Texas EMS Recertification Requirements
CE hours by content area, all 5 DSHS renewal options, jurisprudence, fees, and late renewal rules for Texas ECAs, EMTs, AEMTs, Paramedics, and Licensed Paramedics
Last updated October 15, 2026 · Checked against 25 Texas Administrative Code §157.34 and §157.38 and Texas DSHS EMS renewal guidance
Texas EMS certifications renew every four years through DSHS. Most providers renew one of two ways: hold a current NREMT certification, or complete Texas continuing education: 36 hours for ECA, 72 for EMT, 108 for AEMT, and 144 for Paramedic or Licensed Paramedic, with minimums in eight content areas. Every option also requires a DSHS-approved Texas EMS jurisprudence exam before you submit your renewal. On-time renewal costs $60 for ECA/EMT and $90 for AEMT/Paramedic.
Texas EMS recertification depends on two things: your certification level and how you choose to renew with DSHS. The hour totals between the NREMT route and the Texas CE route are very different, and picking the wrong one can mean doing far more CE than you need. Here is everything you need to renew, in one place.
Texas EMS Recertification: NREMT vs. Texas State CE
These are the two most common ways Texas providers renew. Both are shown side by side so you can compare hours at your level.
NREMT Path
Texas State CE Path
Find your Texas EMS hours at a glance
| Certification Level | NREMT Path (per 2-yr NREMT cycle) | Texas State CE (per 4-yr Texas cycle) |
|---|---|---|
| ECA / EMR | 16 hrs (NREMT EMR) | 36 hrs (ECA) |
| EMT | 40 hrs | 72 hrs |
| AEMT | 50 hrs | 108 hrs |
| Paramedic / Licensed Paramedic | 60 hrs | 144 hrs |
Texas certifies Emergency Care Attendants (ECAs) rather than EMRs. Because NREMT recertifies every two years and Texas every four, a provider on the NREMT path recertifies with the National Registry twice per Texas cycle and must hold current NREMT certification on the day they apply to DSHS.
Texas State CE Hours by Content Area
If you renew through Texas CE, hitting the total is not enough. DSHS splits your four-year hours into eight content areas, each with a minimum. The content-area minimums make up three quarters of your total, and the last quarter can come from any approved category.
| Content Area | ECA | EMT | AEMT | Paramedic / Licensed Paramedic |
|---|---|---|---|---|
| Preparatory | 3 | 6 | 9 | 12 |
| Airway Management / Ventilation | 3 | 6 | 9 | 12 |
| Patient Assessment | 2 | 4 | 6 | 8 |
| Trauma | 3 | 6 | 9 | 12 |
| Medical | 9 | 18 | 27 | 36 |
| Special Considerations | 3 | 6 | 9 | 12 |
| Clinically Related Operations | 1 | 2 | 3 | 4 |
| Pediatric | 3 | 6 | 9 | 12 |
| Minimum in content areas | 27 | 54 | 81 | 108 |
| Additional hours, any approved category | 9 | 18 | 27 | 36 |
| Total for recertification | 36 | 72 | 108 | 144 |
Medical is the biggest block at every level, a third of the content-area minimum. Pediatric is its own required area, so general medical or trauma hours will not cover it. DSHS lists the topics under each area on its continuing education content areas page.
Source: Texas DSHS, CE Hour and Content Area Requirements
All 5 Ways to Renew a Texas EMS Certification
Most Texas EMS recertification guides only cover NREMT and state CE. Texas rule 25 TAC §157.34 actually gives you five options. You pick one, and every option also requires the jurisprudence exam.
| Option | What You Do |
|---|---|
| 1. Examination | Pass the National Registry assessment exam as your state exam, with a score of at least 70. You schedule and pay National Registry separately. If you fail, you cannot switch to another option, though retakes are allowed. |
| 2. Continuing Education | Complete the content-area hours above during your four-year period. You attest to them on your application and only send records if audited. |
| 3. National Registry | Hold current NREMT certification when you apply. Enter your NREMT number and expiration date on the application. |
| 4. Formal Recertification Course | Complete a DSHS-approved, structured recertification course during your four-year period. Minimum contact hours: ECA 24, EMT 48, AEMT 72, Paramedic and Licensed Paramedic 96. |
| 5. CCMP | Be credentialed in a DSHS-approved Comprehensive Clinical Management Program through your EMS provider for at least six continuous months, with a signed statement from the CCMP medical director. |
Which path should you choose?
