Texas EMS License Renewal Requirements for EMRs, EMTs, AEMTs, & Paramedics
Impact EMS Training offers CAPCE-accredited online continuing education designed to help EMS professionals maintain National Registry certification and meet EMS renewal requirements.
In Texas, EMS certification is regulated by the Texas Department of State Health Services (DSHS). EMS professionals must maintain an active Texas certification to practice.
Texas EMS certifications renew every four years. Texas offers multiple renewal pathways, including National Registry recertification, continuing education, formal recertification courses, examination, and participation in an approved Comprehensive Clinical Management Program (CCMP).
Providers who maintain active National Registry certification at the time of renewal may use their National Registry credential as a Texas renewal pathway. Because requirements may change, EMS professionals should always verify current renewal requirements with Texas DSHS and the National Registry of Emergency Medical Technicians.
Texas Renewal Options
Texas EMS professionals may renew their certification through one of five DSHS-approved pathways::
- National Registry Recertification
- Continuing Education Recertification
- Formal Recertification Course
- Examination
- Comprehensive Clinical Management Program (CCMP)
- Texas EMS professionals affiliated with a DSHS-approved Comprehensive Clinical Management Program (CCMP) may be eligible to renew through their provider organization’s CCMP. To qualify, providers must meet participation requirements established by DSHS and their EMS agency.
Common Texas renewal pathways include maintaining National Registry certification, continuing education, or a formal recresher course.
Texas EMR (ECA) Recertification
Emergency Medical Responders (EMRs), known as Emergency Care Attendants (ECAs) in Texas, renewing National Registry certification must complete continuing education through the National Continued Competency Program (NCCP). NCCP requirements are divided into National, Local/State, and Individual Components.
Texas also maintains separate renewal requirements for providers holding a Texas EMS certification.
NREMT Requirements
National Registry recertification requirements are based on the National Continued Competency Program (NCCP), which consists of National, Local/State, and Individual Components.
National Component: 8 hours
- Airway, Respiration & Ventilation: 1.5 hours
- Cardiology: 2 hours
- Trauma: 1 hour
- Medical: 2.5 hours
- Operations: 1 hour
Local/State Component: 4 hours
Continuing education determined by state EMS offices, local agencies, medical directors, or regional EMS systems. Topics may include protocol updates, regional clinical priorities, quality improvement initiatives, and other EMS-related education.
Individual Component: 4 hours
Continuing education selected by the provider based on individual educational needs and professional development goals.
Total NREMT Continuing Education: 16 hours
State Requirements
Texas accepts active National Registry certification as one pathway for state renewal. Providers maintaining current National Registry certification at the time of renewal may use their National Registry credential toward Texas recertification.
Providers who do not maintain National Registry certification may renew through another approved Texas renewal pathway, including continuing education, a formal recertification course, examination, or participation in an approved Comprehensive Clinical Management Program (CCMP).
Texas Continuing Education Pathway
Emergency Care Assistants (ECAs), the Texas certification level most comparable to National Registry EMR, must complete the following minimum continuing education requirements during the four-year certification cycle:
- Preparatory: 3 hours
- Airway Management: 3 hours
- Patient Assessment: 2 hours
- Trauma: 3 hours
- Medical: 9 hours
- Special Considerations: 3 hours
- Clinically Related Operations: 1 hour
- Pediatrics: 3 hours
- Additional approved continuing education: 9 hours
Total Required: 36 hours
Additional Requirements:
- Renewal cycle: Every 4 years
- Completion of the Texas EMS Jurisprudence Exam is required for every renewal cycle
- Renewal applications may be submitted during the certification period before expiration
- Continuing education records must be maintained for 5 years
- Continuing education documentation is the responsibility of the provider
- Continuing education records may be audited by Texas DSHS
- Providers must maintain an active Texas EMS certification to practice
Formal Recertification Course Option
Texas also allows ECAs to renew through completion of a formal recertification course completed during the four-year certification period.
Minimum ECA recertification course requirement: 24 hours
Suggested Refresher Course:
- 16-Hour Online EMR Refresher
- Meets National Registry NCCP requirements
- CAPCE-accredited
- Ideal for Texas providers maintaining National Registry certification
- 100% online and self-paced
- Instant certificate upon completion
State of Texas & NREMT Continuing Education Resources for ECAs/EMRs
Texas EMT Recertification
Emergency Medical Technicians (EMTs) renewing National Registry certification must complete continuing education through the National Continued Competency Program (NCCP). NCCP requirements are divided into National, Local/State, and Individual Components.
Texas also maintains separate renewal requirements for providers holding a Texas EMS certification.
