Open a jurisdiction to review its dated requirements and official sources. Use the compact tables to compare which states participate.
All 51 jurisdictions · Compact status table · Plan the crossing: offshore · 911 ground · IFT
Can I work a 13-week contract here on my home-state licence?
Only with the hiring agency’s cooperation
Agency-dependent: national privilege has no time limit and applies at all times, but that does not guarantee any given Texas agency will hire or credential a traveler — agencies decide whether to use Compact personnel, who meets their hiring standards, and what credentialing they require, per the FAQ.
Agency-dependent: national privilege has no time limit and applies at all times, but that does not guarantee any given Texas agency will hire or credential a traveler — agencies decide whether to use Compact personnel, who meets their hiring standards, and what credentialing they require, per the FAQ. Remote/Home-State classification (a currently held Texas license makes Texas a Home State), state-office/employer verification, and local onboarding must confirm the individual case.
EMS Compact Commission · emscompact.gov · verified 2 Oct 2026 · Partly supported
Requirements include source links and review dates. Expand each source quotation for the supporting text. Unverified and incomplete information is labelled alongside the relevant requirement.
The items most likely to cost you a start date.
Adds a requirement
An out-of-state paramedic without a qualifying degree is certified as EMT-Paramedic, not Licensed Paramedic. Licensed Paramedic requires an Associate degree in EMS, or a Bachelor or higher degree in any field, or a postgraduate degree.
Whether the two levels differ in clinical scope, or only in title and fee, has not been established. That distinction matters to a traveller and is an open question.
State EMS office · dshs.texas.gov · verified 7 Aug 2026
(Remember, EMT-Paramedic certification does not require a degree.)
dshs.texas.gov · State EMS office
Adds a requirement
Reciprocity and renewal applicants at every level must complete a Texas EMS jurisprudence CE course with exam before the application can be submitted.
Cheap and quick, but it is a hard gate rather than a formality, and it must be found and booked through a DSHS-approved CE program.
State EMS office · dshs.texas.gov · verified 7 Aug 2026
Must take the State of Texas Jurisprudence CE course with exam.
dshs.texas.gov · State EMS office
Adds a requirement
Verification Form A must be sent to every state where the applicant has ever been certified, not only the current one, and each state agency returns it directly to DSHS.
For a career traveller with five or six state cards this is the rate-limiting step, and none of it is under the applicant's control.
State EMS office · dshs.texas.gov · verified 7 Aug 2026
Submit the Verification Form A to each State where the applicant has ever been certified and/or is currently certified.
dshs.texas.gov · State EMS office
The office that issues the card, and the law it issues it under.
4 of 5 answered from a source · 1 written up as absences
Who actually issues an EMS licence in Texas?
Texas Department of State Health Services, EMS and Trauma Systems
Texas Department of State Health Services EMS Licensing and Certification
dshs.texas.gov · State EMS office
Where is Texas's EMS licensing office online?
Who do I call or email about Texas licensure?
emscert@dshs.texas.gov / 512-834-6734
The reciprocity page lists 512-834-6700; the renewals page lists 512-834-6734. Both are DSHS EMS numbers.
Where do I actually submit an application in Texas?
Not yet verified
DSHS routes applicants to the Regulatory Services Online Licensing System via an unlabelled link; no stable public URL is printed on the certification pages. Needs a human to capture the destination URL from the live link.
Which statute or rule governs EMS licensure in Texas?
25 Texas Administrative Code, Title 25, Part 1, Chapter 157; Texas Health and Safety Code Chapter 773
Chapter 157 is under active revision following the 89th Regular Legislative Session; DSHS has published a proposed rule draft and held webinars in July 2026. Expect fee, CE, and renewal fields to move. Re-verify before the next quarterly cycle.
Title 25, Part 1, Chapter 157.1, Purpose
dshs.texas.gov · State administrative code
Levels, term, and what your National Registry does and does not buy you.
5 of 6 answered from a source · 1 written up as absences
What levels does Texas issue, and what does my cert become there?
