California does not certify EMTs from Sacramento. The EMS Authority (EMSA) sets the rules, and a local EMS agency (LEMSA) or other certifying entity issues your card, which is good statewide. Everything below comes from EMSA's EMT page and Title 22 of the California Code of Regulations, checked October 18, 2026. County fees and steps vary, so confirm with your LEMSA before you pay.
Study aid, not a protocol. Nothing on this site replaces your course, your medical director or your agency's protocols. Built by an RN and former EMT. Headed In LLC is not affiliated with, endorsed by or connected to the National Registry of Emergency Medical Technicians (NREMT) or any state EMS office; their names appear here only to point you to the real thing.
The national steps, briefly
A state-approved EMT course
Every state approves its own programs, all taught to the National EMS Education Standards. Most run 150 to 300 hours over three to six months.
A healthcare-provider CPR card
AHA BLS or an equivalent your state accepts, usually before clinicals.
The cognitive exam
The National Registry (NREMT) EMT exam: 70 to 120 adaptive questions in 2 hours, $104 per attempt, six attempts within two years of your course.
Your state's license or certification
The card comes from the state, not the Registry. The state's own steps are below.
California EMS Authority (EMSA) and your local EMS agency
Title 22's EMT rules moved from Chapter 2 to Chapter 3.1 on January 1, 2025, so older section numbers you may see (100079, 100080) now point to 100068 and 100069.01.
Course: a state-approved EMT training program. The course completion record counts for certification for two years.
Age:18 or older.
Exam: the National Registry EMT cognitive exam, passed within two years of the date you apply; Title 22 defines California's certifying exam as the Registry's. Title 22 and EMSA also name the Registry's psychomotor exam, which the Registry no longer gives for EMTs, so ask your program how your skills are verified and documented for the LEMSA.
Where to apply:one LEMSA or certifying entity in the county where you live or plan to work. EMSA has no online application. The application is signed under penalty of perjury, asks about past certification actions, pending charges and convictions, and must list every agency you applied to in the last 12 months.
Background check: a state and federal criminal history check, which LEMSAs run through Live Scan. The results must reach the certifying entity before it issues your card. Use your LEMSA's own Live Scan request form; Santa Cruz County warns that another agency's form sends the results elsewhere and has to be redone at your cost.
Fees: a $75 state fee for an initial EMT certificate (Title 22, 100221.02), plus whatever your LEMSA sets to cover its costs. Example: Santa Cruz County's 2025 guidelines list a $150 county fee plus the $75 state fee, paid by cash, cashier's check or money order, and ask for a valid CPR card, photo ID, course certificate and Registry card, each within two years. Card within 45 days of a complete application.
Renewal: the card expires the last day of the month two years after it is issued. Renew with 24 hours of approved continuing education or a 24-hour refresher course within the last two years, plus a skills competency verification form (EMSA-SCV) from an approved provider. The state renewal fee is $37 plus the county's. Title 22 also adds naloxone, epinephrine auto-injector and glucometer training for first-time renewers; ask your LEMSA whether it applies to you yet.
From another state: a current National Registry EMT, AEMT or Paramedic registration qualifies you on its own; a current out-of-state EMT certificate also works with the Registry exams passed within two years. You still apply to a LEMSA and complete its background check.