EMS O
ces and EMS region directors (where applicable); however, agency-
level administrators (Medical Directors and Training Ocers) may dictate this component if permitted
by the state.
Recommended topics for the Local Component may include, but are not limited to:
+ Changes in local protocols
+ Tasks that require remediation based upon a quality assurance system
+ National EMS Information Systems (NEMSIS)
+ Run reviews and/or grand rounds
+ Community-based needs assessment
+ EMS-related training courses required for local or state credentialing
+ Academic or college-related courses that directly apply to EMS patient care
Education or credits claimed within the Local Component can be below, at, or above the individual’s
certication level.
Individual Component
The Individual Component represents 25% of the required continuing education. To satisfy these
requirements, an individual may select courses or credits that apply directly to EMS and patient care.
Recommended topics for the Individual Component may include, but are not limited to:
+ Changes in local protocols
+ Tasks that require remediation based upon a quality assurance system
+ Run reviews and/or grand rounds
+ Community-based needs assessment
+ EMS-related training courses required for local or state credentialing
+ Academic or college-related courses that directly apply to EMS patient care
+ EMS-related subjects that have personal interest
+ Extra hours from courses in National or Local components
Education or credits claimed within the Individual Component can be below, at, or above the
individual’s certification level.
Accepted Continuing Education
In addition to general EMS continuing education courses, which are recognized by the state EMS
office or accredited by CAPCE, the following may also be applied to the NCCP Model (National,
Local, and Individual Components).
Standardized Courses/Card Courses
+ Prior to April 1, 2023: Hour-for-hour credit can be applied for standardized courses to the
National, Local, or Individual Components. After April 1, 2023, all courses must follow
the Accepted Education and Documentation Policy (see page 18).
• Further information on courses and what they cover see the table in the appendix.
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College Courses/Academic Credit
+ College or academic credit may be applied for general college courses that relate to your role
as an EMS professional.
+ The courses must directly apply to EMS topics or direct EMS patient care.
+ College courses before April 1, 2023 can be applied as 1 college credit = 8 CE hours.
• As of April 1, 2023, per the Academic Credit Policy, college courses will not be allowed
within the National Component.
• As of April 1, 2023, 1 college credit = 10 CE hours.
EMS Education Programs
+ Hours from the following can be applied hour-for-hour:
• Teaching or instructing EMS Programs.
• EMS Course Instruction.
• Critical Care.
• Wilderness EMS training at or above your current certification level.
** All courses must be U.S. State EMS Office, DAA (Designated Authorized Agency),
CAPCE accredited, from a U.S. Academic Institution, or approved by National Registry
Recertification Alternative Credits Policy**
Continuing Education that is not accepted
The National Registry does not accept the following for continuing education:
+ Performance of duty or volunteer time with agencies: Paid or volunteer working or duty
hours for any organization, agency, or medical facility.
+ Clinical rotations: Clinical rotations that
are not part of an EMS Education Program.
+ Instructor methodology courses: Includes all courses to become an instructor or courses to
achieve instructor-level certifications.
+ Management/leadership courses:
Includes business management and leadership, Fire/EMS
administrative courses.
+ Preceptor hours: Courses in which an individual takes to become a preceptor or that cover
preceptor methodologies.
+ Serving as a skills examiner or participant: Includes skills examiner, acting as a patient, or
proctor for state level or National Registry psychomotor examinations.
+ Duplicate courses: Courses that are the same content or title and instructed by the same
program, instructor, or organization within the same certification cycle.
+ College courses: Most core or general education college course topics, such as algebra,
statistics, chemistry, biology, sociology, languages, psychology, and so on that do not apply
directly to EMS.
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RECERTIFICATION BY CONTINUING
EDUCATION CHECKLIST
Update Profile: Ensure your email and demographics are current.
Manage Affiliations: For “Active Status,” please check that your agency affiliation is correct.
* Agency affiliation is not required. You can recertify in the Inactive Status.
+ Remove any old agency affiliations to avoid your application being denied at the agency
level.
+ Follow up with any pending affiliation requests.
+ If you are not affiliated with an agency, you will renew as “Inactive.”
Add Continuing Education to your Professional Transcript
* Pro Tip: Use the NREMT phone app to take photos of your proof of education and attach
these images to your courses within the app. No need to upload to a computer or laptop.
+ Prepare scanned or digital copies to upload all education you are submitting.
+ Check account for any education entered by your training officer.
+ Check for CAPCE education that is available to import from “CAPCE Import
function.”
+ Add all education you are submitting to your transcript.
Manage Your Education: Assign education to the National, Local, and Individual sections.