Emergency Care Attendant (ECA)
EMT
Advanced EMT
EMT-Paramedic
Licensed Paramedic (LP)
The quote supports the paramedic split only. The full five-level list is corroborated by the DSHS fee schedule (ECA or EMT / Advanced EMT or EMT-P / Licensed Paramedic) and the CE hour table (ECA / EMT / Advanced EMT / EMT-P and Licensure). The EMT-Paramedic vs Licensed Paramedic distinction is the single most common surprise for medics transferring into Texas: an out-of-state paramedic without a degree gets EMT-Paramedic, not LP.
How long does a Texas licence last before renewal?
Four years is unusually long; most states run two. expiration_convention is inferred from the renewal windows being expressed relative to 'your expiration date' rather than a calendar date, and is the weakest part of this claim.
For a four-year certification/license: Must be at least 18 years old and have a high school diploma or GED.
dshs.texas.gov · State EMS office
Do I need National Registry to get licensed in Texas?
Yes
You must pass the NR exam to become eligible for state certification
dshs.texas.gov · State EMS office
Do I have to keep National Registry current to keep a Texas licence?
No
Holding current NREMT is one of several renewal routes, not a requirement. A Texas medic can maintain state certification on CE alone.
Does Texas make me sit its own exam?
Yes
Conditional: required only for applicants who hold a state certification without current NREMT. An applicant with current NREMT does not retest.
Must take the Texas Assessment Exam through National Registry, if State certified only.
dshs.texas.gov · State EMS office
What criminal history bars me from licensure in Texas?
Not yet verified
DSHS links to a page on how criminal history may affect eligibility but the certification pages do not enumerate categorical bars. Enumerated offenses, if any, would be in 25 TAC Chapter 157 and have not been read.
The EMS Compact — formally REPLICA, the Recognition of EMS Personnel Licensure Interstate Compact. Enacted, in force, and verifiable status are separate dated facts, plus what privilege covers.
6 of 10 answered from a source · 4 written up as absences
Has Texas passed the EMS Compact into law?
Nothing recorded
Official House history dates the Governor's signature June 17, 2015. The current Commission Texas page narrates September 1, 2015 as the signing date; that is the effective date per the enrolled act (see statutorily_effective), so the Commission's signing-date language is not followed here.
Defect in this source The Commission Texas page calls September 1, 2015 the signing date. Official HB 2498 history instead dates the Governor signature June 17, 2015; the enrolled act identifies September 1 as the effective date. This record follows the official legislative history and enrolled act.
E | Signed by the Governor | | 06/17/2015 | | 6049
capitol.texas.gov · State legislature
Is Texas's compact law actually in effect yet?
Nothing recorded
The enrolled act's own effectiveness section was read. Delay-clause status is null: the full act was not read for a deferral clause, so no false-from-absence; this corrects the former false.
SECTION 2. This Act takes effect September 1, 2015.
capitol.texas.gov · State legislature
Can my Privilege to Practice actually be verified in Texas?
Texas is fully integrated with NEMSCD per the current Commission Texas page. Connected_date remains null; the Commission publishes no connection date. Prior NEMSCD-table citation is replaced with this state-page citation.
What do I have to satisfy for compact privilege to apply in Texas?
Partly supported
National conditions per the Commission's current Privilege to Practice FAQ, not a Texas statement. Support is partial: the retained passage covers the four numbered requirements plus remote-state compliance; the EMR exclusion is a national condition not enumerated in that passage. Whether Texas or its agencies impose anything further has not been established from a Texas source — additional state/agency onboarding unknown.
To exercise it, you must meet four requirements. 1 Be at least 18 years of age. Section 4.B.1 2 Hold a current, unrestricted license in at least one EMS Compact participating state, as an EMT, AEMT, Paramedic, or a state-recognized level between EMT and Paramedic. Section 4.B.2 3 Affiliate with an EMS agency in the remote state that provides EMS medical direction. Section 4.B.3 4 Adhere to the Commission's Professional Code of Conduct . Rules 4.0(E) and 4.6 Then, as you practice: follow the local scope of practice, protocols, and laws of the state you are working in, under Rule 4.4 of the Commission's administrative rules.
emscompact.gov · EMS Compact Commission
Which situations does compact privilege cover in Texas?
Not established in the cited source
No Texas-published enumeration of covered circumstances located. The Commission's national material frames privilege as applying at all times rather than by enumerated circumstance, but that is a national statement and has not been confirmed against Texas rule.
