Emergency Medical Technician (EMT) License Requirements in Missouri
- Training hours
- —
- Upfront cost
- $104
- Exam
- NREMT EMT-Basic Cognitive Examination
- Renewal cycle
- Every 5 years
- Issuing board
- Missouri Department of Health and Senior Services (DHSS), Bureau of Emergency Medical Services (BEMS)
How to get licensed
- 1
Meet the prerequisites
Pass a criminal background check. RSMo 190.142 requires initial applicants to submit to a state and FBI criminal background check through the Missouri State Highway Patrol (fee borne by the applicant), processed via IDENTOGO/MACHS before the license application is submitted; BEMS's licensing page confirms fingerprint results must be complete before submission. The statute authorizes DHSS to set age requirements by rule but does not itself state a minimum age, and no specific age figure was located in the regulations reviewed (19 CSR 30-40.342), so minAge is left null rather than guessed. Applicants must also demonstrate the ability to speak, read, and write English. [2]
- 2
Complete approved training
Complete training at a state-approved program. Missouri's initial-licensure requirement is proof of current National Registry of EMTs (NREMT) certification -- the EMT-B is not admitted through a separate state-published hour count on the licensing or regulation pages reviewed; training program requirements are set through DHSS-approved training entities under 19 CSR 30-40.331 following National EMS Education Standards. Left null rather than citing a third-party estimate. The Bureau of EMS retired its licensing.php page and the EMT-B relicensure guidelines PDF; the citation above is the Bureau's current EMS section. The recorded figures were not restated on the replacement page and should be re-verified against the Bureau's current relicensure guidance. [1]
- 3
NREMT EMT-Basic Cognitive Examination
Pass the NREMT EMT-Basic Cognitive Examination (fee: $104). Computer-adaptive test administered at Pearson VUE test centers or via OnVUE remote proctoring. RSMo 190.142 and BEMS's licensing page both require initial licensure applicants at all EMS levels to hold current National Registry of EMTs certification -- Missouri does not run a separate state written exam. Fee is NREMT's published national rate paid to NREMT/Pearson, not to BEMS. [2]
- 4
Submit your application
Submit your application to Missouri Department of Health and Senior Services (DHSS), Bureau of Emergency Medical Services (BEMS). [2]
- 5
Receive your license
Once your application is approved, Missouri Department of Health and Senior Services (DHSS), Bureau of Emergency Medical Services (BEMS) issues your Emergency Medical Technician (EMT-Basic) for Missouri.
Fees
| Fee | Amount |
|---|---|
| Application fee [2] | None specified |
| License fee [2] | None specified |
| Renewal fee [2] | None specified |
| NREMT EMT-Basic Cognitive Examination [2] | $104 |
No BEMS application, license, or renewal fee is published on the EMT and Paramedic Licensing Information page, and RSMo 190.142 does not set a general license fee -- it only requires the applicant to cover the cost of the state/FBI criminal background check itself ('any fees due for a criminal background check shall be paid by the applicant,' processed through IDENTOGO/MACHS). Left null rather than guessed; the identified costs are the background-check vendor fee and the NREMT exam fee (recorded under exams).
Renewal & continuing education
Renew every 5 years. 100 continuing education hours required per cycle.
RSMo 190.142: 'The department shall issue a license to all levels of emergency medical technicians, for a period of five years.' The BEMS EMT-Basic Relicensure Guidelines require either current National Registry of EMTs certification, or 100 hours of continuing education (48 hours matching the EMT-Basic refresher curriculum topics, plus 52 additional CE hours, with a maximum of 26 hours from any single topic), plus current CPR certification. Renewal applications must be submitted no less than 30 and no more than 120 days before expiration. The Bureau of EMS retired its licensing.php page and the EMT-B relicensure guidelines PDF; the citation above is the Bureau's current EMS section. The recorded figures were not restated on the replacement page and should be re-verified against the Bureau's current relicensure guidance.
Reciprocity
No reciprocity or endorsement route was found. Participates in: EMS Personnel Licensure Interstate Compact (REPLICA / EMS Compact).
Missouri is a confirmed current member state on the EMS Compact Commission's own commissioners page. Outside of the Compact's Privilege to Practice mechanism, BEMS's licensing page states plainly that 'EMS licenses from other states cannot be transferred to Missouri' -- an out-of-state EMT without a Compact-eligible home-state license must follow the standard initial licensure process (current NREMT certification plus a Missouri background check), not a separate reciprocity/endorsement pathway. The Bureau of EMS retired its licensing.php page and the EMT-B relicensure guidelines PDF; the citation above is the Bureau's current EMS section. The recorded figures were not restated on the replacement page and should be re-verified against the Bureau's current relicensure guidance.
9 state-approved training providers in Missouri — browse programs and compare schools on tradecolleges.org.
Cost calculator
- $104
Frequently asked questions
Does Missouri require NREMT certification for EMTs?
Yes. RSMo 190.142 and BEMS's licensing page require all levels of EMS personnel, including EMT-Basic, to hold current National Registry of EMTs (NREMT) certification for initial licensure -- Missouri does not run a separate state exam.
How much does it cost to get an EMT license in Missouri?
No general BEMS license fee is published; RSMo 190.142 only requires the applicant to pay for the state/FBI criminal background check itself (processed through IDENTOGO/MACHS), in addition to the NREMT cognitive exam fee (about $104, paid to Pearson VUE).
How often do Missouri EMTs need to renew their license?
Every 5 years, per RSMo 190.142. Renewal requires either current NREMT certification or 100 hours of continuing education (including 48 hours matching the EMT-Basic refresher curriculum), plus current CPR certification, submitted 30-120 days before expiration.
Does Missouri require a background check for EMT licensure?
Yes. RSMo 190.142 requires initial applicants to complete a Missouri State Highway Patrol and FBI criminal background check, at the applicant's own expense, before submitting a license application.
Can an EMT licensed in another state transfer their license to Missouri?
Not through a standard transfer -- BEMS states EMS licenses from other states cannot be transferred to Missouri, so an out-of-state EMT must complete Missouri's initial licensure process. The exception is the EMS Compact (REPLICA), of which Missouri is a member: EMS personnel licensed in another Compact member state can obtain a Privilege to Practice in Missouri without full relicensure.
Sources
- [1] health.mo.gov/safety/ems/ — accessed 2026-07-27
- [2] revisor.mo.gov/main/OneSection.aspx — accessed 2026-07-12