NREMT Requirements
National Registry recertification requirements are based on the National Continued Competency Program (NCCP), which consists of National, Local/State, and Individual Components.
National Component: 20 Hours
- Airway, Respiration & Ventilation: 1.5 hours
- Cardiology: 2.5 hours
- Trauma: 3 hours
- Medical: 3.5 hours
- Operations: 2 hours
- EMS Systems: 1 hour
- EMS Safety: 1 hour
- Flexible Content: 5.5 hours
Local/State Component: 10 hours
Continuing education determined by state EMS offices, local agencies, medical directors, or regional EMS systems. Topics may include protocol updates, regional clinical priorities, quality improvement initiatives, and other EMS-related education.
Individual Component: 10 hours
Continuing education selected by the provider based on individual educational needs and professional development goals.
Total NREMT Continuing Education: 40 hours
State Requirements
Texas accepts active National Registry certification as one pathway for state renewal. Providers maintaining current National Registry certification at the time of renewal may use their National Registry credential toward Texas recertification.
Providers who do not maintain National Registry certification may renew through another approved Texas renewal pathway, including continuing education, a formal recertification course, examination, or participation in an approved Comprehensive Clinical Management Program (CCMP).
Texas Continuing Education Pathway
Providers renewing through the Texas continuing education pathway must complete the following minimum continuing education requirements during the four-year certification cycle:
- Preparatory: 6 hours
- Airway Management: 6 hours
- Patient Assessment: 4 hours
- Trauma: 6 hours
- Medical: 18 hours
- Special Considerations: 6 hours
- Clinically Related Operations: 2 hours
- Pediatrics: 6 hours
- Additional approved continuing education: 18 hours
Total Required: 72 hours
Additional Requirements
- Renewal cycle: Every 4 years
- Completion of the Texas EMS Jurisprudence Exam is required for every renewal cycle
- Renewal applications may be submitted during the certification period before expiration
- Continuing education records must be maintained for 5 years
- Continuing education documentation is the responsibility of the provider
- Continuing education records may be audited by Texas DSHS
- Providers must maintain an active Texas EMS certification to practice
Formal Recertification Course Option
Texas also allows EMTs to renew through completion of a formal recertification course completed during the four-year certification period.
Minimum EMT recertification course requirement: 48 hours
Suggested Refresher Course:
- 40-Hour Online EMT Refresher
- Meets National Registry NCCP requirements
- CAPCE-accredited continuing education
- Ideal for Texas providers maintaining National Registry certification
- 100% online and self-paced
- Instant certificate upon completion
NREMT & State of Texas Continuing Education Resources for EMTs
Texas AEMT Recertification
Advanced EMTs (AEMTs) renewing National Registry certification must complete continuing education through the National Continued Competency Program (NCCP). NCCP requirements are divided into National, Local/State, and Individual Components.
Texas also maintains separate renewal requirements for providers holding a Texas EMS certification.
NREMT Requirements
National Registry recertification requirements are based on the National Continued Competency Program (NCCP), which consists of National, Local/State, and Individual Components.
National Component: 25 hours
- Airway, Respiration & Ventilation: 2 hours
- Cardiovascular: 3 hours
- Trauma: 3 hours
- Medical: 4 hours
- Operations: 2 hours
- EMS Systems: 1.5 hours
- Special Populations: 1.5 hours
- EMS Safety: 1 hour
- Flexible Content: 7 hours
Local/State Component: 12.5 hours
Continuing education determined by state EMS offices, local agencies, medical directors, or regional EMS systems. Topics may include protocol updates, regional clinical priorities, quality improvement initiatives, and other EMS-related education.
Individual Component: 12.5 hours
Continuing education selected by the provider based on individual educational needs and professional development goals.
Total NREMT Continuing Education: 50 hours
State Requirements
Texas accepts active National Registry certification as one pathway for state renewal. Providers maintaining current National Registry certification at the time of renewal may use their National Registry credential toward Texas recertification.
Providers who do not maintain National Registry certification may renew through another approved Texas renewal pathway, including continuing education, a formal recertification course, examination, or participation in an approved Comprehensive Clinical Management Program (CCMP).
