Do EMTs From Other States Need a Refresher Course to Transfer Certification?
- gloryanng8
- Jan 20
- 4 min read
As more EMTs relocate for work, cost of living, family, or new EMS opportunities, a common question arises: Do EMTs from other states need a refresher course to transfer certification? The answer depends on where you’re moving to, how your certification was obtained, and what your new state's EMS office requires for reciprocity. State-to-state EMT transfers can be simple in some regions and complex in others, especially when states require additional education, hands-on skills assessments, or proof of recent experience.
Understanding EMT reciprocity rules ensures you avoid delays, unnecessary testing, or unexpected training requirements. This guide explains whether EMTs need a refresher course when transferring certification, how state EMS agencies determine eligibility, the role of NREMT in multi-state mobility, and what to do if your certification is expired or inactive.
What Is EMT Reciprocity and How Does It Work?
Reciprocity is the process that allows an EMT certified in one state to obtain certification in another. While the NREMT provides standardized testing nationally, each state controls certification and licensure, meaning the receiving state decides what additional steps are required.
Most states follow a similar reciprocity process:
Verify your current EMT certification
Confirm that it is active and in good standing
Provide proof of NREMT certification (if required)
Submit background checks and application forms
Complete any additional state-mandated training
Not all states require NREMT certification for receprocity but many do. Some will accept state-only credentials, while others require the National Registry exam even if you are actively certified elsewhere.
Do EMTs Need a Refresher Course When Transferring to Another State?
The short answer: Sometimes.
 Whether a refresher is needed depends on how your new state evaluates your qualification.
States That Commonly Require Refresher Training for Transfers
Some states want to ensure incoming EMTs meet local scope-of-practice expectations. These states may require a refresher if:
Your certification is expired
You haven't completed required CE hours
Your EMS authority operates under protocols your current state does not use
Your original training program lacked content the new state considers essential
However, requirements can change quickly so make sure to follow your local EMS agency guidelines.
Some states may NOT Require a Refresher Course
These states may rely on a current NREMT certification as validation and may not mandate a full refresher course unless you have been inactive. Once again, make sure you check out your local EMS agency guidelines.
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When a Refresher Becomes Mandatory Regardless of State
A refresher course is typically required if:
Your certification has expired
You have not been in the field for a long time
You lack proof of required CE hours
You're applying for reinstatement rather than reciprocity
You were previously inactive for multiple years
In these situations, states want to ensure EMTs are clinically prepared and current with national guidelines.
How NREMT Certification Affects State Transfers
Holding an active NREMT certification significantly simplifies reciprocity. Most states accept a National Registry certification as proof of competency. However:
You will still likely need a background check
Some states might require additional testing
A few states do not rely on NREMT and issue their own exams
If your NREMT is inactive or expired, you may need:
A refresher course
Additional CE hours
Cognitive and possibly psychomotor retesting
NREMT status can determine whether transferring states treat your application as reciprocity or reinstatement.
When States Require Extra Training for Transferring EMTs
State-Specific Protocol Differences
Some states define EMT scope-of-practice more narrowly or broadly. If your current training does not align with local expectations, a refresher or supplemental class may be mandatory.
Pharmacology and Skill Variations
Not all states allow EMTs to administer the same medications or perform the same procedures. A refresher course brings you up to speed on:
Naloxone policies
Glucometer use
Supraglottic airway availability
Nebulizer guidelines
Local CE and Cultural Competency Requirements
Certain states require unique modules, such as:
State-specific EMS culture
Abuse reporting
Local medical legal rules
Expanded pediatric or obstetric care
Refresher programs help bridge these gaps.
What if Your EMT Certification Is Expired When You Move States?
If your certification is expired, your new state may require:
A full EMT Refresher Course
Additional CE hours
Skills verification
NREMT retesting
Some states will not issue reciprocity unless you renew or reinstate first in your original state. Others allow direct reinstatement.
If you’ve been away for several years, foundational review is essential. EMTs in this situation often benefit from strengthening core knowledge before enrolling in a refresher or retaking exams.
Do You Need a Refresher If You Are NREMT-Certified but Moving States?
In most cases, no refresher is required as long as:
You are fully active
Your CE hours are complete
Your skills verification is documented
You meet your current state's renewal timeline
However, if your CE portfolio is incomplete, a refresher may be required before you can renew or transfer.
FAQs: EMT Reciprocity and Refresher Course Requirements
1. Do EMTs need a refresher course to transfer certification?
Only if the new state requires additional training or your certification is expired, inactive, or lacking required CE hours.
2. Does NREMT certification make reciprocity easier?
Yes. Most states accept NREMT as the national standard but some states have different regulations. Make sure to learn and follow your local guidelines.
3. Can I transfer certification if my EMT license has expired?
You may need a refresher course, CE hours, and or retesting depending on expiration length. Check with your local EMS agency to make sure you meet all of the requirements.
4. Do all states require the same EMT skills?
No. Specific Scope-of-practice guidelines and medication administration guidelines differ widely between states and often in different EMS Systems within a state.
5. How long does reciprocity take?
Anywhere from two weeks to several months depending on state processing times.
6. Will I have to retake the EMT cognitive exam?
Not usually, unless your NREMT certification has expired.
7. Do employers have different requirements from states?
Yes. Fire departments and EMS agencies may require additional skills or training modules.
8. What if I haven't worked as an EMT in several years?
A refresher course and preparation program are strongly recommended before transferring.
Whether or not your new state requires a refresher course, the key to transferring EMT certification successfully is preparation. Strengthening foundational knowledge in anatomy, physiology, patient assessment, and emergency care helps you meet any state requirement with confidence.
Visit https://www.emteat.com to explore EMT Preparation courses or full EMT training courses.
Have questions? Call 310-295-0271. Our team is here to support your EMT journey wherever you’re relocating.