* Pro Tip: College courses are best placed in the local or individual components. No college
courses will be accepted in the National Component after April 1, 2023. College courses must
be related to EMS direct patient care.
+ All sections must be complete to recertify.
+ In the National Component, all topics and subtopics must be met for it to be
considered complete. Assign courses to the corresponding topic, such as diabetic
emergencies in the medical topic. Hover over the (i) icon to see the subtopic
requirements under each broad topic (airway, cardiology, trauma, medical,
operations).
+ Your state or local EMS agency sets the Local
Component. If there are no
established local requirements, you can use any EMS direct patient care-related
education.
+ The Individual Component can be any EMS-related education.
Recertication Application
+ Complete the Recertification Application under “My Certification Role.”
+ Once payment is made and completed, return to recert application screen.
+ After you complete all sections, click “Submit Application.”
+ Important: Your application is not submitted until you click “Submit
Application.”
Check your status: Log in to your account and monitor the progress of your application until a
new expiration date appears.
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Check your Message Center: Applications may need further actions due to:
+ Being selected for a random audit
+ Being marked incomplete and returned for the individual to make
corrections
+ Pending Training Officer and/or Medical Director verifications
Check your Email: National Registry frequently sends important information and email reminders
for recertification.
+ Reminders to recertify: If you have submitted your application, and are still receiving
emails to recertify, this means you are not yet recertified. Check your account and
messages for more information. Action is required.
+ Application actions: If your application is returned for correction or you are randomly
selected for audit, you will be notified by email in addition to receiving a message in
your account.
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PRO TIPS FOR SUCCESSFUL
RECERTIFICATION
+ Frequently check the status of your recertification application. Once you see your expiration date
has been updated, your recertification is complete.
+ The education applied in the National Component must be at or above the current certification
level.
+ All subtopics within a topic of the National Component must be met for the topic to be fully
completed. Hover over the (i) under manage education for subtopic information.
+ The Registry encourages you to enter your education into your transcript throughout your
recertification cycle. Do not wait until the last minute.
+ Portions of/or completed EMS education programs (EMR, EMT, AEMT, and Paramedic) within
the current certification cycle dates, which have been awarded credit with proof of education or
certifications of completion, can be used for recertification.
+ One standardized course does not cover enough subtopics to cover all the topics of the National
Components.
+ Classes can only be used one time. A class can be assigned in different components or areas of
the recertification application until maximum hours are assigned. But you cannot have multiple
classes of the same class.
+ Once education is entered and education shows 100% complete, this does not automatically
qualify that education meets the requirements for recertification. The final determination is made
by National Registry staff review.
+ If your recertification application is marked incomplete for education, check the Message Center
what needs correction.
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LOOKING FOR EDUCATION?
+ CPR and other standardized certificate or card courses can be used for recertification hours.
Use these sites to convert your course completion to continuing education hours:
• American Red Cross: https://www.redcross.org/take-a-class/capce
• American Heart Association: https://cpr.heart.org/en/resources/faqs/need-to-claim-your-
aha-continuing-education-credits
+ CAPCE Accredited Courses: www.capce.org
+ State EMS Offices:
• Check your local state EMS office for state-approved education. Most states have a
state-approved EMS education learning management system.
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RECERTIFICATION BY EXAMINATION (RBE)
The Recertication by Examination (RBE) option allows you to demonstrate cognitive competency
without having to obtain and document continuing education.
RBE option is available beginning April 1 (EMR is October 1), up to one year before your current
expiration date. You may attempt RBE only one time per recertification cycle. For RBE application
dates, refer to the IMPORTANT DATES FOR EMT, AEMT, AND PARAMEDICS section, the EMR
important dates follow that section.
NEW: You can now test RBE one time before your current expiration date to satisfy an audit. You will
need to successfully complete the exam before your expiration date. Refer to the "Audits" Section for
more information on the Recertification by Examination in lieu of submitting proof of education.
If you are not testing to satisfy an audit and are unsuccessful at the RBE attempt, you can recertify
by continuing education. You will need to complete all continuing education by your expiration date
for your expiration year and submit a completed recertification application.
NOTE: All recertification fees are nonrefundable (This includes Recertification by Examination fees).
How to apply for your Recertification by Examination:
+ Log in to your account on the National Registry website:
• Select the “My Certification” role.
• Click the “Recert by Exam” tab and then “Application.
”
• Complete the application and submit your application.
• Apply payment.
+ To locate your Authorization to Test (ATT):
• Select the “Recert by Exam” tab and “App Status/Results.”
• Follow the directions on the letter to schedule your examination with Pearson VUE.
+ Take and pass the examination by the expiration date of your expiration year:
• After passing, print your Cognitive Competency by Exam form.