Choose the NREMT path if you already hold National Registry, might work outside Texas, or want the fewest total hours. Over one four-year Texas cycle, an EMT keeping NREMT does 80 hours across two NREMT cycles compared with 72 hours of Texas CE, but NREMT hours do not have to match the eight Texas content areas.
Choose the Texas CE path if you have let NREMT lapse, only plan to work in Texas, and want to plan around the content-area table.
Consider a formal course or CCMP if your agency offers one. Ask your EMS coordinator what is available.
Texas EMS Jurisprudence Exam Required
No matter which of the five options you use, Texas requires a DSHS-approved EMS jurisprudence exam covering Texas EMS laws, rules, and policies. DSHS says you must complete it before you submit your renewal application. It applies to ECAs, EMTs, AEMTs, Paramedics, and Licensed Paramedics, and to the NREMT path too.
Want to know what it covers first? Read our guide to the Texas EMS jurisprudence exam.
How to Renew Your Texas EMS Certification Online
Texas EMS renewals are filed online through the DSHS licensing system. DSHS recommends starting three to four months before your expiration date, and you can apply up to one year before it. Your certification does not extend past your expiration date while an application is pending.
- Finish your renewal option and the jurisprudence exam.
- Log in to your DSHS online account at vo.ras.dshs.state.tx.us and verify your license information.
- Select the application under "Time to Renew," complete it, and choose your renewal option.
- Pay the nonrefundable fee.
- Confirm the new expiration date on your license home page under Show Details.
If you were fingerprinted for your original certification, you usually do not need to be fingerprinted again. DSHS ends your background check subscription one year after expiration, so if you reapply after that, you will need new fingerprints.
Texas EMS Renewal Fees
| Level | On-Time Renewal |
|---|---|
| ECA or EMT | $60 |
| AEMT or Paramedic | $90 |
| EMS volunteers | No fee, unless paid during the certification period |
On-time fees from 25 TAC §157.34. Online convenience fees may apply. Licensed Paramedic renewal fees differ, so check your DSHS account for your exact amount.
Late Renewal, Expired, and Inactive Certifications
Once your Texas certification expires, you are not certified and cannot work or present yourself as certified until it is renewed. Here is how DSHS handles it:
| Time Since Expiration | Basic (ECA/EMT) | Advanced (AEMT/Paramedic) | Licensed Paramedic |
|---|---|---|---|
| Up to 90 days | $94 | $141 | $186 |
| 91 days to 1 year | $124 | $186 | $246 |
| 1 year or more | Cannot renew. You must complete initial or equivalency certification. | ||
Late renewal also requires you to complete a renewal option and submit the EMS Skills Verification Form for Late Renewal from an approved education program. Fees shown are the DSHS late renewal amounts, including late fees.
Inactive status: You can request inactive status up to one year past expiration. It lasts four years, and you cannot provide EMS care, paid or volunteer, while inactive. Returning to active status requires extra steps under 25 TAC §157.34(f), including exams.
What Counts as Approved Texas EMS Continuing Education?
Texas CE must be preapproved. DSHS accepts CE from approved Texas providers and from accrediting agencies it recognizes, including:
A few rules from 25 TAC §157.38 worth knowing:
- No reporting unless audited. DSHS has not required CE reporting since 2002, but you must be able to prove it.
- Keep certificates for five years after each completion date.
- Audits are due in 30 days. If audited, you have 30 days from the notice to send documentation.
- No repeats. Identical CE repeated more than once in the same period does not count twice.
