Emergency medical responder levels by U.S. state

In the United States, the licensing of prehospital emergency medical providers (emergency medical technicians (EMTs)) and oversight of emergency medical services are governed at the state level. Each state is free to add or subtract levels as each state sees fit. Therefore, due to differing needs and system development paths, the levels, education requirements, and scope of practice of prehospital providers varies from state to state. Even though primary management and regulation of prehospital providers is at the state level, the federal government does have minimum requirements for EMT-Basics and EMT-Paramedics set through the National Highway Traffic Safety Administration(NHTSA). In the list, certification levels are provided from most basic to most advanced.

While states are able to set their own additional requirements for state certification, a quasi-national certification body exists in the form of the National Registry of Emergency Medical Technicians (NREMT). The NREMT offers a national certification based on the NHTSA National Standard curriculum for the levels of First Responder, EMT-Basic, EMT-Intermediate 1985, EMT-Intermediate 1999, and EMT-Paramedic. Individual states are allowed to use NREMT certification as part of their certification process, but are not required to. As of 2006, 39 states use the NREMT examination for EMT-Basic certification and 44 states use the NREMT examination for EMT-paramedic certification. These levels are denoted below using an asterisk (*). At present time, use of the NREMT examination for EMT-Intermeidate 85 and 99 have not been included in this list.

Any provider between the levels of EMT-Basic and EMT-Paramedic is a form of EMT-Intermediate, but the use of the terms "EMT-Intermediate/85" and "EMT-Intermediate/99" denotes use of the NHTSA EMT-Intermediate 1985 curriculum and the EMT-Intermediate 1999 curriculum respectively. In addition, not all states use the "EMT" prefix for all levels (e.g. Texas uses EMT-Paramedic and Licensed Paramedic). Finally, some states have levels that have partially been phased out. While no new certifications are provided at this level, providers can be grandfathered in provided they meet recertification requirements. Any level that has been completely phased out (i.e. not used for new or continuing providers) is not listed.

Alabama

 * EMT-Basic*
 * EMT-Intermediate
 * EMT-Paramedic*

Alaska

 * EMT-I* (One) (analogous to EMT-Basic)
 * EMT-II (Two) (analogous to EMT-Intermediate/85)
 * EMT-III (Three)
 * Mobile Intensive Care Paramedic (MICP)

Arizona

 * EMT-Basic*
 * EMT-Intermediate/99
 * EMT-Paramedic*

Arkansas

 * EMS First Responder
 * EMT-Ambulance* (analogous to EMT-Basic)
 * EMT-Intermediate/99
 * EMT-Paramedic*

California

 * EMT-I (One)* (analogous to EMT-Basic)
 * EMT-II (Two)
 * EMT-Paramedic*

Colorado

 * EMT-Basic*
 * EMT-Intermediate/99
 * EMT-Paramedic*

Connecticut

 * Medical Response Technician
 * EMT* (analogous to EMT-Basic)
 * EMT-I/85
 * EMT-Paramedic*

Delaware

 * EMT-Basic*
 * EMT-Paramedic*

Florida

 * EMT* (analogous to EMT-Basic)
 * Paramedic

Georgia

 * EMT-Basic*
 * EMT-Intermediate/85
 * EMT-Cardiac Tech (No new licenses granted since 1998, Similar to the NREMT-I/99)
 * EMT-Paramedic*

Hawaii

 * EMT-Basic*
 * EMT-Paramedic*

Idaho

 * First Responder
 * EMT-Basic*
 * Advanced EMT (analogous to EMT-Intermediate/85)
 * EMT-Intermediate (State specific level)
 * EMT-Paramedic*

Illinois

 * EMT-Basic*
 * EMT-Intermediate/99
 * EMT-Paramedic*

Indiana

 * First Responder
 * EMT-Basic
 * EMT-Basic Advanced
 * EMT-Intermediate/99
 * Paramedic*

Iowa

 * First Responder
 * EMT-Basic*
 * EMT-Intermediate
 * EMT-Paramedic (analogous to EMT-Intermediate/99)
 * Paramedic Specialist* (analogous to EMT-Paramedic)

Kansas

 * First Responder
 * EMT-Basic*
 * EMT-Defibrillator
 * EMT-Intermediate/85
 * EMT-Intermediate/Defibrillator
 * Mobile Intensive Care Technician* (analogous to EMT-Paramedic)

Kentucky

 * First Responder
 * EMT
 * Paramedic

Louisiana

 * First Responder
 * EMT-Basic
 * EMT-Intermediate/99
 * EMT-Paramedic

Maine

 * First Responder
 * Ambulance Attendant (no new licenses granted since 1996)
 * EMT-Basic*
 * EMT-Intermediate
 * EMT-Critical Care (no new licenses after 1998)
 * EMT-Paramedic

Maryland

 * First Responder
 * EMT-Basic
 * Cardiac Rescue Technician (will be phased out on June 30, 2008)
 * Cardiac Rescue Technician-Intermediate (analogous to EMT-Intermediate/99)
 * EMT-Paramedic*