• This form can be found under the “Recert by Exam” tab, App Status/Results.
• Email the completed form to the National Registry for processing at [email protected].
NOTE
: The ATT should post within 24 to 48 hours (about two business days), the applicant will
need to log into their account and check to see if the ATT letter has been posted to your account. If
614-888-4484 during business hours.
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REINSTATEMENT PERIOD
If an individual completed all continuing education requirements within their certication cycle,
including all education, and before their current expiration date, they may qualify for reinstatement.
The reinstatement allows an individual to submit their application for an additional fee during the
reinstatement period.
Reinstatement occurs between April 1 to April 30 for EMT, AEMT,
and Paramedics. For EMRs, the
reinstatement is between October 1 to October 31 of the current expiration year.
+ The reinstatement period only allows individuals to submit a late application if they are
renewing by continuing education
+ There is a $50 late
fee in addition to the application fee.
+ All education must be completed within the recertification cycle dates as it will not be accepted
if completed after the current expiration date.
+ There is no guarantee an application will be accepted or individual recertified during the
reinstatement period. To recertify, an application must meet all recertification requirements and
can be returned incomplete for correction by staff, randomly selected for audit, or approved for
recertification.
+ Reinstatement does not apply to Recertification by Examination (RBE). National Registry staff
will continue to accept signed Cognitive Competency forms for active status during the
reinstatement period per the instructions on the form.
+ If utilizing the reinstatement period and recertified, the start date of your next cycle, or rolling
recertification date, will begin the day after your application is processed and approved by
National Registry staff. It does not reset back to April 1 (EMT, AEMT, NRP) or October 1
(EMR).
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REQUEST FOR AN EXTENSION OF
CERTIFICATION DATE
National Registry may assess individual requests for a time extension to meet all education
requirements and/or submission of the recertification application for qualifying events. You must
apply before your current expiration date, unless a situation prevents that. Email [email protected]
with supporting documentation. An extension may be considered for examples such as, but not
limited to, overseas military deployment or a significant, incapacitating personal medical event that
impacted most of the current recertification cycle.
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INITIAL CERTIFICATION CYCLE DATES
For individuals recertifying for the rst time:
Your initial recertication cycle starts when you gain your full certication and ends with your
expiration date.
+ EMTs, AEMTs, and Paramedics have recertification dates that are based on a 2-year
recertification cycle that ends March 31
of your expiration year.
+ EMRs have recertification dates that are based on a 2-year recertification cycle that ends on
September 30 of your expiration year.
+ Expiration dates are set when you gain your full, initial certification.
• Individuals who gain initial certification between January to June will be issued an
expiration date two years in the future.
• Individuals who gain initial certification between July to December will be three years in
the future.
+ All education must be completed within your certification cycle and before your expiration
date. For the first recertification, your certification cycle starts the date you gained certification.
+ Your expiration date for your National Certification may be different from your state license
expiration date.
+ The 2-year recertification cycle is supported by a balance of the interactions with licensure
processes, degradation of knowledge over time, and changes to the EMS community.
ROLLING RECERTIFICATION CYCLE DATES
Pro Tip: If your education is completed and recertification period is open for renewal, submit early!
Rolling recertication is a benet to those who submit early.
+ The new certification cycle starts the day after the recertification application is processed and
approved by the National Registry.
+ For Recertification by Examination (RBE), the cycle date starts the day after the Cognitive
Competency by Examination Form is processed by the National Registry.
+ The rolling recertification cycle start date will change, but the expiration date will not, even if
the individual renews early.
+ Once the new cycle date is granted, the individual can begin earning and assigning education
for their next recertification cycle.
+ Rolling recertification dates are automatically assigned and cannot be changed.
+ EMS professionals must recertify before their current expiration date, or they will lapse.
• If an EMS professional lapses, they must regain national certification through the
appropriate reentry or state-licensed entry pathways, as outlined in the "RELATED
POLICIES AND PROCEDURES" section.
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IMPORTANT DATES FOR EMT, AEMT, AND
PARAMEDICS
April 1 - 1 year
before the
current expiration
date
Recertification by Examination (RBE) opens. You can test through March
31 of your expiration date.
October 1 -
6 months before your
expiration date
Recertification by application (CEU) opens. Submit your completed
application now until March 31 of your expiration date.
March 31 –
expiration date
This is the last day to submit your application without the additional
reinstatement fee.
April 1 to April 30
– expiration year
This is the reinstatement period. Submit your application with an
additional reinstatement fee.
