Texas
Licensure & Recertification Requirements for EMR, EMT, AEMT & Paramedics
Impact EMS Training offers CAPCE-accredited, 100% online continuing education designed to help EMS professionals complete recertification requirements efficiently.
The Texas Department of State Health Services (DSHS) regulates EMS certification throughout the state. Texas EMS certification and National Registry certification are separate credentials. Texas allows providers to renew using an active National Registry certification, but EMS professionals must maintain an active Texas certification issued by the Texas Department of State Health Services (DSHS) to legally practice in Texas.
Providers may renew by maintaining a current NREMT credential, completing a Texas-approved refresher program, or meeting state continuing education (CE) requirements. Providers must hold an active Texas certification to practice; National Registry alone does not authorize practice in Texas.
Texas certifications operate on a four-year renewal cycle, based on the individual provider’s expiration date. Renewals are completed through the Texas DSHS Online Licensing System.
Since requirements can change, EMS professionals should always verify renewal requirements with Texas DSHS and the National Registry.
Texas EMR (ECA) Recertification
Emergency Medical Responders (EMRs), known as Emergency Care Attendants (ECAs) in Texas, seeking to maintain National Registry EMR certification must complete the National Continued Competency Program (NCCP) every two years. The NCCP consists of National, Local/State, and Individual components.
Texas also offers separate state renewal pathways for providers who do not maintain National Registry certification.
NREMT Requirements
- 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
- Individual Component: 4 hours
Total: 16 hours
State Requirements
To renew a Texas ECA certification, providers must choose from three pathways:
- Maintain Current NREMT Certification
- Texas will accept NREMT certification for renewal
- Many providers choose to renew by maintaining NREMT certification because it is the most straightforward and widely accepted pathway
- Texas will accept NREMT certification for renewal
- Texas Refresher Pathway
- Complete a Texas-approved refresher course
- Complete Texas CE Requirements
- Complete 36 total CE hours over 4 years
- Must meet minimum content requirements across EMS topic areas, including:
- Preparatory: 3 hours
- Trauma: 3 hours
- Medical: 9 hours
- Pediatric: 3 hours
- Additional categories as required
- Must meet minimum content requirements across EMS topic areas, including:
- Complete 36 total CE hours over 4 years
- Providers must complete required skills competencies in addition to continuing education hours
Additional Requirements:
- Completion of a Texas EMS Jurisprudence Exam is required for each renewal cycle
- Renewal submitted through the Texas DSHS Online Licensing System
Renewal Deadline:
- Texas ECA certifications expire every four years based on the provider’s individual certification date
Suggested Refresher Course:
- 16-Hour EMR Refresher Course
- Meets National Registry NCCP requirements
- Accepted for Texas EMS renewal
- CAPCE-accredited
- 100% online and self-paced
- Instant certificate upon completion
State of Texas & NREMT EMR Continuing Education Resources
Texas EMT Recertification
EMTs 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 EMT recertification requires 40 hours of continuing education every two years through the NCCP model.
