Mississippi

Licensing authority

Who actually issues an EMS licence in Mississippi?

Mississippi State Department of Health, Office of Emergency Medical Services and Acute Care Systems (OEMSACS)

Mississippi names the office on its own certification page, which supersedes the National Registry directory's shorter 'Mississippi Bureau of EMS'.

Contact

Who do I call or email about Mississippi licensure?

Office of EMS and Acute Care Systems - Certification, 310 Airport Road South, Pearl, MS 39208; (601) 576-7380

Applications go to the Pearl certification address by mail, not to the Jackson departmental headquarters. The phone number is from the National Registry's office directory.

Certification levels

What levels does Mississippi issue, and what does my cert become there?

• Emergency Medical Responder (EMR)

  Maps to

  EMR

  State-only

  No

  Notes

  Certified alongside a separately listed Medical First Responder certification whose relationship to EMR is not explained on the page.

• Emergency Medical Technician (EMT)

  Maps to

  EMT

  State-only

  No

• Advanced EMT (AEMT)

  Maps to

  AEMT

  State-only

  No

• Paramedic

  Maps to

  Paramedic

  State-only

  No

• Critical Care Paramedic

  Maps to

  none

  State-only

  Yes

  Notes

  A Mississippi endorsement above Paramedic requiring an OEMSACS-approved critical care programme, an associate degree from a regionally accredited institution, and a current FP-C or CCP-C. Recertification adds PHTLS, 48 approved critical care CE hours and a 24-hour bi-annual refresher.

• EMS Driver

  Maps to

  none

  State-only

  Yes

  Notes

  A driving credential, not a patient-care level. Requires a driver-training certificate and an official driving history from the licensing state.

The quote covers five of the six; Critical Care Paramedic is from the requirements table on the same page. Mississippi's fee schedule also lists an 'EMT - Driver (8 Year)' at $80, a combination credential that appears nowhere in the prose and is not represented here.

Conditions for privilege

What do I have to satisfy for compact privilege to apply in Mississippi?

• Be at least 18 years of age.
• Hold a current, unrestricted license in at least one EMS Compact participating state at an eligible EMS level.
• Affiliate with an EMS agency in the remote state that provides EMS medical direction.
• Adhere to the Commission's Professional Code of Conduct and follow the remote state's scope of practice, protocols, and laws.

Partly supported

These are the Commission's national conditions, not a Mississippi statement. Whether Mississippi imposes anything further has not been established from a Mississippi source — see compact.privilege.state_specific_restrictions.

Can I take a contract on privilege alone

Can I work a 13-week contract in Mississippi on my home-state licence?

Yes — privilege alone covers a contract here

Partly supported

The Commission states privilege carries no time limit and is not restricted to declared emergencies, so a 13-week contract is covered provided the medic holds an unrestricted licence in another Member State, is affiliated with an agency authorised in Mississippi, and practises under a physician medical director. Confidence is medium and quote_supports is partial because this is the Commission speaking nationally, not Mississippi speaking about Mississippi. It is reversed for anyone who already holds a Mississippi licence of any status — see compact.privilege.home_state_licenses.

If you already hold a licence here

I have an old or inactive Mississippi card — can I still use compact privilege here?

A licence here forfeits privilege

Yes

The Commission states that even an inactive license makes that state a Home State, and that a Home State is not a Remote State, so Compact privilege does not apply there. This is the Commission speaking nationally; this source does not establish whether the state offers inactive status or its reactivation pathway, so both remain unknown.

Verify privilege

Where does an employer verify my privilege for Mississippi?

emscompact.gov

Partly supported

Quick Verify is embedded on the Commission homepage and keyed to the 12-digit National EMS ID, which is neither your state licence number nor your NREMT number.

Compact law enacted

Has Mississippi passed the EMS Compact into law?

Status

Yes

Enacted

Nothing recorded

Citation

MS Code § 41-59-101

Current EMS Compact Commissioner page identifies Mississippi's enacted Compact law and reports 2017-03-20 as the signing date. The obsolete Commission State Laws table source and its caveat were removed because this state-specific page directly supplies the law citation and enactment fact.