When do I need full Texas licensure instead of privilege?
Not established in the cited source
Not stated by DSHS or the Commission for Texas specifically. The only universal exclusions the Commission states are that privilege does not create independent practice and does not apply in the clinician's own home state.
Can I work a 13-week contract in Texas on my home-state licence?
Only with the hiring agency’s cooperation
Partly supported
Agency-dependent: national privilege has no time limit and applies at all times, but that does not guarantee any given Texas agency will hire or credential a traveler — agencies decide whether to use Compact personnel, who meets their hiring standards, and what credentialing they require, per the FAQ. Remote/Home-State classification (a currently held Texas license makes Texas a Home State), state-office/employer verification, and local onboarding must confirm the individual case.
Participation is always optional: agencies decide whether to use Compact personnel, who meets their hiring standards, and what credentialing they require.
emscompact.gov · EMS Compact Commission
I have an old or inactive Texas card — can I still use compact privilege here?
Conflicting or incomplete source information
No compound value recorded — ambiguous. Currently held licences make Home States, and Position Paper 2024-01's worked Kansas scenario counts a still-held voluntarily inactive licence as a Home State with no privilege there, while voluntarily electing inactive status is not an adverse action; the paper does not support extrapolating that holding to every expired, surrendered, or revoked status. Whether Texas offers an inactive status and what reactivation requires is not established from a Texas source.
Does Texas add anything on top of the compact?
Not yet verified
DSHS certification pages make no mention of the EMS Compact at all. Silence is not evidence of absence; 25 TAC Chapter 157 has not been read for compact provisions.
Where does an employer verify my privilege for Texas?
Partly supported
National lookup uses the clinician's 12-digit National EMS ID, distinct from state licence and NREMT numbers. Texas-issued license records are integrated. A traveler licensed in another home state depends on that issuing state's data submission; missing database display requires state EMS office verification and is not by itself a legal disqualification.
Verify a Privilege to Practice Confirm whether an EMS clinician holds an active Compact Privilege to Practice using their National EMS ID.
emscompact.gov · EMS Compact Commission
The route in when privilege does not cover you.
7 of 9 answered from a source · 2 written up as absences
Will Texas recognise my out-of-state certification at all?
Yes
An out-of-state certified emergency medical services (EMS) person may apply for Texas certification by reciprocity.
dshs.texas.gov · State EMS office
What does Texas call its out-of-state pathway?
EMS Reciprocity Certification
Where do I start a reciprocity application for Texas?
Partly supported
The application itself sits behind the DSHS Regulatory Services online licensing portal, reached from an Apply online link. This is the stable public landing page, not the application form.
Submit an online reciprocity application and pay the non-refundable application fee.
dshs.texas.gov · State EMS office
What does Texas require from an out-of-state applicant?
Minimum age and education
Current certification
Level eligibility
Texas Assessment Exam
Texas Jurisprudence CE course with exam
Verification Form A
Fingerprint-based background check
AEMT skills verification
Paramedic academic transcript
Every item is drawn from the Requirements and Paramedic Applicants sections of the reciprocity page. The Verification Form A requirement applies to every state the applicant has EVER held a certification in, not just the current one, which is the most common cause of delay for medics with a long licence history.
Persons with Emergency Care Attendant (ECA); First Responder (FR) or Emergency Medical Responder (EMR) are not eligible for Texas Reciprocity.
dshs.texas.gov · State EMS office
What does it cost to get licensed in Texas from out of state?
source_quote is a table row, pipe-joined. The $126 reciprocity fee is flat across levels, unlike initial certification which runs $64 to $126 by level. DSHS states the amounts are set by the Texas Online Authority, so they can change without a rule amendment.
How long will Texas take to process my application?
Not established in the cited source
DSHS publishes no processing time for reciprocity. The initial certification page states processing may take up to 4 weeks from submission, and the renewals page states the same for renewals, but neither statement is made about reciprocity, which carries extra dependencies DSHS does not control: Verification Form A must be returned directly by every state the applicant has ever been certified in, and IdentoGO results are returned separately. Publishing 4 weeks here would be a guess dressed as a fact.
