Missouri EMT, AEMT & Paramedic License Renewal Requirements

Missouri EMS licenses are regulated by the Missouri Department of Health and Senior Services (DHSS), Bureau of Emergency Medical Services (BEMS). Missouri has a 5-year renewal cycle — the longest in the country — with correspondingly high CE hour requirements.

At a Glance

Detail	Information
Regulatory Body	Missouri DHSS, Bureau of EMS
Renewal Cycle	Every 5 years
Application Window	No more than 120 days, no less than 30 days before expiration
NREMT Required	Required for initial licensure; accepted as alternative for renewal
Email	EMSINFO@health.mo.gov

Two Renewal Pathways

Option 1: Current NREMT Certification

Maintain current NREMT certification at your level. No additional state CE documentation required.

Option 2: State CE Hours (5-Year Cycle)

Level	Total CE Hours	Core Hours	Elective Hours
EMT	100 hours	48 hours (core topics)	52 hours (EMS electives)
AEMT	144 hours	72 hours (core topics)	72 hours (EMS electives)
Paramedic	144 hours	96 hours (core topics)	48 hours (EMS electives)

Additional Requirements by Level

• EMT: Current CPR certification required
• AEMT: Current CPR certification required
• Paramedic: Current ACLS certification required

Missouri-Specific Notes

• 5-year cycle. Missouri is the only state with a 5-year EMS renewal. This means very high total CE hours but the longest timeframe to accumulate them.
• Strict application window. Submit your renewal application no more than 120 days and no less than 30 days before expiration. Applications outside this window will not be processed.
• NREMT simplifies renewal. Since NREMT renews every 2 years and Missouri renews every 5, using NREMT means you'll go through 2–3 NREMT cycles within one Missouri cycle. But presenting current NREMT at Missouri renewal time avoids having to document 100–144 state CE hours.
• Core vs. elective split. State CE pathway requires specific core curriculum topics. Check the BEMS website for the detailed core CE requirements for each level.
• CAPCE-accredited courses accepted.
• Fingerprints required if you've resided outside Missouri at any time in the last 5 years (including military deployments).
• Retain CE documentation for 5 years after relicensure.
• EMS licenses from other states cannot be "transferred." To practice in Missouri, you must obtain a Missouri BEMS license through the initial licensing process with current NREMT.

How to Renew

1. Choose pathway: current NREMT or state CE hours
2. If state CE: Complete all required core and elective hours over the 5-year cycle
3. Maintain current CPR (EMT/AEMT) or ACLS (Paramedic)
4. Submit renewal application within the 120-to-30-day window before expiration
5. Include proof of NREMT or CE documentation
6. Pay the renewal fee

Contact Information

Missouri DHSS — Bureau of Emergency Medical Services

• Website: health.mo.gov/safety/ems/licensing
• Email: EMSINFO@health.mo.gov
• Phone: (573) 751-6356
• Fax: (573) 751-6348
• Address: PO Box 570, Jefferson City, MO 65102-0570

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This page is for informational purposes only. Requirements may change — always verify current requirements with Missouri BEMS before renewing. Last reviewed March 2026.

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