Emergency Medical Technician License Reciprocity by State (2026)
EMS Compact (REPLICA)
EMTs, AEMTs and paramedics transfer through the EMS Compact. A clinician holding an unrestricted licence in one member state automatically receives a Privilege to Practice in the others — with no application, no approval and no fee.
- Covers:
- EMT, Advanced EMT (AEMT) and paramedic levels.
- Does not cover:
- EMS agency and vehicle licensing stays with each state and is outside the compact.
- Governing body:
- Interstate Commission for EMS Personnel Practice
What to know before you rely on it
- The privilege activates only while you hold a current, unrestricted licence in a member home state.
- You must be at least 18 and affiliated with an EMS agency operating under a physician medical director.
- Default scope of practice is your home-state scope, but the remote state may modify or limit it.
- A remote state can suspend or revoke your privilege there, and must report the action to your home state.
- The privilege is for EMS duties as assigned by an appropriate authority, not general practice.
Jurisdictions where EMS Compact (REPLICA) is active (25)
Alabama, Louisiana, South Carolina, Arkansas, Mississippi, South Dakota, Colorado, Missouri, Tennessee, Delaware, Nebraska, Texas, Georgia, Nevada, Utah, Idaho, North Dakota, Virginia, Indiana, Oklahoma, West Virginia, Iowa, Pennsylvania, Wyoming, Kansas
Enacted but not yet usable: Arizona, Alaska, Connecticut
Verify this first: Confirm both your home state and your destination are active member states on the EMS Compact site.
United States EMS Compact ↗State-by-state reciprocity notes
12 of 51 states have a published reciprocity note in our dataset. For the remaining states, the note is not published — check both state boards before you move. Provides emergency medical care and transport. Requires a state-approved course and the NREMT cognitive and psychomotor exams.
| State | Reciprocity note | Verify with |
|---|---|---|
| Arizona | Yes — NREMT registration recognized for endorsement | Arizona Department of Health Services — Bureau of EMS ↗ |
| California | Yes — NREMT registration recognized for endorsement | California Emergency Medical Services Authority (EMSA) ↗ |
| Florida | Yes — NREMT registration recognized for endorsement | Florida Department of Health — Bureau of Emergency Medical Oversight ↗ |
| Georgia | Yes — NREMT registration recognized for endorsement | Georgia Department of Public Health — Office of EMS ↗ |
| Illinois | Yes — IDPH endorsement / NREMT registration recognized | Illinois Department of Public Health — Emergency Medical Services ↗ |
| Michigan | Yes — NREMT registration recognized for endorsement | Michigan Department of Health & Human Services — EMS Division ↗ |
| New York | Partial — NY administers its own exam; endorsement available from other states | New York State Department of Health — Bureau of Emergency Medical Services ↗ |
| North Carolina | Yes — NREMT registration recognized for endorsement | North Carolina Department of Health and Human Services — Office of EMS ↗ |
| Ohio | Yes — NREMT registration recognized for endorsement | Ohio Department of Public Safety — Division of Emergency Medical Services ↗ |
| Pennsylvania | Yes — NREMT registration recognized for endorsement | Pennsylvania Department of Health — Bureau of Emergency Medical Services ↗ |
| Texas | Yes — DSHS reciprocity / NREMT registration recognized | Texas Department of State Health Services — EMS/Trauma Systems ↗ |
| Washington | Yes — NREMT registration recognized for endorsement | Washington State Department of Health — Emergency Medical Services ↗ |
| Alabama | check both state boards | board site pending |
| Alaska | check both state boards | board site pending |
| Arkansas | check both state boards | board site pending |
| Colorado | check both state boards | board site pending |
| Connecticut | check both state boards | board site pending |
| Delaware | check both state boards | board site pending |
| District of Columbia | check both state boards | board site pending |
| Hawaii | check both state boards | board site pending |
| Idaho | check both state boards | board site pending |
| Indiana | check both state boards | board site pending |
| Iowa | check both state boards | board site pending |
| Kansas | check both state boards | board site pending |
| Kentucky | check both state boards | board site pending |
| Louisiana | check both state boards | board site pending |
| Maine | check both state boards | board site pending |
| Maryland | check both state boards | board site pending |
| Massachusetts | check both state boards | board site pending |
| Minnesota | check both state boards | board site pending |
| Mississippi | check both state boards | board site pending |
| Missouri | check both state boards | board site pending |
| Montana | check both state boards | board site pending |
| Nebraska | check both state boards | board site pending |
| Nevada | check both state boards | board site pending |
| New Hampshire | check both state boards | board site pending |
| New Jersey | check both state boards | board site pending |
| New Mexico | check both state boards | board site pending |
| North Dakota | check both state boards | board site pending |
| Oklahoma | check both state boards | board site pending |
| Oregon | check both state boards | board site pending |
| Rhode Island | check both state boards | board site pending |
| South Carolina | check both state boards | board site pending |
| South Dakota | check both state boards | board site pending |
| Tennessee | check both state boards | board site pending |
| Utah | check both state boards | board site pending |
| Vermont | check both state boards | board site pending |
| Virginia | check both state boards | board site pending |
| West Virginia | check both state boards | board site pending |
| Wisconsin | check both state boards | board site pending |
| Wyoming | check both state boards | board site pending |
Frequently asked questions
How does a EMT license transfer between states?
EMTs, AEMTs and paramedics transfer through the EMS Compact. A clinician holding an unrestricted licence in one member state automatically receives a Privilege to Practice in the others — with no application, no approval and no fee.
Which states accept a EMT license under EMS Compact (REPLICA)?
Interstate Commission for EMS Personnel Practice lists 25 jurisdictions where this is active today: Alabama, Louisiana, South Carolina, Arkansas, Mississippi, South Dakota, Colorado, Missouri, Tennessee, Delaware, Nebraska, Texas, Georgia, Nevada, Utah, Idaho, North Dakota, Virginia, Indiana, Oklahoma, West Virginia, Iowa, Pennsylvania, Wyoming, Kansas. Also enacted, but not yet usable: Arizona, Alaska, Connecticut. Membership changes, so confirm on the official source before you rely on it.
Does EMS Compact (REPLICA) mean I skip the exam entirely?
Not automatically. The privilege activates only while you hold a current, unrestricted licence in a member home state. The only reliable answer for your situation comes from the destination board, so verify before you pay application fees.
Can I transfer my EMT license to another state?
In our dataset, 12 states have a published reciprocity note (see the table). For every other state the rule is not published here — check both state boards before moving.
What does reciprocity mean for a license?
Reciprocity lets an already-licensed professional from one state qualify for a license in another state without repeating the full education and exam process. Some states have formal agreements or compacts; others require a state-specific exam or extra coursework even when they accept your license. Many states do not grant a license on reciprocity at all — they grant it by comity or endorsement, meaning you still file an application and meet their requirements.
Why do some states say "check both state boards"?
State reciprocity tables are not consistently published in machine-readable form. When a state has not published an official note in our verified sources, we point you to both boards rather than guess. That is the safest answer for a decision that can affect your eligibility to work.
Does holding a license in one state guarantee a license in another?
No. Every state sets its own licensing law. Even in states with reciprocity or a compact, you typically still file an application, pay a fee, pass a background check and sometimes pass a state-specific exam. Always confirm directly with the destination state board.
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Reciprocity rules and compact membership change frequently and are set by each state legislature and board. “Check both state boards” means the note is not published in our dataset — it is not a negative answer. Mechanism data retrieved 2026-09-13; always verify with both boards before relocating.