What background check does Texas require, and how do I do it from out of state?
fee_usd is null: DSHS states any fees associated with fingerprinting are the applicant's responsibility but does not publish the amount, which is set by IdentoGO. The service code must be requested by email before scheduling, which is an easy step to miss.
All applicants will be required to undergo an FBI fingerprint criminal history check using IdentoGo.
dshs.texas.gov · State EMS office
Can I start working in Texas before full approval?
Not yet verified
No provisional or temporary personnel certificate is described on the DSHS certification pages. A Provisional License appears in the fee schedule at $30 but under the EMS provider (agency) fee table, not personnel, so it is almost certainly an agency licence and not a route for an individual to start work early. Not resolved.
Does my National Registry have to be current to apply in Texas?
No
A current out-of-state certification satisfies this on its own, but an applicant without current NREMT must pass the National Registry assessment exam, and DSHS will not approve them to sit it until the application, fees, and verification of the out-of-state certification are all in hand.
Must either have a current Out of State certification or current National Registry certification.
dshs.texas.gov · State EMS office
The renewal clock and what it costs in hours.
6 of 7 answered from a source · 1 written up as absences
How often do I recert in Texas?
4
Notice: CE hours shown are for the 4 year period.
dshs.texas.gov · State EMS office
How many CE hours does Texas want, and in what?
ECA
EMT
Advanced EMT
EMT-P and Licensed Paramedic
source_quote is a table row, pipe-joined; columns are ECA, EMT, Advanced EMT, EMT-P and Licensure. 144 hours over four years is 36 per year, comparable to NCCP's 60 over two, so the burden is lower than the headline number suggests. CE need not be reported unless audited, but records must be kept five years.
Total required for recertification eligibility | 36 | 72 | 108 | 144
dshs.texas.gov · State EMS office
Can I use NCCP hours to recert in Texas, or does it want its own?
Either NCCP or the state’s own scheme
Partly supported
Texas offers current NREMT as one renewal route (Option 3) alongside its own CE content-area scheme, an examination route, a formal refresher course, and a CCMP route. It does not adopt NCCP as its CE framework. Confidence is medium because DSHS never uses the term NCCP; the equivalence is inferred from NREMT currency being accepted.
You must hold current NR certification at the time of renewing your Texas certificate.
dshs.texas.gov · State EMS office
What does Texas require at renewal that other states do not?
The jurisprudence exam is also required for reciprocity applicants. It is a CE course covering Texas EMS laws and rules and is offered by DSHS-approved CE programs.
All EMS Personnel (ECA, EMT, AEMT, EMTP, and Licensed Paramedic) renewal applicants must complete an EMS jurisprudence examination approved by the Department before submitting a renewal application.
dshs.texas.gov · State EMS office
Does Texas make me take a refresher course to recert?
No
Optional, not required. If chosen, minimum contact hours are ECA 24, EMT 48, Advanced EMT 72, EMT-P and Licensed Paramedic 96, completed any time during the four-year period.
My Texas cert expired — can I still get it back?
The one-year cliff is hard. Also note DSHS unsubscribes the licensee's DPS background check one year after expiry, so re-entry after that point requires fresh fingerprinting.
Applicants whose certification has been expired for one year or more may not renew the certificate.
dshs.texas.gov · State EMS office
Where do I find CE that Texas will accept?
Not yet verified
DSHS links to a list of EMS CE programs offering the jurisprudence exam from unlabelled inline links; no stable URL captured. Needs a human to follow the link.
Where a service record shortens the path.
4 of 4 answered from a source · 0 written up as absences
Does Texas have a faster route for military training or veterans?
Yes
Current military service members, military veterans, and military spouses who received emergency medical technician (EMT) training in the military and have a current National Registry certification are eligible for a Texas EMT certification.
dshs.texas.gov · State EMS office
What does Texas's military pathway actually get me?
Military members, veterans and spouses follow the same process as out-of-state reciprocity applicants, because military coursework is not Texas-approved and is treated the same as out-of-state training. A fee exemption is available on submission of a current military ID, a DD214 (member copy 4 preferred), or the spouse's and service member's military IDs.
The pathway is an expedited fee waiver, not an expedited process. The quoted eligibility sentence names EMT training specifically; whether military paramedic training is treated the same is not stated.
