Maryland EMT, CRT & Paramedic Certification/License Renewal Requirements
Maryland EMS credentials are managed by the Maryland Institute for Emergency Medical Services Systems (MIEMSS). Maryland distinguishes between BLS (EMR, EMT — certified) and ALS (CRT, Paramedic — licensed) providers, with different renewal cycles for each. Maryland also has a unique Cardiac Rescue Technician (CRT) level not found in most states.
At a Glance
| Detail | Information |
|---|---|
| Regulatory Body | MIEMSS (Maryland Institute for Emergency Medical Services Systems) |
| BLS Renewal Cycle (EMR, EMT) | Every 3 years |
| ALS Renewal Cycle (CRT, Paramedic) | Every 2 years |
| NREMT Required | Required for Paramedic (initial and renewal); accepted for EMR/EMT |
| ALS License Expiration | April 30 |
| NREMT Expiration | March 31 |
| Annual Protocol Updates | Required at all levels |
BLS Providers (EMR and EMT) — 3-Year Cycle
Option 1: Current NREMT Certification
Maintain current active NREMT registration at EMT level or higher. Complete any MIEMSS-assigned education.
Option 2: State CE Method
| Level | Total CE Hours (3-year cycle) | Breakdown |
|---|---|---|
| EMR | 12 hours | 2 hrs Medical, 2 hrs Trauma, 2 hrs Local, 6 hrs Skills |
| EMT | 24 hours | 4 hrs Medical, 4 hrs Trauma, 4 hrs Local, 12 hrs Skills |
Plus: 3 most recent years of Annual Maryland EMS Protocol Updates and affiliation with an EMS operational program.
ALS Providers (CRT and Paramedic) — 2-Year Cycle
Paramedic
- Current active NREMT Paramedic registration is required
- Complete the NREMT NCCP (60 hours)
- Complete any MIEMSS-assigned ALS education
- MIEMSS-approved technical proficiency verification
- All NREMT certifications expire March 31; Maryland ALS licenses expire April 30
Cardiac Rescue Technician (CRT)
- Current NREMT-I99 or higher, OR
- 60 hours of CE equivalent to Paramedic NCCP requirements (if no current NREMT)
- MIEMSS-approved technical proficiency verification
- Any MIEMSS-assigned ALS education
Note: NREMT has downgraded all previously certified NREMT-I/99s to AEMT. This AEMT certification does not translate to Maryland CRT licensure. CRTs now fall under the state-only renewal process.
Maryland-Specific Notes
- Separate BLS and ALS cycles. BLS providers renew every 3 years; ALS every 2 years. This is unusual nationally.
- Annual Protocol Updates required. All providers must complete the 3 most recent years of Annual Maryland Medical Protocols for EMS Updates.
- MIEMSS sends renewal notices 8 weeks before expiration to your address on file.
- Submit application at least 2 weeks before expiration.
- EMS operational program affiliation required for EMR and EMT certification.
- CAPCE-accredited courses accepted for NREMT NCCP CE.
- Renewal applications are submitted through the MIEMSS Licensure and Certification portal.
How to Renew
BLS (EMR/EMT)
- Complete state CE hours OR maintain current NREMT
- Complete the 3 most recent Annual EMS Protocol Updates
- Verify affiliation with an EMS operational program
- Submit renewal through MIEMSS portal at least 2 weeks before expiration
ALS (Paramedic)
- Renew NREMT Paramedic certification (by March 31)
- Complete any MIEMSS-assigned ALS education
- Complete technical proficiency verification
- Submit renewal through MIEMSS portal (state license expires April 30)
Contact Information
Maryland Institute for Emergency Medical Services Systems (MIEMSS)
- Website: miemss.org
- Renewal Info: miemss.org/home/renewal-certification
- Email: licensure-support@miemss.org
- Phone: (410) 706-3666 or (800) 762-7157
- Address: 653 West Pratt Street, Baltimore, MD 21201
This page is for informational purposes only. Requirements may change — always verify current requirements with MIEMSS before renewing. Last reviewed March 2026.
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