New York certifies its own EMTs through the Department of Health's Bureau of EMS. It gives its own written exam, or you may take the National Registry exam instead (policy 24-06, September 2024); either way the content is the national standards and the skills exam is New York's. Checked October 16, 2026 against the Bureau's pages; confirm there 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: New York's own, or the NREMT
New York gives its own written EMT exam through PSI; the National Registry exam (70 to 120 adaptive questions, 2 hours, $104) is accepted in its place.
Your state's license or certification
The card comes from the state, not the Registry. The state's own steps are below.
New York State Department of Health, Bureau of EMS
Course: a Bureau-approved course sponsor; the state lists every sponsor and upcoming course by county, from county EMS academies and fire departments to SUNY and CUNY colleges. You must be 17 by the last day of the month the course ends. Sponsors run about 150 to 190 hours plus 10 hours of clinical observation. Example cost (Erie County, 2026): $1,050, or $0 if you belong to a New York EMS agency, since the state reimburses sponsors for agency members.
CPR: taught and tested inside the course to AHA guidelines; you must pass it before the skills exam. A current CPR card is required again at every renewal.
Skills exam: the New York BLS Practical Skills Exam, given by your course: four mandatory stations (trauma assessment, medical assessment, cardiac arrest with AED, bag-valve-mask) plus two random skill stations, with a same-day retest if you fail two or fewer.
Written exam: the state written exam, computer-based at a PSI test center or by remote proctor (under 18: test center only). Three attempts per eligibility; a remediation with your sponsor buys three more; you have two years from the end-of-course date. Sponsors list PSI's fee at $31. Or take the National Registry exam instead.
Application: nothing separate. Your sponsor's end-of-course paperwork is the application, PSI emails your authorization to test about ten days after the course ends, a temporary certificate prints at the test center when you pass, and the card arrives by mail in four to six weeks. No state certification fee appears on the Bureau's pages.
Renewal: certificates issued after July 1, 2024 run 48 months from the end of the month they were issued. Renew through the CME program: 45 hours (20 hours of core refresher content signed by a certified instructor coordinator, 25 hours of other EMS education including 1 hour of EMT mental health, 1 of lifting and moving, 1 of safe pediatric transport and 2 of emergency vehicle operations), a current CPR card and a skills sign-off, filed 45 days to 9 months before expiry. Or take a refresher course with the state exams.
From another state: a current EMT card from any state, the military or the National Registry gets reciprocity with a New York reason (residency, a job or a volunteer spot), a course on the 2021 standards with no more than half the lectures online-asynchronous, an exam passed in the last 18 months, a good-standing letter, and a non-refundable fee of up to $99. First review takes 60 to 90 days; the New York card expires with your home one, capped at 36 months.