April 5 –
expiration year
Applications pending Training Ocer and Medical Director verication for
active status are converted to inactive status and submitted to National
Registry for review. This prevents a lapsed certification status and
expiration of many state licenses. This includes those who tested RBE and
are not yet recertified.
May 1 –
expiration year
For anyone who submitted during the reinstatement period or earlier,
applications pending Training Ocer and Medical Director verication for
active status are converted to inactive status and submitted to National
Registry for review.
May 1 –
expiration year
Lapse of certification. You will need to regain your national EMS certification.
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IMPORTANT DATES FOR EMRs
October 1 -
1 year before the
current expiration
date
Recertification by Examination (RBE) opens. You can test through
September 30 of your expiration date.
April 1 -
6 months before
your expiration
date
Recertification by application (CEU) opens. Submit your completed
application now until September 30 of your expiration date.
September 30 –
expiration date
This is the last day to submit your application without the additional
reinstatement fee.
October 1 to
October 31 –
expiration year
This is the reinstatement period. Submit your application with an
additional reinstatement fee.
October 5
–
expiration year
Applications pending Training Ocer verication for active status are
converted to inactive status and submitted to National Registry for review.
This prevents a lapsed certification status and expiration of many state
licenses. This includes those who tested RBE and not yet recertified.
November 1 –
expiration year
For anyone who submitted during the reinstatement period or earlier,
applications pending Training Ocer verication for active status are
converted to inactive status and submitted to National Registry for review.
November 1 –
expiration year
Lapse of certification. Y
ou will need to regain your national EMS
certification by taking a new EMR education program.
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AUDITS
Recertification applications submitted to the National Registry are randomly selected by computer
for audit. If an individual’s application is chosen at random, the individual must provide
documentation for all courses listed on the recertification application before their current
expiration date. If audited during the reinstatement period, individuals have until May 31 (EMT,
AEMT, Paramedic) or Nov 30 (EMR) of the current expiration year to provide documentation.
Starting April 1, 2023, education cannot be swapped for new education dated after the initial
submission date.
In place of submitting proof of education, an individual may take and successfully pass the
Recertication by Examination (RBE) one time before their current expiration date. If selected for
audit during the reinstatement period, the individual must submit proof of education.
From the Accepted Education and Documentation Policy:
Accepted proof of documentation must be one of the following:
+ Certificates of course completion
+ Copies of standardized course cards and certificates of completion will be accepted for
courses listed on the National Registry Standardized Course Guide.
+ A roster that includes all data elements on the training organization’s letterhead and includes
the Training Officer’s signature.
+ Data imported directly in the National Registry transcript from an approved, trusted source for
continuing education.
+ Official transcript from an accredited school, university, or state-approved EMS program.
+ Downloaded report of completed education through an educational provider or platform that
contains the name and signature of the verifying Training Officer or downloaded from the
source directly–not a written letter of completion.
Proof of education must include the following information for all education
dated on or after April 1, 2023:
+ Name of individual
+ Date of course completion
+ Number of credits/hours/or continuing education units awarded
+ Scope (course topic, course name, or description)
+ Name of certificate issuer (training provider name)
+ Name of course issuer/approver (education accepted or approved by CAPCE, State EMS
Office, Academic Institution, by National Registry Policy)
Applications selected for random audit can have the application returned for correction. The
denied education can be replaced with any courses completed between the start of the individual’s
recertification cycle and the date of the original application submission. If education cannot be
swapped, the individual may take the Recertification by Examination (RBE). It is up to the individual
state EMS oce if a State License Only (SLO) individual can use Recertication by Examination
(RBE) to satisfy audit requirements.
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Nationally Registered individuals may test the Recertication by Examination (RBE) in place of
submitting documentation if the individual is within his/her current recertification cycle and before
their current expiration date. Individuals have one attempt to successfully pass the exam at the
current level of certification. If successfully passed, the individual will satisfy the audit requirements
and be recertified. If the individual is unsuccessful, the individual will lapse on their expiration date.
The fees for the recertication application and for Recertication by Examination (RBE) are non-
refundable.
Individuals selected for audit during the reinstatement period are not eligible for Recertication by
Examination (RBE) and must submit the required documentation.
AUDITS DUE TO REASON OR CAUSE
The National Registry reserves the right to investigate recertification materials at any time. Nationally
certified EMS professionals must retain the proof of all education submitted for recertification for a
period of five years. Failure to submit verification or documentation when audited will result in denial
of eligibility to recertify and will result in a lapsed status or possible revocation.
An individual audited due to reason or cause will be notied of an investigation and their audit status
through the email designated in their account. From the time of notification, the individual has 30
days to submit documentation to support the audited application and do not have the option of
Recertication by Examination (RBE).