Massachusetts

 * EMT-Basic
 * EMT-Intermediate/85
 * EMT-Paramedic

Michigan

 * Medical First Responder
 * EMT-Basic*
 * EMT-Specialist (analogous to EMT-Intermediate/85)
 * EMT-Paramedic*

Minnesota

 * EMT-Basic*
 * EMT-Intermediate/99
 * EMT-Paramedic*

Mississippi

 * Medical First Responder
 * EMT-Basic*
 * EMT-Intermediate/99
 * EMT-Paramedic*

Missouri

 * EMT-Basic*
 * EMT-Paramedic*

Montana
(endorsements are listed below each level are optional and can be achieved in any order and combination)
 * EMT-First Responder
 * Immbolization
 * Monitoring
 * Ambulance
 * EMT-Basic*
 * Airway
 * Monitoring
 * IV and IO initiation
 * IV and IO maintenance
 * Endotracheal intubation
 * Medication
 * EMT-Intermediate
 * Needle decompression/surgical airway
 * Immunizations
 * Drips and pumps
 * 12 lead transmit
 * EMT-Paramedic*
 * 12 lead interpretation
 * Medications
 * Fibrinolytic with 12 lead interpretation
 * Critical Care Transport

Nebraska

 * First Responder
 * EMT-Basic*
 * EMT-Intermediate
 * EMT-Paramedic*

Nevada

 * First Responder
 * EMT-Basic
 * EMT-Intermediate/85
 * EMT-Advanced (analogous to EMT-Paramedic)

New Hampshire

 * First Responder
 * EMT-Basic*
 * EMT-Intermediate/85
 * EMT-Paramedic*

New Jersey

 * EMT-Basic*
 * EMT-Paramedic*

New Mexico

 * EMS First Responder
 * EMT-Basic
 * EMT-Intermediate
 * EMT-Paramedic*

New York

 * Certified First Responder
 * EMT-Basic
 * EMT-Intermediate
 * EMT-Critical Care
 * EMT-Paramedic

North Carolina

 * Medical Responder
 * EMT*
 * EMT-Intermediate/99
 * EMT-Paramedic*

North Dakota

 * First Responder
 * Advanced First Aid Ambulance (no new licenses)
 * EMT (analogous to EMT-Basic. Only used for providers under the age of 18 and providers requesting reciprocity from another state)
 * EMT-Basic*
 * EMT-Intermediate/85
 * EMT-Paramedic*

Ohio

 * First Responder
 * EMT-Basic*
 * EMT-Intermediate/99
 * EMT-Paramedic*

Oklahoma

 * First Responder
 * EMT-Basic*
 * EMT-Intermediate/85
 * EMT-Paramedic*

Oregon

 * EMT-Basic*
 * EMT-Intermediate (state specific)
 * EMT-Paramedic* (requires a college degree)

Pennsylvania

 * Ambulance Attendant
 * First Responder
 * EMT-Basic
 * EMT-Paramedic*
 * Prehospital Registered Nurse
 * Health Professional Physician

Rhode Island

 * EMT-Basic*
 * EMT-Cardiac
 * EMT-Paramedic*

South Carolina

 * EMT-Basic*
 * EMT-Intermediate/99
 * EMT-Paramedic*

South Dakota

 * EMT-Basic*
 * EMT-Intermediate/85
 * EMT-Intermediate/99
 * EMT-Paramedic*

Tennessee

 * First Responder
 * EMT-Basic*
 * EMT-IV
 * EMT-Paramedic*

Currently, Tennessee is in the process of developing the Advanced Practice/Critical Care Paramedic Licensure Level.

Texas

 * Emergency Care Attendant
 * EMT-Basic*
 * EMT-Intermediate
 * EMT-Paramedic*
 * Licensed Paramedic (paramedic with a college degree)

Utah

 * EMT-Basic*
 * EMT-Intermediate (state specific)
 * EMT-Intermediate Advanced (analogous to EMT-Intermediate/99)
 * EMT-Paramedic*

Vermont

 * EMT-Basic*
 * EMT-Intermediate (State specific)
 * EMT-Paramedic*

Virginia

 * EMS First Responder
 * EMT-Basic
 * EMT-Enhanced
 * EMT-Intermediate/99
 * EMT-Paramedic*

Washington

 * First Responder
 * EMT-Basic
 * Intravenous Therapy Technician
 * Airway Management Technician
 * IV/Airway Technician
 * Intermediate Life Support Technician
 * ILS and Airway Technician
 * Paramedic

West Virginia

 * First Responder
 * EMT-Mining (specialty certification)
 * EMT-Basic*
 * EMT-Intermediate/99
 * EMT-Paramedic*
 * Critical Care Transport-Paramedic
 * Critical Care Transport-Registered Nurse

Wisconsin

 * Medical First Responder
 * EMT-Basic*
 * EMT-Intermediate Technician (analogous to EMT-Intermediate/85)
 * EMT-Intermediate/99
 * EMT-Paramedic*

Wyoming

 * EMT-Basic*
 * EMT-Intermediate/85
 * EMT-Paramedic*