To receive the fee exemption please attach a PDF copy of:
dshs.texas.gov · State EMS office
Where does Texas document its military pathway?
Partly supported
DSHS also has a separate Military Service Members, Veterans, and Spouses page in the certification menu which has not been read.
Does Texas extend its military pathway to spouses?
Yes
DEA rewrote the narcotics rules for EMS in February 2026. Registration moved from the medical director to the agency itself, and the rule spells out storage, restocking and standing-order administration. These rules are federal and read the same in every state.
10 federal facts, quoted from the Federal Register · 2 of 2 Texas facts answered from state law
What changed, and when did it take effect?
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.
Who holds the DEA registration an ambulance operates under?
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.
the Act directs the Attorney General (and thus the Administrator) to allow a registered EMS agency to obtain a single registration for each State in which the EMS agency administers controlled substances, rather than requiring the agency to obtain a separate registration for each location at which it operates within that State.
Does one DEA registration cover operating in another state?
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.
EMS agencies that wish to operate in multiple States must register with DEA in each State in which they operate.
Can a medic administer controlled substances without the medical director present?
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.
the Act allows emergency medical services professionals to administer controlled substances outside the physical presence of a medical director or authorizing medical professional pursuant to a valid standing or verbal order.
How do narcotics have to be stored in the vehicle?
EMS vehicles storing controlled substances must be locked when parked outside of an enclosed registered or designated location, with the controlled substances stored in a securely locked, substantially constructed cabinet or safe that cannot be readily removed.
Does a hospital-based agency need its own 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.
The CSA, as amended by the Act, expressly allows hospital-based EMS agencies to operate under the hospital's registration rather than obtaining their own separate registration.
Can the truck restock controlled substances from a hospital?
the Act allows non-hospital-based EMS agencies to receive controlled substances from a hospital for the purpose of restocking an EMS vehicle following an emergency response.
What does the DEA registration cost an agency?
this rule reflects the current fee of $888 so that, as intended, the fee for EMS registrants is the same as that for other dispensers of controlled substances.
Do municipal and fire-based services pay the fee?
Even if the EMS agency is not operated by a government fire department, if the EMS agency itself is operated by the local government, it would also be exempt from application fees.
When does an existing service have to move to the new registration?
DEA recommends agencies contact their local field office to complete the transition.
The three options for EMS agencies to transition are: (1) transition immediately on the effective date established by DEA; (2) transition at the expiration of their current registration; or (3) transition three to six months prior to their renewal date.
Does Texas law let a medic push scheduled drugs on standing orders, the way the DEA rule assumes?
Partly supported
The Texas Medical Board’s current EMS Medical Director guidance requires protocol and standing-order documentation for physician compliance. This supports standing orders in EMS oversight but does not itself state controlled-substance-specific authority, so support remains partial.
The physician is in compliance with Board rule, by submitting documentation of protocols and standing orders upon request;
tmb.texas.gov · State agency
Does Texas require its own controlled-substance registration for EMS agencies?
Partly supported
The Medical Board states the elimination in terms of physicians and PAs, but SB 195 repealed the DPS registration program itself — Chapter 481.061 registrations no longer exist for any registrant class, EMS agencies included. The stray space before the comma in the quote is the Board's own markup, reproduced verbatim.
Under Senate Bill 195 (2015) , the requirement for controlled substances registration (CSR) with the Texas Department of Public Safety (DPS) was eliminated on September 1, 2016. DPS has stopped accepting applications for the Texas Controlled Substances Registration under Chapter 481.061 of the Health and Safety Code.
tmb.texas.gov · State agency
Questions not yet settled from a primary source.
25 TAC Chapter 157 is under active revision after the 89th Regular Legislative Session. Fees, CE and renewal fields may all move. Confirm the rulemaking timeline.
opened 7 Aug 2026 · blocks reciprocity.fee, recertification.ce_hours, licensure.term
What Texas-specific onboarding (if any) beyond the national conditions applies to privilege holders, and how does Texas classify voluntarily inactive, expired, surrendered, or revoked licences for Home-State purposes? DSHS certification pages do not mention the Compact and 25 TAC Chapter 157 has not been read for compact provisions.
opened 2 Oct 2026 · blocks compact.privilege.traveler_contract_assessment, compact.privilege.home_state_licenses