Please visit the National Registry Policies page for more information at www.nremt.org.
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ACTIVE AND INACTIVE STATUS
Active status
Verication of skills competency is a requirement for an individual to maintain active status and is
validated by the agency’s designated EMS authority (Training Officer for EMR and EMT, Medical
Director for AEMT, and Paramedic). The expectation of skills competency validation is determined by
and performed at the local level (agency or organization) and affirms that the EMS professional has
been verified as competent for level-specific skills and any necessary remediation has been
undertaken.
The agency’s Training Officer and Medical Director should determine the specific skills as part of the
local credentialing process. For reference to level-specific skills, please refer to the National EMS
Scope of Practice Model
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document.
Inactive status
Inactive status is designated for Nationally Certied EMS professionals and specic State License
Only Providers who are not actively working or volunteering in EMS, or do not have an agency
affiliation or Training Officer/Medical Director verification of skills and education. Individuals who wish
to declare inactive status must continue to meet the National Registry requirements for cognitive
competency via Recertification by Examination or continuing education in subsequent cycles. If
cognitive competencies are met, the provider may remain in inactive status indefinitely.
Inactive status is not for those who have had limitations or revocation of a health care license. It is
also not for individuals who are unable to meet recertication requirements prior to their expiration
date. Inactive status does not delay, postpone, or change the certification expiration date.
RETURNING TO ACTIVE STATUS
Nationally Certied EMS professionals may request to return to active status at any time. The
individual must meet active status requirements of an agency affiliation and a continued competency
skill attestation by Training Officer or Medical Director (certification-level appropriate) to return to
active status. This verification can be done efficiently through Registry's online process or by finding
the
“Inactive to Active” form online and sending it back to [email protected].
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FREQUENTLY ASKED QUESTIONS
Who do I contact if I need help with my recertication application or have
questions?
Recertification questions can be sent to [email protected].
The National Registry’s regular business hours are between 9:00 a.m. and 5:00 p.m. EDT Monday
through Friday.
Why does my agency need an account on the National Registry website?
The National Registry encourages online submission of recertification applications. Having the
agency registered with the National Registry allows for the electronic verication of recertication
applications and provides access to information, dashboards, online roles, roster review, and
timely communications to serve their EMS professionals better. Online agencies and application
submissions signicantly reduce processing times and increase accuracy.
What are the requirements of an agency to request aliation with the
National Registry?
The requirements are to employ Nationally Certified individuals and submit electronic recertification
applications. The Training Officer of the agency creates the new agency, and Registry will approve
the request if appropriate. The agency must have individuals who work or volunteer using their EMS
skills.
How can I tell if I am affiliated with an agency?
Log in to your National Registry account and select My Certification role. Under the Agency Affiliation
selection on your Dashboard, it will display any agencies with which you are currently affiliated with or
which you have requested affiliation. You may add and delete any agency by clicking the Add or
Remove Agency Affiliation link.
Can a Training Ocer or certied individual aliate with more than
one agency?
Yes, a Training Officer or certified individual can affiliate with multiple agencies.
What education is accepted for the National Registry recertication?
The National Registry accepts state EMS office recognized, CAPCE accredited education, and
education recognized in the Alternative Recertification Credits Policy. Please check with your state
EMS oce for additional information on accepted state-approved or local component requirements, or
state exceptions.
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What is the intended use of the Education Updates or Guidelines?
Education updates are guidelines or suggested lesson plans for the National Component topics and
subtopics. Note: You are not required to use the lesson plans verbatim and are not required to use
or turn in skills assessment sheets with recertification applications.
If I fail Recertication by Examination, can I still be recertied?
Individuals who do not receive a passing score on the Recertification by Examination may still renew
by continuing education if all requirements are completed by their current expiration date. Individuals
using Recertication by Examination to satisfy an audit or under investigation do not qualify for the
CE application. An unsuccessful examination in those cases will result in a lapsed certication.
Can I drop my certification to a lower level?
Requests to drop a certification to a lower level can be sent to [email protected].
To return to a higher level, all certication requirements must be met to include both the cognitive and
psychomotor examinations.
Can I renew late?
EMT, AEMT, Paramedic late renewal
If the renewal application was not submitted before the March 31 deadline, the individual may pay a
$50 late application fee and submit the application by April 30 of the current expiration year.
All continuing education requirements must have been met before March 31 of their current
recertification cycle.
EMR late renewal
If the renewal application was not submitted before the September 30 deadline, the individual may
pay a $50 late application fee and submit the application by October 31 of the current expiration year.
All continuing education requirements must have been met before September 30 of their current
recertication cycle.