Compact law in force

Is Mississippi's compact law actually in effect yet?

Status

Yes

Effective

Nothing recorded

Delayed clause

No

Current EMS Compact Commissioner page explicitly states the statutory effective date. The has_delayed_implementation_clause value remains false as previously recorded; this Commissioner page does not independently establish absence of such a clause.

Connected to NEMSCD

Can my Privilege to Practice actually be verified in Mississippi?

Status

Yes

The Commission's state-specific Commissioner page identifies Mississippi as fully integrated with NEMSCD. This establishes current database integration, distinct from enactment and statutory effect. The page does not publish the initial connection date, so connected_date remains null.

Reciprocity available

Will Mississippi recognise my out-of-state certification at all?

Yes

Mississippi runs reciprocity as a document you add to the ordinary certification application rather than as a separate pathway, and prices it as a separate line item in the fee schedule.

What you must provide

What does Mississippi require from an out-of-state applicant?

• Application for Mississippi EMS Certification (form AP07)

  Detail

  Submitted by mail with fees and documentation to the Pearl certification office. The eLicense portal handles recertification only.

• Copy of National Registry of EMTs certification

  Detail

  Listed for EMT and Paramedic certification and recertification.

• Original, signed Jurisdictional Medical Control Agreement

  Detail

  An original signature, not a scan, tying you to a medical control jurisdiction.

• Reciprocity agreement from home state, where applicable

  Detail

  Mississippi also publishes a separate EMS Out of State Reciprocity Verification form for the applicant's prior licensing states to complete.

The Jurisdictional Medical Control Agreement is the item that surprises travellers: certification is not issued to you in the abstract, it is issued against a signed medical control relationship, which means you need the receiving service lined up before the paperwork can complete.

Application fee

What does it cost to get licensed in Mississippi from out of state?

Amount

25

Per

application

Also payable

• EMT or Paramedic certification / recertification

  Amount

  40

• Provider reinstatement, for a lapsed or suspended Mississippi certification

  Amount

  40

• New Critical Care Paramedic

  Amount

  69

• EMS Driver history

  Amount

  15

source_quote is a table row, pipe-joined. The $25 reciprocity line is charged in addition to the $40 EMT or Paramedic certification fee, not instead of it — the fee schedule lists them separately. Personal cheques are refused.

How long it takes

How long will Mississippi take to process my application?

Fastest published

28

Slowest published

42

Basis

published_by_state

One of the few states that publishes a processing estimate at all. basis is published_by_state, not statutory — this is MSDH's own estimate and it carries the state's warning that an incomplete application may be returned or delayed. Mississippi separately recommends starting recertification three to four months before expiry, which is a longer margin than the four-to-six-week estimate implies.

Current NREMT required

Does my National Registry have to be current to apply in Mississippi?

Yes

Partly supported

Listed as a required document for EMT and Paramedic certification. The page does not say the certification must be current, though a copy of a lapsed card would be an odd thing to require, so confidence is medium rather than high.

The rule and its clock

What changed, and when did it take effect?

Citation

91 FR 5216

Published

2026-02-05

Effective

2026-03-09

The DEA final rule implementing the Protecting Patient Access to Emergency Medications Act of 2017 (PPAEMA). It amends 21 CFR parts 1300, 1301, 1304 and following to create the EMS agency registration and the storage, delivery and recordkeeping rules below.

The agency holds the registration now

Who holds the DEA registration an ambulance operates under?

Status

Yes

Category

Emergency Medical Services Agency

Scope

one registration per state covers every location the agency operates in that state

Before this rule most services ran narcotics under their medical director's practitioner registration. The registration now belongs to the agency, as its own DEA business-activity category.

Crossing state lines with the drug box

Does one DEA registration cover operating in another state?

Status

No

Detail

a separate DEA registration is required in each state the agency operates in

The fact that matters most to a traveler: compact privilege can carry your licence across a border, but it does not carry your agency's DEA registration. An agency running trucks in two states registers twice.