CE Solutions EMS courses are CAPCE accredited, and CAPCE is on the DSHS list of recognized accrediting agencies.
Common Mistakes Texas EMS Providers Make at Recertification
Recertify with CE Solutions
CAPCE-accredited EMS packages and TCFP-approved fire packages built for Texas EMS providers and firefighters. One-time purchase, no subscription. Choose the package that fits your path.
Required before every Texas EMS renewal, whichever option you use. Covers Texas EMS laws, rules, and policies.
Required annually for every Texas Commission on Fire Protection certified firefighter. Covers TCFP injury reporting requirements.
Texas EMS Continuing Education Through CE Solutions
CE Solutions is a family-owned company that has delivered online EMS continuing education to Texas providers since 1997. Texas providers get:
- A full library of CAPCE-accredited EMS courses for both the NREMT path and the Texas CE path
- A Texas EMS Jurisprudence course for the DSHS requirement
- TCFP-approved fire continuing education for Texas firefighters
- One-time purchase per recertification, never a subscription
- Downloadable certificates for your five-year records
- Real customer support when you have questions
Renewing in another state? See our EMS recertification guide.
Texas EMS Recertification FAQs
How many CE hours do I need for Texas EMS recertification?
On the Texas CE path, you need 36 hours for ECA, 72 for EMT, 108 for AEMT, and 144 for Paramedic or Licensed Paramedic over your four-year certification, with minimums in eight content areas. On the NREMT path, you hold current National Registry certification, which requires 16 hours for EMR, 40 for EMT, 50 for AEMT, and 60 for Paramedic every two years.
How often do Texas EMS providers recertify?
Every four years. You can apply up to one year before your expiration date, and DSHS recommends starting three to four months before it. NREMT runs on a separate two-year cycle.
Can I renew my Texas EMS certification with NREMT?
Yes. If you hold current National Registry certification when you apply, you can use the National Registry option. Enter your NREMT number and expiration date on your DSHS application. You still need the Texas EMS jurisprudence exam.
Is the Texas EMS jurisprudence exam required for every renewal?
Yes. All renewal applicants must complete a DSHS-approved EMS jurisprudence exam before submitting the renewal application, no matter which renewal option they use.
What are the five ways to renew a Texas EMS certification?
Under 25 TAC §157.34: the National Registry assessment exam, continuing education, current National Registry certification, a DSHS-approved formal recertification course, or a Comprehensive Clinical Management Program (CCMP). Every option also requires the jurisprudence exam.
Does Texas accept CAPCE-accredited CE?
Yes. DSHS lists CAPCE among the CE accrediting agencies it recognizes. On the Texas CE path, your courses still need to meet the content-area minimums.
How much does it cost to renew a Texas EMS certification?
On-time renewal is $60 for ECA or EMT and $90 for AEMT or Paramedic. EMS volunteers pay no fee unless they were paid during the certification period. Late renewal costs more.
What happens if my Texas EMS certification expires?
You can renew up to one year after expiration by completing a renewal option, paying a late fee, and submitting the EMS Skills Verification Form for Late Renewal. After one year, you cannot renew and must complete initial or equivalency certification.
Do I have to report my CE hours to DSHS?
No, unless you are audited. DSHS has not required CE reporting since 2002, but you must keep your certificates for five years and send them within 30 days if you are audited.
Does CE Solutions offer Texas EMS Jurisprudence and fire CE?
Yes. Our Texas EMS Jurisprudence course is $25 online. We also offer TCFP-approved fire packages: 20 CEUs for $109 and 80 CEUs for $249, plus the TCFP Injury Report course for $25.
Official Sources
- Texas DSHS: Renewals, EMS Personnel Certification and Licensure
- Texas DSHS: CE Hour and Content Area Requirements
- Texas DSHS: Acceptance of CE Approved by Other Accrediting Agencies
- 25 Texas Administrative Code §157.34: Recertification
- 25 Texas Administrative Code §157.38: Continuing Education
- National Registry of EMTs: Recertification