- National Component: 20 hours
- Airway, Respiration, & Ventilation: 1.5 hours
- Cardiovascular: 2.5 hours
- Trauma: 3 hours
- Medical: 3.5 hours
- Operations: 2 hours
- EMS Systems: 1 hour
- Special Populations: 1 hour
- EMS Safety: 1 hour
- Flexible: 4.5 hours
- Local/State Component: 10 hours
- Individual Component: 10 hours
State Requirements
To renew a Texas EMT license, providers may choose from three pathways:
- NREMT Renewal:
- Maintain active NREMT certification
- Texas will accept NREMT certification for renewal
- Many providers choose to renew by maintaining NREMT certification because it is the most straightforward and widely accepted pathway
- Texas Refresher Pathway
- Complete a Texas-approved refresher course
- Texas CE Pathway
- Complete 72 total CE hours over 4 years
- Continuing education must meet minimum requirements across EMS topic areas, including:
- Preparatory: 6 hours
- Airway: 6 hours
- Patient Assessment: 4 hours
- Trauma: 6 hours
- Medical: 18 hours
- Pediatric: 6 hours
- Operations: 2 hours
- Providers must complete required skills competencies in addition to continuing education hours
- Continuing education must meet minimum requirements across EMS topic areas, including:
- Complete 72 total CE hours over 4 years
Additional Requirements:
- Completion of a Texas EMS Jurisprudence Exam is required for each renewal cycle
- Renewal submitted through the Texas DSHS Online Licensing System
Renewal Deadline:
- Texas EMT certifications expire every four years based on the provider’s individual expiration date
Suggested Refresher Course:
- 40-Hour EMT Refresher Course
- Meets National Registry NCCP requirements
- Accepted for Texas EMS renewal
- CAPCE-accredited
- 100% online and self-paced
- Instant certificate upon completion
NREMT & State of Texas EMT Continuing Education Resources
Texas AEMT Recertification
Advanced EMTs 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 AEMT recertification requires 50 hours of continuing education every two years through the NCCP model:
- 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: 7 hours
- Local/State Component: 12.5 hours
- Individual Component: 12.5 hours
State Requirements
To renew a Texas AEMT license, providers may choose from three pathways:
- NREMT Renewal
- Maintain active NREMT certification
- Texas will accept NREMT certification for renewal
- Many providers choose to renew by maintaining NREMT certification because it is the most straightforward and widely accepted pathway
- Texas Refresher Pathway
- Complete a Texas-approved refresher course
- Texas CE Pathway
- Complete 108 total CE hours over 4 years
- Minimum topic requirements include:
- Preparatory: 9 hours
- Airway: 9 hours
- Patient Assessment: 6 hours
- Trauma: 9 hours
- Medical: 27 hours
- Pediatric: 9 hours
- Operations: 3 hours
- Providers must complete required skills competencies in addition to continuing education hours
- Minimum topic requirements include:
- Complete 108 total CE hours over 4 years
Additional Texas Requirements:
- Completion of a Texas EMS Jurisprudence Exam each renewal cycle
- Renewal submitted through the Texas DSHS Online Licensing System
Renewal Deadline:
- Texas AEMT certifications expire every four years based on the provider’s individual expiration date
Suggested Refresher Course:
- 50-Hour Advanced EMT Refresher Course
- Meets National Registry NCCP requirements
- Accepted for Texas EMS renewal
- CAPCE-accredited
- 100% online and self-paced
- Instant certificate upon completion
NREMT & State of Texas AEMT Continuing Education Resources
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 Paramedic recertification requires 60 hours of continuing education every two years through the NCCP model:
- 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: 8 hours
- Local/State Component: 15 hours
- Individual Component: 15 hours
State Requirements
To renew a Texas paramedic license, providers may choose from three pathways:
- NREMT Renewal:
- Maintain active NREMT certification
- Texas will accept NREMT certification for renewal
- Many providers choose to renew by maintaining NREMT certification because it is the most straightforward and widely accepted pathway
- Texas Refresher Pathway:
- Complete a Texas-approved refresher course
- Texas CE Pathway:
- Complete 144 total CE hours over 4 years
- Continuing education must meet minimum requirements across EMS topic areas, including:
- Preparatory: 12 hours
- Airway Management: 12 hours
- Patient Assessment: 8 hours
- Trauma: 12 hours
- Medical: 36 hours
- Special Considerations: 12 hours
- Operations: 4 hours
- Pediatric: 12 hours
- Additional 36 hours may be completed in any approved category
- Providers must complete required skills competencies in addition to continuing education hours
- Continuing education must meet minimum requirements across EMS topic areas, including:
- Complete 144 total CE hours over 4 years
Additional Texas Requirements:
- Completion of a Texas EMS Jurisprudence Exam is required for each renewal cycle
- Renewal submitted through the Texas DSHS Online Licensing System
Renewal Deadline:
- Texas paramedic certifications expire every four years based on the provider’s individual expiration date
Suggested Refresher Course:
- 60-Hour Paramedic Refresher Course
- Meets National Registry NCCP requirements
- Accepted for Texas EMS renewal
- CAPCE-accredited
- 100% online and self-paced
- Instant certificate upon completion
NREMT & State of Texas Paramedic Continuing Education Resources
*This information was updated on June 2, 2026*
Always verify current requirements with the Texas DSHS and the National Registry, as policies may 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.