Pushing narcotics on standing orders

Can a medic administer controlled substances without the medical director present?

Status

Yes

Conditions

authorized by state law, under a valid standing or verbal order that meets the statutory conditions

Federal law now says yes, but only where state law agrees: EMS professionals are only allowed to make such administrations if authorized by State law. Whether your state's law does is the per-state question at the end of this section.

Storage on the truck

How do narcotics have to be stored in the vehicle?

Locked vehicle

Yes

Container

securely locked, substantially constructed cabinet or safe that cannot be readily removed

Hospital-run services

Does a hospital-based agency need its own registration?

Status

No

Detail

may keep operating under the hospital's registration

Hospital-based means owned or operated by a hospital. If you work for a hospital service, the drug box stays on the hospital's paper.

Restocking at the hospital

Can the truck restock controlled substances from a hospital?

Status

Yes

Detail

non-hospital-based agencies may receive controlled substances from a hospital to restock after an emergency response

What registration costs

What does the DEA registration cost an agency?

Amount

888

Per

three-year registration period

Government services pay nothing

Do municipal and fire-based services pay the fee?

Status

No

Detail

agencies operated by a state or local government are exempt from application fees

The switch-over window

When does an existing service have to move to the new registration?

Options

• immediately on the effective date
• at the expiration of the current registration
• three to six months before the renewal date

DEA recommends agencies contact their local field office to complete the transition.

Standing orders under state law

Does Mississippi law let a medic push scheduled drugs on standing orders, the way the DEA rule assumes?

Status

Yes

Citation

15 Miss. Admin. Code Pt. 12, Subpt. 31, R. 1.9.3 (Narcotics); definition of Standing Orders in the same rules

Detail

Mississippi defines standing orders as the portions of the treatment protocols ALS personnel may carry out without contacting medical control, and separately authorises certified ALS personnel under an approved medical control jurisdiction to be issued controlled substances for pre-hospital use at the off-line medical director's discretion.

Partly supported

Mississippi is unusually explicit for this question but splits the answer across two provisions. The quoted definition establishes that standing orders operate without contacting medical control; Rule 1.9.3 supplies the controlled-substance half — 'Certified ALS personnel (paramedics and RNs) functioning under approved medical control jurisdiction may be issued approved controlled substances for pre-hospital use upon the discretion of the off-line medical director.' Read together they answer yes. quote_supports is partial because no single sentence carries both halves. Note the friction inside Rule 1.9.3 itself: its narcotics-handling paragraphs are written around receiving an order from medical control for each administration, which sits awkwardly beside the standing-orders definition. A medic should expect the operative rule to be whatever their off-line medical director's protocol says.

A state registration on top of DEA's

Does Mississippi require its own controlled-substance registration for EMS agencies?

Status

Yes

Registration name

Controlled Substance Registration (facility class)

Issuer

Mississippi Board of Pharmacy

Detail

The Board of Pharmacy requires a facility controlled substance registration of anyone who handles or maintains controlled substances on the premises, which reaches an ambulance service's drug stock, and it is separate from and additional to DEA registration.

Partly supported

READ THIS BEFORE RELYING ON IT. The Board of Pharmacy rule is written in general terms — any facility or business where controlled substances are 'manufactured, distributed, sold, bought, dispensed, or maintained' must hold a $50 annual facility Controlled Substance Registration, and the quoted sentence extends that to premises that merely maintain stock rather than dispense — but it nowhere names EMS agencies. Pulling the other way, the State Department of Health's own narcotics rule for EMS (R. 1.9.3) tells non-hospital-based ALS services exactly what registration to obtain and names only the federal DEA certificate, listing the medical director as practitioner at the ambulance address. The two are not in direct conflict: MSDH is silent on the state layer rather than denying it. Recorded true because the Board's rule is the one that creates the obligation and its trigger ('maintain') plainly describes an ambulance drug box, but an operator should confirm with the Board at (601) 899-8880 rather than infer. This one deserves human adjudication.