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HOW THE EMS SYSTEM FITS TOGETHER
The relationship between education, certication, licensure, and credentialing is evident. More
importantly, the relationship of how Training Officers, Medical Directors, State EMS Officials,
the National Registry, and EMS professionals interact within those components for continued
EMS competency ensures that the best patient care is delivered within each community.
The National EMS Scope of Practice Model (2019), p.15, describes a model which reflects an
interdependency between education, certification, licensure, and credentialing.
Education
Education includes all areas of cognitive and psychomotor skill, and eective learning that an EMS
professional undergoes for initial and ongoing competency. Education is an important, lifelong
learning activity throughout the EMS Professional’s career and an important part of certication,
licensure, and credentialing.
Certification
Certification is an external verification of the competencies an individual achieves. The National
Registry of Emergency Medical Technicians is the nation’s EMS certification organization, which
verifies cognitive and psychomotor competency for national certification. The National Registry’s
mission is centered on protecting the public and advancing the EMS profession.
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Licensure
State EMS oces have regulatory authority to grant EMS professionals the permission to practice
within their scope. Licensure is the mechanism by which the state grants this authority. EMS
professionals meet the requirements of state EMS licensure and are granted licensure at their
level of practice if they meet those requirements. Most states have maintenance or recerti
cation
requirements for their state licensure. In some states, National Registry is required for maintaining a
state license.
Credentialing
Credentialing is a verication by the physician Medical Director that conrms the EMS professional is
qualied and authorized to perform skills within their scope of practice and certication and licensed
level. Credentialing occurs at the local level, which is the local agency’s responsibility for employment
or roster status of EMS professionals.
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ROLES AND RESPONSIBILITIES
EMS professionals are unique health care professionals who provide medical care in many
environments, locations, and situations. Much of this care occurs in an out-of-hospital setting with
minimal onsite supervision. Medical Directors provide medical oversight to ensure and maintain safe
EMS practices. The National Registry recognizes the importance of interactions and intersections
between the EMS professionals, Training Ocers, and Medical Directors for safe and eective
practice within the communities they serve.
EMS Professionals
After attending initial EMS education, achieving certication and state licensure, EMS professionals
should focus on lifelong continuing education. EMS professionals are responsible for their continued
competency and should maintain their national certification, state licensures, and local credentialing
within their scope of practice for safe and effective patient care. As an EMS professional, it is the
responsibility of the individual/registrant to make sure that they have completed all necessary steps
for recertication.
EMS Agencies, Training Officers, Medical Directors
EMS Agencies, Training Officers, and Physician Medical Directors are responsible for local
credentialing and employment. Training Officers and Physician Medical Directors ensure the
continued competence of nationally certified EMS providers for active status by validating continued
EMS skills and education. Physician Medical Directors are responsible for clinical oversight,
ensuring safe and competent EMS care within their community, and establishing protocols for
credentialed EMS professionals through evidence-based guidelines and practice.
Training Officers can set up an agency, maintain an agency roster and agency affiliation, approve
education and skills verification appropriate to certification levels, apply education to individuals’
accounts, and approve or remove Training Officers and Medical Director affiliation.
Physician Medical Directors using the National Registry website under the Medical Director role are
responsible for approving skills verification for advanced-level individuals (AEMT, Paramedics).
State EMS Officials
State EMS Officials have the legal authority of granting an EMS professional’s ability to practice
within their scope. Each state has its own authority granted through the regulatory process. Some
states use a separate application and recertification process to renew a state EMS license, which is
separate from, or in addition to, National Registry requirements. Other states require National
Registry recertification, which automatically renews an EMS professional’s state license.
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A BRIEF HISTORY OF NATIONAL EMS
CONTINUED COMPETENCY
Since the registration of the first nationally certified EMS professional in 1971, EMS practice
has evolved significantly. Over the last four decades, the EMS profession has advanced from
fundamental methods of care and transportation to the delivery of more advanced emergency
medicine in the out-of-hospital environment. The changes in the EMS Scope of Practice, the
Practice Analysis, development and inclusion of evidence-based guidelines, and shifting
community-based needs that helps drive the importance of continued competency and maintenance
of certification.
The 2007 release and 2019 update of the National EMS Scope of Practice
Model identified four levels of provider care:
+ Emergency Medical Responder
+ Emergency Medical Technician
+ Advanced Emergency Medical Technician
+ Paramedic
Further, in 2009 the National EMS Education Standards were completed. These standards outlined
the education necessary to bring entry-level providers to a competency level recognized in the
National EMS Scope of Practice Model.