Texas Continuing Education Pathway
Providers renewing through the Texas continuing education pathway must complete the following minimum continuing education requirements during the four-year certification cycle:
- Preparatory: 9 hours
- Airway Management: 9 hours
- Patient Assessment: 6 hours
- Trauma: 9 hours
- Medical: 27 hours
- Special Considerations: 9 hours
- Clinically Related Operations: 3 hours
- Pediatrics: 9 hours
- Additional approved continuing education: 27 hours
Total Required: 108 hours
Additional Requirements
- Renewal cycle: Every 4 years
- Completion of the Texas EMS Jurisprudence Exam is required for every renewal cycle
- Renewal applications may be submitted during the certification period before expiration
- Continuing education records must be maintained for 5 years
- Continuing education documentation is the responsibility of the provider
- Continuing education records may be audited by Texas DSHS
- Providers must maintain an active Texas EMS certification to practice
Formal Recertification Course Option
Texas also allows AEMTs to renew through completion of a formal recertification course completed during the four-year certification period.
Minimum AEMT recertification course requirement: 72 hours
Suggested Refresher Course:
- 50-Hour Online Advanced EMT Refresher
- Meets National Registry NCCP requirements
- CAPCE-accredited
- Ideal for Texas providers maintaining National Registry certification
- 100% online and self-paced
- Instant certificate upon completion
NREMT & State of Texas Continuing Education Resources for AEMTs
Texas Paramedic Recertification
Paramedics maintaining National Registry certification must complete the National Continued Competency Program (NCCP) every two years. The NCCP includes National, Local/State, and Individual components.
Texas also maintains separate state renewal requirements.
NREMT Requirements
National Registry recertification requirements are based on the National Continued Competency Program (NCCP), which consists of National, Local/State, and Individual Components.
National Component: 30 hours
- Airway, Respiration & Ventilation: 2 hours
- Cardiovascular: 3 hours
- Trauma: 4 hours
- Medical: 5 hours
- Operations: 3 hours
- EMS Systems: 2 hours
- Special Populations: 2 hours
- EMS Safety: 1 hour
- Flexible Content: 8 hours
Local/State Component: 15 hours
Continuing education determined by state EMS offices, local agencies, medical directors, or regional EMS systems. Topics may include protocol updates, regional clinical priorities, quality improvement initiatives, and other EMS-related education.
Individual Component: 15 hours
Continuing education selected by the provider based on individual educational needs and professional development goals.
Total NREMT Continuing Education: 60 hours
State Requirements
Texas accepts active National Registry certification as one pathway for state renewal. Providers maintaining current National Registry certification at the time of renewal may use their National Registry credential toward Texas recertification.
Providers who do not maintain National Registry certification may renew through another approved Texas renewal pathway, including continuing education, a formal recertification course, examination, or participation in an approved Comprehensive Clinical Management Program (CCMP).
Texas Continuing Education Pathway
Providers renewing through the Texas continuing education pathway must complete the following minimum continuing education requirements during the four-year certification cycle:
- Preparatory: 12 hours
- Airway Management: 12 hours
- Patient Assessment: 8 hours
- Trauma: 12 hours
- Medical: 36 hours
- Special Considerations: 12 hours
- Clinically Related Operations: 4 hours
- Pediatrics: 12 hours
- Additional approved continuing education: 36 hours
Total Required: 144 hours
Additional Requirements:
- Renewal cycle: Every 4 years
- Completion of the Texas EMS Jurisprudence Exam is required for every renewal cycle
- Renewal applications may be submitted during the certification period before expiration
- Continuing education records must be maintained for 5 years
- Continuing education documentation is the responsibility of the provider
- Continuing education records may be audited by Texas DSHS
- Providers must maintain an active Texas EMS certification to practice
Formal Recertification Course Option
Texas also allows Paramedics to renew through completion of a formal recertification course completed during the four-year certification period.
Minimum Paramedic recertification course requirement: 96 hours
Suggested Refresher Course:
- 60-Hour Online Paramedic Refresher
- Meets National Registry NCCP requirements
- CAPCE-accredited continuing education
- Ideal for Texas providers maintaining National Registry certification
- 100% online and self-paced
- Instant certificate upon completion
NREMT & State of Texas Continuing Education Resources for Paramedics
This information was updated on June 18, 2026
Always verify current renewal requirements with the Texas DSHS and the National Registry of Emergency Medical Technicians (NREMT), as regulations and renewal requirements are subject to change.
NREMT
The National Registry is accredited by the National Commission for Certifying Agencies (NCCA), the accreditation body of the Institute for Credentialing Excellence. The National Registry maintains NCCA accreditation for each of our four certification programs: (1) Emergency Medical Responder (2) Emergency Medical Technician (3) Advanced Emergency Medical Technician (4) Paramedic. The National Registry, established in 1970 as a non-profit organization, is the Nation’s Emergency Medical Services Certification organization. The mission of the National Registry of Emergency Medical Technicians has always been centered on protecting the public and advancing the EMS profession.
