StateLicensed

Emergency Medical Technician (EMT) License Requirements in Texas

Verified · July 2026
Training hours
—
Upfront cost
$168
Exam
National Registry (NREMT) Cognitive Examination, NREMT Psychomotor (Skills) Examination
Renewal cycle
Every 4 years
Issuing board
Texas Department of State Health Services (DSHS), EMS and Trauma Systems

How to get licensed

  1. 1

    Meet the prerequisites

    Be at least 18 years old, High school diploma or GED certificate, pass a criminal background check. DSHS requires EMT applicants to be at least 18 years old, hold a high school diploma or GED, successfully complete a DSHS-approved EMS training course, and submit fingerprints for a Texas/FBI criminal history check. [2]

  2. 2

    Complete approved training

    Complete training at a state-approved program. DSHS requires applicants to successfully complete a DSHS-approved EMS training course, and DSHS adopted the National EMS Education Standards and Instructional Guidelines (replacing the older DOT National Standard Curriculum) as the basis for approved program content. DSHS's own initial-certification page does not itself publish a fixed statewide clock-hour minimum for the EMT-Basic course (individual approved programs set their own hour totals meeting the national standards), so hours is left null rather than guessed. Note: hhs.texas.gov (a different Texas agency, Health and Human Services Commission) is bot-defended per this project's known-host list, but Texas EMS personnel certification is administered by a separate agency, dshs.texas.gov, which loaded directly without needing a Wayback snapshot. [1]

  3. 3

    National Registry (NREMT) Cognitive Examination

    Pass the National Registry (NREMT) Cognitive Examination (fee: $104). DSHS requires applicants to schedule and pass the National Registry exam independently at nremt.org before applying for Texas state certification; DSHS certification is granted upon successful completion. $104 is NREMT's own published national EMT cognitive-exam fee; DSHS's own page does not republish this number, so verify current pricing directly with NREMT before publishing a verified page. [2]

  4. 4

    NREMT Psychomotor (Skills) Examination

    Pass the NREMT Psychomotor (Skills) Examination. Required as part of NREMT certification, which DSHS's initial-certification pathway relies on. No separate DSHS or NREMT-published fee specific to the psychomotor component was found; typically coordinated through the training program, so left null. [2]

  5. 5

    Submit your application

    Submit your application to Texas Department of State Health Services (DSHS), EMS and Trauma Systems with the $64 application fee. Typical processing time: Up to 4 weeks from date of submission. [2]

  6. 6

    Receive your license

    Once your application is approved, Texas Department of State Health Services (DSHS), EMS and Trauma Systems issues your Emergency Medical Technician (EMT) Certification for Texas.

Fees

Fee Amount
Application fee [3] $64
License fee [3] None specified
Renewal fee [3] $64
National Registry (NREMT) Cognitive Examination [2] $104
NREMT Psychomotor (Skills) Examination [2] None specified
Reciprocity certification (all levels) [3] $126
Late renewal (within 90 days after expiration) [3] $94
Extended late renewal (91 days to 1 year after expiration) [3] $124
Retest fee [3] $30
Inactive-status fee [3] $30

DSHS's EMS Application Fees page lists a single $64 fee for ECA/EMT covering initial certification, and a separate $64 renewal fee within 12 months prior to expiration (both figures identical at the EMT level, unlike the tiered AEMT/EMT-P/Paramedic fees) -- DSHS does not itemize a further distinct 'license' fee beyond the application/certification fee, so license is left null to avoid double-counting the same $64 figure. Reciprocity is a flat $126 regardless of level for out-of-state-certified applicants.

Renewal & continuing education

Renew every 4 years. 48 continuing education hours required per cycle.

DSHS certifications renew on a four-year cycle; DSHS recommends beginning the recertification process three to four months prior to expiration. The Formal Recertification Course pathway (one of several renewal options, alongside National Registry recertification, an approved continuing-education pathway, examination, or a Comprehensive Clinical Management Program) requires 48 contact hours over the four-year period for the EMT level. All renewal applicants must also complete a DSHS-approved EMS Jurisprudence examination before submitting a renewal application. Certification does not extend beyond the expiration date under any circumstances; renewal after 1 year past expiration requires pursuing initial certification instead.

Reciprocity

Endorsement/reciprocity from another state is available. Participates in: EMS Personnel Licensure Interstate Compact (REPLICA).

DSHS allows reciprocity certification for out-of-state EMT applicants (not available for ECA/First Responder/EMR) who are at least 18 with a high school diploma or GED and hold a current out-of-state certification or current NREMT certification. Applicants who are not already NREMT-certified must take the Texas Assessment Exam through National Registry; NREMT-certified applicants have this waived. Reciprocity applicants must complete the State of Texas Jurisprudence CE course/exam, submit Verification Form A to all states of prior/current certification, and undergo an FBI fingerprint-based background check through IdentoGo; the reciprocity fee is a flat $126. Texas is also listed as a current member state on the EMS Compact Commission's own member-state page (emscompact.gov).

30 state-approved training providers in Texas — browse programs and compare schools on tradecolleges.org.

Cost calculator

  • $64
  • $104
Total$168

Frequently asked questions

How old do you have to be to become an EMT in Texas?

At least 18 years old, with a high school diploma or GED certificate, per DSHS's initial certification requirements.

Does Texas require the National Registry (NREMT) exam to become an EMT?

Yes. DSHS requires applicants to schedule and pass the National Registry exam independently through nremt.org after completing a DSHS-approved EMS training course, before applying for state certification.

How much does it cost to become an EMT in Texas?

DSHS's application/certification fee for ECA or EMT is $64. Renewal within 12 months of expiration is also $64; late renewal fees rise to $94 (within 90 days) or $124 (91 days to 1 year) after expiration.

How often do Texas EMT certifications need to be renewed?

Every 4 years. DSHS recommends starting the recertification process 3-4 months before the expiration date, and requires a DSHS-approved EMS Jurisprudence exam before submitting a renewal application.

Can an EMT certified in another state get certified in Texas?

Yes, via DSHS's reciprocity pathway: applicants need a current out-of-state or NREMT certification, must complete the Texas Jurisprudence course/exam, submit verification of their prior certifications, and pass a fingerprint-based background check. Texas is also a member of the EMS Personnel Licensure Interstate Compact (REPLICA).

Sources

  1. [1] dshs.texas.gov/dshs-ems-trauma-systems/ems-education-programs — accessed 2026-07-12
  2. [2] dshs.texas.gov/dshs-ems-trauma-systems/ems-personnel-certification-licensure/initial-certification-licensure — accessed 2026-07-12
  3. [3] dshs.texas.gov/dshs-ems-trauma-systems/ems-application-fees — accessed 2026-07-12
  4. [4] dshs.texas.gov/dshs-ems-trauma-systems/ems-personnel-certification-licensure/renewals-ems-responder-certification — accessed 2026-07-12
  5. [5] dshs.texas.gov/dshs-ems-trauma-systems/ems-personnel-certification-licensure/ems-reciprocity-certification — accessed 2026-07-12