The National Registry utilized the Traditional Model of recertication since the 1980s when
recertification requirements were based on the premise that all providers completed the same “clock
hours” of training. While there was some flexibility to adapt training to local needs, the recertification
process did not provide a formal pathway for adaptability. Refresher content areas did not prescribe
training over areas of practice where significant change had occurred. Lastly, there was no ability for
Medical Directors and systems to focus training on needs identified by the continuous quality
improvement process. As a result, the need for a new, more contemporary model of recertification
was created.
The National Registry periodically reviews and improves the recertification model requirements for
National EMS Certification. Stakeholder input, national EMS organizations, State EMS Officials, and
federal partners are instrumental in developing a continued competency model that is centered on a
nationally accepted, scientic, evidence-based approach.
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PRINCIPLES AND APPLICATION OF THE
CONTINUED COMPETENCY PROGRAM
In 2010, a task force met to consider revisions of the National Registry recertification process. The
task force was a multi-disciplinary group comprised of representatives of the major regulatory,
medical oversight, and operational components of Emergency Medical Services.
During the 2000s, continued competency was being addressed as a necessity for all medical
specialties. The ongoing work of the American Board of Medical Specialties (ABMS) was reviewed
by the task force. In summary, the National Registry continued competency task force selected five
key principles identied by ABMS that were adopted and included in the recertication process for
National EMS Certification.
The 5 principles include:
1. Professional Standing
2. Practice Performance
3. Lifelong Learning
4. Individual Continuing Education
5. Self-Assessment*
* Self-Assessment was originally adopted and included in the early stages of the NCCP recertification
model and is no longer required, but can be valuable and insightful to many.
Professional standing
For an individual to hold National EMS Certification, the individual must not be barred from licensure/
certification in any state. Holding a current valid license/certification is a critical element to assure the
public that EMS providers have not faced any action that would bar them from practice.
The National Registry requires disclosure of any criminal convictions or licensure/certication
limitations as part of the certication and recertication requirements.
The National Registry has adopted a Criminal Conviction Policy to safeguard the public from
individuals who, in practice as an EMS professionals, might pose a danger to the public. All applicants
for certication or recertication must disclose any criminal conviction as required on an application.
The National Registry may deny an applicant eligibility to sit for a certication examination, deny
certication, suspend or revoke an individual’s certication, or take other appropriate actions with
respect to the applicant’s certication or recertication based on their felony or misdemeanor criminal
convictions and all other criminal convictions relating to crimes involving physical assault, use of
a dangerous weapon, sexual abuse or assault, abuse of children, the elderly or infirm and crimes
against property, including robbery, burglary and felony theft.
You may review further information related to this policy at www.nremt.org under Policies.
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Practice performance
Each EMS system across the nation has evolved to meet the individual needs of the community or
region it serves. National EMS Certification requires competency and education at the local level to
best serve specific state and community needs. Continued competency to practice may be validated
by psychomotor or skills assessments and other performance measurement tools. Validation of
practice performance is the responsibility of the provider’s EMS supervisor or Training Ocer at the
EMR and EMT levels and by the provider’s Medical Director at the AEMT and Paramedic levels for
active certification.
Lifelong learning
Initial education/training is intended to provide entry-level knowledge and skills for an EMS provider.
Building on the foundation of initial education, lifelong learning aids providers in adapting to the
continuous changes in patient care, education, protocols, and other inuencing factors of EMS
practice.
The improvement of patient care and providing quality care should be the goal of every EMS
professional regardless of location. Lifelong learning is part of continued competency; therefore a
requirement of the National Continued Competency Program, while being a key component to an
EMS professional’s career.
Individual continuing education
A continuous competency program must focus on the entire clinical domain of out-of-hospital
emergency care. Continuing education focused on areas of need of the EMS professional has
the potential to improve knowledge, better skills, and positively aect patient outcomes. Individual
continuing education embraces the principle of lifelong learning.
Self-Assessment (not currently utilized in NCCP)
In the pilot phase of the new National Continued Competency Program, the National Registry
launched a low-stakes self-assessment covering four broad domains of out-of-hospital emergency
care to include Airway, Respiration & Ventilation; Cardiology & Resuscitation; Medical, Obstetrics
& Gynecology; and Trauma. Because this self-assessment was low-stakes and the culture around
self-assessment was not widely accepted in the EMS community, the reliability of aggregated data
to inform individual providers, agencies, and states could not be optimized. While it is the vision and
hope of the National Registry that the EMS community will embrace the importance and utility of
self-assessment data, the National Registry will not require a self-assessment component as part of
national EMS recertication at this time.
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RELATED POLICIES AND PROCEDURES
National Registry certication policies are established to assure the public, EMS licensing or
authorizing agencies, employers, and other healthcare providers that certified EMS professionals
have demonstrated the required knowledge and skills to practice safely and effectively. Policies are
regularly reviewed and updated.
+ Academic Credit Policy: Details the requirements for using college courses, initial EMS
education programs, and other forms of academic credit for recertification and certification
processes.
+ Accepted Education and Documentation Policy:
Outlines what education is accepted for
recertification and certification, and how that education must be documented to be accepted.
+ Alternative Recertification Credits: Policy authorizing National Registry to award credits for
recertification to function as an alternative to continuing education in certain, appropriately
defined circumstances.
+ Appeals Policy: Defines the appeals process for individuals in cases of adverse decisions.
+ Certificant Personal Information Policy: Outlines public and personal or private information
and authorized sharing of information.
+ Certification Schemes: All Levels: Identifies requirements to gain initial certification, maintain
certification, and regain National Certification if lapsed or expires.
+ Code of Conduct: Outlines values, compliance, and professional standards as a condition of
certification and recertification.
+ Criminal Convictions: Establishes eligibility requirements for National Certification related to
criminal convictions and applies to eligibility requirements for both initial certification and
recertification.
+ Disciplinary Actions Policy: Specifies the situations that may lead to action against a
certification.
+ Examination Irregular Behavior: Specifies situations that constitute irregular behavior during
an examination, including Recertification by Examination (RBE).
+ Fee Structures and Refunds: Payment policies for fee structures, forms of payment, and
issuance of refunds.
+ Inactive Status: Defines the inactive status requirements and process to return to active status
certification.
+ Live Remote Proctored Examinations (updated to include RBE): Outlines the uses,
restrictions, and processes for Live Remote Proctored examinations, which now includes EMR
and EMT Recertification by Examination (RBE).
+ Mark King Initiative (MKI): The policy is for select states and time periods only. It allows
previously Nationally Certified individuals to regain certification and for them to maintain their
National EMS Certification.
+ Recertification Audits: Explains the random sampling of individuals audited, the process,
30
and failure to submit documentation to support the education claimed on the recertication
applications.
+ Reconsideration of Eligibility Policy: Specifies the circumstances under which
reconsideration of eligibility or reinstatement of certification is allowed.
+ Reporting of Possible Misconduct: Articulates the obligation and importance of reporting
misconduct information to the National Registry
.
+ Terms of Certification Policy: Establishes requirements for eligibility for certification and
recertification.
For the most recent and updated policy information, please visit the Policies page on
the National Registry's website: www.nremt.org.
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GLOSSARY
Active Status:To renew with an "active status," EMTs must be affiliated with an EMS Agency or
Service and have the proper skills and education verication from a Training Ocer and/or Medical
Director.
Affiliation: Your affiliation is the EMS agency/organization you work for that will verify your continuing
education and skills competency. You may submit an affiliation request from your “My Certification”
tab.
Agency:Your agency is the EMS organization where you work. This agency will be responsible for
verifying your continuing education and skills competency. You must submit a request to become
electronically affiliated with your agency under your “My Certification” tab.
Distributive Education (DE): DE is a method of delivering EMS education where the instructor,
student, and materials are not able to interact in real time. Examples include online courses, journal
article reviews, and videos.
Inactive Status: Inactive Status is for Nationally Certified EMS Professionals who are currently
not providing patient care at their certification level or those who do not have an agency affiliation,
Training Officer, or Medical Director able to validate education and skills. Individuals wanting
to declare inactive status must continue to meet the National Registry continuing education
recertification requirements. Inactive status is not for those who cannot obtain and meet the
educational requirements or those who have limitations or revocation of a health care license.
Lapsed: If you do not complete the recertification process by your expiration date, your National EMS
Certification is considered lapsed. Please see the Certification Scheme (level-specific policy) for more
information on the requirements to regain your National EMS Certification.
Medical Director:The Medical Director is responsible for verifying the continued competence of ALS
providers’ skills when they recertify their National EMS Certication and when updating from inactive
to active status.
National Continued Competency Program (NCCP): NCCP is a recertification model that allows
flexibility at the local and individual levels. The NCCP is comprised of three components: national,
local, and individual.
Training Officer: A Training Officer is an individual responsible for managing the education
requirements of an EMS agency. This person may be nationally certified, but it is not a requirement.
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APPENDIX
33
REFERENCES
1
CAPCE. (2022). Answers to Frequently Asked Questions. Retrieved from https://capce.org/Home/FAQ
2
National Association of State EMS Officials. National EMS Scope of Practice Model 2019 (Report No.
DOT HS 812-666). Washington, DC: National Highway Traffic Safety Administration
version 3 - 11/12/2022
